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A comparison of continuous, interval, and accumulated workouts with equalized exercise volume: excess post-exercise oxygen consumption in women

BMC Women's Health volume 24, Article number: 466 (2024) Cite this article

Abstract

Background

Despite the well-known health benefits of exercise, women’s participation in exercise is low worldwide. As women are at risk of developing various chronic diseases as they age, suggesting effective exercise methods that can maximize energy consumption is needed to prevent such conditions. Excess post-exercise oxygen consumption (EPOC) can maximize energy consumption. In this crossover, randomized controlled trial, we aimed to compare the EPOC for different exercise modalities including continuous exercise (CE), interval exercise (IE), and accumulated exercise (AE) that spent the homogenized energy expenditure during exercise in healthy women.

Methods

Forty-four participants (age, 36.09 ± 11.73 years) were recruited and randomly allocated to three groups. The intensity of each modality was set as follows: CE was performed for 30 min at 60% peak oxygen uptake (VO2peak). IE was performed once for 2 min at 80% VO2peak, followed by 3 min at 80% VO2peak, and 1 min at 40% VO2peak, for a total of six times over 26 min. AE was performed for 10 min with a 60% VO2peak and was measured thrice a day.

Results

During exercise, energy metabolism was higher for IE and CE than that for AE. However, this was reversed for AE during EPOC. Consequently, the greatest energy metabolism was shown for AE during total time (exercise and EPOC).

Conclusions

By encouraging regular exercises, AE can help maintain and improve body composition by increasing compliance with exercise participation, given its short exercise times, and by efficiently increasing energy consumption through the accumulation of EPOC.

Trial registration

Clinical number (KCT0007298), 18/05/2022, Institutional Review Board of Konkuk University (7001355-202201-E-160).

Peer Review reports

Background

Physical activity and exercise can help reduce the risk of noncommunicable lifestyle-related diseases (NCDs), such as cardiovascular diseases [1], cancer [2], and type 2 diabetes [3] and improve quality of life [4]. Women experience physical changes related to aging, such as menopause. One notable characteristic during this period is sarcopenia, which refers to the involuntary loss of muscle mass, strength, and function [5, 6]. Due to aging and menopause, most middle-aged women tend to experience a quicker decline in health-related fitness compared to younger women, affecting aspects such as cardiovascular endurance, muscular strength, flexibility, muscular endurance, and body composition [7, 8]. This decline in health-related fitness with aging increases the risk of NCDs [5, 7]. On the other hand, regular exercise training mitigates age-related physical function decline by improving cardiovascular and metabolic function, enhancing energy consumption, and overall quality of life [9, 10]. Many public health organizations, including the American College of Sports Medicine, provide guidelines recommending moderate-intensity aerobic exercise for at least 30 min per day, 5 d a week, or high-intensity aerobic exercise for at least 20 min per day, 3 d a week [11].

Despite these guidelines, global physical inactivity remains high. The World Health Organization reported in 2018 that 27.5% of people were physically inactive in 2016, with women (31.7%) being more inactive than men (23.4%) [12]. Therefore, considering that the lack of physical activity is more prominent in women than in men, recognizing the barriers to exercise participation and solving them so that the rate of women’s participation in physical activity can be increased is of prime importance. In this regard, Baillot et al. [13] analyzed the motivations and barriers to exercise for women. They reported that pain and physical discomfort, lack of motivation, and lack of time are the main obstacles to exercise participation. Therefore, suggesting an exercise method that can enhance exercise compliance and effectively improve body composition and health while considering the barriers to exercise participation is important [14, 15].

Moderate-intensity continuous exercise (CE) is generally suggested to enhance physical activity and cardiorespiratory capacity [16]. However, because the exercise time is relatively long, it may not be an appropriate exercise modality for those for whom “lack of time” is a barrier to exercise participation [17]. High-intensity interval exercise (IE), which alternates between high-intensity exercise and recovery periods, requires relatively less time compared to CE [18, 19]. However, IE may not be suitable for individuals with low fitness levels [20]. Accumulated exercise (AE) has been proposed as a way to overcome “low fitness levels” and “self-discipline”, and “lack of time” [21, 22]. AE is a strategy that involves performing short, moderate-to-high-intensity exercises multiple times throughout the day, which can help improve exercise adherence [21, 22]. However, AE does not show the improvement effect on cardiopulmonary health seen during long-duration exercise [22, 23].

