Effect of Pilates Exercises Versus Intermittent Fasting Diet on Physical and Metabolic Aging Process in Obese Perimenopausal Women

Obesity is associated with a shorter life expectancy, partly due to its role in accelerating the aging process. The conditions and comorbidities linked to obesity mirror those of age-related diseases. Individuals with obesity are at a higher risk for various age-related conditions, including cardiovascular disease (CVD), hypertension, type 2 diabetes mellitus (T2DM), and cance.

Aging is a natural part of the human life cycle, characterized by a gradual loss of physiological integrity, leading to functional decline and increased vulnerability to mortality. Alongside the onset of age-related diseases in older adults, common aging phenotypes, such as redox imbalance, mitochondrial dysfunction, increased apoptosis, cellular senescence, insufficient autophagy, and chronic inflammation, are observed in both humans and animals. Similar mechanisms underpin the onset of age-related diseases in obesity and excessive calorie intake, suggesting that obesity accelerates aging through these interconnected pathways.

Pilates has gained popularity as a holistic exercise approach that emphasizes respiration, body control, and movement precision. Current research supports the positive effects of Pilates on respiratory muscle strength, balance, overall physical performance, and quality of life. Additionally, a recent systematic review and meta-analysis concluded that Pilates is an effective alternative for improving maximal oxygen uptake (VO2max) values.

Fasting, which involves abstaining from food for extended periods ranging from hours to days, triggers significant metabolic changes referred to as the 'metabolic switch'. One of the most important metabolic shifts during fasting is the increased production of ketone bodies, such as acetoacetic acid, β-hydroxybutyric acid (β-HB), and acetone, in the liver.

Given the heightened vulnerability of obese perimenopausal women to accelerated aging processes and metabolic dysfunction, there is a critical need to identify the most effective lifestyle interventions for this high-risk population. While both Pilates exercise and intermittent fasting show promise in addressing aging-related parameters through different mechanisms, no direct comparative studies have evaluated their relative efficacy on comprehensive physical and metabolic aging markers in obese perimenopausal women.