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IMPORTANT: Consult your personal physician before attempting these workouts to make sure you are clear for vigorous activity. Need more information? Check out the American College of Sports Medicine article: When to See a Physician Before Exercising

Health Disclaimer: This content is for your information only and may not be regarded as medical advice or instruction. No action or inaction should be taken based merely on the contents of this information; instead, readers should consult appropriate health professionals on any matter relating to their health and well-being.

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High-intensity interval training (HIIT) is hot. Everyone (including their mother) is doing HIIT for its time efficiency and weight loss benefits. Many of the workout gurus have added a “Tabata” workout to their programs. Almost always these HIIT workouts are entirely out of context from how the research was conducted. This HIIT Quick Start Guide will quickly get you on track doing HIIT workouts the evidence-based way.

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I hate long workouts. As a busy physician, I want efficiency. I want the most bang for my buck. Not that I don’t have the time. We all have the time (we prioritize our time) . . . but I want to make the most of it. How did I discover high-intensity interval training?

My wife. Yep. You would think as a physician, I would be the chief health-promotion officer for my household, but I’m not. It’s my wife. She’s our “nutritional gatekeeper” and she works out way more consistently than I do. My wife was trying out a new workout program. You know one of those you find on late night infomercials with the genetically superior trainer whipping people into shape with their

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newest program . . . .with a hyped-up, uber-masculine, high-octane name . . . with a number in it . . . She was sold on a workout that was under 30 minutes a day . . . she’s a busy mom. I get it. But c’mon. Really? You’re gonna get fit in under 30 minutes a day? I knew better. I know that the American College of Sports Medicine recommends 30-60 minutes of exercise daily as a minimum. Studies have found that 60 minutes of exercise daily is needed for weight loss. But there she was getting fit and looking great in under 30 minutes a day. The scientist in me needed answers. Some of the marketing information referenced “High-Intensity Interval Training” or “HIIT.” What the heck is “HIIT?” So, I plugged “HIIT” into Google Scholar along with PubMed and found several articles about HIIT.

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It turns out there were studies published in the 90’s demonstrating physiologic benefits to high-intensity interval training. Great benefits . . . like fat loss, improved aerobic fitness, increased strength, improved blood sugar control . . . all from just a slight variation on your typical aerobic workout. The best part was that HIIT often demonstrated equal and even superior benefits when compared to regular aerobic exercise. Surprisingly these benefits were often demonstrated in half the time of regular aerobic training. Better results in half the time! I have been fascinated with this line of research ever since and it has changed my practice. I recommend HIIT to my patients when appropriate as an exercise prescription. What you are reading here is the result of many hours of study, numerous scientific papers and anecdotal experience through practicing HIIT myself as well as coaching my patients. HIIT is an exciting and rapidly evolving field of research. Imagine being a kid again.

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What did you do when you were a kid? You played. You probably played really hard. If your childhood was like mine, you ran around the neighborhood with friends, playing games. I played tag, ditch, football, skateboarded and biked. . . typical boy stuff. This play involved bursts of activity . . . which is natural. I could play for hours and not feel like I was bored of “working out.” We are born to do bursts of activity. Play is a natural high-intensity interval training. Studies have even found that HIIT is more enjoyable than regular aerobic exercise, which is no surprise. My goal is to help you use the science of high-intensity interval training to meet your health goals. This could be fat loss, while retaining muscle and strength. It could be improving your aerobic fitness.

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It may be getting your blood sugars under better control. These are all potential benefits of HIIT.

Who’s This HIIT Stuff For Anyway? That depends. HIIT could potentially benefit anyone, but specifically HIIT can help manage weight and aid in fat loss. So, if you need to focus on fat loss to help your overall health and well-being, then HIIT may be your thing. No one can guarantee results, but at least HIIT has some research demonstrating that study participants managed to lose weight. This is better than picking up the newest, en vogue workout program. HIIT has also been shown to help lower blood sugar levels in both the short and long term. So, if you have diabetes or prediabetes, you may want to consider HIIT.

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Be careful and talk to your physician if you are on medications for diabetes

to be clear about how to manage your blood sugar around exercise and

avoid seriously low blood sugar episodes.

HIIT has been studied in a range of patients including those with lung and heart disease. I’ve written an article previously about how HIIT can benefit the heart in particular. You can check it out here. What this proves is that HIIT can be done by even the sickest patients such as those with bypass surgery, stents in their hearts, heart failure and even heart transplants. If you have a heart condition you will need to work with your medical team.

I am not your physician and you may need to do HIIT in a more controlled

environment such as with a cardiac rehab specialist.

You might have the misperception that HIIT is only for healthy people. Indeed, HIIT has been studied in healthy athletes, but it has been studied even more in the sedentary and obese crowd. Men, women, athletes, sedentary, overweight, obese, heart and lung patients, diabetics and prediabetics. . . they’ve all been studied. So, I think you can understand that HIIT is quite possibly for you.

