Exercise modalities and their effects on vascular, cognitive, and mental health in obese postmenopausal women.
| Exercise type | Protocol | Vascular outcomes | Cognitive outcomes | Mental health outcomes | Key references | Limitations/Evidence gaps |
|---|---|---|---|---|---|---|
| Aerobic training (AT) | 50–70% VO2max, 3–5 sessions/week, 8–12 weeks | ↑FMD, ↓PWV, ↓CRP, ↓IL-6 | ↑Executive function,↑Memory | ↓Depressive symptoms,↑QoL | [7, 43, 47] | Stronger evidence base than other modalities, but obesity-specific and menopause-specific studies remain limited. |
| Resistance training (RT) | 50–70% 1RM, 2–3 sessions/week, 8–12 weeks | Mixed effects on arterial stiffness, ↑Skeletal muscle perfusion | Potential cognitive support | ↑Self-efficacy,↓Depressive symptoms | [50, 51, 54, 55] | Direct evidence for cognitive outcomes in obese postmenopausal women remains limited. |
| Combined training (CT) | AT + RT, 2–3 sessions/week, 12 weeks | Greatest ↑FMD,↓PWV,↓SBP,↓Inflammation | ↑Executive function,↑Processing speed | ↑Emotional well-being, ↓Anxiety/Depression | [56, 57, 59] | Comparative evidence against other modalities remains limited despite favorable multidomain findings. |
| High-intensity interval training (HIIT) | 85–95% HRmax intervals (30–90 s) + recovery, 8–12 weeks | ↑Endothelial function,↓PWV,↓Inflammation | ↑Executive function,↑Processing speed | ↓Depression/anxiety,↑Psychological well-being | [60–64] | Evidence in obese postmenopausal women is still limited, particularly for cognitive and psychological outcomes. |
| Hypoxic training | AT or CT under normobaric/ hypobaric hypoxia, 2–3 sessions/week | ↑FMD, ↓PWV,↑VEGF,↑Angiogenesis | Potential cognitive support | Potential psychological benefits | [65–67, 69–71, 73–75] | Evidence is derived partly from non-target populations, and population-specific evidence remains limited. |
CRP: C-reactive protein; FMD: flow-mediated dilation; PWV: pulse wave velocity; SBP: systolic blood pressure; QoL: quality of life; VEGF: vascular endothelial growth factor; 1RM: one-repetition maximum; ↑ indicates an increase or improvement; ↓ indicates a decrease or reduction.
This study was supported by the KU Research Professor Program of Konkuk University.
JJ: Conceptualization, Methodology, Writing—original draft, Visualization. HYP: Conceptualization, Supervision, Writing—review & editing. Both authors read and approved the submitted version.
The authors declare no conflicts of interest.
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