AUCTORES
Globalize your Research
Review Article | DOI: https://doi.org/10.31579/2690-8794/153
1 Head of Clinical pharmacy department, El minia hospital for mental health and addiction treatment.
2 Head of Clinical research department,Manager of El minia hospital for mental health and addiction treatment.
3 Lecturer of internal medicine department, University of deraya.
*Corresponding Author: Shiva Aliabbar, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Citation: M.A. Nagy, M.M. Mahmoud, N A. Ibrahim (2023), Drug Repurposing Against Covid-19 Through Anticytokine Activity, Clinical Medical Reviews and Reports, 5(3); DOI:10.31579/2690-8794/153
Copyright: © 2023, Muhammad Arshad Ullah. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 02 May 2023 | Accepted: 12 May 2023 | Published: 20 May 2023
Keywords: high-intensity interval training; interval training; exercise; obesity; fat mass; body composition
Background
Obesity is considered one of the chronic diseases associated with an increased risk of mortality and morbidity. Nowadays, exercise is considered one of the most effective treatments for it. In recent years, various studies have been carried out to find the most effective exercise prescription.
Objective
The aim of this scoping review is to answer the question of whether increasing the intensity of exercise is an effective solution to weight loss in adults with overweight or obesity.
Method
systematic reviews and Meta-analyses from 2017 to 2022 investigated high-intensity interval training (HIIT) in adults (18–65 years old) with obesity or overweight included. The expected outcomes were weight, body mass index (BMI), and total and abdominal fat mass.
Results
A total of four systematic reviews which included 165 RCT and 4427 participants were included. Long term-HIIT was effective in decreasing body weight, body mass index (BMI), and total and abdominal fat mass.
Conclusion
HIIT is a time-efficient exercise prescription to reduce weight, BMI, waist circumference (WC), and total and abdominal fat mass, however, the outcomes were similar and no significant differences were found compared to moderate intensity continuous training (MICT). The lack of time can be compensated for by increasing the intensity, but this is not the most effective option with the most effects, so according to the physiology of exercise, perhaps the most effective solution for losing weight is to prescribe exercises tailored to each person's physiology and based on critical power.
Obesity is one of the growing problems worldwide, and according to the latest available statistics more than one-third of adults are obese [1]. Obesity is generally classified into two groups: android obesity and gynecoid obesity. Android obesity, also known as visceral obesity, indicates an increase in fat around the chest and abdominal cavities; this type of obesity increases the risk of metabolic disorders and mortality compared to individuals who have gynecoid obesity (fat distribution in the hips and thighs) [2]. Therefore, weight control should pay, special attention to the reduction of visceral fat as a health factor. According to physiology, exercise and increasing aerobic fitness, can push muscle metabolism toward fat [3]. Based on this hypothesis, exercise is expected to be even more effective than a hypocaloric diet in reducing body fat [4].
The WHO and the American College of Sports Medicine (ACSM) recommended 75–150 minutes of exercise per week to maintain health, which can be increased to more than one hour per day if weight loss is desired [5]. The problem that always arises with exercise and restrictions is time, therefore; the limiting factor of time; should be considered when prescribing exercise, in addition to the issue of dose response and pleasure [6–9].
Two important and controversial issues in prescribing exercise are the intensity and duration of exercise. In recent years, the use of a specific exercise method called high-intensity interval training (HIIT) has been considered [10, 11]. HIIT is defined as short,4-minute bouts of high-intensity exercise (greater than 90% maximal heart rate (HR) or 85% of HR reserve) followed by 3-minute rest or active recovery periods [12, 13]. This hypothesis about HIIT states that catecholamine release in the body increases after intense exercise, and because B-adrenergic receptors are located on adipose tissue, it is expected that there will be a greater reduction in adipose tissue during high-intensity exercise. Another common training method recommended for weight loss is the moderate-intensity continuous training (MICT), an endurance training method that continues to train at moderate intensity (40–60% HR reserve) [14].
To date, many studies have been conducted comparing these two training methods (HIIT vs. MICT) and their effects on weight management [15–19]. In addition, many reviews have compared and summarized the advantages and disadvantages of these two methods [14, 20–26]
In this study, we decided to summarize the most efficient exercise prescription for weight management in adults with overweight or obesity, emphasizing the visceral adipose tissue reduction approach as an important health aspect.