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If that’s the case . . . read on. I’m gonna show you how to quickly get started doing HIIT in 5 easy steps.

HIIT Workouts in 5 Steps:

Step 1. Pick an Exercise. Fortunately there are several exercise modalities that have been studied for HIIT. I’ve chosen the modalities that have actual science supporting them. Each exercise has at least one human study (and usually several) supporting its use. This gives you multiple options to choose from. Whether or not to mix and match types of exercises is really up to you. No one has studied the effectiveness of this, however. For instance, you could do an interval walking routine on Day 1, then a HIIT Treadmill Sprint on Day 2 followed by HIIT Elliptical on Day 3. This mixing up of the exercise is probably fine, but again not studied, so it’s unknown how effective it could be. Most of the studies focused on one form of exercise for at least several weeks (such as up to 15 weeks). So, find a modality you have easy access to and something you’ll enjoy.

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One benefit of HIIT is its simplicity. No need for fancy equipment. Much of the equipment is readily available either in your basement (time to dust off the treadmill?) or at a work-out facility near you. Here’s the list of HIIT exercises based on the research: • Walking • Sprinting • Cycling • Elliptical • Treadmill • Burpees Go ahead and pick one.

Step 2. Pick Your Intensity Ultimately doing HIIT involves going two speeds . . . fast and slow. It’s pretty simple. The fast interval is the high-intensity burst of activity, while the slow is recovery time. I like to call the intense interval a “burst.” Call it what you want, but the idea is to increase your activity level to a high intensity . . . an intensity that is often “maximal” or “near maximal.”

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For instance, in many of the studies the participants would “go all out.” The level of intensity was determined more scientifically, but for practical purposes you can accomplish this in two ways. First, you can monitor your heart rate. It turns out that heart rate monitoring is a pretty good determinant of your exercise intensity. In fact, some of the research simply used maximal heart rate or near-maximal heart rate to monitor intensity. Some treadmill and elliptical machines have heart rate monitoring built in. You’ve probably noticed or used the metal front bars on a treadmill that you can grip to monitor your heart rate. I don’t like this option. These bars tend to be sluggish to respond and difficult to use when you are moving fast. You could self-monitor by checking your pulse and timing it over 10 to 60 seconds (do the math to get beats per minute), but again this is a slow option and not the best for HIIT in practice. I think the best option is a heart rate monitor. A heart rate monitor is instant, always-on, access to your heart rate. I promote and get a small “commission” to sell Fitbit products (so I’m

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strongly biased, but feel free to check out my sales link below). You could monitor your heart rate and “activity level” with a fashionable device that fits neatly on your wrist . . . Fitbit Charge HR.TM There are many brands of heart rate monitors including types that strap around your chest. Both wrist and chest strap options are accurate. Now let’s calculate your maximal heart rate. Technically, you would NOT need to “go all out” at 100% maximal heart rate. Some studies have found that bursts up to 80-90% of maximal heart rate worked very well. So, you would do fine to choose between 80% to 100% of your maximal heart rate. To calculate your maximal heart rate do the trusty-ol’ calculation of 220 minus your age. Maximal Heart Rate = 220-Age So, for a 20 year-old . . . . . . . 220-20 = 200 bpm The maximal heart rate is 200 bpm (beats per minute). This is also the 100% maximal heart rate.

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If you want to calculate the 80% of maximal heart rate you would simply multiply by 0.8. i.e. 220-age x 0.8 So, in our example . . . [220-20] x 0.8 = 160 beats per minute For the recovery heart rate zone you can monitor to target a heart rate around 60-70% of heart rate max. If monitoring your heart rate is too much work, there’s another option . . . The second way to track your intensity is using the Borg Scale of Perceived Exertion, which is a rough estimate of how hard you’re working. This is a scale from 6 to 20 to rate your level of exertion . . . twenty being maximal and 6 being no exertion. Nine is a “walk in the park.” Turns out there is a slight correlation to one’s perceived exertion and heart rate. For example, if the Borg rating is 12, then heart rate is 10 x 12 = 120 beats per minute. This is a very rough estimate. Regardless, it’s

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likely practical to judge your exertion on your own without needing a heart rate monitor. You can start without watching your heart rate closely by using the Borg Scale and progress to heart rate monitoring over time as you see fit. Here’s the Borg Scale from CDC.gov: Try to appraise your feeling of exertion as honestly as possible, without thinking about what the actual physical load is. Your own feeling of effort and exertion is important, not how it compares to other people. Look at the scales and the expressions and then give a number. 6 No exertion at all 7 Extremely light (7.5) 8 9 Very light 10 11 Light 12 13 Somewhat hard 14 15 Hard (heavy) 16 17 Very hard 18 19 Extremely hard 20 Maximal exertion 9 corresponds to "very light" exercise. For a healthy person, it is like walking slowly at his or her own pace for some minutes 13 on the scale is "somewhat hard" exercise, but it still feels OK to continue. 17 "very hard" is very strenuous. A healthy person can still go on, but he or she really has to push him- or herself. It feels very heavy, and the person is very tired.

