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J Physiol 590.5 (2012) pp 10771084

Physiological adaptations to low-volume, high-intensity

interval training in health and disease
Martin J. Gibala1 , Jonathan P. Little2 , Maureen J. MacDonald1 and John A. Hawley3
1

Department of Kinesiology, McMaster University, Hamilton, Ontario L8S 4K1, Canada

School of Arts and Sciences, University of British Columbia Okanagan, Kelowna, British Columbia V1V 1V7, Canada
3
Exercise Metabolism Group, RMIT University, Bundoora, Victoria 3083, Australia

The Journal of Physiology

Abstract Exercise training is a clinically proven, cost-effective, primary intervention that delays
and in many cases prevents the health burdens associated with many chronic diseases. However,
the precise type and dose of exercise needed to accrue health benefits is a contentious issue
with no clear consensus recommendations for the prevention of inactivity-related disorders and
chronic diseases. A growing body of evidence demonstrates that high-intensity interval training
(HIT) can serve as an effective alternate to traditional endurance-based training, inducing similar
or even superior physiological adaptations in healthy individuals and diseased populations, at
least when compared on a matched-work basis. While less well studied, low-volume HIT can
also stimulate physiological remodelling comparable to moderate-intensity continuous training
despite a substantially lower time commitment and reduced total exercise volume. Such findings
are important given that lack of time remains the most commonly cited barrier to regular exercise
participation. Here we review some of the mechanisms responsible for improved skeletal muscle
metabolic control and changes in cardiovascular function in response to low-volume HIT. We
also consider the limited evidence regarding the potential application of HIT to people with, or
at risk for, cardiometabolic disorders including type 2 diabetes. Finally, we provide insight on the
utility of low-volume HIT for improving performance in athletes and highlight suggestions for
future research.
(Received 16 November 2011; accepted after revision 23 January 2012; first published online 30 January 2012)
Corresponding author M. J. Gibala: Department of Kinesiology, McMaster University, 1280 Main Street West, Hamilton,
Ontario, L8S 4K1 Canada. Email: [email protected]
Abbreviations HIT, high-intensity interval training; PGC-1, peroxisome-proliferator activated receptor coactivator;
PPO, peak aerobic power output.

Introduction
High-intensity interval training (HIT) describes physical
exercise that is characterized by brief, intermittent bursts

of vigorous activity, interspersed by periods of rest or

low-intensity exercise. HIT is infinitely variable with the
specific physiological adaptations induced by this form of

Martin Gibala (pictured) is Professor and Chair of the Department of Kinesiology at McMaster University. He studies the
regulation of skeletal muscle energy metabolism including the impact of nutrition and training on exercise performance.
Maureen MacDonald is also a Professor of Kinesiology at McMaster, where she studies the effect of exercise on cardiovascular
regulation. Jonathan Little completed doctoral studies at McMaster and is currently a postdoctoral fellow at the University
of British Columbia. John Hawley is Professor and Head of the Exercise Metabolism Group at RMIT University, whose focus
is skeletal muscle energy metabolism related to exercise and diabetes.

This review is from the symposium Exercise metabolism at The Biomedical Basis of Elite Performance, a joint meeting of The Physiological Society
and the British Pharmacological Society, together with The Journal of Physiology, Experimental Physiology, British Journal of Pharmacology and The
Scandinavian Journal of Medicine and Science in Sports, at the Queen Elizabeth Hall, London on 20 March 2012.

