Effects of Individualized Periodized Combined Training on Lipid Profile and Atherogenic Cardiovascular Risk in Sedentary Middle-aged Colombian Women

Background: Cardiovascular disease remains the leading cause of death among women, with cardiometabolic risk increasing during the menopausal transition due to adverse changes in lipid metabolism, body fat distribution, vascular function, and systemic inflammation. Although combined exercise is recommended for cardiovascular prevention, evidence on individualized periodized exercise regulated through internal monitoring of training load remains scarce in sedentary Latin American women. Objective: To evaluate the effects of a 20-week individualized periodized combined training program on body mass index, waist circumference, lipid profile, and atherogenic cardiovascular risk assessed by the Castelli Risk Indices in sedentary Colombian women aged 50 to 60 years. Methods: A single-group, pretest-posttest quasi-experimental study was conducted with 15 sedentary Colombian women (55.4 ± 3.2 years). Participants completed a supervised, individualized, 20-week periodized combined training program that included three weekly aerobic and strength training sessions (60 min/session) and two weekly unsupervised walking sessions. Exercise intensity was individualized using the TRIMP (Banister Training Impulse) model and the sRPE scale. Body mass index, waist circumference, lipid profile, and Castelli risk indices I and II were assessed before and after the intervention. Wilcoxon signed-rank tests, Rosenthal effect sizes, Hodges-Lehmann estimators, and Spearman correlation analysis were used to analyze the effects of the intervention. Results: Program adherence was 88.3%, and no exercise-related adverse events were reported. Significant improvements were observed in total cholesterol (−8.2%, p < 0.001), LDL cholesterol (−11.6%, p < 0.001), HDL cholesterol (+4.1%, p < 0.001), waist circumference (−3.8%, p < 0.001), Castelli risk index I (−11.7%, p < 0.001), and Castelli risk index II (−14.6%, p < 0.001). Triglycerides decreased, although the absolute magnitude of the change was small (−0.3%, p = 0.005). Large Rosenthal effect sizes (r = 0.55–0.94) were observed for all clinically significant outcomes. Greater reductions in waist circumference were associated with greater decreases in LDL cholesterol (ρ = 0.672, p = 0.006) and the Castelli Risk Index II (ρ = 0.650, p = 0.009). Conclusions: Individualized, periodized combined training regulated by internal monitoring of objective (TRIMP) and subjective (sRPE) training load resulted in clinically significant improvements in body mass index, waist circumference, lipid profile, and atherogenic cardiovascular risk in previously sedentary middle-aged Colombian women. These findings support individualized, periodized combined training with internal monitoring of training load as an effective community-based strategy for precision exercise medicine to improve cardiometabolic health and reduce cardiovascular risk in sedentary middle-aged women.