Sex-Specific Effects of Resistance Training Intensity on High-Density Lipoprotein Cholesterol in Aging Adults
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Purpose of the study: This study aims to examine the effects of light and moderate resistance training intensities on high-density lipoprotein (HDL) cholesterol levels in aging adults, compare sex differences in HDL cholesterol responses, and analyze whether sex modifies the relationship between training intensity and lipid adaptation.
Methodology: This study employed a quasi-experimental 2×2 factorial design involving adults aged 45–75 years from the Senam Sehat Indonesia (SSI) PWRI group in Karangpandan, Indonesia. Participants underwent eight weeks of light- or moderate-intensity resistance training. HDL cholesterol was assessed through blood analysis, and changes were evaluated using two-way ANOVA following normality and homogeneity assumption testing.
Main Findings: Both light and moderate resistance training were associated with increased HDL cholesterol levels, with no significant difference between training intensities (p = 0.769). Female participants showed a higher average HDL improvement than male participants at the descriptive level; however, this sex difference did not reach statistical significance (p = 0.187), despite a medium effect size (η² = 0.06), indicating that the study was likely underpowered to detect it. No significant interaction was found between training intensity and sex (p = 0.482).
Novelty/Originality of this study: Rather than assuming a uniform physiological response, this study explored whether biological sex influences lipid adaptation following resistance training. Although the sex-related effect was not statistically significant, the observed medium effect size highlights potential biological differences in HDL responses. These findings emphasize the importance of adequately powered sex-stratified trials and provide effect-size estimates to support future research design
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How to cite
Sex-Specific Effects of Resistance Training Intensity on High-Density Lipoprotein Cholesterol in Aging Adults. (2026). Multidisciplinary Journal of Tourism, Hospitality, Sport and Physical Education, 3(1), 206-216. https://doi.org/10.37251/jthpe.v3i1.3278 -
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- [1] N. H. Siam, N. N. Snigdha, N. Tabasumma, and I. Parvin, “Diabetes mellitus and cardiovascular disease: exploring epidemiology, pathophysiology, and treatment strategies,” Rev. Cardiovasc. Med., vol. 25, no. 12, p. 436, 2024.
- [2] C. Dina, D. M. Tit, A. Radu, G. Bungau, and A.-F. Radu, “Obesity, dietary patterns, and cardiovascular disease: a narrative review of metabolic and molecular pathways,” Curr. Issues Mol. Biol., vol. 47, no. 6, p. 440, 2025.
- [3] F. N. Ahmed, H. H. Mohammed, G. A. Mohammed, and M.-O. M. Rahim, “Hyperlipidemia and Its Systemic Effects: Molecular Mechanisms, Clinical Consequences, and Therapeutic Approaches: A Narrative Review,” J. Sulaimani Med. Coll., vol. 15, no. 1, pp. 71–88, 2025.
- [4] H.-C. Lee, A. Akhmedov, and C.-H. Chen, “Spotlight on very-low-density lipoprotein as a driver of cardiometabolic disorders: Implications for disease progression and mechanistic insights,” Front. Cardiovasc. Med., vol. 9, p. 993633, 2022.
- [5] M. B. Liester and J. D. Moore, “Re-evaluating cardiovascular risk: A narrative review challenging the cholesterol hypothesis and identifying modern dietary drivers,” Cureus, vol. 18, no. 3, 2026.
- [6] A. R. Tall, D. G. Thomas, A. G. Gonzalez-Cabodevilla, and I. J. Goldberg, “Addressing dyslipidemic risk beyond LDL-cholesterol,” J. Clin. Invest., vol. 132, no. 1, 2022.
- [7] R. Masuda et al., “Plasma lipoprotein subclass variation in middle-aged and older adults: Sex-stratified distributions and associations with health status and cardiometabolic risk factors,” J. Clin. Lipidol., vol. 17, no. 5, pp. 677–687, 2023.
