Investigating the Effect of High-intensity Interval Training on Serum Levels of Antioxidants and Oxidative Stress in Overweight and Obese Girls

EXTENDED ABSTRACT

Background

Obesity and overweight have become increasingly prevalent worldwide and have been associated with increased oxidative stress. [1, 4, 5] In obese individuals, increased production of free radicals and reduced antioxidant defense may contribute to an imbalance between oxidants and antioxidants. [7] Malondialdehyde (MDA), total antioxidant capacity (TAC), and reduced glutathione (GSH) are among the indicators used to assess oxidative stress and antioxidant status. [10] Regular physical activity can induce physiological adaptations and may improve antioxidant defenses; however, the effects of exercise depend on the type, intensity, duration, and frequency of training. [9] High-intensity interval training (HIIT) has received increasing attention because of its metabolic adaptations and potential usefulness for individuals with overweight and obesity. [11, 12] Despite this interest, the effect of combined high-intensity interval training on serum antioxidant and oxidative-stress indices in obese and overweight girls had not been sufficiently investigated. Therefore, the present study aimed to determine the effect of four weeks of combined high-intensity interval training (CHIIT) on serum antioxidant status and oxidative stress, as well as selected blood lipid variables, in obese and overweight girls.

Methods

This applied, semi-experimental study used a pretest–posttest design with a control group. The study population consisted of young obese and overweight girls recruited through announcements at health clinics in Qom. Twenty-four volunteers participated and were randomly allocated to an exercise group (n=12) or a control group (n=12). The exercise group had a mean age of 21.6±2.0 years, weight of 71.00±4.13 kg, and body mass index (BMI) of 28.58±1.68 kg/m². The corresponding values in the control group were 20.1±9.2 years, 71.75±5.40 kg, and 28.08±1.59 kg/m². Sample-size calculation was performed using G*Power version 3 for repeated-measures analysis of variance, with an effect size of 0.38, statistical power of 0.85, and alpha level of 0.05, resulting in a required sample of 24 participants. Participants were randomly assigned equally to the two groups, and none withdrew before completion of the intervention.

The exercise intervention consisted of four sessions per week for four weeks, for a total of 16 sessions, whereas the control group remained without structured exercise and continued routine daily activities. Each exercise session included 12 minutes of warm-up consisting of stretching and mobility movements and five minutes of light running, followed by 25 minutes of the main exercise protocol and five minutes of cool-down. The main protocol consisted of four four-minute sets of cycling with three minutes of active recovery after each set. The aerobic interval intensity progressed from 60–65% of maximum heart rate in week 1, to 65–70% in week 2, 70–80% in week 3, and 80–90% in week 4. Resistance-exercise intensity progressed from 40–45% of one-repetition maximum in week 1, to 45–50%, 50–55%, and 55–60% in weeks 2, 3, and 4, respectively. Active recovery was performed at 50% of maximum heart rate, with 15 seconds of rest between stations. [14]

Blood samples were collected 24 hours before the intervention and 48 hours after the final exercise session. Participants were fasting for 12 hours and had performed no vigorous exercise during the preceding 24 hours. To reduce the effect of circadian variation, sampling was performed between 08:00 and 09:00. Ten milliliters of blood were collected from the left antecubital vein while participants were seated. Samples were centrifuged at 3,000 rpm for 10 minutes, and separated serum was stored at −80°C until analysis. Serum TAC, GSH, MDA, total cholesterol (TC), triglycerides (TG), HDL-C, and LDL-C were assessed. Descriptive statistics were expressed as mean±standard deviation, minimum, and maximum. Normality and homogeneity of variances were assessed using the Shapiro–Wilk and Levene tests, respectively. Repeated-measures analysis of variance was used to examine changes over time and between groups. Analyses were performed using SPSS version 26, with P<0.05 considered statistically significant. The study followed Iranian Ministry of Health research-ethics guidelines and the latest version of the Declaration of Helsinki and received ethics approval from Allameh Tabataba’i University (IR.ATU.REC.1399.058).