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DOI: 10.1113/jphysiol.2011.224725

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M. J. Gibala and others

J Physiol 590.5

Table 1. Summary of protocols in studies from our laboratory that directly compared 6 weeks of either high-intensity interval training
(HIT) or traditional endurance training
Variable
Protocol
Training intensity (workload)
Weekly training time commitment
Weekly training volume

HIT group

Endurance group

30 s 46 repeats, 4.5 min rest (3 sessions per week)

All out maximal effort (500 W)
10 min (1.5 h including rest)
225 kJ

4060 min cycling (5 sessions per week)

65% of V O2 peak (150 W)
4.5 h
2250 kJ

From Burgomaster et al. (2008). V O2 peak , peak oxygen uptake.

training determined by a myriad of factors including the

precise nature of the exercise stimulus (i.e. the intensity,
duration and number of intervals performed, as well
as the duration and activity patterns during recovery).
When compared on a matched-work basis or when
estimated energy expenditure is equivalent, HIT can serve
as an effective alternate to traditional endurance training,
inducing similar or even superior changes in a range of
physiological, performance and health-related markers
in both healthy individuals and diseased populations
(Wisloff et al. 2007; Tjonna et al. 2009; Hwang et al.
2011). Less is known regarding the effects of low-volume
HIT, but growing evidence suggests this type of training
stimulates physiological remodelling comparable with
moderate-intensity continuous training despite a substantially lower time commitment and reduced total
exercise volume (Gibala & McGee 2008). These findings
are important from a public health perspective, given
that lack of time remains one of the most commonly
cited barriers to regular exercise participation (Stutts
2002; Trost et al. 2002; Kimm et al. 2006). Moreover,
recent evidence suggests that HIT is perceived to be more
enjoyable than moderate-intensity continuous exercise
(Bartlett et al. 2011). Here we review some of the
mechanisms responsible for improved skeletal muscle
metabolic control and changes in cardiovascular function
in response to low-volume HIT, as well as the potential
health-related implications for patients with chronic
diseases including type 2 diabetes and cardiovascular
disease. We also speculate on the practical application
of low-volume HIT for elite performance. Although it is
recognized that the underlying mechanisms are probably
different compared with less-trained subjects (Iaia &
Bangsbo 2010), responses in elite athletes may help our
understanding of why low-volume HIT is such a potent
exercise stimulus.
Physiological remodelling after low-volume HIT

The most common model employed in low-volume HIT

studies has been the Wingate test, which consists of a 30 s
all out cycling effort against a supra-maximal workload.
Subjects typically perform four to six work bouts separated
by 4 min of recovery, for a total of 23 min of intense

exercise during a training session that lasts 20 min. As

little as six sessions of this type of training, totalling
15 min of all out cycle exercise over 2 weeks, increased
skeletal muscle oxidative capacity as reflected by the
maximal activity and/or protein content of mitochondrial
enzymes (Burgomaster et al. 2005; Gibala et al. 2006).
We have also directly compared 6 weeks of Wingate-based
HIT with traditional endurance training that was designed
according to current public health guidelines (Table 1)
(Burgomaster et al. 2008; Rakobowchuk et al. 2008). We
found similar training-induced improvements in various
markers of skeletal muscle and cardiovascular adaptation
despite large differences in weekly training volume
(90% lower in the HIT group) and time commitment
(67% lower in the HIT group). In addition to an
increased skeletal muscle oxidative capacity (Fig. 1), other
endurance-like adaptations have been documented after
several weeks of low-volume HIT including an increased
resting glycogen content, a reduced rate of glycogen
utilization and lactate production during matched-work
exercise, an increased capacity for whole-body and skeletal
muscle lipid oxidation, enhanced peripheral vascular
structure and function, improved exercise performance
as measured by time-to-exhaustion tests or time trials
and increased maximal oxygen uptake (Burgomaster et
al. 2005, 2008; Gibala et al. 2006; Rakobowchuk et al.
2008).
Wingate-based HIT is, however, extremely demanding
and may not be safe, tolerable or appealing for some
individuals. We therefore sought to design a more practical
model of low-volume HIT that is time efficient while
also having wider application to different populations
including people at risk for chronic metabolic diseases. To
accomplish this goal we decreased the absolute intensity of
the work bouts, but increased their duration and shortened
the rest intervals. Our new practical HIT model consists
of 10 60 s work bouts at a constant-load intensity that
elicits 90% of maximal heart rate, interspersed with
60 s of recovery. The protocol is still time efficient in
that only 10 min of exercise is performed over a 20 min
training session. Importantly, this practical, time-efficient
HIT model is still effective at inducing rapid skeletal
muscle remodelling towards a more oxidative phenotype,
similar to our previous Wingate-based HIT studies and

