The Effect Of Exercise And Nutritional Weight Loss On The Balance Performance Of Healthy Sedentary Women

The Effect Of Exercise And Nutritional Weight Loss On The Balance Performance Of Healthy Sedentary Women | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Effect Of Exercise And Nutritional Weight Loss On The Balance Performance Of Healthy Sedentary Women Tunay DILICAN, Ramiz ARABACI This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7065676/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 8 You are reading this latest preprint version Abstract The aim of this study is to investigate the effect of weight loss, resulting from a 12-week resistance exercise and nutrition program, on 30-second static balance performance in healthy sedentary young women aged 25–35. A total of 90 sedentary women who met the inclusion criteria participated voluntarily and were randomly assigned into three groups: exercise and nutrition group (ENG), nutrition group (NG), and control group (CG). The balance performance of all participants was measured using the Tecnobody Prokin Pk 200 WL device. Subsequently, a 12-week exercise and nutrition program was applied to the ENG, only a nutrition program was administered to the NG, and no intervention was applied to the CG. After completing the 12-week programs, balance performance measurements were repeated to identify the differences. Before the study and at the end of the first six weeks, participants’ maximum strength levels were determined using the 1RM calculation method, and exercises were performed at 50% of these maximums. The analyses revealed that after the 12-week intervention, balance performance improved by 37.6% in the ENG and by 16.0% in the NG. The balance performance improvement in the ENG was found to be 21.6% higher compared to the NG. In conclusion, the combination of an exercise program supported by a nutrition plan has a more significant effect on balance performance than a nutrition program alone. These findings suggest that such interventions can positively impact daily life and improve the quality of life in sedentary women. Thai Clinical Trials Registry (TCTR), Trial registration: Current Controlled Trials TCTR20250721002 (21.07.2025), Retrospectively registered. Balance Exercise Nutrition Introduction A sedentary lifestyle is a defining characteristic of modern times. People increasingly rely on cars instead of walking, prefer phones and telecommunications over face-to-face interactions, and benefit from household technologies such as washing machines and robotic appliances that greatly ease daily life. However, the challenges associated with a sedentary lifestyle have increased proportionally ( 1 ). This lifestyle is linked to obesity, cardiovascular diseases, cancer, and various age-related disorders. Among these, balance problems closely associated with falls are of particular concern. Balance is a critical prerequisite for acquiring complex motor skills during childhood and serves as the foundation for effectively performing daily and sport-related activities throughout life. In the study, a training and nutrition program targeting overall physical development particularly of the lower extremities, which directly influence balance was implemented. Age-related biomechanical, physiological, and functional declines in the lower extremities such as elevated plantar pressure, reduced gait efficiency, foot deformities, and foot pain have been associated with impaired balance and, ultimately, increased risk of falls or a significant reduction in physical activity levels ( 2 , 3 , 4 ). The quality and extent of bodily changes vary depending on the type, intensity, and duration of exercise. Research has shown that resistance training can lead to improvements in various motor performance variables, including speed, balance, coordination, jumping ability, and flexibility ( 5 ). A review of the literature reveals that most studies examining factors influencing and improving balance have focused on elderly individuals, while research involving healthy sedentary women aged 25–35 is very limited underscoring the significance of this study. Studies have shown that the combination of healthy nutrition and regular physical exercise constitutes a powerful lifestyle strategy that positively impacts lifelong health. It improves body composition, regulates steroid hormone levels, enhances physical performance in women, and contributes to the prevention of chronic diseases ( 6 ). Method This study was approved by the Ethics Committee of Çanakkale Onsekiz Mart University, Türkiye (Decision No: 2021-YÖNP-0515). All procedures were conducted in accordance with the Declaration of Helsinki, Informed consent was obtained from all individual participants included in the study. This study was conducted and reported in accordance with the CONSORT 2025 guidelines for randomized controlled trials. 