**4. Health-enhancing physical exercise for the management of excessive body weight in middle-aged women**

Solving the issue of overweight by workouts in gyms and fitness studios is complicated by periodic bans and quarantine restrictions on the operation of the latter, so the search for an alternative becomes particularly relevant. In light of the mentioned facts, designing independent preventive and health-enhancing workouts aimed at body weight management and their further implementation for middle-aged women is a full-fledged alternative for group exercise classes. The need for scientific substantiation of the criteria for assessing the effectiveness of independent workouts aimed at body weight management in middle-aged women determined the direction of our research.

The treatment of overweight in middle-aged women includes planning, managing, and controlling certain indicators to achieve the basic goal, that is, effective management of body weight. Body weight measurements are already criteria that allow for evaluation of the effectiveness of a body weight management program. However, our research allows us to suggest a more comprehensive approach to the organization of the management of excessive body weight using physical exercise [92]. We

have identified and substantiated a list of indicators of physical condition, which, in our opinion, should serve as benchmarks in the planning, management, and control of excessive body weight in middle-aged women. Furthermore, we developed the recommendations that include the most effective parameters of physical exercise workouts aimed at body weight management in middle-aged women. Taken together, the proposed approach to planning, managing, and controlling excessive body weight can be seen as an original strategy for improving health in middle-aged women.

The following methods were used to address the objectives of the study—theoretical analysis of special scientific and methodological literature; anthropometric, physiological, and pedagogical methods; and mathematical statistics. The physiological research methods used were as follows—assessment of adaptation potential, assessment of the level of physical health using the Apanasenko technique, and measurement of vital capacity (VL) using ergospirometric system Oxycom Pro. Oxygen saturation was measured with a pulse oximeter Beurer PO 80 (Germany). To assess the level of physical fitness and evaluate the maximum oxygen consumption (VO2max) as well as the aerobic and anaerobic thresholds, cardiopulmonary exercise tests were performed with a treadmill (LE-200 CE, Jaeger, Germany). Pedagogical testing included performing several physical fitness tests from the Eurofit battery to determine the level of physical condition. The results of the study were subjected to statistical data analysis using conventional tools of Statistica 10.0 statistical software.

The data obtained during the study allowed to identify "problematic" indicators of physical and functional condition (such as signs of visceral obesity, risks of metabolic syndrome, hypertension, tachycardia, and an unsatisfactory level of adaptation potential) in overweight women. The identification of "problematic" indicators, in turn, allowed to provide recommendations on the most desirable profile of the organization of fitness classes for middle-aged women, that is, preventive and healthenhancing classes. Among the different variations of the means used in the modern fitness industry, the programs with preventive and health-enhancing goals are the most expedient in the framework of the management of excessive body weight. The validity of our recommendations was also confirmed by the results of our study of the motivational priorities of fitness classes in middle-aged women (n = 105). Good health was indicated as a priority motive for the participation in physical exercise classes by 82.7% of respondents. Moreover, a low level of quality of life in the parameter of health was observed in the studied contingent according to the Scale of Quality of Life (SF-36). Summing up, we can conclude that the most appropriate profile for organizations of fitness classes is preventive and health-enhancing classes.

Factor analysis was used to develop the most informative criteria for assessing the effectiveness of independent preventive and health-enhancing workouts for overweight middle-aged women. As a result of the analysis, four factors were identified that account for 81.4% of the total variance in the original data. We found that the largest factor loadings (42.1% of the total variance of the sample) had indicators that characterize physical development. This factor 1 included 14 indicators—chest circumference (CC) at inhalation (r = 0.875 at p < 0.01); chest circumference (CC) at exhalation (r = 0.848 at p < 0.01); relative muscle mass (r = 0.777 at p < 0.01); chest excursion (r = 0.768 at p < 0.01); and basal metabolic rate (r = 0.711 at p < 0.01). The following indicators had negative factor loading—abdomen circumference (r = −0.927 at p < 0.01); waist circumference (r = −0.926 at р < 0.01); waist-to-hip ratio (WHR) (r = −0.922 at р < 0.01); CC (r = 0.893 at р < 0.01); the waist-to-height ratio (WHtR) (r = −0.884 at р < 0.01); body weight (r = −0.820 at р < 0.01); BMI (r = −0.807 at р < 0.01); and hip circumference (r = −0.732 at р < 0.01). The second

