Comparative effects of aerobic exercise intensity strategies on cardiorespiratory fitness and cardiometabolic risk factors in overweight and obese postmenopausal women

[Purpose] This study compared the effects of moderate-intensity exercise (MIE), vigorous-intensity exercise (VIE), and combined moderate- and vigorous-intensity exercise (CIE) on cardiorespiratory fitness, anthropometric variables, cardiometabolic risk factors, and adipokine levels in overweight and obese postmenopausal women under matched exercise energy expenditure conditions.[Methods] Seventy-four postmenopausal women completed the study: MIE (<i>n</i> = 19), CIE (<i>n</i> = 20), VIE (<i>n</i> = 17), and control (CON; <i>n</i> = 18). Participants in the exercise groups performed supervised aerobic training for 12 weeks with matched energy expenditure (approximately 1,700 kcal/week). Outcomes were assessed pre- and post-intervention using two-way repeated-measures ANOVA.[Results] VO<sub>2</sub>peak increased significantly in all exercise groups compared to CON, with no significant differences between the groups. Body weight and body mass index (BMI) decreased significantly in all exercise groups compared with those in the CON group. Decreases in waist circumference were greater in the CIE and VIE groups than in the CON group, whereas changes in body fat percentage were less consistent. Fasting insulin and Framingham Risk Score-related indices improved in some groups, whereas blood pressure, triglyceride, and glucose levels showed no consistent between-group differences. Leptin levels decreased significantly in all the exercise groups, with greater reductions observed in the CIE and VIE groups than in the CON group. Only adiponectin demonstrated a significant change over time.[Conclusion] Energy-matched aerobic exercise improved cardiorespiratory fitness and several anthropometric outcomes regardless of intensity. However, exercise programs incorporating vigorous-intensity components yielded greater reductions in waist circumference, indicating additional benefits for abdominal obesity-related outcomes.