1. Participants A total of 90 women aged between 25 and 35, residing in the Çanakkale province, participated in this study. The participants were randomly assigned to three equal groups: the Control Group (CG), the Nutrition Group (NG), and the Exercise and Nutrition Group (ENG). To examine the differences in the groups’ pre-intervention variables, a Levene’s test was conducted. The analysis revealed that the groups were homogeneous prior to the start of the study. In this study, the sample size estimation was performed using the G*Power 3.1 program. Based on the analysis, with an effect size of f = 0.25, α = 0.05 (5% Type I error rate), and power β = 0.95, the minimum required sample size was calculated to be 66 participants. To account for potential participant dropout during the study, a sample size 50% larger than that calculated in the power analysis (n = 99) was initially planned. Consequently, the study began with 99 participants. However, due to participant withdrawals for reasons such as discontinuing the diet, being unable to adhere to the diet or exercise program, or relocating to another city, the study was completed with 90 participants. This study is derived from the doctoral dissertation of the first author and was approved by the Scientific Research Ethics Committee of the Graduate Education Institute at Çanakkale Onsekiz Mart University, with the decision number 2021-YÖNP-0515, dated 02.07.2021. 2. Experimental Procedure The “Readiness for Exercise Questionnaire for Everyone” (EGZ-A+) was administered to all participants, and only those deemed suitable for exercise based on the questionnaire results were included in the study. Initially, the groups’ balance performance levels and body composition values were assessed. Subsequently, the Exercise and Nutrition Group (ENG) followed a regular physical exercise and nutrition program, the Nutrition Group (NG) received only a nutrition program, and no intervention was applied to the Control Group (CG). At the end of the 12-week intervention period, the balance performance levels and body composition values of the groups were reassessed. The study aimed to investigate the effect of weight loss resulting from exercise and nutrition on balance performance. For all participants in the ENG, NG, and CG groups, measurements including height, weight, body mass index (BMI), and body composition (analyzed using a Tanita device) were recorded. Balance performance was then assessed using the Technobody Prokin PK 200 WL balance measurement system. Following the 12-week exercise and nutrition program, final assessments were conducted, and the relationship between weight loss resulting from the exercise and nutrition interventions and balance performance was evaluated. Before the start of the exercise program, the exercises were introduced to the participants by the researcher through explanations and preparatory sessions. During the trial phase, all participants’ maximum performance levels were assessed both before the intervention and at the end of the sixth week. The training sessions were then conducted at 50% of each participant’s maximum capacity. 3. Tests Body composition and balance measurements were conducted for all study groups. A combined nutrition and exercise program was implemented for the Exercise and Nutrition Group, while only a nutrition program was administered to the Nutrition Group. Detailed information regarding the tests and measurements is provided below. 3.1. Body Composition Measurement Participants’ height was first measured using a Mesitaş brand stadiometer tape measure. Subsequently, body composition was assessed using the Tanita BC-418 MA device. For each measurement, the participant’s age and measured height were individually entered into the Tanita Body Composition Analyzer, and the body type was selected as "Female-Standard." Participants stepped onto the device barefoot and held the grip electrodes with both their right and left hands. Once the device stabilized the participant’s weight, the measurement was completed. The printouts generated by the device were recorded. 