Effects of exercise on metabolic risk, cardiovascular fitness, and body composition in elderly women of the past decade: a systematic review and meta-analysis.

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Original abstract

<h4>Background</h4>Age-related reductions in physical activity and unfavorable body composition changes promote metabolic dysfunction and cardiovascular risk elevation in older populations. Due to estrogen-related factors, differences in cardiovascular risks, and musculoskeletal conditions, exercise may be one of the most accessible and widely applicable lifestyle interventions for older women. A comprehensive and systematic search has not yet been carried out on the effects of exercise on cardiovascular risk and its related indicators in elderly women. This meta-analysis evaluates exercise effects on metabolic risk, cardiovascular health, and body composition in healthy elderly women.<h4>Methods</h4>Following PRISMA guidelines, we systematically searched PubMed, Cochrane Library, Web of Science, Embase, Scopus, CNKI, VIP, Wanfang, and Sinomed (2014-2024) for randomized controlled trials (RCTs) comparing supervised exercise with nonexercise controls. Data were analyzed with fixed- and random-effect models in Stata 17.0. The Cochrane RoB2 tool assessed bias risk, while the certainty of evidence was evaluated through the GRADE approach.<h4>Results</h4>Twenty-three RCTs (33 intervention arms, 23 controls) were included. Exercise significantly reduced triglycerides (TG) (-8.56 mg/dL, 95% CI: -16.72, -0.40), total cholesterol (TC)(-26.67 mg/dL, 95% CI: -34.92, -18.42), low-density lipoprotein cholesterol (LDL-C) (-23.77 mg/dL, 95% CI: -34.48, -13.05), blood glucose (Glu) (-5.59 mg/dL, 95% CI: -10.12, -1.06), and C-reactive protein (CRP) (-0.86 mg/L, 95% CI: -1.37, -0.35). Cardiovascular improvements included increased VO2peak (+2.78 mL/kg/min, 95% CI: 1.87, 3.70) and reduced systolic blood pressure (SBP) (-8.35 mmHg) and diastolic blood pressure (DBP) (-3.26 mmHg). Regarding body composition, relative body fat (RF, i.e. body fat percentage) decreased (-2.47%, 95% CI: -3.42, -1.53), but no significant changes were observed in body weight, trunk fat mass (TFM), waist circumference (WC), fat-free mass (FFM), or skeletal muscle mass (SMM). According to the GRADE framework, the evidence was of moderate certainty for reductions in TC, TG, RF, VO₂peak, and SBP; and low certainty for all other outcomes.<h4>Conclusion</h4>This meta-analysis provides evidence that appropriate exercise (aerobic, resistance, combined exercise) effectively reduces cardiovascular risk factors in elderly women via dual mechanisms of body composition remodeling and metabolic homeostasis enhancement, with particular efficacy in lipid regulation and blood pressure control.

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