# Efficacy of Pilates in Functional Body Composition: A Systematic Review
## 4 Discussion
These results point to evidence that the practice of Pilates positively influences the factors related to FBC, even when considered as a broad concept. Moreover, significant differences in BMI and FM, as well as significant increases in lean mass and metabolic rate, were obtained in patients at cardiovascular risk. The effect size was rated as high for weight, BMI, FM, lean mass, and basal metabolic rate, despite the small sample size [25]. We highlight the fact that Pilates influences the basal metabolic rate, given that it can have control over weight. Another study that used the bioimpedance technique found a significant decrease in body fat percentage and in abdominal fat percentage [26]. In this group of young university students, an increase in lean mass was also identified in the group that had Pilates intervention. In a variant of Pilates using an aquatic environment, there were also significant advantages in weight and BMI, with a small effect size, and in FM percentage, where the effect was moderate [27]. In addition to the positive results of Pilates in the different parameters of the FBC, the size of the effect of the indicated evidence is highlighted. Additionally, a 21-week follow-up study with adolescents found that the WHR was maintained in the group that practiced Pilates, while the control group increased that measure [28]. In another study, a set of anthropometric and BMI measurements were compared between groups practicing Pilates in two Brazilian cities--the city of Osorio and the city of Canoa. The study, which involved 50 women, found no significant differences between the participants of two cities in any of the measures collected [29]. In contrast, in another study using overweight women, it was concluded that there was a significant effect in reducing BMI. The same authors also indicated that the Pilates training model tends to be effective in altering BMI and muscle mass [30]. In the molecular field, evidence also seems to point to the efficiency of Pilates in FBC. Accordingly, it was observed that 3 months of Pilates practice produced a significant increase in Sirtuin 1 protein [31]. The authors used a saffron supplement, and significant advantages were found in both Pilates groups (with or without this supplement). Advantages were also identified in the results obtained for the BFP. In terms of physical capacities, namely, in strength, muscle strength, and muscle mass, in a sample of elderly women, significant increases were observed in the Pilates practitioners group and in the muscle strength training group, when compared to the control group (\(p<0.001\) and \(p=0.05\), respectively) [32]. Similarly, in the analysis of the Pilates method for overweight people, a normative value of \"good\" was assigned to this method, as a strategy to improve BMI [33]. This study also proposed a series of methodological suggestions to improve its effectiveness and keep it attractive to practitioners. Furthermore, the results obtained in another study [34], with a sample of men and women, pointed to a reduction in waist circumference, systolic and diastolic pressure, fat mass, and fat percentage. The broad spectrum of results in the different components of the FBC, from physical capacities to metabolic rate or cardiac issues, seems to consolidate the validity of the influence of Pilates in this domain. Regarding Pilates on an apparatus, in a sample of women, after 8 weeks of practice, mat Pilates and reformer Pilates also brought benefits in FBC and the WHR [35]. Mat Pilates was more effective in reducing WHR and increasing muscle mass. Reformer Pilates, on the other hand, was more efficient in BMI and decreasing FM. These results are interesting in the sense of being able to characterize the types of Pilates and their influences. Regarding the effect of Pilates practice on the measurement of six skinfolds and the BFP, in a sample of 41 men and women, significant differences were obtained between the Pilates practitioner group (during20 weeks) and the control group [36].