We haven't done a HIIT-related thread in a while, but today I was inspired by this new meta-analysis on Sprint Interval Training (SIT), so here we go. I will teach you how you too can say incredible, mind-bending things and get them past the reviewers (in Frontiers, but still...)
What did the meta find? (1) The worst you'll feel during SIT does not differ from the worst you'll feel during moderate-intensity continuous exercise (MICE), and (2) enjoyment of SIT and MICE does not differ.
Now, you don't need to be an expert to understand that these claims are made up and patently false. Anyone who has done a Wingate test knows that this is one of the most brutal, most violently unpleasant physical experiences, so imagine doing several of these back-to-back.
Yet, here are the data -- and you can't argue with data, can you? As you can see, the diamond crosses the zero line, indicating no difference between SIT and moderate-intensity continuous exercise for the worst feeling during exercise! How is this possible? Stick around, kids.
The first thing you have to do is start giving new meanings to words. Like "sprint" does not really mean "sprint," "high intensity" does not really mean "high intensity," and so on. It's a little Orwellian but it works when your readers are gullible or share your agenda.
So, what is "legit" SIT? Depends on who you ask and when you ask them. What argument are they trying to make at the time? One of the tricks of this business is that you have to learn to speak from both sides of your mouth -- while keeping a straight face. It ain't easy.
If you want to convince your readers that SIT is physiologically effective, you say that SIT involves "all out" effort, and a workload that exceeds the workload associated with VO2max. And a good example of SIT is a Wingate test (30s against resistance of 7.5% of body weight).
For example, when you want to be certain you'll find physiological adaptations, you set a workload to the equivalent of 250% of VO2peak. And you forget to mention anything about adverse events, like nausea, lightheadedness, or vomiting.
But obviously you know that average people can't do this stuff without barfing or passing out. And when you're in the right frame of mind, you may even admit it publicly. "SIT" per se is not safe, tolerable, or appealing / sustainable in "real life."
So, now you have to start making up stuff. You say that "SIT" is no longer "SIT," it's something kinder and gentler. So, you reduce the duration of each interval to 20 sec and the resistance to 5% of body weight. This brings "SIT" down to the "vigorous" range (RPE 14-17 by ACSM).
This is because you know one simple but important thing: even if your intensity is "all out," physiological intensity (e.g., VO2) can't rise to 90-100% in 20-30 seconds.
Exercise physiologists know about the dynamics of physiological parameters, such as VO2, at the onset of severe exercise. Even if the workload increases in square-wave fashion, physiological parameters take several seconds of minutes to rise to meet the demand.
One thing we learned from Tabata is that, if you want to reach ~100% VO2peak within a short period (e.g., 20 sec), you need to set the workload to a level that corresponds to 170% VO2peak.
The problem, of course, is that even young and athletic participants cannot finish more than 2 of these 20-sec intervals at a workload corresponding to 170% VO2peak. I guess only Japanese exercise-science students can do 7-8 intervals, but no one else.
So, let's return to the studies that allegedly showed that doing SIT does not make you feel any worse than doing moderate-intensity continuous exercise... and let's look at only a couple of their tricks: (a) intensity and (b) timing of affect assessments. Are you ready?
You will notice 2 things. (1) None of the studies tested "SIT" but rather various shortened or lighter versions of doubtful physiological effectiveness. (2) Affect was assessed during recovery, NOT during the high-intensity intervals, in an effort to capture the "relief" effect.
Look. Niven et al. (2018) had 6-sec intervals and asked participants how they felt only AFTER the intervals were over and participants were in recovery.
Olney et al. (2018) had 20-sec intervals and asked participants how they felt -- you guessed it -- only AFTER the intervals were over and participants were in recovery.
Songsorn et al. (2020) had 20-sec intervals and asked participants how they felt -- you guessed it -- only AFTER the intervals were over and participants were in recovery.
Stork et al. (2018) had 20-sec intervals and asked participants how they felt -- you guessed it -- only AFTER the intervals were over and participants were in recovery.