After acute exercise, oxygen consumption increases beyond resting levels, known as excess post-exercise oxygen consumption (EPOC) [24]. EPOC reflects the contribution of the phosphagen system and anaerobic glycolysis, which is measured using VO2 and blood lactate concentrations post-exercise [25,26,27]. Henderson et al. [28] reported that glycerol production and fatty acid mobilization were elevated minutes to hours after moderate-intensity exercises and therefore lipid oxidation occurred during EPOC. Therefore, EPOC has attracted attention as a modality for improving weight maintenance and loss [16, 29].

While many studies have examined the differences in EPOC using various exercise modalities in men, there is a lack of research focused on healthy women. When confirming some studies that looked at differences in EPOC according to exercise modalities in women, Hunter et al. [30] confirmed the difference in EPOC between CE and IE in 33 healthy women and reported that IE had a larger EPOC than CE. Additionally, AE performed by dividing sessions of moderate-intensity persistent movements led to a significant increase in the overall energy consumption due to the accumulation of EPOC [31]. Jung et al. [32] compared the differences in EPOC for CE and AE in 34 healthy male and female college students and reported that EPOC was larger in AE than in CE.

While many studies focus on maximizing EPOC through different exercise modalities [30,31,32], most take a fragmentary approach, examining “CE vs. IE” or “CE vs. AE,” and tend to be interventional rather than acute. Exercise not only aids in weight maintenance and loss but also improves metabolic and cardiovascular health factors. Therefore, suggesting and informing people about the effective intensity and volume (type, frequency, and duration) of exercise to create exercise habits for people who lack physical activity is important. The purpose of this study was to confirm the differences in EPOC, including in energy metabolism and cardiopulmonary function, for CE, IE, and AE, with equalized EE during exercise, in healthy women. We hypothesized that despite equalizing EE during exercise, IE and AE would exhibit greater EE and duration during EPOC than CE.

Methods

Participant

Fifty healthy women from a community that did not exercise regularly participated in this study voluntarily. Participants performed three exercise modalities according to a randomized crossover design. However, six participants dropped out because of personal reasons or injury. Thus, 44 participants (36.09 ± 11.73 years) completed the study. The sample size was pre-calculated using G*Power 3.1.9.7 (Franz Faul, University of Kiel, Kiel, Germany) based on VO2 during EPOC, as reported in previous studies [33]. With a power of 0.95 and an effect size of 0.25, and setting the significance level at 0.05, the optimal sample size was determined to be 50 participants, accounting for a 20% dropout rate.

All participants were informed about the experimental procedure and purpose of the study, and written informed consent and a Physical Activity Readiness Questionnaire Plus [34] were subsequently obtained. All study procedures were approved by the Institutional Review Board of Konkuk University (7001355-202201-E-160) in Korea and registered with cris.nih.go.kr (No. KCT0007298). The CONSORT flowchart presenting the study procedure and participant inclusion and exclusion criteria is shown in Fig. 1, and the physical characteristics of the participants are shown in Table 1. We used CONSORT reporting guidelines [35].

Fig. 1
figure 1

CONSORT flow diagram. CE: continuous exercise, IE: interval exercise, AE: accumulated exercise

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Table 1 Characteristics of the participants (n = 44)
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Study design