3.2. Balance Measurement To assess the balance abilities of the participants, a balance performance test was administered twice—once as a pre-test and once as a post-test using the Technobody Prokin PK 200WL device. The test was performed with participants standing on the platform with both feet and their eyes open. During the test, they stood on an unstable balance platform and attempted to maintain their balance by following a circular guide displayed on the monitor. The device was set up and connected to the monitor prior to the measurements. The device includes easy, medium, and hard difficulty levels; for this study, the “easy” level was selected. Prior to testing, participants were informed about the procedure, and each participant completed the test individually. The monitor was positioned at a height and distance that allowed for clear visibility. After stabilizing their posture, participants notified the test administrator when they were ready, and the measurement began. The test lasted 30 seconds, during which participants stood with both feet on the platform and their arms extended laterally. If a participant lost balance or stepped off the platform before the time elapsed, the test was stopped and repeated. Each participant completed the balance test twice, and the better result was recorded. 3.3. Nutrition Programme According to the World Health Organization’s energy formula, the daily caloric requirement for individuals with moderate physical activity and an average body weight of 65 kg is 2,350 kcal. For individuals with no physical activity and the same average body weight, the daily caloric requirement is 1,850 kcal. The exercise program followed by the Exercise and Nutrition Group (ENG) resulted in a daily caloric deficit of approximately 500–600 kcal. In the Nutrition Group (NG), since no physical activity was performed, no caloric deficit occurred. Both nutrition programs were designed to achieve a weight loss of 500 grams per week, leading to a total weight loss of approximately 6 kilograms by the end of the 12-week period. Since the Nutrition Group did not follow any exercise program, they adhered to the following nutrition plan: For breakfast, they consumed 1 slice of whole wheat or multigrain bread (25 g), low-fat cheese (30 g), 1 boiled egg (50 g), 2 teaspoons of honey (14 g), tomatoes, cucumber, and greens (200 g), 6–7 black olives (28 g), and tea (70 g). At lunch, the meal included 1 bowl of vegetable soup (100 g), a vegetable dish (100 g), 5–6 tablespoons of rice or pasta (100 g), salad (100 g), and either yogurt (100 g) or 2 glasses of ayran (200 g). For dinner, they had meat or chicken equivalent to 2 meatballs (60 g), 8 tablespoons of a vegetable dish (200 g), 6–8 tablespoons of rice or pasta (120 g), salad (300 g), and 3–4 tablespoons of low-fat yogurt (45 g). Alternatively, the meal could consist of 8 tablespoons of legumes (100 g), 1 slice of whole grain bread (25 g), 1 medium-sized fish or 20 anchovies (200 g), and baked potatoes (150 g). Since the Exercise and Nutrition Group followed a 12-week resistance training program, they adhered to a nutrition plan designed to compensate for the resulting calorie deficit. For breakfast, they consumed 3 slices of whole wheat or multigrain bread (75 g), low-fat cheese (30 g), 1 boiled egg (50 g), 2 teaspoons of honey (14 g), tomatoes, cucumber, and greens (200 g), 6–7 black olives (28 g), and tea (70 g). At lunch, the meal included 1 bowl of vegetable soup (100 g), a vegetable dish (100 g), 5–6 tablespoons of rice or pasta (100 g), salad (100 g), yogurt (100 g) or 2 glasses of ayran (200 g), and 1 serving of fruit (100 g). For dinner, they had meat or chicken equivalent to 4 meatballs (120 g), 8 tablespoons of a vegetable dish (200 g), 6–8 tablespoons of rice or pasta (120 g), salad (100 g), and low-fat yogurt (45 g). As alternatives, the meal could consist of 10 tablespoons of legumes (125 g), 3 slices of whole grain bread (75 g), 2 medium-sized fish or 40 anchovies (400 g), and baked potatoes (150 g). A night snack included 1 serving of fruit (100 g) and 1 glass of milk (200 g). These plans support a balanced intake of carbohydrates, protein, and fat. The nutrition list was updated according to individuals' eating habits and was prepared and monitored in collaboration with a professional dietitian. 