Results

After four weeks of combined high-intensity interval training, the morphological indicators of the exercise group showed reductions compared with baseline, whereas no corresponding meaningful improvement was observed in the control group. In the exercise group, mean body weight decreased from 71.00±4.13 kg at pretest to 70.58±3.80 kg at posttest, while the control group changed from 71.75±5.40 to 71.67±5.91 kg. Mean BMI in the exercise group decreased from 28.58±1.68 to 28.40±1.50 kg/m², whereas the control group changed from 28.08±1.59 to 28.03±1.73 kg/m². These descriptive changes in body composition were not accompanied by statistically significant effects for the principal biochemical outcomes except MDA.

Repeated-measures analysis showed that four weeks of CHIIT did not produce statistically significant between-group changes in TAC (F=3.837, P=0.063) or GSH (F=1.17, P=0.292). Thus, the intervention did not significantly improve the measured antioxidant capacity or reduced-glutathione level compared with the control condition. The principal oxidative-stress finding was a significant reduction in serum MDA after the intervention compared with the control group (P<0.05). The study therefore demonstrated an effect on an indicator of lipid peroxidation despite the absence of a statistically significant change in TAC or GSH. The exact numerical MDA values were presented graphically in Figure 1 rather than as a numerical table; therefore, no additional MDA value is reproduced here.

Table 3. Repeated-measures analysis of serum antioxidant, oxidative-stress, and lipid-profile variables in overweight girls.

The intervention also failed to produce statistically significant changes in the measured lipid profile. Total cholesterol showed F=0.182 and P=0.674; triglycerides showed F=0.485 and P=0.493; HDL-C showed F=1.93 and P=0.179; and LDL-C showed F=0.843 and P=0.369. Mean TC in the exercise group changed from 167.92±3.05 to 168.33±3.69, while the control group changed from 168.58±3.05 to 170.08±3.69. Mean TG changed from 102.50±2.21 to 104.00±2.36 in the exercise group and from 97.67±2.21 to 100.75±2.36 in the control group. Mean HDL-C changed from 47.75±1.63 to 47.50±1.86 in the exercise group and from 50.33±1.63 to 48.92±1.86 in the control group. Mean LDL-C changed from 92.08±1.70 to 92.33±1.95 in the exercise group and from 94.42±1.70 to 96.17±1.95 in the control group.

Overall, the statistically significant effect of the four-week intervention was confined to a reduction in MDA, while TAC, GSH, TC, TG, HDL-C, and LDL-C did not show significant changes relative to the control group. The study also reported that the absence of significant lipid-profile changes occurred alongside no significant change in body-composition indicators. The authors identified the small sample size, restriction to girls and a limited age range, lack of precise dietary supervision, and short intervention period as limitations that should be considered when interpreting the findings.

Conclusion

Four weeks of combined high-intensity interval training did not significantly improve serum TAC or GSH and did not significantly alter TC, TG, HDL-C, or LDL-C in obese and overweight girls. However, the intervention significantly reduced serum MDA compared with the control group. Thus, the training protocol affected an indicator of oxidative stress without producing significant changes in the measured antioxidant indices or lipid profile. Based on the findings, the authors concluded that this type of exercise may be considered an effective approach for reducing oxidative stress in obese and overweight girls. The authors also noted that the short intervention, limited sample size and age and sex range, and lack of precise dietary control should be considered in future research.