This study was a crossover, randomized controlled trial. All participants performed CE, IE, and AE with a 1-week washout period before the next trial. At the first visit, body composition and a graded exercise test (GXT) for VO2peak confirmation were performed as pretests. The ambient room temperature was maintained at 23 ± 1 °C, and the relative humidity was maintained at 50 ± 5%. The second through fourth measurements were CE, IE, or AE in a randomized order. Participants visited the laboratory at 7:30 a.m. following 12 h of fasting and 48 h of no vigorous physical activity and consumed a standardized breakfast (two slices of bread (837 KJ), one boiled egg (335 KJ), one cup of orange juice (502 KJ), and one cup of water) [36]. Afterward, the participants wore a heart rate (HR) monitor (Polar 800; Polar Electro, Kempele, Finland), sat in a chair, and rested until their HR stabilized. During all tests, respiratory responses were measured breath by breath through a stationary gas analyzer (Quark CPET; COSMED, Rome, Italy), and the HR was also continuously monitored. Gas analyzers were calibrated prior to each test using a gas mixture of known concentration (16.0% O2 and 5.0% CO2) [37]. Flowmeter calibration was performed with a 3 L air syringe [37]. Respiratory data and HR were measured for 10 min before each exercise, and the average of the last 5 min of the 10 min was used as the baseline for EPOC termination [36, 38]. CE, IE, and AE exercises were performed using a stationary cycle ergometer (Aero bike 75 XLIII; Konami, Tokyo, Japan), and exercise intensity was set with reference to previous studies that homogenized EE during exercise [36, 39]. CE was performed for 30 min at 60% VO2peak intensity; IE was performed once for 2 min at 80% VO2peak, followed by 3 min at 80% VO2peak, and 1 min at 40% VO2peak, for a total of six times over 26 min; and AE was performed at 60% VO2peak for 10 min a total of three times at approximately 2 h intervals. For the AE, measurements were completed before lunch to prevent any interference from additional dietary intake on the results. Immediately after the exercise, participants stepped off the cycle ergometer and rested sitting in a chair until the baseline was reached. The study design is illustrated in Fig. 2.

Fig. 2
figure 2

Study design. CE; continuous exercise, IE; interval exercise, AE; accumulated exercise, VO2peak; peak oxygen uptake, VE; minute ventilation, VO2; oxygen uptake, VCO2; carbon dioxide excretion, RER; respiratory exchange rate, HR; heart rate

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Measures

Body composition

Body composition was measured in the morning after fasting for 8 h and having avoided strenuous physical activity for 48 h prior to testing, with the participants wearing light clothing. Body composition was measured using an eight-electrode segmental multi-frequency bioelectrical impedance device (InBody 770; Inbody Inc., Seoul, Republic of Korea) to determine the body mass (kg), body mass index (BMI) (kg/m2), lean mass (kg), body fat mass (kg), and body fat percentage (%). BMS330 (Inbody Inc, Seoul, Korea) was used to measure height (cm).

Aerobic capacity test

On the first visit, participants performed a graded exercise test (GXT) using a stationary cycle ergometer (Aero Bike 75 XLIII; Konami), a respiratory gas analyzer (Quark CPET; COSMED), and a HR monitor (Polar 800; Polar Electro) to assess their VO2peak and HRmax. The participants were seated in a chair, rested so that their HR could be stabilized, and then measured. The GXT protocol was performed at a pedaling speed of 50 rpm, starting at 25 watts/min for the first 2 min, then increasing by 12.5 watts/min every 2 min until the participant reached exhaustion [36]. During measurement, the ratings of perceived exertion (RPE) were checked using the Borg scale at each step. The measurement was terminated when two of the following conditions were satisfied: (1) when respiration or HR did not increase, even when exercise intensity increased; (2) when the respiratory exchange rate (RER) was greater than 1.15; (3) when the RPE was higher than 17 on the Borg scale [40].

Cardiopulmonary function and energy metabolism during trials

Respiratory function was assessed using minute ventilation (VE), VO2, carbon dioxide excretion (VCO2), and RER with a respiratory gas analyzer (Quark CPET, COSMED) during exercise and EPOC period. HR was measured using a HR monitor (Polar 800; Polar Electro) during exercise and EPOC period. The energy metabolism during exercise and EPOC period was calculated using VO2 and VCO2 obtained from a respiratory gas analyzer and substituted into the following formulas to calculate carbohydrate oxidation (CHO), fatty acid oxidation (FAO), and EE [41,42,43].

$$\:CHO\:\left({g\bullet\:min}^{-1}\right)=4.210\times\:{VCO}_{2}\:\left({mL\bullet\:min}^{-1}\right)$$
$$-2.962\times\:{VO}_{2}\left({mL\bullet\:min}^{-1}\right)$$
$$\:FAO\left({g\bullet\:min}^{-1}\right)=1.695\times\:{VO}_{2}\left({mL\bullet\:min}^{-1}\right)$$
$$-1.701\times\:{VCO}_{2}\left({mL\bullet\:min}^{-1}\right)$$
$$\:EE\left({KJ\bullet\:min}^{-1}\right)=4.07\times\:CHO\left({g\bullet\:min}^{-1}\right)$$
$$+9.75\times\:FAO\left({g\bullet\:min}^{-1}\right)\:$$