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Adaptations to low-volume, high-intensity interval training

Figure 1. Peak oxygen uptake (top panel) and the maximal

activity of the mitochondrial enzyme citrate synthase
measured in biopsy samples (bottom panel) obtained before
(PRE) and after (POST) 6 weeks of Wingate-based
high-intensity interval training (HIT) or traditional
moderate-intensity endurance training (ET)
Total exercise volume was 90% lower in the HIT group. Redrawn
from Burgomaster et al. (2008) with permission. P  0.05 vs Pre;
main effect for time.

high-volume endurance training (Little et al. 2010b). Both

types of low-volume HIT protocols are also effective for
improving functional performance, as shown by cycling
time trials that resemble normal athletic competition
(Gibala et al. 2006; Little et al. 2010b).

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The molecular mechanisms underlying skeletal muscle

metabolic adaptations to low-volume HIT have recently
been investigated. Given the potency of HIT to increase
mitochondrial capacity, it is perhaps not surprising that
investigations have examined the influence of low-volume
HIT on the activation of peroxisome-proliferator activated
receptor coactivator (PGC)-1, which is regarded as the
master regulator of mitochondrial biogenesis in muscle
(Wu et al. 1999). Evidence suggests that exercise intensity
is the key factor influencing PGC-1 activation in human
skeletal muscle (Egan et al. 2010). In this respect, acute
low-volume Wingate-based HIT increases PGC-1 mRNA
by several-fold when measured 3 h post-exercise (Gibala
et al. 2009; Little et al. 2011b). This is comparable with the
acute increase in PGC-1 mRNA expression observed after
a bout of continuous endurance-type exercise (Norrbom
et al. 2004; Egan et al. 2010). Similar to endurance
exercise (Wright et al. 2007; Little et al. 2010a), acute
Wingate-based HIT may activate PGC-1 by increasing its
nuclear translocation (Little et al. 2011b). The increase
in nuclear PGC-1 following low-volume HIT coincides
with increased mRNA expression of several mitochondrial
genes (Little et al. 2011b), suggesting that a program
of mitochondrial adaptation is engaged with these short
bursts of intensity exercise (Fig. 2).
The upstream signals that activate PGC-1 and
mitochondrial biogenesis in response to low-volume HIT
have not been clearly elucidated but probably relate to
robust changes in intramuscular ATP:ADP/AMP ratio
following exercise (Chen et al. 2000) and the concomitant
activation of 5-adenosine monophosphate-activated
protein kinase (AMPK) (Gibala et al. 2009; Little et al.
2011b). Activation of p38 mitogen-activated protein
kinase (MAPK), possibly via increased generation of
reactive oxygen species (ROS) (Kang et al. 2009), may

Figure 2. Potential intracellular signalling

mechanisms involved in HIT-induced
mitochondrial biogenesis
Low-volume HIT has been shown to activate
5-AMP-activated protein kinase (AMPK) and
p38 mitogen-activated protein kinase (MAPK).
Both of these exercise-responsive signalling
kinases are implicated in direct phosphorylation
and activation of PGC-1. Increased nuclear
abundance of PGC-1 following HIT is
hypothesized to co-activate transcription
factors (TF) to increase mitochondrial gene
transcription, ultimately resulting in
accumulation of more mitochondrial proteins
to drive mitochondrial biogenesis.

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M. J. Gibala and others

also be involved (Gibala et al. 2009; Little et al. 2011b).