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19 on the scale is an extremely strenuous exercise level. For most people this is the most strenuous exercise they have ever experienced. For the purposes of beginner HIIT, I would shoot for 17+ on the Borg Scale during your burst, high-intensity intervals. This reminds me of a quick point I want to make . . . Remember . . . what is maximal for one person, may not be maximal for you. We are all at different levels, but we all have a “max.” If you’re sedentary, your heart rate and perceived exertion will go up at a much easier work load than someone who is a fit athlete. So, don’t think you’re unable to “go all out” or near-maximal if you’re just starting out. That’s the beauty of HIIT. It drives me crazy to see trainers recommend “working-up” to it. This makes no physiologic sense. The body will change (physiologic adaptation) when you stress it out. So start where you are . . . but go for it. Go at YOUR max.

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Step 3. Pick Your Intervals Now that you know your intensities . . . you burst and recovery, it’s time to think about how long your intervals will be. In the literature there is quite a variation on the timing of the intervals. The time for a high-intensity burst ranges from 20 seconds up to 3 minutes. That’s quite a range. Often the intervals are created in terms of a ratio of “work” to “rest,” such as a 2:1 ratio or 1:1 ratio. For instance, the original HIIT was “Tabata” named after Dr. Izumi Tabata, the original researcher from Japan. This original “Tabata” workout was completed on the stationary cycle utilizing a burst of 20 seconds “all out” followed by 10 seconds of rest. This is a 2:1 ratio of work to rest. Often 30 seconds of work is used. So, a 1:1 ratio of work to rest would be 30 second burst followed by a 30 second rest. You could technically do any ratio, but there are some recommendations

based on the science that I’ll discuss at the end.

To accomplish any interval, you’ll need to time yourself.

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If you are using a treadmill or elliptical, a timer is often built into the machine, which makes that step easy. You just need to keep track of the time yourself. However, if you are not using a machine you’ll need to consider getting an interval timer. For instance, you could try Gymboss, which is a dedicated interval timer or a watch like the Timex Ironman. There are also interval timer apps available for your phone . . . Bit Timer, Seconds app, or Interval Timer. These are all fine options. Find one that works for you. The benefit of an interval timer is the beep that signals when to pick up the pace and when to slow down.

Step 4. Pick How Long You’ll Work Out The last step is to figure out how long you’ll work out. Typically, you’ll need to work out for 20 minutes or less . . . maybe 30 minutes at most . . . though, I do have a walking program that can run for 45-60 minutes doing interval walking. However, for the typical HIIT exercise you’re looking at 20-30 minutes. You can get “Minimal” and do as little as 3 minutes to get results. No kidding. The evidence is right here.

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In order to figure this out you simply need to calculate how long one bout of burst and rest is. So, if you are doing 1:1 interval of 60 seconds or burst and 60 seconds of rest . . . that’s a 2 minute interval. Complete 8 bouts in a 16 minute period. Add a 3 minute warm-up and 3 minute cool down for a 22 minute workout. It’s that simple. I would always recommend warming up really well for at least 3-5 minutes prior to HIIT. You should also add on an appropriate cool down for a couple of minutes. If you are cycling for example, just cycle at a modest pace such as 50-70% of heart rate max or a 10-15 on the Borg Scale.

Step 5. Get Serious About HIIT What’s your next step? . . . get serious about HIIT! I’ve created 8 HIIT Workout Templates showing you specifically how to do HIIT based on the science.

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They were extracted from research protocols and translated into the real world to make it easier to do HIIT as it was intended. Think of the 8 HIIT Workouts as your exercise prescription . . . They insure that you are doing it “by the book” with all of the correct interval timings, intensities, bouts and durations . . . demonstrated by research to get significant results. Just like you would take a medication with correct dose, the 8 HIIT Workout Templates makes sure you are getting the proper “dose” of exercise. Do workouts that are BASED ON SCIENCE. Improve your strength, lose weight, improve cardiovascular fitness . . . and do it in less time than conventional aerobic exercise. If you are a trainer, fitness or wellness coach, you now can get evidence-based workout programs to use with your clients. This makes it easy to plug in and complete HIIT exactly as it was studied.

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Here’s the workouts: 1. HIIT Tabata 2. HIIT Walking Program 3. HIIT Elliptical 4. HIIT Burpee Workout 5. Minimal Viable Exercise (Very Low-Volume HIIT) 6. HIIT Uphill Treadmill Workout 7. HIIT Sprint Treadmill Workout 8. Low-Volume HIIT Workout You can pick ‘em up by going to the link below: [8 HIIT Workouts] To Your Best Health, Nick at weightlessMD.com