EPOC criteria and O2 deficit calculation

The end time of each participant’s EPOC was determined based on the average values of measured VE, VO2, RER, and HR for 5 min in a resting state before exercise [36]. The results of calculating the EPOC measurement time for each exercise modality using the aforementioned termination criteria were as follows: CE was 20.43 ± 8.28 min and IE was 19.46 ± 6.33 min. For AE, it was 13.81 ± 5.52 min during one exercise and 41.44 ± 16.56 min when all three exercises were performed. The magnitude of EPOC is significantly influenced by the compensatory response to the oxygen deficit that occurs at the onset of exercise and during high-intensity exercise [44, 45]. Therefore, this study aims to verify whether EPOC was appropriately assessed by examining its correlation with O2 deficit. The O2 deficit was calculated by subtracting the amount of O2 intake during the time to reach the steady state after obtaining the area based on the O2 intake when reaching the steady state [24, 46].

Statistical analysis

Data obtained in this study were analyzed using SPSS 28.0 (IBM Corporation, Armonk, NY, USA), and the mean and standard deviations were calculated to present descriptive statistics. Descriptive statistics data can be found in the supplementary material. The assumptions of normality and equal variance for parametric statistical analysis were verified using the Shapiro–Wilk test for all dependent variables. A one-way analysis of variance with repeated factors was conducted to verify the differences in cardiopulmonary function and energy metabolism during exercise and EPOC as well as in O2 deficit during exercise and the O2 intake during EPOC between trials. In addition, Mauchly’s sphericity test was applied to the data and sphericity was assumed to be violated when the “F” test was significant. In case of sphericity violation, the Greenhouse–Geisser Epsilon correction was used. Post-hoc analysis was conducted using Bonferroni correction to verify the significant differences between trials. Effect sizes were calculated using partial eta squared (ηp2). Pearson’s correlation analysis was performed to examine the correlations between the O2 deficit during exercise and O2 intake during EPOC. Statistical significance was set at p < 0.05.

Results

Cardiopulmonary function and energy metabolism during exercise

The differences in cardiopulmonary function and energy metabolism during the three exercise trials are shown in Fig. 3. This study showed that EE (KJ) during exercise was not significantly different among CE, IE, and AE. A significant main effect by trial was observed in HR_sum, RER, CHO, and FAO. On post-hoc analysis, HR_sum and FAO were significantly lower in IE than in CE. RER and CHO were significantly higher in IE than in CE. RER was significantly higher in IE than in AE, while FAO was significantly higher in AE than in IE.

Fig. 3
figure 3

Cardiopulmonary function and energy metabolism during exercise. (a) Difference in HR, (b) difference in VE, (c) difference in VO2, (d) difference in VCO2, (e) difference in RER, (f) difference in CHO, (g) difference in FAO, (h) difference in EE. HR; heart rate, VE; minute ventilation, VO2; oxygen uptake, VCO2; carbon dioxide excretion, RER; respiratory exchange ratio, CHO; carbohydrate oxidation, FAO; fatty acid oxidation, EE; energy expenditure, a = indicates significant difference between CE and IE, b = indicates significant difference between CE and AE, c = indicates significant difference between IE and AE

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Cardiopulmonary function and energy metabolism in EPOC

The differences in cardiopulmonary function and energy metabolism during EPOC after the three exercise trials are shown in Fig. 4. A significant main effect by trial was observed in HR_sum, VE_sum, VO2_sum, VCO2_sum, RER, CHO, FAO, and EE. On post-hoc analysis, HR_sum, VE_sum, VO2_sum, VCO2_sum, and metabolic energy consumption were significantly higher in IE than in CE. All variables were significantly higher in CE, and cardiopulmonary function, CHO, and EE were significantly higher in AE than in IE.

