A short Pilates program was associated with improvements in heart health, blood sugar control, and stress-related biomarkers, with older women showing the strongest physiological responses.
Study: Effects of a 4-week Pilates program on cardiovascular, metabolic, and neuroendocrine responses in previously sedentary adult women: An age-stratified longitudinal study. Image credit: PeopleImages/Shutterstock.com
A four-week Pilates program may improve cardiovascular, metabolic, and neuroendocrine responses in previously sedentary women, according to a new study published in the journal life.
How Pilates supports physical and mental health
Pilates is a complete mind-body exercise intervention known to improve physical strength, balance, postural control, muscular endurance, mental health, and quality of life in a wide variety of people. Due to its various physical and psychological benefits, it has attracted great attention in physical therapy, rehabilitation, and preventive medicine settings.
The Pilates approach is fundamentally based on six principles: Breathing, Concentration, Control, Precision, Centering, and Flow. Existing evidence shows that regularly practicing Pilates not only improves physical fitness, but also reduces mental distress and improves mental well-being.
Given the well-documented evidence for the physical and mental benefits of various mind-body exercise interventions, this study aimed to investigate the effects of a 4-week structured Pilates program on cardiovascular, metabolic, anthropometric, and neuroendocrine responses in previously sedentary adult women.
Sedentary woman completes 4 weeks of Pilates
This longitudinal study included 30 sedentary women stratified into two age groups: 30–40 years and 50–60 years. All participants followed a standardized supervised Pilates program designed to induce gradual physiological adaptations. The intervention period was 4 weeks, with 3 sessions per week, and each session lasted 50–60 minutes.
Participants’ resting heart rate, systolic and diastolic blood pressure, body mass index (BMI), waist circumference, fasting blood sugar, and serum cortisol (a stress hormone) were assessed at baseline and after completion of the intervention.
Pilates improved multiple health measures in women
A 4-week Pilates program was associated with improvements in cardiovascular, metabolic, anthropometric, and neuroendocrine measures, although not all changes were statistically significant within each age group.
In the younger age group, significant reductions in heart rate, blood pressure, BMI, and fasting blood glucose were observed after 4 weeks of intervention. Post-intervention blood pressure reductions were significantly greater in the older age group than in the younger age group. Participants in older age groups also had significantly lower blood sugar and cortisol levels after the intervention than participants in younger age groups.
Correlation analyzes revealed significant associations between cardiovascular, metabolic, and neuroendocrine adaptations, particularly between heart rate and blood pressure responses in the younger group, and changes in BMI and fasting blood glucose levels in the older group.
Pilates may support cardiometabolism and stress regulation
This study highlights findings supporting Pilates as a potentially useful multifaceted exercise intervention for cardiometabolic health and stress regulation. Specifically, this study reveals that a 4-week Pilates program is associated with favorable cardiovascular, metabolic, anthropometric, and neuroendocrine adaptations in previously sedentary women.
In the 30-40 and 50-60 year age groups, significantly greater blood pressure reductions were observed in the older age groups. This may be due to a higher cardiometabolic load at baseline, which may lead to a higher likelihood of improvement after intervention.
Similarly, the relatively greater reductions in fasting blood glucose and cortisol levels observed in older participants suggest that those with higher baseline metabolic and neuroendocrine dysfunction may benefit more from structured exercise interventions such as Pilates.
Although Pilates is known to improve body composition by increasing energy expenditure and neuromuscular activation and improving adherence to healthy behaviors, the researchers believe that the magnitude of the reduction in BMI observed over four weeks is likely not explained by Pilates training alone. Rather, the researchers believe that the observed changes were due to the combined effects of Pilates and dietary modification, as participants were instructed to avoid alcohol, sugar-containing products, and sugar-sweetened beverages during the intervention period.
In younger age groups, the observed correlation between heart rate and blood pressure suggests that the cardiovascular response after Pilates intervention is coordinated. Similarly, the observed negative correlation between cortisol and blood pressure and positive correlation between cortisol and BMI suggest that neuroendocrine adaptations may be closely linked to cardiovascular and anthropometric modulation after intervention.
In the elderly group, a positive association was observed between BMI and fasting blood glucose levels, highlighting the relationship between obesity and metabolic regulation. Similarly, the observed positive correlation between blood pressure and BMI suggests that improved vascular regulation may be associated with weight loss.
Overall, the findings indicate that Pilates-induced physiological adaptations involve interrelated cardiovascular, anthropometric, metabolic, and neuroendocrine mechanisms, with different response patterns depending on age.
Short-term findings require long-term confirmation
Due to the absence of a non-experimental control group, this study lacks internal validity and definitive causal inference. Additionally, the relatively small sample size reduces statistical power and limits the generalizability of the results. The authors also noted that cortisol was assessed using a single morning fasting measurement, which limits conclusions regarding broader hypothalamic-pituitary-adrenal (HPA) axis regulation.
Larger studies with longer follow-up periods are needed in the future to more definitively establish a causal relationship between Pilates training and physiological adaptations.
Click here to download your PDF copy.
Reference magazines:
- Onu A. (2026). Effects of a 4-week Pilates program on cardiovascular, metabolic, and neuroendocrine responses in previously sedentary adult women: an age-stratified longitudinal study. life. Doi: https://doi.org/10.3390/life16060945 https://www.mdpi.com/2075-1729/16/6/945