2. Evidence Acquisition
Procedure
This study is a scoping review; the study was conducted in five stages, which are: identify research question, identify relevant studies, study selection, charting the data, collating summarizing and reporting the results [27]
Research question
Is high-intensity interval training the most effective exercise prescription to lose weight for adults with obesity?
Database search
Relevant studies published between 2017 and 2022 were searched using the PubMed, Cochrane, Science Direct and Google Scholar search engines. The following search terms were used across all search engines: (high intensity interval training OR interval training OR exercise) AND (obesity OR fat mass OR weight loss OR body composition)
Screening
Three steps were taken to select the appropriate articles. In the first step, after the initial search, the articles related to the topic were selected based on the title. Then, the abstracts of the articles were reviewed by two reviewers, and if approved based on the inclusion and exclusion criteria, they moved to the final stage. In this step, access to the full text and the English language of the article were included in the assessment.
The inclusion criteria were studies analysing adults of both sexes (aged 18–65 years old) with overweight (BMI over 25kg/m2) or obesity (BMI over 30kg/m2) who combined HIIT intervention (intensity over 80% VO2max) with other types of exercise prescription, particularly MICT.
Exclusion criteria were studies that used other interventions such as diet, medication, and supplements together with exercise. In addition, studies of obesity in specific disease groups such as diabetes, sarcopenia, cancer survivors, pregnancy and osteoarthritis were excluded from this study.
Study selection
3431 articles were found using the above keywords. We used Endnote software to organise the articles. In a first step, 988 articles were removed due to duplication. Then, 2332 articles were removed by checking the titles of the articles. Of the remaining 111 articles, 107 articles were removed after a detailed review of the summary of the articles. Finally, four articles were selected and evaluated by two reviewers (Figure 1).
Figure 1: flow chart of the study selection process
Charting the data, collating and summarizing the results
The data on all included studies are summarised in Table No. 1
| study | Sample size | intervention | outcome |
|---|---|---|---|
| Andreato (22) | 48 RCT | HIIT (more than 80% vo2max) Vs. MICT | WHR, BF%, WC, BMI, abdominal subcutaneous fat area, abdominal visceral fat area decreased as the same as MICT Body mass decreased but greater in MICT when studies not equalized and HIIT superior when studies equalized. |
| Wewege (14) | 13 RCT | HIIT (more than 85% HR max) Vs. MICT 8–10 week | BF% and WC decreased as the same as MICT |
| Maillard (21) | 39 RCT | HIIT (80–100% HR peak) 12 weeks | Total fat mass, abdominal and visceral fat mass decreased |
| Batacan (20) | 65 RCT | LT-HIIT (more than 85% Vo2 max) Vs. ST-HIIT | WC and body fat decreased in LT-HIIT but only WC decreased in ST-HIIT |
Table 1: A summary of studies and their outcomes on the effect of HIIT on people with obesity
HIIT (high intensity interval training), MICT (moderate intensity continuous training), LT-HIIT (long term more than 12 weeks-high intensity interval training), ST-HII (short term less than 12 weeks-high intensity interval training), BMI (body mass index), WHR (waist hip ratio), BF% (body fat percentage), WC (waist circumference)
3. Results
This study is a review of the effectiveness of the HIIT method in weight loss. This review included four systematic reviews involving 165 RCT and a total of 4427 participants. All studies were conducted in adults (18–65 years old) who were obese or overweigh (BMI over 25kg/m2), but two studies were conducted in both obese and non-obese participants [20, 21].
In general, HIIT is an exercise protocol with an intensity greater than 90% VO2max [5], but in this review we considered exercise with an intensity greater than 80% VO2max or HR peak as HIIT; because exercise with an intensity of 90%VO2max or more requires a high level of physical fitness, which may not be present in the normal population. The average frequency of this protocol is 95 min/week. Most protocols have taken the form of 4 min of high-intensity exercise and 3 min of active recovery at moderate or lower intensity, but in some studies high-intensity exercise performed for only 1 min or less [21].
MICT is another intervention compared to HIIT in this study. MICT is defined as training at an intensity of 40–60% VO2max or HRR for an average of 158 minutes/week.
The duration of training prescriptions averaged more than eight weeks in all studies,and one study compared long-term (LT)-HIIT(more than 12 weeks) with short-term (ST)-HIIT(less than 12 weeks) [20].