Fig. 4
figure 4

Cardiopulmonary function and energy metabolism during EPOC. (a) Difference in HR, (b) difference in VE, (c) difference in VO2, (d) difference in VCO2, (e) difference in RER, (f) difference in CHO, (g) difference in FAO, (h) difference in EE. HR; heart rate, VE; minute ventilation, VO2; oxygen uptake, VCO2; carbon dioxide excretion, RER; respiratory exchange ratio, CHO; carbohydrate oxidation, FAO; fatty acid oxidation, EE; energy expenditure, a = indicates significant difference between CE and IE, b = indicates significant difference between CE and AE, c = indicates significant difference between IE and AE

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Cardiopulmonary function and energy metabolism during total time (exercise plus EPOC)

The differences in cardiopulmonary function and energy metabolism during the three exercise trials and EPOC measurements are shown in Fig. 5. A significant main effect by trial was observed in HR_sum, VE_sum, VO2_sum, VCO2_sum, RER, CHO, FAO, and EE. On post-hoc analysis, CE was significantly higher than IE in FAO, and IE was significantly higher than CE in RER and CHO. AE was significantly higher than CE in cardiopulmonary function, CHO, and EE, and significantly higher than IE in HR_sum, VE_sum, VO2_sum, VCO2_sum, and metabolic energy consumption.

Fig. 5
figure 5

Cardiopulmonary function and energy metabolism during total time. (a) Difference in HR, (b) difference in VE, (c) difference in VO2, (d) difference in VCO2, (e) difference in RER, (f) difference in CHO, (g) difference in FAO, (h) difference in EE. HR; heart rate, VE; minute ventilation, VO2; oxygen uptake, VCO2; carbon dioxide excretion, RER; respiratory exchange ratio, CHO; carbohydrate oxidation, FAO; fatty acid oxidation, EE; energy expenditure, a = indicates significant difference between CE and IE, b = indicates significant difference between CE and AE, c = indicates significant difference between IE and AE

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Differences between O2 deficit and EPOC according to three exercise modalities

The differences between the O2 deficit after exercise and VO2 during EPOC according to the three exercise modalities are shown in Fig. 6. A significant main effect by trial was observed for the O2 deficit and VO2 (mL) during EPOC. On post-hoc analysis, IE was significantly higher than CE in the O2 deficit and EPOC. AE was significantly higher than CE and IE for the O2 deficit and EPOC.

Fig. 6
figure 6

Differences in O2 deficit and EPOC among the three exercise modalities. CE; continuous exercise, IE; interval exercise, AE; accumulated exercise, VO2; oxygen uptake, a = significant difference between CE and IE, b = significant difference between CE and AE, c = significant difference between IE and AE. The solid line represents the difference in O2 deficit according to exercise modalities. The dotted line represents the difference in the EPOC according to the exercise modalities

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Correlations between the O2 deficit and EPOC according to the three exercise modalities

The correlations between the O2 deficit after exercise and VO2 during EPOC according to the three exercise modalities are shown in Fig. 7. There was a significant correlation between the O2 deficit after exercise and VO2 during EPOC in all exercise modalities. In addition, for all exercise modalities, the correlation between the O2 deficit after exercise and VO2 during EPOC was R = 0.840.

Fig. 7
figure 7

Correlations between O2 deficit and EPOC. (a) correlation for continuous exercise. (b) correlation for interval exercise. (c) correlation for accumulated exercise. (d) correlation for three exercise trials. VO2; oxygen uptake

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Discussion

We aimed to identify the effects of three exercise modalities, in which EE was homogenized, on cardiopulmonary function and energy metabolism during EPOC and the difference in EPOC according to exercise modality. The main finding was that during the entire session including exercise and EPOC, AE showed a higher metabolic benefit for EPOC than the other two exercise modalities, although EE during exercise did not differ significantly among CE, IE, and AE.

During exercise, an O2 deficit occurs, which is compensated for after exercise to normalize the increased metabolism, resulting in EPOC [33, 44, 45]. These compensatory effects manifest as “fast” components related to the resynthesis of phosphocreatine, oxygen storage in muscles and blood, and increased heart and respiratory rates, as well as “slow” components related to lactate removal, elevated body temperature, and increased hormone levels [47,48,49]. In this study, the EPOC duration after exercise was 20.43 ± 8.28 min for CE, 19.46 ± 6.33 min for IE, and 13.81 ± 5.52 min for AE after a single 10-min session, accumulating to 41.44 ± 16.56 min over three sessions. Previous research has reported that when the EPOC duration is less than an hour, it is primarily influenced by the fast component [47]. Therefore, it is believed that the EPOC in our study was significantly affected by the oxygen deficit that occurred during exercise.