Keywords: Antioxidants; Interval Exercise Training; Obesity; Oxidative Stress

REFERENCES

1. Tayebi SM, Ghanbari-Niaki A, Saeidi A, Hackney AC. Exercise training, neuregulin 4 and obesity. Ann Appl Sport Sci. 2017;5(2):1. PMID: 30899900 DOI: 10.18869/acadpub.aassjournal.5.2.1
2. Tayebi SM, Saeidi A, Khosravi M. Single and concurrent effects of endurance and resistance training on plasma visfatin, insulin, glucose and insulin resistance of non-athlete men with obesity. Ann Appl Sport Sci. 2016;4(4):21-31. DOI: 10.18869/acadpub.aassjournal.4.4.21
3. Saeidi A, Tayebi SM, Khosravi A, Razi O, Sellami M, Abderrahman AB, Zouhal H. Obesity, Fat Mass, Osteopontin and Exercise Training. Int J Appl Exerc Physiol. 2019;8(1):177-9. DOI: 10.30472/ijaep.v8i1.372
4. Amirkhizi F, Siassi F, Dhahraki SH, Jalali M. Valuation of oxidative stress and total antioxidant capacity in women with general and abdominal adiposity. Med J Mashhad Univ Med Sci. 2012;55(3):170-7. DOI: 10.22038/mjms.2012.431
5. Epingeac ME, Gaman MA, Diaconu CC, Gad M, Gaman AM. The evaluation of oxidative stress levels in obesity. Rev Chim (Bucharest). 2019;70(6):2241-4. DOI: 10.37358/RC.19.6.7314
6. Delavar R, Mogharnasi M, Khoobkhahi N. The Effects of Combined Training on OxidativeStress and Antioxidant Defense Indicators. Int J Basic Sci Med. 2017;2(1):29-32. DOI: 10.15171/ijbsm.2017.07
7. Tayebi SM, Saeidi A, Fashi M, Pouya S, Khosravi A, Shirvani H, Ahmadian M, Abderrahman AB, Hackney AC, Zouhal H. Plasma retinol-binding protein-4 and tumor necrosis factor-α are reduced in postmenopausal women after combination of different intensities of circuit resistance training and Zataria supplementation. Sport Sci Health. 2019;15:551-8. PMID: 31885723 DOI: 10.1007/s11332-019-00544-2
8. Flensted-Jensen M, Gram M, Dela F, Helge JW, Larsen S. Six weeks of high intensity cycle training reduces H2O2 emission and increases antioxidant protein levels in obese adults with risk factors for type 2 diabetes. Free Radical Biol Med. 2021;173:1-6. PMID: 34273538 DOI: 10.1016/j.freeradbiomed.2021.07.020
9. Mohammadi S, Lotfi K, Mirzaei S, Asadi A, Akhlaghi M, Saneei P. Dietary total antioxidant capacity in relation to metabolic health status in overweight and obese adolescents. Nutr J. 2022;21(1):54. PMID: 36038871 DOI: 10.1186/s12937-022-00806-9
10. Lorente L, Martín MM ,Pérez-Cejas A, Abreu-González P, López RO, Ferreres J, et al. Serum total antioxidant capacity during the first week of sepsis and mortality. J Crit Care. 2018;47:139-44. PMID: 29981999 DOI: 10.1016/j.jcrc.2018.06.025
11. Ben-Zeev T, Okun E. High-Intensity Functional Training: Molecular Mechanisms and Benefits. Neuromolecular Med. 2021;23(3):335-8. PMID: 33386577 DOI: 10.1007/s12017-020-08638-8
12. Asjari M, Abedi B, Fatolahi H. Effects of aerobic training and licorice extract consumption on inflammation and antioxidant states in overweight women. Obesity Medicine. 2021;21:100271. DOI: 10.1016/j.obmed.2020.100271
13. Tayebi SM, Mehdipour A. The Effect of 8 Weeks of Cardio Kickboxing Training on Some Metabolic and Inflammatory Indicators in Adults with Type 2 Diabetes. J Mazandaran Univ Med Sci. 2023;33(2):212-221.
14. Soltani N, Esmaeil N, Marandi SM, Hovsepian V, Momen T, Shahsanai A, et al. Assessment of the effect of short- term combined high-intensity interval training on TLR4, NF-κB and IRF3 expression in young overweight and obese girls. Public Health Genomics. 2020;23(1-2):26-36. PMID: 32101857 DOI: 10.1159/000506057