Elevated levels of PGC-1 protein also accompany increased
markers of mitochondrial content following a period
of low-volume HIT. Six weeks of Wingate-based HIT
increased the protein content of PGC-1 by 100% in
young, healthy individuals (Burgomaster et al. 2008)
and 2 weeks of 10 1 min HIT resulted in a 25%
increase in nuclear PGC-1 protein (Little et al. 2010b).
Collectively, these results indicate that PGC-1 is probably
involved in regulating some of the metabolic adaptations
to low-volume HIT. Given the positive effects that a modest
increase in muscle PGC-1 appears to have on oxidative
capacity, anti-oxidant defence, glucose uptake, resistance
to age-related sarcopenia and anti-inflammatory pathways
(Sandri et al. 2006; Benton et al. 2008; Wenz et al. 2009),
the increase in PGC-1 following low-volume HIT may
highlight potential widespread health benefits for this type
of exercise.
The impact of interval types of training programs
on cardiovascular structure and function has also been
investigated (Wisloff et al. 2009), but few studies have
utilized low-volume HIT models. However, as little as
2 weeks of Wingate-based HIT has been reported to
increase cardiorespiratory capacity as reflected by changes
in peak oxygen uptake (V O2 peak ) (Whyte et al. 2010)
although this is not a universal finding (Burgomaster
et al. 2005). Another study showed that 6 weeks of
Wingate-based HIT increased V O2 peak to the same extent
as traditional endurance training despite a markedly
reduced time commitment and total training volume
(Burgomaster et al. 2008). We have also shown in
young healthy men and women that low-volume HIT
increases compliance in peripheral but not central
arteries (Rakobowchuk et al. 2008). The protocol also

Figure 3. The effect of varying the intensity of interval

training on changes in 40 km time-trial performance
Well-trained male cyclists were randomly assigned to one of five
different doses of high-intensity interval training (HIT): 12 30 s at
175% of peak sustained power output (PPO), 12 1 min s at 100%
PPO, 12 2 min at 90% PPO, 8 4 min at 85% PPO, or 4 8 min
at 80% PPO. Cyclists completed six HIT sessions over a 3 week
period in addition to their habitual aerobic base training. Redrawn
from Stepto et al. (1999) with permission.

J Physiol 590.5

increased endothelial function in the trained legs to an

extent that is comparable to changes observed after a
much higher volume of continuous moderate-intensity
training (Rakobowchuk et al. 2008). The mechanisms
regulating cardiovascular adaptations to various forms
of low-volume HIT have yet to be comprehensively
examined.

Potential application of HIT in people with or at risk

for cardiometabolic disorders

While much of the work conducted to date has involved

relatively high-volume protocols that are comparable in
volume to traditional endurance training, HIT has been
shown to improve cardiorespiratory fitness in a range of
populations including those with coronary artery disease,
congestive heart failure, middle age adults with metabolic
syndrome and obese individuals (Warburton et al. 2005;
Wisloff et al. 2007; Moholdt et al. 2009; Munk et al.
2009). In many cases, the increase in cardiorespiratory
fitness after HIT was superior to after continuous
moderate-intensity training (Wisloff et al. 2007; Tjonna et
al. 2008, 2009; Moholdt et al. 2009). Endothelial function,
assessed using flow-mediated dilatation of the brachial
artery, is improved to a greater extent following HIT
compared with continuous moderate-intensity training
(Wisloff et al. 2007; Tjonna et al. 2008, 2009; Moholdt
et al. 2009). Other studies have documented beneficial
changes in various components of resting blood pressure
(Rognmo et al. 2004; Schjerve et al. 2008; Whyte et al. 2010)
and left ventricular morphology (Wisloff et al. 2007). It
appears that this type of cardiac remodelling requires a
longer duration of training and greater exercise volume
than the load required to alter cardiorespiratory fitness
or peripheral vascular structure and function. It could be
that the short intense bursts of activity with low-volume
HIT induce large-magnitude increases in cellular and peripheral vascular stress, while effectively insulating the
heart from those stresses due to the brief duration of
the exercise bouts. This relative central insulation permits
individuals to train at much higher intensities than they
would otherwise, but may also result in different timelines
and effective stimulus loads between the central and peripheral components of the cardiovascular system.
Low-volume HIT studies in persons who might be
at risk for cardiometabolic disorders or patients with
chronic disease are very limited. However, recent work has
shown that as few as six sessions of either Wingate-based
HIT and the more practical constant-load model over
2 weeks improve estimated insulin sensitivity in previously
sedentary, overweight individuals (Whyte et al. 2010;
Hood et al. 2011). Insulin sensitivity in these studies
was calculated based on either single fasting glucose
and insulin measurements (Hood et al. 2011) or the