Islam et al. [50] compared EPOC and FAO after CE and IE in eight healthy men. In EPOC, VO2 and FAO were significantly higher in IE than in CE. Kristian et al. [51] compared EPOC of CE and IE in 10 participants with type 2 diabetes and found larger EPOC in IE but no difference in carbohydrate and lipid oxidation rates. Greer et al. [33] compared the EPOC in isocaloric CE and IE in 10 healthy men and found higher energy consumption during EPOC in IE than in CE. In this study, when CE and IE were compared EPOC, IE led to significantly greater HR_sum, VE_sum, VO2_sum, VCO2_sum, CHO, FAO, and EE based on higher exercise intensity and a greater O2 deficit. This indicates that when performing an exercise with homogenized EE, IE involves a shorter exercise time but results in a larger EPOC, consistent with previous studies [33, 50, 51].

AE causes an O2 deficit multiple times which accumulates. An accumulated O2 deficit affects the size of EPOC by inducing the oxidation of more energy substrates to compensate for energy consumption after exercise [52, 53]. Additionally, lipolysis in adipose tissue during moderate-intensity aerobic exercise is enhanced when repeating workouts of the same intensity and duration [54]. In Stich et al. [55] seven men perform 60 min of exercise at 50% VO2max followed by 60 min of rest twice, using a cycle ergometer. They found that glycerol concentration increased by about 55% after the second exercise block compared to the first, and plasma catecholamine concentrations, which induce the mobilization of energy substrates, increased significantly for epinephrine but not for norepinephrine.

In a study comparing the EPOC for CE and AE, Goto et al. [56] confirmed that the contribution of fat to total energy consumption during EPOC was significantly greater in AE than in CE. Darling et al. [57] compared EE during EPOC for CE and AE in 20 male participants. Energy consumption during exercise was higher in the CE (1962.3 ± 280.33 KJ) group than in the AE (1933.01 ± 280.33 KJ) group. On the other hand, EE during EPOC was greater in the AE (439.32 ± 54.39KJ) group than in the CE (347.27 ± 37.66 KJ) group, and consequently, for total EE by exercise, AE was greater than CE. Additionally, Jung et al. [36] confirmed the differences in EPOC for CE, IE, and AE in nine female participants. EPOC was longer in IE (42.44 ± 14.06 min) and AE (45.00 ± 14.31 min) than in CE (25.22 ± 15.06 min), and EE during EPOC was in the order of AE (370.58 ± 180.04 KJ/min), IE (265.85 ± 89.50 KJ/min), and CE (162.38 ± 96.48 KJ/min).

The EPOC size appears to be proportional to the increase in exercise intensity [44]. In other words, during high-intensity exercise, the amount of oxygen required at the beginning of exercise rapidly increases, and the amount of the O2 deficit increases accordingly, which seems to affect EPOC [47]. Thornton and Potteiger [58] reported that high-intensity exercise results in a larger EPOC than moderate-intensity exercise. On the other hand, AE causes an accumulated O2 deficit, thus increasing the EPOC size [31]. Therefore, in the difference between oxygen deprivation and EPOC according to the three exercise trials in this study, IE appeared larger than CE and AE appeared larger than CE and IE. The correlation between the O2 deficit and EPOC according to the exercise trials also showed a significant correlation with CE, IE, and AE, thus confirming that both the O2 deficit caused by high-intensity exercise and the accumulation of O2 deficit caused by AE affect the EPOC size.

In this study, AE led to significantly greater cardiopulmonary function and energy metabolism than CE and IE during EPOC. This means that AE showed a significantly larger EPOC based on more compensation systems because of the accumulation of O2 deficit caused by repeating the exercise thrice. This was confirmed through the correlation between the O2 deficit due to exercise and EPOC. These results show that even if the exercise is performed in short 10-min increments, as it was in this study, EPOC can be maximized based on a repetitive O2 deficit to increase oxidation of energy metabolism, which is consistent with the results of the previous studies [36, 55,56,57].

