Six HIT Sessions Improve Cardiorespiratory Fitness and Metabolic Flexibility in Insulin Resistant and Insulin Sensitive Adolescents with Obesity
, Hellyelson Lopes de Omena Couto 1, Thais Miriã da Silva Santos 1, Alison Fabiano Cunha Cruz 1, Nayara Barbosa Lopes 1, Marcelo Santin Cascapera 2, Vivian Bertoni Xavier 3, Cristiane Kochi 4, Vera Lúcia dos Santos Alves 5 and Antonio Herbert Lancha, Jr. 6Round 1
Reviewer 1 Report
This manuscript described a 2-week, 6 session HIT intervention in adolescents with obesity who were either insulin resistant or sensitive. The authors are to be commended on their strong methods and the novelty of findings. Below are some comments they may wish to consider.
Minor
1. Page 1, line 24: First sentence in abstract seems to be missing “To” before evaluate.
2. Page 1, line 38: “in CHOox” should be ‘CHOox’.
3. Page 1, line 39”: consider changing ‘controlling physical fitness’ to ‘increasing physical fitness and controlling glycemia’.
4. Title: Suggest changing title to “Six HIT sessions improve cardiorespiratory fitness and metabolic flexibility in insulin resistant and insulin sensitive adolescents with obesity” to be more descriptive and use people-first language.
5. There are several grammatical errors throughout that the authors should consider correcting.
Major
1. Figure 1: It’s surprising that 190 potential participants refused to participate or were unable to attend just 6 sessions. This should be discussed in terms of feasibility and generalizability of results, as this may cause a selection bias because the participants who agreed were more motivated to participate or perhaps had greater baseline fitness. Also, why weren’t the sessions at times when parents could bring the children to participate? This may have unnecessarily excluded people who wanted to participate and biased your demographics (e.g., higher SES families).
Author Response
Please see the attachment.
Author Response File: 
Author Response.docx
Reviewer 2 Report
The topic is interesting, the paper is well written and structured. Some clarification would be needed in my opinion as following.
In the introduction there is a theoretical background about obesity but not about insulin resistance, which should be included.
The sample seems to have included both children from the schools and from an hospital (?) Who were that children from the hospital? Did they have a medical condition? Or were they just in a regular following procedure?
All the individuals included were obese? this is not clear along the paper. Please clarify.
Author Response
Please see the attachment.
Author Response File: Author Response.docx
