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July 26, 2026MetabolitesOpen Access

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

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Key result

Mat Pilates is linked to improved flow-mediated dilation and obesity-dependent body composition changes in women.

  • P<0.05
  • n=32

Why the study?

Mat Pilates is widely recommended for middle-aged women, but whether baseline obesity modifies its effects remains unclear.

Does a 12-week mat Pilates programme improve body composition and cardiometabolic risk factors in middle-aged women, and does baseline obesity modify these effects?

Population

32 premenopausal middle-aged women

Comparison

Non-obese (BMI <25 kg/m2) vs obese (BMI ≥25 kg/m2) groups undergoing mat Pilates

Design

Exploratory secondary analysis of an uncontrolled single-arm intervention cohort

Follow-up

12 weeks

Authors

WJWon‐Sang JungWKWon-Je KimELEunjoo Lee

Discussion

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Overview

May enhance endothelial function across obesity strata; leaves open differential responses pending randomized confirmation.

Key Points

  • To determine how baseline obesity modifies the effects of a 12-week mat Pilates program on various health outcomes in middle-aged women.
  • Exploratory secondary analysis of an uncontrolled cohort study with 32 premenopausal women (47.5 ± 7.6 years)
  • Participants categorized into non-obese (<25 kg/m²) and obese (≥25 kg/m²) groups and completed 60-minute sessions three times weekly for 12 weeks
  • Outcomes analyzed using mixed-design ANOVA and Bonferroni-corrected paired t-tests.
  • Body weight, fat mass, and percent body fat showed significant group × time interactions (p < 0.05).
  • Flow-mediated dilation increased significantly in both groups (NOG +15.6%, OG +29.7%; p < 0.05).
  • Obesity-dependent changes were noted only for body-weight and composition; other outcomes showed no significant differences between groups.

Study Design

Type

Cohort (n=32)

Structured PICO

Does a 12-week mat Pilates programme improve body composition and cardiometabolic risk factors in middle-aged women, and does baseline obesity modify these effects?

P
Population
32 premenopausal middle-aged women (mean age 47.5 years) who completed a 12-week mat Pilates programme, stratified by baseline BMI into non-obese and obese groups.
E
Exposure
12-week mat Pilates programme, consisting of 60-minute sessions three times weekly, with intensity progressed every four weeks.
O
Outcome
Changes in body-composition, cardiovascular, blood-metabolic, haemorheological and autonomic endpoints at 12 weeks.surrogate

Main Result

Absolute Event Rate: 29.7% vs 15.6%

p-value: p=< 0.05

A 12-week mat Pilates program improved endothelial function in middle-aged women, with differential body composition responses depending on baseline obesity status, though lack of a control group limits causal inference.

Limitations

  • Lacked a non-exercising control group, so associations cannot be attributed causally to mat Pilates.
  • Apparent BMI dependence was not reproduced when adiposity was modelled continuously.
  • All between-group contrasts are hypothesis-generating.
  • Lacked a non-exercising control group
  • Apparent BMI dependence was not reproduced when adiposity was modelled continuously
  • Lack of objective monitoring of diet, non-exercise activity, sleep and menstrual-cycle phase

Cite This Study

Jung et al. (2026) conducted a cohort in Premenopausal middle-aged women (n=32). Obesity (BMI ≥25 kg/m2) vs. Non-obese (BMI <25 kg/m2) was evaluated on Flow-mediated dilation (p=< 0.05). In middle-aged women undergoing a 12-week mat Pilates programme, flow-mediated dilation increased in both obese (+29.7%) and non-obese (+15.6%) groups, with significant group-by-time interactions for body composition.

synapsesocial.com/papers/6a65a660d3aea3239cd77c2fhttps://doi.org/10.3390/metabo16080517
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Effects of a mat pilates program on cardiometabolicparameters in elderly women2013 · 64 citations
  2. 2Effects of a 4-Week Pilates Program on Cardiovascular, Metabolic, and Neuroendocrine Responses in Previously Sedentary Adult Women: An Age-Stratified Longitudinal Study2026
  3. 3Eight-week mat Pilates improves blood pressure, vascular, and autonomic function in adults with elevated blood pressure or stage 1 hypertension2026
  4. 4The Influence of Mat Pilates Training on Cardiometabolic Risk Factors in Postmenopausal Women with Single or Multiple Cardiometabolic Diseases2025 · 2 citations
  5. 5The Effects of Mat Pilates Training on Vascular Function and Body Fatness in Obese Young Women With Elevated Blood Pressure2020 · 40 citations