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Adaptations to low-volume, high-intensity interval training

J Physiol 590.5

response to an oral glucose tolerance test (Whyte et al.

2010) and therefore primarily reflects hepatic as opposed
to peripheral (skeletal muscle) insulin sensitivity. Peripheral insulin sensitivity following exercise training may
be improved by increased skeletal muscle glucose transport capacity, mediated in part by the protein GLUT4.
Skeletal muscle GLUT4 content after short-term HIT is
increased by a comparable magnitude (2-fold) to that
observed after high-volume endurance training (Hood et
al. 2011). We also recently demonstrated that low-volume
HIT was well tolerated and rapidly improved skeletal
muscle GLUT4 content in eight patients with type 2
diabetes (Little et al. 2011a). This small pilot study also
showed that six sessions of HIT over 2 weeks reduced
average 24 h blood glucose concentration and postprandial glucose excursions, measured via continuous
glucose monitoring under standardized diet but otherwise
free-living conditions (Little et al. 2011a). These beneficial
adaptations were realized even though the weekly training
time commitment was much lower than common public
health guidelines that generally call for at least 150 min
of moderate to vigorous exercise per week to promote
health. While the preliminary evidence from these
small, proof-of-principle studies are intriguing, large-scale
studies are clearly needed to resolve whether low-volume
HIT is a realistic, time-efficient exercise alternative to
reduce the risk of cardiometabolic disease or improve
health and wellbeing in patients with chronic disease.
HIT and athletic performance

HIT has been an integral part of training programs for the

enhancement of athletic performance since the beginning
of the 19th century. Yet despite being a core component
of competition preparation, the unique effect of specific
training interventions on the performances of well-trained
individuals is sparse. This, perhaps, is understandable
for several practical reasons. First, exercise physiologists
have found it difficult to convince elite athletes that it
could be worthwhile to experiment with their normal
training programs. Second, even if athletes (and their
coaches) were willing to modify their training practices,
conventional approaches to investigate the response to
different doses of a treatment (i.e. interval training) using
repeated-measures design in which each athlete receives
all the different doses is totally impractical for studies of
physical training; the long-lasting effects of any given dose
of training prevent athletes from receiving more than one
dose of the treatment.
Over a decade ago we embarked on a series of
investigations into the effects of interval training in
competitive endurance athletes using a standardized
training protocol, namely, replacing a portion (1520%)
of an athletes aerobic base training with six to eight
sessions of continuous (5 min) high-intensity (90% of

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V O2 peak ) work bouts undertaken twice a week throughout