*Personalized Strategy of Obesity Prevention and Management Based on the Analysis… DOI: http://dx.doi.org/10.5772/intechopen.105094*

most important factor had a 21.2% contribution to the total variance, and identified 10 indicators that characterize the capacity of the aerobic energy supply and functional state. This factor showed a statistically significant direct correlation with the following indicators: VO2max (r = 0.945 at р < 0.01); VC (mL) (r = 0.791 at р < 0.01); VC (mL/kg) (r = 0.715 at р < 0.01); and IPC (r = 0.714 at р < 0.01). The following indicators had negative factor loadings on the second factor: AP (r = −0.936 at р < 0.01); HR recovery time after 20 squats in 30 s (min) (r = −0.837 at р < 0.01); Robinson index (r = −0.832 at р < 0.01); BPsys (r = −0.824 at р < 0.01); Bayevsky's stress index (r = −0.820 at р < 0.01); resting heart rate (r = −0.812 at р < 0.01); and BPdia (r = −0.806 at р< 0.01). The third factor had a 9.8% contribution to the total variance and consisted of six indicators that characterize the endurance and strength abilities. The fourth factor, which had an 8.3% contribution to the total variance, was formed by the indicators that characterize coordination abilities.

Taking into account the specifics of the studied contingent and based on the data of factor analysis, we selected five indicators that are recommended to use for the assessment of the effectiveness of independent preventive and health-enhancing exercise workouts for middle-aged women—waist circumference, abdomen circumference, waist-to-hip ratio, adaptive potential, and maximum oxygen consumption. To assess the informativeness of the selected indicators, we performed a correlation analysis to identify significant relationships.

The waist circumference correlated with 28 of the studied parameters, and the correlation coefficients ranged from r = 0.210 at p < 0.05 to r = 0.852 at p < 0.001. The abdomen circumference correlated with 29 studied parameters, and the correlation coefficients ranged from r = −0.211 at p < 0.05 to r = 0.852 at p < 0.001. Waist-tohip ratio (WHR) significantly correlated with 24 indicators of physical condition. The adaptation potential showed high correlations with 24 parameters and the correlations coefficients ranged from r = 0.222 at p < 0.05 to r = 0.902 at p < 0.001. Maximum oxygen consumption was significantly correlated with 18 parameters.

The indicators from the groups of the first and second factors had the highest loadings, so we consider them as criteria for effective planning, management, and control of body weight.

Furthermore, we experimentally substantiated methodological guidelines for the organization of fitness workouts for middle-aged women. We recommend doing 50–60 min of physical activity 3–4 times a week. Independent workouts should include exercise for the development of strength and general endurance with own body weight in the mode of alternating performance and aerobic exercise in the mode of continuous performance. Depending on the level of individual fitness, we recommend the percentage of special and general exercises ranged from 40–25% and 60 to 75%, respectively. The target heart rate zone for the aerobic part of workouts should be between 140 and 160 bpm for training activities and between 120 and 130 bpm for recovery activities. The intensity should range from 50–70% of VO2max. Exercise load should be increased by increasing the coordination complexity of the exercises, the use of supersets of exercises, and circuit training.

We developed the plant for independent workouts that allowed to achieve a steady decrease in body weight and improved physical condition among the studied middleaged women. After the study, we observed significant changes in the body weight, BMI, and body circumferences, as well as in the anthropometric measurements that indicate the harmony of the body: BMI decreased by 11.9%, waist circumference decreased by 12.1%, abdomen circumference decreased by 9.6%, and BW decreased by 10.6%. The data obtained showed the improvement of cardiopulmonary function


### **Table 3.**

*Risk factors in developing obesity and resistance to weight-loss intervention programs.*

and increase in the body's adaptation potential, as well as the economization of cardiac pump function, which was evidenced by the changes in the heart rate, BPsys, and BPdia values. The risk of developing hypertension was reduced in the subjects as their BP values ranged from 90 to 130 mmHg for systolic pressure and from 65 to 80 mmHg for diastolic pressure. In women, there were observed statistically significant (p < 0.05; p < 0.01) improvements in lung vital capacity and heart rate recovery after dynamic exercise, which characterize the cardiopulmonary function. An increase of 10.8% in the mean group value of maximum oxygen consumption indicates an increase in the level of physical working capacity.

The results of the study demonstrate an example of an effective program for excessive body mass management in middle-aged women and allow to recommend a wider general use of the scientifically substantiated methodical guidelines for overweight management through health-enhancing physical activity for middle-aged women. Assessment of the obesity-related risks (**Table 3**) helps to establish a population that additionally benefits from the suggested weight-loss program. The annual blood check with selected hormone level determination and popularity of individual genetic tests may be practical tools for the advanced introduction of nutritional lifestyle changes and augmentation of physical activity. As well, specific identification of microbiome changes, shifts of its metabolite levels, and some genetic SNPs can be a basis of efficient individual dietary plan development.