15. Azizbeigi K, Azarbayjani MA, Peeri M, Agha-alinejad H, Stannard S. The effect of progressive resistance training on oxidative stress and antioxidant enzyme activity in erythrocytes in untrained men. Int J Sport Nutr Exerc Metab. 2013;23(3):230-8. PMID: 23239675 DOI: 10.1123/ijsnem.23.3.230
16. Khaki E, Dehkodi KJ, Taghian F, Hosseini SA. Interactive Effect of Grape Seed Nanoparticle Extract and Resistance Training on Antioxidant System Function in Myocardial Infarction Rat Model. Gene, Cell and Tissue. 2023;10(1). DOI: 10.5812/gct-123703
17. Amirkhani Z, Azarbayjani MA. Effect of eight weeks resistance training on malondialdehyd, total ,antioxidant capacity, liver enzymes and lipid profile in overweight and obese women. J Gorgan Univ Med Sci. 2018;20(3):48-55.
18. Shahidi F, Shakeri C, Delfani Z. The effect of eight weeks interval aerobic exercise and consumption of green tea supplementation on oxidative stress indices of inactive young girls. Razi J Med Sci. 2019;25(11):72-84.
19. Fakhri S, Shakeryan S, Alizadeh A, Shahryari A. Effect of 6 weeks of high intensity interval training with nano curcumin supplement on antioxidant defense and lipid peroxidation in overweight girls-clinical trial. Iranian J Diabetes Obesity. 2020;11(3). DOI: 10.18502/ijdo.v11i3.2606
20. Ruangthai R, Phoemsapthawee J. Combined exercise training improves blood pressure and antioxidant capacity in elderly individuals with hypertension. J Exerc Sci Fitness. 2019;17(2):67-76. PMID: 30949214 DOI: 10.1016/j.jesf.2019.03.001
21. Kukreja RC, Hess ML. The oxygen free radical system: from equations through membrane-protein interactions to cardiovascular injury and protection. Cardiovasc Res. 1992;26(7):641-55. PMID: 1423428 DOI: 10.1093/cvr/26.7.641
22. Sarkar S, Debnath M, Das M, Bandyopadhyay A, Dey SK, Datta G. Effect of high intensity interval training on antioxidant status, inflammatory response and muscle damage indices in endurance team male players. Apunts Sports Med. 2021;56(210):100352. DOI: 10.1016/j.apunsm.2021.100352
23. Ozata M, Mergen M, Oktenli C, Aydin A, Sanisoglu SY, Bolu E, et al. Increased oxidative stress and hypozincemia in male obesity. Clin Biochem. 2002;35(8):627-31. PMID: 12498997 DOI: 10.1016/s0009-9120(02)00363-6
24. Pashaei Z, Jafari A, Alivand M. The Effect of High Intensity Interval Training on Lipid Profile and Glucose Homeostasis in Overweight/Obese Middle-Aged Women. J Appl Health Stud Sport Physiol. 2020;6(2):56-64. DOI: 10.22049/jassp.2020.14018
25. Kessler HS, Sisson SB, Short KR. The potential for high- intensity interval training to reduce cardiometabolic disease risk. Sports Med. 2012;42:489-509. PMID: 22587821 DOI: 10.2165/11630910-000000000-00000
26. Pramono A, Jocken JW, Essers YP, Goossens GH, Blaak EE. Vitamin D and tissue-specific insulin sensitivity in humans with overweight/obesity. J Clin Endocrinol Metab. 2019;104(1):49-56. PMID: 30137362 DOI: 10.1210/jc.2018-00995
27. Zhao S, Zhong J, Sun C, Zhang J. Effects of aerobic exercise on TC, HDL-C, LDL-C and TG in patients with hyperlipidemia: A protocol of systematic review and meta- analysis. Medicine (Baltimore). 2021;100(10):e25103. PMID: 33725906 DOI: 10.1097/MD.0000000000025103
28. Rajamand N, Tartibian B, Tayebi SM. Acute Response of Muscular Damage Biomarkers after HIFT Exercise in Overweight Men. New Approaches in Exercise Physiology. 2023;5(9):5-16. DOI: 10.22054/nass.2023.74086.1138
29. Tayebi SM, Mottaghi S, Mahmoudi SA, Ghanbari-Niaki A. The effect of a short-term circuit resistance training on blood glucose, plasma lipoprotein and lipid profiles in young female students. Jentashapir J Cell Mol Biol. 2016;7(5):e33899. DOI: 10.17795/jjhr-33899