a 3 week intervention period (see Hawley et al. 1997
for review). We systematically examined the effect
of this interval training protocol on a variety of
outcome measures including performance (Lindsay et al.
1996; Stepto et al. 1999), skeletal muscle metabolism
(Westgarth-Taylor et al. 1997; Stepto et al. 2001), cell
signalling (Yu et al. 2003; Clark et al. 2004) and the
interaction of HIT with various diet manipulations
(Stepto et al. 2002; Yeo et al. 2008). Stepto et al. (1999)
employed a novel approach to determine the effects
of divergent interval training protocols on performance
lasting 1 h by fitting polynomial or other curves
to the responses for each interval training dose for
individual athletes. As we originally hypothesized, training
sessions that employed work bouts that were closely
matched to race-pace (8 4 min at 85% of peak aerobic
power output (PPO)) significantly enhanced performance
(2.8%, 95% CI = 4.31.3%). Yet, somewhat surprisingly,
short-duration, supra-maximal work bouts (12 30 s
at 175% of PPO) were just as effective in improving
performance (2.4%, 95% CI = 4.00.7%). Consistent
with this observation, Psilander et al. (2010) recently
reported that a single bout of low-volume HIT (7 30 s
all out efforts) stimulated increases in mitochondrial
gene expression that were comparable to or greater than
the changes after more prolonged (3 20 min bouts
at 87% of V O2 peak ) endurance exercise in well-trained
cyclists. Given the lower volume of work and the fact
that mitochondrial transcription factor A, the downstream target of PGC-1, was only increased after the 30 s
protocol, the authors concluded that brief intense interval training might be a time-efficient strategy for highly
trained individuals.
Guellich and colleagues (2009) have recently extended
our early findings (Stepto et al. 1999, Fig. 3) that
polarized training enhanced endurance performance.
These workers reported that elite endurance athletes from
a range of sports including rowing, running, cycling and
cross-country skiing perform only a small portion of
their training at competition/race-pace intensities, with
the bulk of their workload comprising low-intensity,
high-volume workouts, and exposure to extreme HIT
sessions. In a recent review Laursen (2010) proposed
that a polarized approach to training, in which 75%
of total training volume be performed at low intensities,
with 1015% performed at supra-maximal intensities may
be the optimal training intensity distribution for elite
athletes who compete in intense endurance events. We
suggest that the unique genetic and/or molecular signature
resulting from polarized training is a fertile area for
future research. Indeed, directly linking exercise-induced
signalling cascades in skeletal muscle to defined metabolic
responses and specific changes in gene and protein
expression that occur after diverse interval training


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M. J. Gibala and others

regimens may provide clues as to why HIT is such a

potent intervention for promoting both health outcomes
and enhancing athletic performance and exercise
capacity.
Conclusion and directions for future research

Considerable evidence currently exists to support a role for

low-volume HIT as a potent and time-efficient training
method for inducing both central (cardiovascular) and
peripheral (skeletal muscle) adaptations that are linked to
improved health outcomes. Limited work has examined
the application of low-volume HIT in people with,
or at risk for, cardiometabolic disorders, and at present the potential benefits of this type of training are
unclear. Regardless of the group studied, the majority of
low-volume studies have utilized relatively short intervention periods (i.e. lasting up to several weeks). Future
work involving long-term (i.e. months to years) interventions in a variety of clinical cohorts (i.e. individuals
with insulin resistance, obesity, type 2 diabetes and cardiovascular disease) are urgently needed to better understand how manipulating the exercise stimulus impacts on
cardiovascular and musculoskeletal remodelling in these
populations. One aspect that is unclear from the present
literature is the precise intensity and minimal volume
of training that is needed to potentiate the effect of the
stimulus-adaptation on outcomes such as mitochondrial
biogenesis and relevant health markers. To answer such
questions, a complex series of studies needs to be undertaken that systematically titrate levels of the training
impulse and determine subsequent cellular, performance
and clinical responses after divergent training interventions. In this regard, the perspectives gained from
the use of supra-maximal interval-based training in
well-trained athletes may aid in understanding why and
how low-volume HIT improves health and functional
performance in the general population and in many
chronic disease states. Information derived from future
studies will need to provide practical, evidence-based
recommendations for novel exercise prescription that can
be incorporated into daily living and form an integral
component in the development of future combinatorial
therapies for the prevention and treatment of chronic
inactivity-related diseases. If achieved, these goals will
simultaneously reduce the economic burden associated
with an inactive lifestyle.
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Acknowledgements
Work cited from the authors laboratories has been supported
by the Natural Sciences and Engineering Research Council
of Canada, the Canadian Institutes of Health Research, the
Canadian Diabetes Association and The Australian Research
Council.


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