The main finding of this study is that HIIT is a time-efficient protocol for reducing body weight, BMI, waist circumference (WC), waist-hip ratio (WHR), body fat percentage (PBF), abdominal fat mass, and visceral fat mass with no significant difference between HIIT and MICT; However, in one study MICT decreased body mass [0.4 [95% CI: 0.09 to 0.72 kg]; p for heterogeneity: 0.002] greater than HIIT when the protocols not equalized, but in equalized studies HIIT was superior in body mass reduction[-0.41 kg [95% CI:-0.79 to -0.02 kg]; p for heterogeneity: 0.97], but this difference may be clinically irrelevant [22].
This review confirmed that after eight weeks of high-intensity training, PBF was reduced by about two kg and waist circumference by about three cm, with no difference from moderate-intensity training.
Running is more effective in reducing total fat mass and visceral fat mass according to studies [14, 21], but further comparisons need to be made to determine the more significant effect of cycling in reducing abdominal fat mass in the meta-analysis by Maillard et al.
According to the meta-analysis by Batacan et al., at least 12 weeks of HIIT are required to reduce WC and total body fat [20].
4. Conclusions
According to this review, HIIT and MICT have the same effect in improving body composition in people with overweight or obesity, but HIIT is a time-efficient protocol (HIIT for an average of 95 minutes/week compared to MICT, which is performed for about 158 minutes/week). Therefore, despite the greater effect of MICT on body mass in some studies [22], it can be concluded that HIIT is the better choice for people with limited time.
There are two mechanisms that considered to increase the effectiveness of HIIT compared to MICT. One of the mechanisms discussed earlier in the introduction is the increase in catecholamine release after intense exercise, but according to this review there was no difference between HIIT and MICT in terms of fat mass and HIIT and MICT has similar effects on adipose tissue.
Another mechanism discussed about the possibility of HIIT having a greater impact on weight management is the greater amount of excess post-exercise oxygen consumption (EPOC) compared to MICT [3]. And this increase in oxygen consumption after HIIT may lead to an increase in fat metabolism over a longer period of time after exercise. But the lack of a difference between the effectiveness of HIIT and MICT in weight management indicates that the increase in EPOC may not play a role in the effectiveness of HIIT.
Another point that can be debated about HIIT is its safety. High-intensity exercise in obese people who are likely to have led a sedentary life is one of the important factors that was not mentioned in any of these studies.
Therefore, according to the available information, it can be concluded that the most effective factor in prescribing exercise for obese people is time and increasing the intensity does not make any significant difference.
According to the concept of exercise physiology, and crossover concept, below 60% vo2 max, fats are the main metabolic pathway, and when exercise intensity is increased above 75% vo2 max, there is a shift towards carbohydrates as the main substrate. This concept is influenced by two items of exercise prescription: intensity and time. During endurance training, biochemical adaptations occur in muscle fibers to maximize the oxidation of lipids, including increased numbers of mitochondria, oxidative enzymes, and changes in B-oxidation and the electron transport chain [3].
Therefore, it can be said that the most effective part of a training prescription for ideal weight loss is time, and that the longer the training, the greater the adaptation of lipid metabolism.
Considering the concept of critical power, which is defined as the highest intensity of exercise for a person who can continue it for a long period of time without fatigue, an exercise prescription based on this concept provides the highest metabolic rate and may theoretically be more beneficial for weight management [3].
Currently, we know that the most effective type of exercise for weight management is running. Further, and stronger evidence is needed for elliptical training and cycling. Table NO.2
In this study, we summarized the effects of increasing intensity when prescribing exercise for adults with obesity. Increasing intensity can control and compensate for the limiting factor of time. However, HIIT is a time-efficient protocol for weight management, but the use of MICT may be safe and more appropriate for the general population.
| Frequency | Intensity | Time | Type |
|---|---|---|---|
5 day/week Start with 3 days if sedentary before | Moderate intensity 40–60% HRR | 50–60 minute per session Start with 30 min if sedentary before | running |
| By increasing the intensity and reducing the time, it is possible to achieve the desired weight loss results in people with limited time | |||
Table 2: Exercise prescription in adults with overweigh or obesity
Declarations
All authors have no conflict of interest.
Authors did not use any financial support for this article.
Additional Declarations
No competing interests reported.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