Since 1995, the US Physical Activity Guidelines have recommended accumulating short exercise sessions throughout the day to meet physical activity goals [59]. While these brief workouts are less effective than traditional exercise for improving cardiorespiratory and vascular function, they may be equally effective in addressing NCDs risk factors, such as lipid profile and fasting plasma insulin [60, 61]. Short, 10-minute workouts are more appealing and can encourage consistent exercise participation, making it easier to achieve the recommended 30 min of moderate-intensity exercise daily [62]. Simply replacing sedentary time with brief activity periods offers additional health benefits [63, 64]. Altena et al. [65] found that accumulated physical activity effectively lowers postprandial triglyceride levels, reducing cardiovascular disease risk [66]. Murphy et al. [52] suggested that AE enhances cardiovascular health and normalizes blood pressure by increasing fat oxidation and maximizing EE through EPOC, making short bouts of moderate-intensity exercise an attractive option for improving body composition and lowering disease risk [60, 67].

Limitations

This study had two major limitations. First, we did not control for additional variables such as participant diet, exercise, and supplement intake during the washout period. Second, women’s menstrual cycle was not considered because of previous studies reporting no effect on EPOC [61]. Finally, as this study focused on the acute response to a single bout of exercise, further investigation is needed to determine whether the increase in EPOC observed after AE can be applied as effective training for improving body composition, aerobic function, and exercise participation in the long term compared to CE and IE.

Conclusions

On analyzing the EPOC according to three exercise modalities with homogenized EE during exercise in healthy women, we found that EPOC was greater in AE compared to CE and IE. Further studies examining the effects of CE, IE, and AE on various metabolic and cardiovascular diseases based on long-term exercise interventions are needed.

Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Abbreviations

AE:

Accumulated exercise

ATP:

Adenosine triphosphate

BMI:

Body mass index

CE:

Continuous exercise

CHO:

Carbohydrate oxidation

CON:

Control group

EE:

Energy expenditure

EPOC:

Excess post-exercise oxygen consumption

FAO:

Fatty acid oxidation

GXT:

Graded exercise test

HR:

Heart rate

H+ :

hydrogen ions

IE:

Interval exercise

NCDs:

Noncommunicable lifestyle-related diseases

ηp 2 :

partial eta squared

RER:

Respiratory exchange rate

RPE:

Ratings of perceived exertion

VCO2 :

Carbon dioxide excretion

VE:

Minute ventilation

VO2 :

Oxygen uptake

VO2max:

Maximal oxygen uptake

VO2peak:

Peak oxygen uptake

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Acknowledgements

This paper was supported by Konkuk University in 2022.

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  1. Yerin Sun and Hun-Young Park contributed equally to this work and share the first authorship.

Authors and Affiliations

  1. Department of Sports Medicine and Science, Graduate School, Konkuk University, Seoul, Republic of Korea

    Yerin Sun, Hun-Young Park, Sung-Woo Kim, Jisoo Seo, Jae-Ho Choi, Jisu Kim & Kiwon Lim

  2. Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Republic of Korea

    Hun-Young Park, Sung-Woo Kim, Jisu Kim & Kiwon Lim

  3. Department of Senior Exercise Prescription, Dongseo University, Busan, Republic of Korea

    Won-Sang Jung

  4. Department of Physical Education, Konkuk University, Seoul, Republic of Korea

    Kiwon Lim

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Contributions

Y.S. and H-Y.P. are joint first authors. Y.S., H-Y.P., and W-S.J. designed the study. Y.S. and H-Y.P. drafted the manuscript. Y.S., W-S.J., J.S., and J.C. collected the data. Y.S. and W-S. J. performed data analysis. All authors contributed to data curation. All authors contributed to manuscript revision, read, and approved the submitted version.

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Correspondence to Kiwon Lim.

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This study was reviewed and approved by the Institutional Review Board of Konkuk University (7001355-202201-E-160) and conducted in accordance with the principles of the Declaration of Helsinki. It was registered with the Clinical Research Information Service (http://cris.nih.go.kr), conforming to the World Health Organization International Clinical Trials Registry Platform (registration number: KCT0007298). Registration date is 18/May/2022.

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Sun, Y., Park, HY., Jung, WS. et al. A comparison of continuous, interval, and accumulated workouts with equalized exercise volume: excess post-exercise oxygen consumption in women. BMC Women's Health 24, 466 (2024). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12905-024-03299-2

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BMC Women's Health

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