Effects of High-Intensity Interval Training versus Moderate-Intensity Continuous Training on Weight Loss and Blood Lipid Metabolism in Chinese Overweight or Obese Populations：A Meta-Analysis

ObjectiveTo compare the effects of high-intensity interval training (HIIT) with moderate-intensity continuous training (MICT) on weight loss and blood lipid metabolism in Chinese overweight or obese populations using a meta-analysis method.MethodsComputer searches were conducted on databases including PubMed, EMbase, the Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform (Wanfang Data), VIP Chinese Science and Technology Periodical Database (VIP), and the Chinese Biomedical Literature Database (CBM) for randomized controlled trials (RCTs) comparing the effects of HIIT and MICT on weight loss and blood lipid metabolism in Chinese overweight or obese populations. The retrieval period was from the inception of each database to April 30, 2025. Outcome measures included weight loss indicators such as body weight, body mass index (BMI), body fat percentage, waist circumference, hip circumference, and waist-to-hip ratio, as well as blood lipid metabolism indicators including total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). Two researchers independently performed literature scree-ning, data extraction, and assessed the risk of bias of the included studies in strict accordance with inclusion and exclusion criteria. Meta-analysis was conducted using RevMan 5.4 and Stata/SE 15.0 software. Subgroup analyses were performed based on age, gender, and training frequency. Egger's linear regression test was used to assess potential publication bias.ResultsA total of 21 RCTs involving 685 participants were included. The meta-analysis showed that HIIT was significantly superior to MICT in improving waist circumference [<italic>WMD</italic>=-1.62, 95% <italic>CI </italic>(-3.12，-0.12), <italic>P</italic>=0.03], waist-to-hip ratio [<italic>WMD</italic>=-0.01, 95% <italic>CI</italic> (-0.01，-0.00), <italic>P</italic>=0.04], and LDL-C level [<italic>WMD</italic>=-0.09, 95% <italic>CI</italic> (-0.16，-0.02), <italic>P</italic>=0.02]. For the remaining outcomes, there was no statistically diffe-rences between two groups (<italic>P</italic>&gt;0.05). Subgroup analyses indicated that HIIT was more effective in reducing body fat percentage than MICT in the female subgroup and in participants training &gt;3 times/week (<italic>P</italic>&lt;0.05). HIIT also produced greater reductions in waist circumference in the young-to-middle-aged subgroup, the female subgroup, and the training frequency &gt;3 times/week subgroup (<italic>P</italic>&lt;0.05). Greater reductions in waist-to-hip ratio were observed with HIIT in the young-to-middle-aged and female subgroups (<italic>P</italic>&lt;0.05). HIIT was more effective than MICT in lowering LDL-C in the young-to-middle-aged subgroup and in the training frequency ≤3 times/week subgroup (<italic>P</italic>&lt;0.05). In addition, HIIT increased HDL-C levels more than MICT in the training frequency ≤3 times/week subgroup (<italic>P</italic>&lt;0.05). Egger's test showed that all outcomes had <italic>P</italic> values &gt;0.05, suggesting no significant publication bias among the included studies. The pooled effects for waist circumference and waist-to-hip ratio showed some dependence on the method used to estimate change-score variance, whereas sensitivity analyses for the other outcomes demonstrated good robustness and stability.ConclusionHIIT and MICT have comparable effects on the body weight, BMI and most lipid indicators of the overall overweight or obese populations in China. However, HIIT shows more significant advantages in improving waist circumference, waist-to-hip ratio and LDL-C. The therapeutic effects of HIIT are more prominent in specific populations.