# Efficacy of Pilates in Functional Body Composition: A Systematic Review
## 4 Discussion
Focusing again on cardiac variables, the advantages in terms of Pilates practice were similar. For 12 weeks, 38 obese women with high blood pressure attended Pilates training, and the results showed the effectiveness of this method in improving vascular function and BFP [4]. The same line of results was obtained in a male sample study on Pilates and its benefit on risk factors for coronary infection [51]. In fact, resting heart rate, VO\({}_{2}\) max, and cholesterol were positively influenced by Pilates practice. As outlined in our review, the metabolic values of 19 obese, middle-aged women were analyzed over a period of 12 weeks of mat/floor Pilates. There was a positive effect on BW, skeletal muscle mass, FM, BFP, and BMI values [33]. Furthermore, in terms of lipid metabolism, this practice had a positive effect on total cholesterol, triglycerides, HDL-C, LDL-C, and fatty acids, thus promoting the prevention of chronic cardiovascular diseases in obese women. In another study carried out with 16 pregnant women, it was found through blood tests that both groups (Pilates and control) showed improvements in BW, FM, and BFP [38]. Even so, the authors considered, due to the balance of water in the tissues, that Pilates strengthened the pelvic floor stabilization muscles, especially when practiced with adequate and effective intensity. However, concerning the self-esteem component and its influence on FBC, there was no effect of Pilates (mat or with small equipment) for 12 weeks in 10 young women [39]. In the analysis of the differences between pre- and post-intervention, significant values were registered in the levels of physical fitness, but not in the levels of self-esteem. Regarding the control of fatty liver disease of nonalcoholic origin, it was found that an 8-week mat Pilates program could play an important role in improving this condition [12]. In this case, 20 men who suffered from this pathology saw their anthropometric measurements, BFC, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) levels, reduced with this practice. Similarly, in the analysis of the effect of Pilates practice under hypoxic conditions, 32 women were distributed in groups practicing Pilates under normal oxygen conditions, another group with Pilates practice under hypoxic conditions, and a control group [40]. Obese women who performed Pilates under hypoxic conditions had significant improvements in diastolic blood pressure, triglycerides, and total cholesterol. The flow-mediated dilation and deformability and aggregation of erythrocytes were also significant in comparison with the control group and Pilates practiced under normal conditions. Thus, the range of benefits and the influence of Pilates were shown through biological mechanisms and processes. In a study with 31 sedentary women, the effect of Pilates on a reformer and Zumba(r) was compared [41]. After 10 weeks, the authors concluded that both practices were effective in improving FBC, while decreasing BMI and some anthropometric measurements. This study also associated the Zumba(r) modality with greater effectiveness in reducing the WC than Pilates, with a better condition of the upper limbs. On the other hand, the safety and feasibility of Pilates practice were analyzed as an influencing factor for FBC and sleep quality in 12 adolescents with anorexia nervosa [42]. Both conditions were improved and led the authors to indicate that Pilates is a safe practice for weight-controlled, anorexia adolescents. In addition, it could also have positive results as an alternative treatment for increasing sleep quality. The effects of Pilates on practitioners with more than 6 months of experience in classic Pilates were also studied, and it was identified that this practice allowed the maintenance of a correct BMI [43].