Journal Article Ahead of print
PubMed: 42431628 DOI: 10.1123/pes.2025-0123
Impact of High-Intensity Interval Training on Cardiometabolic Risk Factors in Youth With Overweight/Obesity: A Systematic Review and Meta-Analysis.
Pediatr Exerc Sci
Authors: Alireza Paahoo, Vahid Tadibi, Todd A Astorino, Fatima Cody Stanford, Ali Bahraminia, António Videira-Silva, David Thivel
Affiliations
- Department of Exercise Physiology, Faculty of Sports Sciences, Razi University, Kermanshah,Iran.
- Department of Kinesiology, California State University, San Marcos, CA,USA.
- Department of Medicine-Division of Endocrinology-Neuroendocrine, Department of Pediatrics-Division of Endocrinology, Massachusetts General Hospital, MGH Weight Center, Nutrition Obesity Research Center at Harvard (NORCH), Harvard Medical School, Boston, MA,USA.
- Research Department of Nanotechnology and Advanced Materials, Materials and Energy Research Center, Karaj,Iran.
- WHO Collaborating Centre for Adolescent Medicine and Training, Clínica Universitária de Pediatria, Faculdade de Medicina, Universidade de Lisboa, Lisbon,Portugal. CIDEFES (Research Centre in Sport, Physical Education, Exercise and Health), Universidade Lusófona, Lisbon,Portugal. CIFI2D (Centre for Research, Training, Innovation, and Intervention in Sport), Universidade do Porto, Porto,Portugal.
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), EA 3533, CRNH, Clermont Auvergne University, Clermont-Ferrand,France.
Abstract
BACKGROUND
Childhood and adolescent obesity is a major global health concern that contributes to early atherosclerotic changes and increased cardiometabolic risk. High-intensity interval training (HIIT) has emerged as a time-efficient intervention that can improve cardiometabolic outcomes. However, its effectiveness on cardiometabolic risk markers, including atherosclerotic indicators in children and adolescents with overweight/obesity, remains inconclusive. This systematic review and meta-analysis aimed to analyze the impact of HIIT on cardiometabolic markers in this population.
METHODS
A systematic literature search was conducted across PubMed, Web of Science, ScienceDirect, SportDiscus, Cochrane, Embase, and Scopus through June 2025. Randomized and nonrandomized controlled trials examining HIIT interventions lasting ≥2 weeks in apparently healthy children and adolescents (aged 8-19 y) with overweight/obesity (body mass index ≥ 85th percentile) were included. Data were synthesized using Hedges' g to calculate effect sizes, with subgroup analyses comparing HIIT versus moderate-intensity interval training, moderate-intensity continuous training, school-based exercise, and pre-post intervention values. Subgroup meta-analyses for specific comparators were performed when data from more than one study were available.
RESULTS
Twenty studies involving 889 participants (M and F) were included. HIIT significantly improved (P ≤ .04) anthropometric indicators (body mass: g = -0.51; body mass index: g = -0.61; body fat percentage: g = -0.69; waist circumference: g = -0.38), blood pressure (systolic: g = -0.63; diastolic: g = -0.42), lipid profile (total cholesterol: g = -0.72; triglycerides: g = -0.63; lipoprotein cholesterol: g = -0.63; high-density lipoprotein cholesterol: g = +0.57), and glycemic markers (glucose: g = -0.27; insulin: g = -0.70; homeostatic model assessment for insulin resistance: g = -0.57), as well as enhancing cardiorespiratory fitness (VO2peak: g = +1.52). Subgroup analyses showed a higher superiority of HIIT on most outcomes compared with moderate-intensity continuous training, but not versus moderate-intensity interval training or school-based exercise. However, comparisons with moderate-intensity interval training and school-based exercise were based on a limited number of studies. Moderate heterogeneity (I2 = 48%-73%) was observed across outcomes.
CONCLUSION
Our data show that HIIT is an effective strategy for improving cardiometabolic health in children and adolescents with overweight/obesity as it significantly reduces blood lipids and improves body composition, glycemic control, and cardiorespiratory fitness, with this effect often surpassing that of traditional moderate-intensity continuous training protocols. Further studies should identify optimal HIIT protocols and explore long-term benefits to develop clinical guidelines.
MeSH
Exercise, Body Mass Index, Insulin, Blood, Cardiorespiratory Fitness, Cardiometabolic Risk Factors, Lipoproteins, Body Composition, Schools, Cholesterol, Adolescent, Obesity, Risk Factors, Atherosclerosis, Overweight, Physical Exertion, High-Intensity Interval Training, Child