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 inaccelerating the aging process. The conditions and comorbidities linked to obesity mirrorthose of age‐related diseases. Individuals with obesity are at a higher risk for variousage‐related conditions, including cardiovascular disease (CVD), hypertension, type 2diabetes mellitus (T2DM), and cance.Aging is a natural part of the human life cycle, characterized by a gradual loss ofphysiological integrity, leading to functional decline and increased vulnerability tomortality. Alongside the onset of age‐related diseases in older adults, common agingphenotypes, such as redox imbalance, mitochondrial dysfunction, increased apoptosis,cellular senescence, insufficient autophagy, and chronic inflammation, are observed inboth humans and animals. Similar mechanisms underpin the onset of age‐related diseases inobesity and excessive calorie intake, suggesting that obesity accelerates aging throughthese interconnected pathways.Pilates has gained popularity as a holistic exercise approach that emphasizesrespiration, body control, and movement precision. Current research supports the positiveeffects of Pilates on respiratory muscle strength, balance, overall physical performance,and quality of life. Additionally, a recent systematic review and meta‐analysis concludedthat Pilates is an effective alternative for improving maximal oxygen uptake (VO2max)values.Fasting, which involves abstaining from food for extended periods ranging from hours todays, triggers significant metabolic changes referred to as the 'metabolic switch'. Oneof the most important metabolic shifts during fasting is the increased production ofketone bodies, such as acetoacetic acid, β‐hydroxybutyric acid (β‐HB), and acetone, inthe liver.Given the heightened vulnerability of obese perimenopausal women to accelerated agingprocesses and metabolic dysfunction, there is a critical need to identify the mosteffective lifestyle interventions for this high‐risk population. While both Pilatesexercise and intermittent fasting show promise in addressing aging‐related parametersthrough different mechanisms, no direct comparative studies have evaluated their relativeefficacy on comprehensive physical and metabolic aging markers in obese perimenopausalwomen.