Resistance and high-intensity interval training on metabolic flexibility in adults with cardiovascular risk factors

Authors

  • Carolina Núñez-Vergara Escuela de Kinesiología, Facultad de Ciencias de la Rehabilitación y Calidad de Vida, Universidad San Sebastián, sede Valdivia (Chile). https://orcid.org/0000-0002-8566-2104
  • Marcela Rojas-Vargas Escuela de Kinesiología, Facultad de Ciencias de la Rehabilitación y Calidad de Vida, Universidad San Sebastián, sede Valdivia (Chile). https://orcid.org/0000-0003-0427-030X
  • Sebastián Báez Vargas Escuela de Kinesiología, Facultad de Ciencias de la Rehabilitación y Calidad de Vida, Universidad San Sebastián, sede Valdivia (Chile). https://orcid.org/0000-0001-6676-9582
  • Sergio Martinez-Huenchullán Escuela de Kinesiología, Facultad de Ciencias de la Rehabilitación y Calidad de Vida, Universidad San Sebastián, sede Valdivia (Chile). https://orcid.org/0000-0002-6336-5571
  • Johnattan Cano Montoya Escuela de Kinesiología, Facultad de Ciencias de la Rehabilitación y Calidad de Vida, Universidad San Sebastián, sede Valdivia (Chile). https://orcid.org/0000-0003-4654-6335

DOI:

https://doi.org/10.47197/retos.v79.117940

Keywords:

Cardiovascular risk , fat oxidation, HIIT, metabolic flexibility, resistance training

Abstract

Introduction: Metabolic inflexibility is a hallmark of cardiometabolic disease characterized by deficiency in mitochondrial substrate selection.

Objective: To estimate the potential effects of eight weeks of resistance training (RT) and high-intensity interval training (HIIT) on metabolic flexibility (METf) and body composition in people with cardiovascular risk factors (CVRF).

Results: after the intervention, both groups showed changes in metabolic flexibility estimators: respiratory exchange ratio de-creased (RT: Δ=-0.100 [95%CI -0.179, -0.021]; HIIT: Δ=-0.038 [95%CI -0.060, -0.017]), fat oxidation increased (RT: Δ=19.0 g/d [95%CI 1.9, 36.1]; HIIT: Δ=13.0 g/d [95%CI 1.6, 24.4]) and energy expenditure derived from lipids increased (RT: Δ=7.57 kcal/h [95%CI 0.76, 14.39]; HIIT: Δ=4.83 kcal/h [95%CI 0.72, 8.95]), with estimates suggesting favorable effects for RT but with wide confidence intervals (ΔΔ=-0.062 [95%CI -0.141, 0.018], g=-0.89 for RER). Changes in body composition were modest in both groups.

Discussion: these results suggest that both RT and HIIT are strategies that could improve metabolic flexibility in people with cardiovascular risk, regardless of substantial changes in body composition.

Conclusions: both modalities represent potential therapeutic tools to counteract metabolic inflexibility, although studies with larger sample sizes are required to obtain conclusive evidence on possible differences between them.

References

Achamrah, N., Delsoglio, M., De Waele, E., Berger, M. M., & Pichard, C. (2021). Indirect calorimetry: The 6 main issues. Clinical Nutrition (Edinburgh, Scotland), 40(1), 4-14. https://doi.org/10.1016/j.clnu.2020.06.024

Allerton, T. D., Irving, B. A., Spielmann, G., Primeaux, S., Landin, D., Nelson, A., & Johannsen, N. M. (2019). Metabolic flexibility is impaired in response to acute exercise in the young offspring of mothers with type 2 diabetes. Physiological Reports, 7(17), e14189. https://doi.org/10.14814/phy2.14189

Amaro-Gahete, F. J., Sanchez-Delgado, G., Ara, I., & R Ruiz, J. (2019). Cardiorespiratory Fitness May Influence Metabolic Inflexibility During Exercise in Obese Persons. The Journal of Clinical Endocrinology and Metabolism, 104(12), 5780-5790. https://doi.org/10.1210/jc.2019-01225

Ang, J.-H. C., Sun, L., Foo, S.-Y. R., Leow, M. K.-S., Vidal-Puig, A., Fontana, L., & Dalakoti, M. (2025). Perspectives on whole body and tissue-specific metabolic flexibility and implications in cardiometabolic diseases. Cell Reports Medicine, 6(9), 102354. https://doi.org/10.1016/j.xcrm.2025.102354

