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Effectiveness of HIIE versus MICT in Improving Cardiometabolic Risk Factors in Health and Disease: A Meta-analysis
Meta-analysis of 55 studies: high-intensity interval exercise (HIIE) was superior to moderate-intensity continuous training (MICT) for improving VO2max and brachial flow-mediated dilation (FMD), whereas MICT was superior for HbA1c; no clear differences for BMI, body mass, body fat %, resting BP, most lipids, CRP, fasting insulin/glucose, or HOMA-IR.
Design
- Random-effects meta-analysis comparing HIIE (HIIT + SIT umbrella) vs MICT
- 55 studies retained
Head-to-head pooled signals (Cohen’s d; abstract)
- VO₂max: HIIE > MICT (d = 0.40, P < 0.001)
- Brachial flow-mediated dilation (FMD): HIIE > MICT (d = 0.54, P < 0.05) — endothelial function metric, not “fasting-mimicking diet”
- HbA1c: MICT > HIIE (d = −0.27, P < 0.05) (direction favours MICT for this marker)
Null / near-null contrasts (abstract)
No differences reported for BMI, body mass, % body fat, SBP/DBP, HDL/LDL/TG/TC, CRP, fasting insulin/glucose, HOMA-IR.
Evidence hygiene
Endpoint-specific story: cardiorespiratory fitness + endothelial function vs longer-horizon glycaemic marker (HbA1c) can diverge between modalities—personalise by risk profile.
Publication
Mattioni Maturana F, et al. Med Sci Sports Exerc. 2021 Mar 1;53(3):559-573. PMID 32890201.
Outcomes
- Effect Size (Cohen's d / SMD)0.4d (Cohen's d)
- Effect Size (Cohen's d / SMD)0.54d (Cohen's d)
- Effect Size (Cohen's d / SMD)-0.27d (Cohen's d)