High-intensity functional training with an adequate and carbohydrate-restricted hypocaloric diet promotes weight loss and cardiometabolic improvements

Main Article Content

Marina de Macêdo Rodrigues Leite
Marzo Edir da Silva Grigoletto
Bárbara Lúcia Fonseca Chagas
Ana Carolina Santos Barbosa Machado
Alan Bruno Silva Vasconcelos
Danielle Goes da Silva
Raquel Simões Mendes-Netto


Introduction: Excess body weight and its comorbidities represent a major public health issue. Interventions based on diet and exercise have not only been shown to promote weight loss, but also improve overall health, including cardiovascular health. Objective: This study aimed to evaluate the effects of a 12-week hypocaloric low-carbohydrate (CHO) diet coupled with high-intensity functional training (HIFT) on the cardiometabolic risk of overweight adults. Methods: This is a randomized controlled trial. A total of 31 overweight adults participated in this study, divided into two groups based on the dietary intervention: reduced-CHO (R-CHO, ≤130 g/day; n=15) and adequate-CHO (A-CHO, >130 g/day; n=16). The cardiometabolic risk was assessed using lipidaemic, insulinemia, and glycaemic parameters. A two-way ANOVA with Bonferroni post-hoc test was utilized to evaluate the effects of the intervention. A p-value < 0.05 was considered statistically significant. Results: Participants from both groups displayed decreased low-density lipoprotein, very-low-density lipoprotein, total cholesterol, and triacylglycerol concentrations, as well as the number of risk factors for the metabolic disease after 12 weeks. The high-density lipoprotein (HDL) cholesterol concentration of both groups increased after 12 weeks, however, the result of the intragroup analysis revealed that a significant increase was only observed in the participants from the A-CHO group. Conclusion: Reduced or adequate CHO intake was both found to be effective in reducing cardiometabolic risk. However, improvements in HDL and final cardiometabolic classification risk indicated that CHO adequacy in the diet might be a better strategy associated with caloric restriction and HIFT.


Download data is not yet available.

Article Details

How to Cite
Leite, M. de M. R., Grigoletto, M. E. da S., Chagas, B. L. F., Machado, A. C. S. B., Vasconcelos, A. B. S., Silva, D. G. da, & Mendes-Netto, R. S. (2023). High-intensity functional training with an adequate and carbohydrate-restricted hypocaloric diet promotes weight loss and cardiometabolic improvements. ABCS Health Sciences, 48, e023226. https://doi.org/10.7322/abcshs.2021173.1885
Original Articles


Hu T, Bazzano LA. The low-carbohydrate diet and cardiovascular risk factors: Evidence from epidemiologic studies. Nutr Metab Cardiovasc Dis. 2014;24(4):337-43. https://doi.org/10.1016/j.numecd.2013.12.008

Johns DJ, Hartmann-Boyce J, Jebb SA, Aveyard P; Behavioural Weight Management Review Group. Diet or exercise interventions vs combined behavioral weight management programs: a systematic review and meta-analysis of direct comparisons. J Acad Nutr Diet. 2014;114(10):1557-68. https://doi.org/10.1016/j.jand.2014.07.005

Dow CA, Thomson CA, Flatt SW, Sherwood NE, Pakiz B, Rock CL. Predictors of improvement in cardiometabolic risk factors with weight loss in women. J Am Heart Assoc. 2013; 2(6):e000152. https://doi.org/10.1161/JAHA.113.000152

Washburn RA, Szabo AN, Lambourne K, Willis EA, Ptomey LT, Honas JJ, et al. Does the method of weight loss effect long-term changes in weight, body composition or chronic disease risk factors in overweight or obese adults? A systematic review. PLoS One. 2014;9(10):e109849. https://doi.org/10.1371/journal.pone.0109849

Foster GD, Wyatt HR, Hill JO, Makris AP, Rosenbaum DL, Brill C, et al. Weight and Metabolic Outcomes After 2 Years on a Low-Carbohydrate Versus Low-Fat Diet: A Randomized Trial. Ann Intern Med. 2010;153(3):147-57. https://doi.org/10.7326/0003-4819-153-3-201008030-00005

Garthe I, Raastad T, Refsnes PE, Koivisto A, Sundgot-Borgen J. Effect of two different weight-loss rates on body composition and strength and power-related performance in elite athletes. Int J Sport Nutr Exerc Metab. 2011;21(2):97-104. https://doi.org/10.1123/ijsnem.21.2.97

Hu T, Mills KT, Yao L, Demanelis K, Eloustaz M, Yancy WS, et al. Effects of low-carbohydrate diets versus low-fat diets on metabolic risk factors: a meta-analysis of randomized controlled clinical trials. Am J Epidemiol. 2012;176(suppl-7):S44-54. https://doi.org/10.1093/aje/kws264