Aparecido, J. M. L., Marquezi, M. L., Couto, H. L. de O., Santos, T. M. da S., Cruz, A. F. C., Lopes, N. B., Cascapera, M. S., Xavier, V. B., Kochi, C., Alves, V. L. D. S., & Lancha, A. H. (2022). Six HIT Sessions Improve Cardiorespiratory Fitness and Metabolic Flexibility in Insulin Resistant and Insulin Sensitive Adolescents with Obesity. International Journal of Environmental Research and Public Health, 19(17), 10568. https://doi.org/10.3390/ijerph191710568

Astorino, T. A., Edmunds, R. M., Clark, A., Gallant, R., King, L., Ordille, G. M., Heath, B., Montell, M., & Bandong, J. (2017). Change in maximal fat oxidation in response to different regimes of periodized high-intensity interval training (HIIT). European Journal of Applied Physiology, 117(4), 745-755. https://doi.org/10.1007/s00421-017-3535-y

Balboa-Castillo, T., Muñoz, S., Serón, P., Andrade-Mayorga, O., Lavados-Romo, P., & Aguilar-Farias, N. (2023). Validity and reliability of the international physical activity questionnaire short form in Chilean adults. PloS One, 18(10), e0291604. https://doi.org/10.1371/journal.pone.0291604

Cano-Montoya, J., Rojas Vargas, M., Báez Vargas, S., Núñez Vergara, C., Martínez Huenchullán, S., Gallegos, F., Álvarez, C., & Izquierdo, M. (2025). Impact of resistance and high-intensity interval training on body composition, physical function, and temporal dynamics of adaptation in older women with impaired cardiometabolic health: A randomized clinical trial. BMC Sports Science, Medicine and Rehabilitation, 17(1), 78. https://doi.org/10.1186/s13102-025-01119-0

Ciolac, E. G., Mantuani, S. S., Neiva, C. M., Verardi, C., Pessôa-Filho, D. M., & Pimenta, L. (2015). Rating of perceived exertion as a tool for prescribing and self regulating interval training: A pilot study. Biology of Sport, 32(2), 103-108. https://doi.org/10.5604/20831862.1134312

Colado, J. C., Furtado, G. E., Teixeira, A. M., Flandez, J., & Naclerio, F. (2020). Concurrent and Construct Validation of a New Scale for Rating Perceived Exertion during Elastic Resistance Training in The Elderly. Journal of Sports Science & Medicine, 19(1), 175-186.

Colpitts, B. H., Seaman, K., Eadie, A. L., Brunt, K. R., Bouchard, D. R., & Sénéchal, M. (2021). Effects of sprint interval training on substrate oxidation in adults living with and without obesity: The i-FLEX study. Physiological Reports, 9(11), e14916. https://doi.org/10.14814/phy2.14916

Dolezal, B. A., & Potteiger, J. A. (1998). Concurrent resistance and endurance training influence basal metabolic rate in nondieting individuals. Journal of Applied Physiology (Bethesda, Md.: 1985), 85(2), 695-700. https://doi.org/10.1152/jappl.1998.85.2.695

Garthwaite, T., Sjöros, T., Laine, S., Koivumäki, M., Vähä-Ypyä, H., Verho, T., Norha, J., Kallio, P., Saarenhovi, M., Löyttyniemi, E., Sievänen, H., Houttu, N., Laitinen, K., Kalliokoski, K. K., Vasankari, T., Knuuti, J., & Heinonen, I. (2024). Sedentary time associates detrimentally and physical activity beneficially with metabolic flexibility in adults with metabolic syndrome. American Journal of Physiology. Endocrinology and Metabolism, 326(4), E503-E514. https://doi.org/10.1152/ajpendo.00338.2023

Geeta, A., Jamaiyah, H., Safiza, M. N., Khor, G. L., Kee, C. C., Ahmad, A. Z., Suzana, S., Rahmah, R., & Faudzi, A. (2009). Reliability, technical error of measurements and validity of instruments for nutritional status assessment of adults in Malaysia. Singapore Medical Journal, 50(10), 1013-1018.

Goodpaster, B. H., & Sparks, L. M. (2017). Metabolic Flexibility in Health and Disease. Cell Metabolism, 25(5), 1027-1036. https://doi.org/10.1016/j.cmet.2017.04.015

Gupta, R. D., Ramachandran, R., Venkatesan, P., Anoop, S., Joseph, M., & Thomas, N. (2017). Indirect Calorimetry: From Bench to Bedside. Indian Journal of Endocrinology and Metabolism, 21(4), 594-599. https://doi.org/10.4103/ijem.IJEM_484_16

Harris, M. B., & Kuo, C.-H. (2021). Scientific Challenges on Theory of Fat Burning by Exercise. Frontiers in Physiology, 12. https://doi.org/10.3389/fphys.2021.685166

