Training Mode Comparisons on Cardiorespiratory, Body Composition and Metabolic Profile Adaptations in Reproductive Age Women: A Systemic Review and Meta-Analysis

Round 1

Reviewer 1 Report

Review „Training mode comparisons on cardiorespiratory, body composition and metabolic profile adaptations in reproductive age 3 women: a systemic review and meta-analysis“

Thank you for the opportunity for reviewing the above-mentioned article. To ensure full transparency I am a German anesthetist and intensive care physician with a special interest in nutrition.

In their review and meta-analysis, Aparecido and colleagues compared the effects of high-intensity interval training, sprint interval training and moderate-intensity continuous training on cardiorespiratory fitness, weight and body fat mass, (fasting) plasma glucose and lipid level in reproductive-age women. Well- and less-known databases were used for literature search, and meta-analyses were conducted using Review Manager software for random-effects models. The authors were able to demonstrate that all exercise modes improved body composition and metabolic profile but nevertheless, moderate-intensity continuous training was significantly better at improving cardiorespiratory fitness compared with high-intensity interval training and with sprint interval training. The authors conclude that both high-intensity interval training and sprint interval training have the potential to be used as a training modality in reproductive-age women, with similar effects to moderate-intensity continuous training on body composition/ metabolic markers, but inferior effects on cardiorespiratory fitness, suggesting that high-intensity interval training and sprint interval training may be considered a ´´time-efficient component´´ of weight management programs. I agree with the authors that the small sample sizes in the selected studies definitely limit their findings.

The paper is well written and add valuable knowledge for the scientific community. Below you will find my (minor) remarks.

ABSTRACT:

Consider deleting abbreviations. If this is fine with the selected journal, please ignore.  

What is measured in ml.min-1.kg-1 (line 28)? Cardiorespiratory fitness expressed as…?

INTRODUCTION:

Line 43: “A Norwegian research group of great relevance in studies related to sports science”

Never heard of them –please revise with focus on the actual statement.

Otherwise well written.

MATERIALS AND METHODS:

Line 92: Why were clinicaltrials.gov or CINAHL excluded?

Line 105: Women might be fertile < 18 and > 35 years?

Line 107: Outcome instead of out-come?

Line 109: Why was 2001 selected?

Line 115: Detailed instead of de-tailed?   

Line 124: Domains instead of do-mains?

Line 124: intended instead of in-tended?

RESULTS:

Line 148 ff: After a systematic analysis, 1632 of them were excluded: 1410 by not meeting the methodological criteria stipulated in this present review and 223 by being duplicated in different databases.” 1410 + 223 = 1633?

DISCUSSION:

Line 389 ff: “This review proposed to compare the efficiency of high-intensity interval training protocols vs. MICT in women between 20 and 30 years old for an initial mapping of the current scientific evidence directed to the female public from the changes in cardiometabolic markers and body composition between both types of training.”  I am missing SIT? Pleas provide at least abbreviations of the analyzed training methods.

Line 390: “women between 20 and 30“ again another age classification - please standardize.

Line 394: gender instead of gen-der?

Line 427: influence instead of in-fluence?

Line 462: “with level of training Physical impairment” is there a punctuation mark missing?

Line 480: “Braun et al [46] add that in obese (or not) insulin resistant, ….” Consider rephrasing

Line 480: increase instead of in-crease?

Limitations: I miss “low “number of participants” or “low number of identified studies” as limitations?!

Author Response

Please see the attachment

Author Response File: Author Response.pdf

Reviewer 2 Report

This is a good systemic review of the different training mode comparisons on several metabolic parameters in reproductive-age women. Except for some typos, I'd like to suggest improving the readability of figures 2 to 6. Second, I'd suggest introducing a small section in the introduction part, indicating the importance of this study which should cover the novelty of the study and how the study could impact future clinical practices.

Author Response

Please see the attachment

Author Response File: Author Response.pdf

Reviewer 3 Report

In this paper, the authors attempt to provide a comprehensive review of the literature on the relationship between training mode and different metabolic traits. My main concern is the authors' assumption that the studies with women are inconsistent because of changes in hormone levels during the menstrual cycle, which is based on the lack of information on this topic in the literature. And yet "circumstantial evidence" could be shown, e.g., do the studies on men mostly agree with each other? Are there studies with menopausal/post-menopausal women?

The introduction describes well what is and what is not a HIT, but MICT is vaguely described.

Why such a timeframe? Since the authors received so few papers for analysis would it not be appropriate to extend the timeframe?

Did the selected publications analyze participants' diets? did they introduce a dietary intervention for participants? many of the analyzed factors change e.g. under the influence of a reducing diet. 

My specific comments are listed below:

- words unnecessarily separated by hyphens occur throughout the manuscript, e.g. line 81,124, 115, 427, 394

- the explanations of an abbreviation do not appear the first time they were used, e.g. lines 46, 48

- line 21: the usual way of doing a list is to place a comma after each item in the list, the last item in a list is often preceded by the words and or or. 

- line 21: "....(%, kg)...." - wrong order of units - % refers to body fat mass, which is listed second

- line 56: different parenthesis when citing literature

- line 76: "in this study" - it is not clear whether this is the study cited above or the work of the authors

- line 128: how did the authors assess whether in article selecting outcome reporting took place?

- line 147: why Bireme is not listed here?

- table 1: in this form, the table is very difficult to read, maybe vertical orientation would help a little? Analysis of the table is made difficult by the constant need to turn the page in search of explanations of abbreviations. Since the title line states that "S" are sessions of the training, is it necessary to state in each line "some number sessions"? Zhang study: did body composition also decrease in the CONT group? and what does a decrease in body composition mean? what does a decrease in fat mean? Kong study: what does off body composition mean? hasn't changed, hasn't been measured? Bonafiglia study: please use the English term. Perhaps arranging the abbreviations in the table in alphabetical order rather than in the order of appearance would increase readability

- line 172: in the table, the abbreviation was written in a different way

- figure 2, 3, 4, 5, 6 - Is it florest or forest plot? The figures are a little bit poor quality

- line 292: growth hormone

- line 390: in section 2.2 was 18-35 years old

- line 406: So is it gamma or alpha?

- line 479: why was reference 45 not included in the analysis?

- line 509-510: "In addition, measures suggesting other measurements suggested" - I don't understand this phrase

- line 507-509: The authors do not compare lipid and CHO metabolism between the sexes, they do not compare lipid and CHO metabolism in different phases of the menstrual cycle or between taking / not taking an oral contraceptive, and yet they conclude that "menstrual cycle, OC use, and gender, may influence relative lipid and CHO metabolism"

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 3 Report

Thank you for the consideration and inclusion of my comments. I have no further comments on the paper