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A 12-week mat Pilates intervention improves endothelial function in both non-obese and obese middle-aged women, but body-composition changes differ by obesity status.

In an uncontrolled secondary analysis of 32 premenopausal middle-aged women, a 12-week mat Pilates program significantly improved flow-mediated dilation in both non-obese (+15.6%) and obese (+29.7%) groups. Significant group-by-time interactions were found for body weight, fat mass, and percent body fat, indicating obesity-dependent body-composition responses, but not for other cardiometabolic outcomes.

Last updated: Aug 28, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. BMI-Stratified Physiological Responses to a 12-Week Mat Pilates Intervention on Body Composition, Cardiometabolic Risk Factors, and Autonomic Function in Middle-Aged Women: An Exploratory Secondary Analysis.

observational

Jung WS, Kim WJ, Lee E, An H, Park HY · Metabolites (2026)

Participants: N/A
Duration: 12 weeks
Intervention: 12-week mat Pilates program, 60-minute sessions three times weekly, with intensity progressed every four weeks.
Outcome: Body composition (weight, fat mass, percent body fat), endothelial function (flow-mediated dilation), blood pressure, lipids, haemorheology, autonomic function.
Effect Size: N/A (not reported in abstract)
Population: 32 premenopausal middle-aged women (mean age 47.5 ± 7.6 years), stratified by BMI into non-obese (<25 kg/m2, n=14) and obese (≥25 kg/m2, n=18) using WHO Asia-Pacific criteria.

Result:

PubMed: 42646256DOI: 10.3390/metabo16080517

Mechanism Graph

Mat Pilates exercises improve endothelial function via increased shear stress and nitric oxide bioavailability.
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Exercise-induced improvements in body composition may reduce adiposity-related inflammation and metabolic risk.
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Obesity status may modulate the magnitude of body-composition adaptations to exercise.
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Result: Endothelial function improved in both groups, but body-composition changes differed by obesity status.

Limitations

  • ⚠Uncontrolled single-arm design without a non-exercising control group, preventing causal attribution.
  • ⚠No objective monitoring of diet, non-exercise activity, sleep, or menstrual-cycle phase, which may confound results.
  • ⚠Exploratory secondary analysis with small sample size; between-group contrasts were not reproduced when adiposity was modeled continuously, suggesting hypothesis-generating findings.

Frequently Asked Questions

Did mat Pilates improve endothelial function in both obese and non-obese women?▼

Yes, flow-mediated dilation increased significantly in both groups, with a larger relative increase in obese women (+29.7%) compared to non-obese (+15.6%).

Were there differences in body composition changes between obese and non-obese women?▼

Yes, significant group-by-time interactions were observed for body weight, fat mass, and percent body fat, indicating that obesity status influenced these outcomes.

Can these results be attributed to mat Pilates?▼

No, because the study lacked a non-exercising control group, so the observed changes cannot be causally attributed to the intervention.

What are the implications for clinical practice?▼

Mat Pilates may be beneficial for improving endothelial function in middle-aged women regardless of BMI, but BMI-dependent effects on body composition require confirmation in randomized controlled trials.

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References

  1. 1.Jung WS, Kim WJ, Lee E, An H, Park HY. "BMI-Stratified Physiological Responses to a 12-Week Mat Pilates Intervention on Body Composition, Cardiometabolic Risk Factors, and Autonomic Function in Middle-Aged Women: An Exploratory Secondary Analysis.." Metabolites, 2026. PMID: 42646256 DOI: 10.3390/metabo16080517
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.