Kirk SFL, Penney TL, McHugh TLF, Sharma AM. Effective weight management practice: a review of the lifestyle intervention evidence. Int J Obes. 2012;36(2):178-85. https://doi.org/10.1038/ijo.2011.80

Gu Y, Yu H, Li Y, Ma X, Lu J, Yu W, et al. Beneficial effects of an 8-week, very low carbohydrate diet intervention on obese subjects. Evid Based Complement Alternat Med. 2013;2013:760804. https://doi.org/10.1155/2013/760804

Naude CE, Schoonees A, Senekal M, Young T, Garner P, Volmink J. Low carbohydrate versus isoenergetic balanced diets for reducing weight and cardiovascular risk: a systematic review and meta-analysis. PLoS One. 2014;9(7):e100652. https://doi.org/10.1371/journal.pone.0100652

Institute of Medicine (IM). Dietary Reference Intakes: the essential guide to nutrient requirements. Washington: National Academy Press; 2006.

Johnstone AM, Horgan GW, Murison SD, Bremner DM, Lobley GE. Effects of a high-protein ketogenic diet on hunger, appetite, and weight loss in obese men feeding ad libitum. Am J Clin Nutr. 2008;87(1):44-55. https://doi.org/10.1093/ajcn/87.1.44

Finelli C, Crispino P, Gioia S, La Sala N, D’Amico L, La Grotta M, et al. The improvement of large High-Density Lipoprotein (HDL) particle levels, and presumably HDL metabolism, depend on effects of low-carbohydrate diet and weight loss. EXCLI J. 2016;15:166-76. https://doi.org/10.17179/excli2015-642

Ruth MR, Port AM, Shah M, Bourland AC, Istfan NW, Nelson KP, et al. Consuming a hypocaloric high fat low carbohydrate diet for 12weeks lowers C-reactive protein, and raises serum adiponectin and high density lipoprotein-cholesterol in obese subjects. Metabolism. 2013;62(12):1779-87. https://doi.org/10.1016/j.metabol.2013.07.006

Mansoor N, Vinknes KJ, Veierød MB, Retterstøl K. Effects of low-carbohydrate diets v. low-fat diets on body weight and cardiovascular risk factors: a meta-analysis of randomised controlled trials. Br J Nutr. 2016;115(3):466-79. https://doi.org/10.1017/S0007114515004699

Halyburton AK, Brinkworth GD, Wilson CJ, Noakes M, Buckley JD, Keogh JB, et al. Low- and high-carbohydrate weight-loss diets have similar effects on mood but not cognitive performance. Am J Clin Nutr. 2007;86(3):580-7. https://doi.org/10.1093/ajcn/86.3.580

Sundgot-Borgen J, Garthe I. Elite athletes in aesthetic and Olympic weight-class sports and the challenge of body weight and body compositions. J Sports Sci. 2011;29(suppl.1):S101-14. https://doi.org/10.1080/02640414.2011.565783

Teixeira CVS, Evangelista AL, Novaes JS, Grigoletto MES, Behm DG. “You’re Only as Strong as Your Weakest Link”: A Current Opinion about the Concepts and Characteristics of Functional Training. Front Physiol. 2017;8:643. https://doi.org/10.3389/fphys.2017.00643

Resende-Neto AG, Silva-Grigoletto ME, Santos MS, Cyrino ES. Treinamento funcional para idosos: uma breve revisão. Rev Bras Cienc Mov. 2016;24(3):167-77.

Stenger LMS. What is functional/neuromotor fitness? ACSM’s Health Fit J. 2018;22(6):35-43. https://doi.org/10.1249/FIT.0000000000000439

Cadore EL, Casas-Herrero A, Zambom-Ferraresi F, Idoate F, Millor N, Gómez M, et al. Multicomponent exercises including muscle power training enhance muscle mass, power output, and functional outcomes in institutionalized frail nonagenarians. AGE. 2014;36(2):773-85. https://doi.org/10.1007/s11357-013-9586-z

Aragão-Santos JC, Resende-Neto AG, Nogueira AC, Feitosa-Neta ML, Brandão LH, Chaves LM, et al. The effects of functional and traditional strength training on different strength parameters of elderly women: a randomized and controlled trial. J Sports Med Phys Fitness. 2019;59(3):380-6. https://doi.org/10.23736/S0022-4707.18.08227-0

Jiménez-Pavón D, Lavie CJ. High-intensity intermittent training versus moderate-intensity intermittent training: is it a matter of intensity or intermittent efforts? Br J Sports Med. 2017;51(18):1319-20. https://doi.org/10.1136/bjsports-2016-097015

Sobrero G, Arnett S, Schafer M, Stone W, Tolbert TA, Salyer-Funk A, et al. A Comparison of High Intensity Functional Training and Circuit Training on Health and Performance Variables in Women: A Pilot Study. Women Sport Phys Act J. 2017;25(1):1-10. https://doi.org/10.1123/wspaj.2015-0035

Boutcher SH. High-Intensity Intermittent Exercise and Fat Loss. J Obes. 2011;2011:868305. https://doi.org/10.1155/2011/868305

World Health Organization (WHO). Obesity: preventing and managing the global epidemic. Geneva: WHO, 2000.