- [8] N. Kudo, R. Nishide, M. Mizutani, S. Ogawa, and S. Tanimura, “Association between the type of physical activity and metabolic syndrome in middle-aged and older adult residents of a semi-mountainous area in Japan,” Environ. Health Prev. Med., vol. 26, no. 1, p. 46, 2021.
- [9] H. Ali et al., “Non-pharmacological approach to diet and exercise in metabolic-associated fatty liver disease: bridging the gap between research and clinical practice,” J. Pers. Med., vol. 14, no. 1, p. 61, 2024.
- [10] X. Nan, S. Zhang, J. Che, J. Yang, and Z. Wu, “Sex-and Age-Stratified relative handgrip strength and risk of eight chronic diseases in Middle-Aged and older adults: evidence from a National aging cohort study in China,” Aging Clin. Exp. Res., vol. 37, no. 1, pp. 1–12, 2025.
- [11] C. N. dos S. Rodrigues et al., “Long COVID Does Not Impair Hemodynamic, Vascular, or Autonomic Responses to Maximal Exercise: Sex-Stratified Study in Young Adults,” J. Pers. Med., vol. 16, no. 1, p. 38, 2026.
- [12] J. T. Stefano, S. M. B. Duarte, R. G. Ribeiro Leite Altikes, and C. P. Oliveira, “Non-pharmacological management options for MAFLD: a practical guide,” Ther. Adv. Endocrinol. Metab., vol. 14, p. 20420188231160390, 2023.
- [13] T. Ispoglou et al., “A narrative review of non-pharmacological strategies for managing sarcopenia in older adults with cardiovascular and metabolic diseases,” Biology (Basel)., vol. 12, no. 7, p. 892, 2023.
- [14] D. Żukowiecka-Sęga et al., “Resistance Training as a Non-Pharmacological Strategy in Chronic Diseases,” Qual. Sport, vol. 52, p. 69464, 2026.
- [15] Y. Zhou et al., “Benefits of different combinations of aerobic and resistance exercise for improving plasma glucose and lipid metabolism and sleep quality among elderly patients with metabolic syndrome: a randomized controlled trial,” Endocr. J., vol. 69, no. 7, pp. 819–830, 2022.
- [16] J. Janikowska et al., “The Efficacy of Non-Pharmacological Interventions in Reducing Elevated Serum LDL Cholesterol Levels: A Review Paper,” Qual. Sport, vol. 41, p. 60226, 2025.
- [17] H. Pourmontaseri et al., “The effects of aerobic and resistant exercises on the lipid profile in healthy women: a systematic review and meta-analysis,” J. Physiol. Biochem., vol. 80, no. 4, pp. 713–725, 2024.
- [18] Q. Zhang, Y. Guo, H. Zhang, W. Xu, and L. Yin, “Effects of aerobic, resistance, interval, and combined training on glucose metabolism in older adults: insights into type, dose, and mechanism,” Front. Physiol., vol. 16, p. 1702669, 2025.
- [19] N. Dimitriadis and D. Panagiotakos, “Aerobic or Resistance Exercise for maximum Cardiovascular Disease Protection? An Appraisal of the Current Level of Evidence,” J. Prev. Med. Hyg., vol. 65, no. 3, p. E323, 2024.
- [20] D. Lee, A. G. Brellenthin, L. M. Lanningham-Foster, M. L. Kohut, and Y. Li, “Aerobic, resistance, or combined exercise training and cardiovascular risk profile in overweight or obese adults: the CardioRACE trial,” Eur. Heart J., vol. 45, no. 13, pp. 1127–1142, 2024.
- [21] A. E. Paluch et al., “Resistance exercise training in individuals with and without cardiovascular disease: 2023 update: a scientific statement from the American Heart Association,” Circulation, vol. 149, no. 3, pp. e217–e231, 2024.
- [22] H. Dores, M. Antunes, D. Caldeira, and H. V Pereira, “Cardiovascular benefits of resistance exercise: It’s time to prescribe,” Rev. Port. Cardiol., vol. 43, no. 10, pp. 573–582, 2024.
