The effect of intermittent hypoxia-normoxia training on exercise metabolism during a multi-component high-intensity interval training

Authors: Maria Emmanouilidou, Dimitrios Balampanos, Dimitrios Draganidis, Theodoros Stampoulis, Christos Kokkotis, Maria Protopapa, Dimitrios Pantazis, Nikolaos Orestis Retzepis, et al.

Arch.Life.Sci.Res. 2026. vol. 2, Iss. 1 pp:36-52
Doi: https://doi.org/10.51585/alsr.2026.1.0012

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Abstract:

Over the last few decades, there has been a significant increase in the scientific community's interest in IHNT, fueled by accumulating evidence of its therapeutic potential for enhancing athletic performance, cardiovascular disease, neurodegenerative conditions, and metabolic disorders. The aim of the study was to examine the acute metabolic and physiological impacts of intermittent hypoxia–normoxia training (IHNT), multicomponent high-intensity interval training (m-HIIT), and their combination in healthy people. Twelve physically active males participated in three randomized crossover trials: IHNT, m-HIIT, and a combination of IHNT and m-HIIT. Blood samples were taken before, immediately after, 1 hour after, and 3 hours after the intervention to assess the metabolic markers. Cardiorespiratory responses were monitored over time. IHNT produced a distinct hypoxic stimulus, as seen by decreased arterial oxygen saturation (SpO2), an elevated heart rate (HR) during hypoxic cycles, and increased levels of Hypoxia-Inducible Factor-1α (HIF-1α). IHNT caused small, short-lived rises in glucose and albumin levels, but it didn't affect insulin sensitivity or lipid indicators. Conversely, m-HIIT and the combined trial resulted in significant acute elevations in glucose, insulin, Homeostasis model assessment index of insulin resistance (HOMA-IR), glycerol, and lactate, indicating considerable metabolic and glycolytic stress. During recuperation, triglyceride levels decreased, although vitamin D and urea demonstrated trial-specific temporal variations. These results indicate that a single trial of IHNT activates metabolic and physiological responses by increasing HIF-1a. levels, HR, glucose, and reducing SpO2. Additionally, m-HIIT enhances glycolysis, and a trial of exercise following IHNT modifies carbohydrate and lipid levels, stimulated by glycogenolysis and gluconeogenesis.

Keywords:

IHNT, m-HIIT, Glycolysis, Glucose homeostasis, Vitamin D

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