Sociedade Brasileira de Hipertensão. Sociedade Brasileira de Cardiologia. Sociedade Brasileira de Endocrinologia e Metabologia. Sociedade Brasileira de Diabetes. Sociedade Brasileira de Estudos da Obesidade. I Brazilian guidelines on diagnosis and treatment of metabolic syndrome. Arq Bras Cardiol. 2005;84(Suppl 1):1-28.

Cohen J. Statistical power analysis for the behavioral sciences. Second edition. New Yok: Lawrence Erlbaum Associates, 1988.

Weiss EP, Albert SG, Reeds DN, Kress KS, McDaniel JL, Klein S, et al. Effects of matched weight loss from calorie restriction, exercise, or both on cardiovascular disease risk factors: a randomized intervention trial. Am J Clin Nutr. 2016;104(3):576-86. https://doi.org/10.3945/ajcn.116.131391

Schoenfeld BJ. Potential mechanisms for a role of metabolic stress in hypertrophic adaptations to resistance training. Sports Med. 2013;43(3):179-94. https://doi.org/10.1007/s40279-013-0017-1

Neves LM, Fortaleza ACS, Rossi FE, Diniz TA, Castro MR, Aro BL, et al. Efeito de um programa de treinamento funcional de curta duração sobre a composição corporal de mulheres na pós-menopausa. Rev Bras Ginecol Obstetr. 2014;36(9):404-9. https://doi.org/10.1590/SO100-720320140005073

Francois ME, Gillen JB, Little JP. Carbohydrate-Restriction with High-Intensity Interval Training: An Optimal Combination for Treating Metabolic Diseases? Front Nutr. 2017;4:49. https://doi.org/10.3389/fnut.2017.00049

Foster GD, Wyatt HR, Hill JO, McGuckin BG, Brill C, Mohammed BS, et al. A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med. 2003;348(21):2082-90. https://doi.org/10.1056/NEJMoa022207

Prado ES, Dantas EHM. Efeitos dos exercícios físicos aeróbio e de força nas lipoproteínas HDL, LDL e lipoproteína(a). Arq Bras Cardiol. 2002;79(4):429-33. https://doi.org/10.1590/S0066-782X2002001300013

Milanović Z, Sporiš G, Weston M. Effectiveness of High-Intensity Interval Training (HIT) and Continuous Endurance Training for VO2max Improvements: A Systematic Review and Meta-Analysis of Controlled Trials. Sports Med. 2015;45(10):1469-81. https://doi.org/10.1007/s40279-015-0365-0

Racil G, Ounis OB, Hammouda O, Kallel A, Zouhal H, Chamari K, et al. Effects of high vs. moderate exercise intensity during interval training on lipids and adiponectin levels in obese young females. Eur J Appl Physiol. 2013;113(10):2531-40. https://doi.org/10.1007/s00421-013-2689-5

Little JP, Safdar A, Wilkin GP, Tarnopolsky MA, Gibala MJ. A practical model of low-volume high-intensity interval training induces mitochondrial biogenesis in human skeletal muscle: potential mechanisms: Interval training adaptations. J Physiol. 2010;588(6):1011-22. https://doi.org/10.1113/jphysiol.2009.181743

Gami AS, Witt BJ, Howard DE, Erwin PJ, Gami LA, Somers VK, et al. Metabolic Syndrome and Risk of Incident Cardiovascular Events and Death. J Am Coll Cardiol. 2007;49(4):403-14. https://doi.org/10.1016/j.jacc.2006.09.032

Pattyn N, Cornelissen VA, Eshghi SRT, Vanhees L. The effect of exercise on the cardiovascular risk factors constituting the metabolic syndrome: a meta-analysis of controlled trials. Sports Med. 2013 ;43(2):121-33. https://doi.org/10.1007/s40279-012-0003-z

Caudwell P, Gibbons C, Finlayson G, Näslund E, Blundell J. Exercise, and weight loss: no sex differences in body weight response to exercise. Exerc Sport Sci Rev. 2014;42(3):92-101. https://doi.org/10.1249/JES.0000000000000019