After menopause, even light aerobic exercise may move blood sugar and triglycerides

After menopause, reductions in ovarian hormones increase the risk of cardiovascular disease, making this a life stage where heart health deserves particular attention. Aerobic exercise training reduces cardiovascular risk in older adults generally, but its effectiveness specifically in postmenopausal females has been less definitive. There is also a practical question hiding inside the general one: does the intensity of aerobic exercise matter for these outcomes, or does any level of effort deliver similar results? This review set out to answer both, pooling every eligible randomised trial of aerobic training in postmenopausal women.

The researchers searched six electronic databases from inception to July 21, 2023 for randomised controlled trials of aerobic training that reported cardiometabolic outcomes in postmenopausal females. They identified 59 studies covering 4,225 women aged 45 to 78, with 53 studies of 3,821 participants included in the quantitative analyses. The interventions varied widely: frequency ranged from 3 to 21 sessions per week, sessions lasted 8 to 60 minutes, and programmes ran from 3 to 52 weeks. Random-effects meta-analyses were performed alongside subgroup analyses by light, moderate and vigorous intensity, with the certainty of the evidence formally graded.

Aerobic training improved a broad sweep of outcomes: systolic blood pressure fell by 4.41 mmHg, resting heart rate by 3.08 beats per minute, BMI by 0.65, waist circumference by 2.03 cm, and body fat by 2.57 kg. LDL cholesterol dropped by 10.46 mg/dL while HDL rose by 3.28 mg/dL, and cardiorespiratory fitness improved substantially. Crucially, the certainty of evidence was rated very low for all outcomes. The subgroup analyses produced the surprise: light and vigorous intensities benefited BMI while moderate intensity showed no effect, and light intensity showed benefits for blood glucose and triglycerides where moderate and vigorous intensities did not.

The overall direction confirms what is known in older adults generally: aerobic training tends to improve cardiometabolic health, and this review extends that specifically to postmenopausal women. The intensity pattern complicates the common assumption that harder is better, since light effort was the only level tied to glucose and triglyceride improvements. The authors are explicit that this warrants further investigation, and the very low certainty ratings across every outcome mean none of these estimates should be treated as precise. Head-to-head intensity trials in this population are the obvious next step.

For women past menopause, this is a reason to think aerobic exercise of many kinds is associated with a healthier cardiometabolic profile, from blood pressure to cholesterol to body composition. It is also a reason not to assume that only hard sessions count: in these pooled comparisons, light-intensity work was the level linked to better blood glucose and triglycerides. The evidence quality is weak throughout, so this describes a promising pattern rather than an established rule about how hard to train.