Energy-matched exercise and metabolic syndrome: anthropometric, metabolic, and adherence outcomes

Background: Metabolic syndrome (MS) is characterized by clustered metabolic risk factors and is strongly associated with physical inactivity and impaired metabolic regulation. Exercise training is an established non-pharmacological intervention; however, it remains unclear whether health-related adaptations depend primarily on exercise modality or on total training load. The present study investigated anthropometric, metabolic, and adherence-related outcomes following exercise modalities matched by adjusting weekly training duration to achieve broadly comparable prescribed weekly energy exposure in individuals with MS. Participants undertook aerobic treadmill training (AER, 300 min/week), high-intensity interval training (HIIT, 200 min/week), or whole-body vibration training (WBVT, 150 min/week). Results: All three groups showed significant pre–post changes in several outcomes; however, significant between-group differences were observed for some anthropometric parameters. Distinct patterns of substrate utilization were observed across modalities. Lack of time was the most frequently reported reason for dropout. Conclusions: Among participants who completed the intervention, all three training protocols were associated with changes in several anthropometric, metabolic, and inflammatory outcomes under conditions designed to provide broadly comparable prescribed weekly exercise energy exposure. These findings are consistent with weekly exercise energy exposure being an important contributor to the observed responses, while not excluding modality-specific effects. However, they do not establish that exercise modality is unimportant or that the investigated protocols are equally effective in the broader population of individuals with MS. The high attrition rate further limits generalization of the findings.