Objective: Cardiometabolic effects of physical exercise depend on its intensity, duration, and type. The aim of this study was to compare the effects of two exercise models, Nordic Walking (NW) and Pilates, on postmenopausal women.

Methods: The study comprised 196 overweight or obese women: 20 were advised to maintain their previous level of physical activity (control group) whereas the others started either an NW exercise program (n = 88) or a Pilates exercise program (n = 88). Blood was collected twice for testing: before the program commenced and after it had ended.

Results: Of the 196 women who enrolled in the study, 147 (75%) completed the study; among those women, 69 (47%) completed a 10-week NW exercise program, 58 (39%) completed a 10-week Pilates exercise program, and 20 (14%) were in the control group. After 10 weeks, women in the NW group showed a significant reduction in body weight (6.4%), body mass index (6.4%), blood glucose (3.8%), total cholesterol (10.4%), non-high-density lipoprotein (HDL) cholesterol (16.7%), low-density lipoprotein cholesterol (12.8%), and triglycerides (10.6%), as well as an increase in HDL cholesterol (9.6%). Significantly smaller—although still favorable—changes, except for glucose and HDL cholesterol levels, were observed in the Pilates group (decreases of 1.7%, 1.7%, 1.6%, 5.3%, 8.3%, 7.5%, and 6% and an increase of 3.1%, respectively). Nevertheless, at the end of the study, the percentage of women with target concentrations of the lipid fractions had significantly increased in both exercise groups. No significant changes in the studied parameters were found in the control group. On multiple regression analysis, type of exercise program was an independent predictor of amplitude changes in most of the studied parameters.

Conclusions: Exercise training in accordance with the NW model causes statistically and clinically more significant changes in glucose and basic blood lipid levels than do Pilates and dietary intervention alone.