Introduction: Middle-aged women undergo significant physiological changes, including hormonal fluctuations and body fat redistribution, which favor visceral fat accumulation and elevate cardiometabolic risk. Anthropometric markers such as waist circumference (WC), waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR) are more sensitive predictors of cardiometabolic risk than body mass index (BMI). Alterations in body water distribution, such as a higher extracellular water (ECW) fraction, have also been associated with systemic inflammation and insulin resistance in women with excess weight.
Objective: To assess the effects of a 16-week interdisciplinary intervention on body water distribution and cardiometabolic risk indicators in middle-aged women with excess weight.
Methods: Twenty-seven women (54.6 ± 5.3 years; BMI: 32.5 ± 5.2 kg/m²) were evaluated before and after a 16-week intervention. The program included twice-weekly physical training sessions, weekly nutritional education, and psychoeducational activities. Body composition was assessed using multifrequency tetrapolar bioelectrical impedance analysis (InBody 570®), measuring total body water (TBW), intracellular water (ICW), ECW, ECW/TBW index, visceral fat level, fat mass, and skeletal muscle mass. Waist and hip circumferences were measured, and WHR and WHtR were calculated.
Results: Significant reductions were observed in waist circumference, WHtR, and WHR (all p < 0.05), with a moderate effect size (d = 0.6). TBW and ICW significantly increased after the intervention (p < 0.05). Although ECW and visceral fat level did not show significant changes, the ECW/TBW index decreased (p = 0.04), indicating improved body water distribution. Fat mass decreased significantly (37.5 ± 10.1 to 36.5 ± 10.5 kg; p = 0.03), while skeletal muscle mass increased (24.6 ± 3.4 to 25.4 ± 3.2 kg; p = 0.003), corroborating the increase in ICW.
Conclusion: The 16-week interdisciplinary intervention resulted in improvements in anthropometric indicators, body composition, and body water distribution. These changes should be interpreted cautiously within the study context. The findings suggest that combining physical training, nutritional education, and psychoeducational strategies can support healthier body composition and hydration status among middle-aged women with excess weight.