To recap: if you want to show that SIT and moderate-intensity exercise feel about the same, remember: (1) don't use "SIT" but something short that barely raises physiological intensity to vigorous level for a few seconds, and (2) ask people how they feel only AFTER they're done.
OK, enough for now. Some other day, I will show you how you can find that enjoyment is about the same after SIT and moderate exercise. Enjoyment has its own little tricks. Lots of "fun" (pun intended).
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"No time to exercise? What about three seconds a day?" Once Pandora's Box was opened and researchers discovered that, if you have a ton of dependent variables and you don't adjust for multiplicity, you can make headlines around the world, it was over.
Dear researchers, we have a beautiful science that can do some good in the world. Approach it with respect, with diligence, with a sense of responsibility. Understand the impact of your press releases on public perception. Please, consider the larger implications of your actions.
In particular, if you don't understand how statistics work, if you don't know what it means to conduct a gazillion tests of probability on samples of 10 to 13, please ask for statistical help. Have someone explain things to you. It's not a shame to ask for help when you need it.
So, @NICEComms released the latest draft of its updated guidelines for the treatment of adult #depression. Although the timeline can be unpredictable, we're probably getting close to the final version. Let's do a thread!
If there was ever any doubt that "evidence-based medicine" should NOT be taken to imply sole reliance on the evidence and nothing else, depression guidelines are a prime example. The problem is so large and the treatment options so poor that this is, to a great extent, political.
To remind everyone, in the distant 2004, with Clinical Guideline 23 (CG23), NICE pioneered the "stepped care model" for the treatment of depression and the idea of using exercise for cases of mild depression.
There is no official announcement from Stanford yet but there is enough chatter to suggest that the legendary Albert Bandura has passed away. We know this day was coming (Bandura was born in December, 1925) but it is still a very sad day in the history of psychology. A tribute...
I think it's fair to say that few people have been able to read (and understand) Bandura from the original. Most know Social Learning Theory and Social Cognitive Theory from simplified and abbreviated secondary sources. His language seems wordy but is densely packed with meaning.
I first tried to read his 1977 classic as an undergrad in the late 1980s. I probably made it to page 2 before giving up, exhausted. It would be years before I managed to return to it, with more experience, and was able to finish it.
Of all the diseases, the ONE that is most often thought as something that can be treated with #exercise is, of course, #obesity. But, instead, obesity is commonly treated with #drugs. Who would like to know more about the history of FDA-approved obesity drugs in the US? A thread!
For economy, let's skip the part about the 1st wave of obesity drugs being based on amphetamine & methamphetamine (to speed up metabolic rate), either alone or in combination with a "downer," to balance the stimulatory effect of the meth/amphetamine on the central nervous system.
In 1959, phentermine (an amphetamine analogue, with less addictive potential) was introduced. It stimulates the release of norepinephrine (primarily), and dopamine and serotonin (secondarily) in the brain. Acts as an appetite suppressant.
Something remarkable, from several angles, happened yesterday. The @US_FDA approved aducanumab for the treatment of Alzheimer’s disease, the first such approval in almost 20 years! This decision is a major blow to Evidence-Based Medicine and introduces new standards. A thread...
As many of you know, besides brain atrophy, there are two microscopic biomarkers of Alzheimer's disease: (a) plaques made up of β amyloid and (b) tangles make up of another protein called τ. These can be detected in cerebral spinal fluid through a spinal tap or via PET imaging.
It is now recognized that initially β and subsequently τ accumulate in the brain several years before the first appearance of behavioral symptoms (e.g., memory loss).
The paradigm shift in exercise prescription cannot / will not come from the propagators of the paradigm. Kuhn told us that "almost always" those who achieve "fundamental inventions of a new paradigm have been either very young or very new to the field whose paradigm they change."
Kuhn predicted that paradigm change will come from iconoclasts and "mavericks": "being little committed by prior practice to the traditional rules of normal science, [they] are particularly likely to [...] conceive another set that can replace them."
So, we are now beginning to see multiple (geographically detached and politically emancipated) organizations issue exercise prescription guidelines that depart from the ACSM-dictated paradigm in important ways.