Huang, W., Ruan, W., Huo, C., Lin, Y., Wang, T., Dai, X., Zhai, H., Ma, J., Zhang, J., Lu, J., & Zhuang, J. (2022). The effect of 12 weeks of combined training on hepatic fat content and metabolic flexibility of individuals with non-alcoholic fatty liver disease: Protocol of an open-label, single-center randomized control trial. Frontiers in Nutrition, 9, 1065188. https://doi.org/10.3389/fnut.2022.1065188

Hunter, G. R., Wetzstein, C. J., Fields, D. A., Brown, A., & Bamman, M. M. (2000). Resistance training increases total energy expenditure and free-living physical activity in older adults. Journal of Applied Physiology (Bethesda, Md.: 1985), 89(3), 977-984. https://doi.org/10.1152/jappl.2000.89.3.977

Lam, Y. Y., & Ravussin, E. (2017). Indirect calorimetry: An indispensable tool to understand and predict obesity. European Journal of Clinical Nutrition, 71(3), 318-322. https://doi.org/10.1038/ejcn.2016.220

Lin, W. W., Su, H., Lan, X. Y., Ni, Q. Y., Wang, X. Y., Cui, K. Y., & Zhang, L. (2024a). Effects of high-intensity interval training (HIIT) and maximum fat oxidation intensity training (MFOIT) on body composition, inflammation in overweight and obese adults. Science & Sports, 39(4), 348-357. https://doi.org/10.1016/j.scispo.2023.09.002

Lionett, S., Kiel, I. A., Røsbjørgen, R., Lydersen, S., Larsen, S., & Moholdt, T. (2021). Absent Exercise-Induced Improvements in Fat Oxidation in Women With Polycystic Ovary Syndrome After High-Intensity Interval Training. Frontiers in Physiology, 12, 649794. https://doi.org/10.3389/fphys.2021.649794

Little, J. P., Safdar, A., Wilkin, G. P., Tarnopolsky, M. A., & Gibala, M. J. (2010). A practical model of low-volume high-intensity interval training induces mitochondrial biogenesis in human skeletal muscle: Potential mechanisms. The Journal of Physiology, 588(Pt 6), 1011-1022. https://doi.org/10.1113/jphysiol.2009.181743

Maillard, F., Pereira, B., & Boisseau, N. (2018). Effect of High-Intensity Interval Training on Total, Abdominal and Visceral Fat Mass: A Meta-Analysis. Sports Medicine (Auckland, N.Z.), 48(2), 269-288. https://doi.org/10.1007/s40279-017-0807-y

Mambrini, S. P., Grillo, A., Colosimo, S., Zarpellon, F., Pozzi, G., Furlan, D., Amodeo, G., & Bertoli, S. (2024). Diet and physical exercise as key players to tackle MASLD through improvement of insulin resistance and metabolic flexibility. Frontiers in Nutrition, 11. https://doi.org/10.3389/fnut.2024.1426551

Moro, T., Marcolin, G., Bianco, A., Bolzetta, F., Berton, L., Sergi, G., & Paoli, A. (2020). Effects of 6 Weeks of Traditional Resistance Training or High Intensity Interval Resistance Training on Body Composition, Aerobic Power and Strength in Healthy Young Subjects: A Randomized Parallel Trial. International Journal of Environmental Research and Public Health, 17(11), 4093. https://doi.org/10.3390/ijerph17114093

Ormsbee, M. J., Thyfault, J. P., Johnson, E. A., Kraus, R. M., Choi, M. D., & Hickner, R. C. (2007). Fat metabolism and acute resistance exercise in trained men. Journal of Applied Physiology (Bethesda, Md.: 1985), 102(5), 1767-1772. https://doi.org/10.1152/japplphysiol.00704.2006

Paoli, A., Moro, T., Marcolin, G., Neri, M., Bianco, A., Palma, A., & Grimaldi, K. (2012). High-Intensity Interval Resistance Training (HIRT) influences resting energy expenditure and respiratory ratio in non-dieting individuals. Journal of Translational Medicine, 10, 237. https://doi.org/10.1186/1479-5876-10-237

Park, S.-Y., & Yang, W.-H. (2023). Applied high-intensity interval cardio yoga improves cardiometabolic fitness, energetic contributions, and metabolic flexibility in healthy adults. Frontiers in Physiology, 14, 1279505. https://doi.org/10.3389/fphys.2023.1279505

Rattanachaiwong, S., & Singer, P. (2019). Indirect calorimetry as point of care testing. Clinical Nutrition (Edinburgh, Scotland), 38(6), 2531-2544. https://doi.org/10.1016/j.clnu.2018.12.035