- [23] Z. Chang et al., “Clinical biomarker profiles reveals gender differences and mortality factors in sepsis,” Front. Immunol., vol. 15, p. 1413729, 2024.
- [24] A. S. Aji et al., “The sex differences of unhealthy food consumption and its association with metabolic profiles among Indonesian adults,” Discov. Food, vol. 6, no. 1, p. 43, 2026.
- [25] Y. Li, H. Xie, B. Liu, C. Elaiho, and N. Vangeepuram, “Sex Differences in Diet and Physical Activity Behaviors Among Racial/Ethnic Minority Adolescents with High Metabolic Risk,” J. racial Ethn. Heal. disparities, vol. 12, no. 1, pp. 384–394, 2025.
- [26] S. Vladimirov, T. Gojković, N. Bogavac‐Stanojevic, A. Zeljković, and V. Spasojević‐Kalimanovska, “Sex differences in cholesterol metabolism and their association with SCORE2 cardiovascular risk based on cholesterol homeostasis markers and principal component analysis,” Eur. J. Clin. Invest., p. e70169, 2026.
- [27] A. Field, Discovering Statistics Using IBM SPSS Statistics, 5th ed. London: SAGE Publications, 2018.
- [28] J. W. Creswell and J. D. Creswell, Research Design Qualitative, Quantitative, and Mixed Methods Approaches Fifth Edition. California: SAGE Publications, Inc., 2018.
- [29] R. Masuda et al., “Plasma lipoprotein subclass variation in middle-aged and older adults: Sex-stratified distributions and associations with cardiometabolic risk factors,” J. Clin. Lipidol, vol. 17, no. 5, pp. 677–687, 2023, doi: 10.1016/j.jacl.2023.06.004.
- [30] S. Vladimirov, T. Gojković, N. Bogavac-Stanojevic, A. Zeljković, and V. Spasojević-Kalimanovska, “Sex differences in cholesterol metabolism and their association with SCORE2 cardiovascular risk based on cholesterol homeostasis markers and principal component analysis,” Eur J Clin Invest, vol. 56, no. 1, p. e70169, 2026, doi: 10.1111/eci.70169.
- [31] N. D. Rahmawati, H. Andriani, F. Wirawan, L. Farsia, A. Waits, and K. A. Karim Taufiqurahman, “Body mass index as a dominant risk factor for metabolic syndrome among indonesian adults: a 6-year prospective cohort study of non-communicable diseases,” BMC Nutr., vol. 10, no. 1, p. 43, 2024.
- [32] T. Wahyuni, D. R. Fitriani, J. W. Harianto, and R. Ritanti, “Cardiovascular disease, comorbidities, and late adult in Indonesia: A cross-sectional population-based national survey,” Media Keperawatan Indones., vol. 5, no. 18, pp. 208–215, 2022.
- [33] W. S. P. Harmadha et al., “Explaining the increase of incidence and mortality from cardiovascular disease in Indonesia: A global burden of disease study analysis (2000–2019),” PLoS One, vol. 18, no. 12, p. e0294128, 2023.
- [34] F. R. Muharram et al., “The 30 years of shifting in the Indonesian cardiovascular burden—analysis of the global burden of disease study,” J. Epidemiol. Glob. Health, vol. 14, no. 1, pp. 193–212, 2024.
- [35] S. Sujarwoto et al., “Healthcare access and socio-demographic determinants of estimated 10-year risk of cardiovascular diseases in Indonesia: A population-based study,” PLoS One, vol. 20, no. 8, p. e0318112, 2025.
- [36] A. Santoso et al., “Towards integrated cardiovascular and mental health management in primary health care in Indonesia: a policy outlook,” Lancet Reg. Heal. Asia, vol. 37, 2025.
- [37] D. S. Arsyad et al., “Modifiable risk factors in adults with and without prior cardiovascular disease: findings from the Indonesian National Basic Health Research,” BMC Public Health, vol. 22, no. 1, p. 660, 2022.
- [38] N. Mboi et al., “The state of health in Indonesia’s provinces, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019,” Lancet Glob. Heal., vol. 10, no. 11, pp. e1632–e1645, 2022.
