Effect of Pilates Exercise versus Aerobic Exercise on Metabolic Syndrome in Pre-menopausal Women

Background and purpose Metabolic syndrome (MetS) is a major global health concern associated with increased cardiovascular risk. While various exercise interventions are recommended, their comparative effectiveness and underlying impact on metabolic regulation remain insufficiently clarified. This study aimed to compare the effects of aerobic exercise and Pilates on key metabolic and cardiovascular indicators in pre-menopausal women with MetS. Materials and Methods Sixty pre-menopausal women (aged 35–45 years; BMI 30–35 kg/m²) diagnosed with MetS were randomly assigned to three groups: control, Pilates, and aerobic exercise. Over 12 weeks, intervention groups followed structured exercise programs alongside lifestyle recommendations. Outcome measures included BMI, waist circumference, mean arterial pressure, and lipid profile. Results Both exercise interventions significantly improved all measured parameters compared to the control condition (p<0.001). However, aerobic exercise demonstrated superior effects across most metabolic indicators, suggesting a stronger influence on cardiovascular and lipid regulation mechanisms. Conclusion The findings indicate that while both exercise modalities are effective, aerobic exercise may play a more pronounced role in modulating key components of metabolic syndrome. These results support the prioritization of aerobic interventions in rehabilitation strategies and suggest broader implications for optimizing exercise-based approaches to metabolic health beyond the studied population. Trial Registration: Pan African Clinical Trials Registry (PACTR) (No. PACTR202403566263718).