Roudi, F., Darroudi, S., Saghi, E., Hosseini, S. R., Kohantorabi, M., Rezvani, A., Jamialahmadi, T., Sahebkar, A., Moohebati, M., & Ghayour-Mobarhan, M. (2025). The correlation between indirect calorimetry data and the metabolic syndrome development in men and women. Journal of Diabetes and Metabolic Disorders, 24(1), 1. https://doi.org/10.1007/s40200-024-01521-4

Rynders, C. A., Blanc, S., DeJong, N., Bessesen, D. H., & Bergouignan, A. (2018). Sedentary behaviour is a key determinant of metabolic inflexibility. The Journal of Physiology, 596(8), 1319-1330. https://doi.org/10.1113/JP273282

Salman, D., Farooqi, M., McGregor, A., & Majeed, A. (2019). Time spent being sedentary: An emerging risk factor for poor health. The British Journal of General Practice: The Journal of the Royal College of General Practitioners, 69(683), 278-279. https://doi.org/10.3399/bjgp19X703781

Schubert, M. M., Clarke, H. E., Seay, R. F., & Spain, K. K. (2017). Impact of 4 weeks of interval training on resting metabolic rate, fitness, and health-related outcomes. Applied Physiology, Nutrition, and Metabolism = Physiologie Appliquee, Nutrition Et Metabolisme, 42(10), 1073-1081. https://doi.org/10.1139/apnm-2017-0268

Shoemaker, M. E., Gillen, Z. M., Fukuda, D. H., & Cramer, J. T. (2023). Metabolic Flexibility and Inflexibility: Pathology Underlying Metabolism Dysfunction. Journal of Clinical Medicine, 12(13), 4453. https://doi.org/10.3390/jcm12134453

Siripoksup, P., Cao, G., Cluntun, A. A., Maschek, J. A., Pearce, Q., Brothwell, M. J., Jeong, M.-Y., Eshima, H., Ferrara, P. J., Opurum, P. C., Mahmassani, Z. S., Peterlin, A. D., Watanabe, S., Walsh, M. A., Taylor, E. B., Cox, J. E., Drummond, M. J., Rutter, J., & Funai, K. (2024). Sedentary behavior in mice induces metabolic inflexibility by suppressing skeletal muscle pyruvate metabolism. The Journal of Clinical Investigation, 134(11), e167371. https://doi.org/10.1172/JCI167371

Smith, R. L., Soeters, M. R., Wüst, R. C. I., & Houtkooper, R. H. (2018). Metabolic Flexibility as an Adaptation to Energy Resources and Requirements in Health and Disease. Endocrine Reviews, 39(4), 489-517. https://doi.org/10.1210/er.2017-00211

Sultana, R. N., Sabag, A., Keating, S. E., & Johnson, N. A. (2019). The Effect of Low-Volume High-Intensity Interval Training on Body Composition and Cardiorespiratory Fitness: A Systematic Review and Meta-Analysis. Sports Medicine (Auckland, N.Z.), 49(11), 1687-1721. https://doi.org/10.1007/s40279-019-01167-w

Vasold, K. L., Parks, A. C., Phelan, D. M. L., Pontifex, M. B., & Pivarnik, J. M. (2019). Reliability and Validity of Commercially Available Low-Cost Bioelectrical Impedance Analysis. International Journal of Sport Nutrition and Exercise Metabolism, 29(4), 406-410. https://doi.org/10.1123/ijsnem.2018-0283

Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., MacLaughlin, E. J., Muntner, P., Ovbiagele, B., Smith, S. C., Spencer, C. C., Stafford, R. S., Taler, S. J., Thomas, R. J., Williams, K. A., … Wright, J. T. (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation, 138(17), e484-e594. https://doi.org/10.1161/CIR.0000000000000596

Willis, L. H., Slentz, C. A., Bateman, L. A., Shields, A. T., Piner, L. W., Bales, C. W., Houmard, J. A., & Kraus, W. E. (2012). Effects of aerobic and/or resistance training on body mass and fat mass in overweight or obese adults. Journal of Applied Physiology (Bethesda, Md.: 1985), 113(12), 1831-1837. https://doi.org/10.1152/japplphysiol.01370.2011

Downloads

Published

02-06-2026

Issue

Section

Original Research Article

How to Cite

Núñez-Vergara, C., Rojas-Vargas, M., Báez Vargas, S., Martinez-Huenchullán, S., & Cano Montoya, J. (2026). Resistance and high-intensity interval training on metabolic flexibility in adults with cardiovascular risk factors. Retos, 79, 163-175. https://doi.org/10.47197/retos.v79.117940