- [39] M. El-Kassas, C. W. Spearman, M. El-Sayed, and Z. M. Younossi, “Metabolic Dysfunction-Associated Steatotic Liver Disease in Africa: From Burden to Action,” Clin. Liver Dis., 2026.
- [40] J. Ardakani, H. Saleem, K. Nasir, and S. Al-Kindi, “Cardiovascular Disease in the Middle East and North Africa, 1990–2021: Burden, Trends, and Risk Factors,” Curr. Atheroscler. Rep., vol. 27, no. 1, p. 98, 2025.
- [41] O. Al Ta’ani et al., “The burden of cirrhosis and other chronic liver disease in the middle east and North Africa (MENA) region over three decades,” BMC Public Health, vol. 24, no. 1, p. 2979, 2024.
- [42] S. A. Nejadghaderi et al., “Burden of diseases attributable to excess body weight in the Middle East and North Africa region, 1990–2019,” Sci. Rep., vol. 13, no. 1, p. 20338, 2023.
- [43] A. M. Al Hashmi et al., “Stroke in young adults in the Middle East and North Africa region: What is the difference from elsewhere? A report from sixteen centers experiences,” Front. Neurol., vol. 16, p. 1653599, 2025.
- [44] S. Hegazi et al., “Prevalence of stroke in young adults in the Middle East and North Africa Region: A systematic review and meta-analysis,” PLOS Glob. Public Heal., vol. 5, no. 10, p. e0004666, 2025.
- [45] Y. A. Al-Ajlouni et al., “The burden of cardiovascular diseases in Jordan: a longitudinal analysis from the global burden of disease study, 1990–2019,” BMC Public Health, vol. 24, no. 1, p. 879, 2024.
- [46] O. Alkouri et al., “Non-HDL Cholesterol and Residual Cardiometabolic Risk in Middle Eastern Patients with Atherosclerotic Cardiovascular Disease,” in Healthcare, MDPI, 2026, p. 565.
- [47] S. Mowafi, S. A. Moustafa, M. Wahdan, S. Heikal, M. Othman, and M. Salama, “Dementia in the MENA region uncharted challenges and emerging insights a literature review,” npj Dement., vol. 1, no. 1, p. 5, 2025.
- [48] I. Campos-Nonato et al., “Prevalence of metabolic syndrome and combinations of its components: findings from the Mexican National Health and Nutrition Survey, 2021,” Metab. Syndr. Relat. Disord., vol. 23, no. 4, pp. 193–204, 2025.
- [49] M. Romero-Martínez et al., “National Health and Nutrition Survey (Ensanut Continua) 2020-2024, methodology and analysis,” Salud Publica Mex., vol. 66, no. 6, pp. 879–885, 2024.
- [50] J. Vargas-Meza et al., “Dietary sodium and potassium intake: data from the Mexican national health and nutrition survey 2016,” Nutrients, vol. 14, no. 2, p. 281, 2022.
- [51] A. M. Velázquez, S. Rodríguez-Ramírez, A. E. P. Gómez, M. C. Medina-Zacarias, L. M. Martínez, and A. Drewnowski, “Dietary Benefits of Pistachio Consumption in Mexico Modeled Using National Health Survey System (ENSANUT) 2012 and 2016 Data,” Nutrients, vol. 17, no. 23, p. 3767, 2025.
- [52] L. Tolentino-Mayo et al., “Changes in the use and understanding of the Mexican front-of-pack warning labeling system, Ensanut 2021-2024,” Salud Publica Mex., vol. 67, no. 6, pp. 795–804, 2026.
- [53] E. López-Hernández et al., “Reducción de la prevalencia de talla baja e incremento de la obesidad en adultos mexicanos con talla baja. ENSANUT 2006 a 2018 Reduced prevalence of short stature and increased obesity in Mexican adults with short stature.,” Rev Mex Endocrinol Metab Nutr, vol. 10, pp. 59–67, 2023.