3.4. Exercise Programme The 12-week exercise program used in the study was designed to strengthen both the lower and upper extremities, which are essential for balance performance. The duration and repetition count for each exercise were specified in a table, and the exercise intensity was maintained at 50%. Participants were expected to burn approximately 500–600 kcal per day on each training day. Repetitive movements were performed according to the given sets and repetitions, while time-based exercises were executed for the specified duration, with 30-second rest intervals between movements. In the first week, chest muscles were targeted with Pectoral Fly and Chest Press Machine, while Midrow and Highrow focused on the back; Body Weight Squat and Step-Up strengthened the legs, and Plank and Side Plank worked the core. The second week focused on shoulder muscles with Shoulder Press Machine and Dumbbell Lateral Raises, legs with Leg Extension and Leg Curl, and core with Lying Knee Up and Leg Raises. In the third week, dynamic exercises such as Sumo Squat and Split Squat were added; cardiovascular endurance was improved with High Knees and 200m Rowing; Push-Up and TRX Row worked the upper body, and core exercises included Superman and V Sit-Up. The fourth week emphasized strength, using Smith Machine Bench Press and Incline Dumbbell Fly for the chest, Lat Pull Down and Seated Row for the back, Arnold Press and Dumbbell Front Raise for the shoulders, Leg Press and Abduction Machine for the legs, and Hyperextension and Bicycle Crunch for the core. In the fifth week, functional movements like Madison Ball Wall Squat and Dumbbell Deadlift were performed, Ski Erg 300m supported cardio endurance, and Shoulder Taps Push-Up and Swiss Ball Plank targeted upper body strength and balance. The sixth week revisited upper body exercises such as Pectoral Fly, Chest Press Machine, Midrow, and Highrow, supported by Dumbbell Lateral Raises, Shoulder Press Machine, and Leg Curl. In the seventh week, strength and cardiovascular endurance were increased with Sumo Squat, Split Squat, High Knees, and Push-Up. The eighth week focused on both upper and lower body muscles through Smith Machine Bench Press, Incline Dumbbell Fly, Lat Pull Down, Seated Row, and Abs Machine. The ninth week emphasized balance and strength with Madison Ball Wall Squat, Dumbbell Deadlift, and Swiss Ball Plank. In the tenth week, upper body development was targeted with Dumbbell Bench Press, Cable Fly, Dumbbell Biceps Curl, Push Down, and Leg Raises. In the eleventh week, functional strength was enhanced with Sumo Squat, High Knees, Push-Up, and Superman. Finally, in the twelfth week, muscular endurance in the upper body was improved with Chest Press Machine, Pectoral Fly, Highrow, and Midrow, while lower body strength was developed with Leg Extension and Leg Curl. Overall, the program was designed to work all major muscle groups in a balanced manner, with varied weekly exercises to ensure comprehensive full-body development. 4. Analyze The statistical analyses were performed using the SPSS 26.0 for Windows software package (IBM Corp., Armonk, New York, USA). The Shapiro-Wilk test was used to assess the normality of data distribution. As the data were normally distributed, a Two-Way Analysis of Variance (Two-Way ANOVA) was employed to evaluate differences between groups. To examine the differences among the variables across the groups, a One-Way ANOVA test was used, and Bonferroni was selected as the Post Hoc test. The effect size of the differences (Cohen’s d) was reported based on Cohen’s classification (small effect: 0.1–0.3, medium effect: 0.3–0.5, and large effect: 0.5 and above), along with partial eta squared (ƞp²) values. In all tests, statistical significance was set at p < 0.05. Results Table 1 Assessment of Between-Group Differences in Dependent Variables Variables Groups Tests x̄±ss f p η 2 Cohen’s d Weight Pre-Test Post-test CG 65.8 ± 13.39 65.82 ± 13.39 2169.435 .001 .980 0.915 NG 64.31 ± 10.47 58.27 ± 10.51 ENG 65.36 ± 10.28 59.29 ± 10.27 BMI CG 23.66 ± 4.51 23.44 ± 4.35 111.233 .001 .719 0.809 NG 23.98 ± 2.64 21.75 ± 2.43 ENG 23.76 ± 3.56 21.57 ± 3.4 Fat % CG 27.5 ± 6.6 28.2 ± 6.4 9.166 .001 .174 0.604 NG 29.4 ± 6.0 26.5 ± 5.6 ENG 29.7 ± 6.7 25.3 ± 8.3 NG 34.2 ± 2.8 31.8 ± 2.3 ENG 34.1 ± 2.9 32.3 ± 2.3 CG: Control Group, NG: Nutrition Group, ENG: Exercise and Nutrition Group As shown in Table 1 , there was a statistically significant difference (p < 0.05) between the pre-test and post-test measurements of the Weight and BMI variables in the CG (Control Group), NG (Nutrition Group), and ENG (Exercise and Nutrition Group). The effect size for the Weight variable was determined as η² = 0.980, and for the BMI variable, it was η² = 0.719. Additionally, a significant difference (p < 0.05) was found in the Body Fat Percentage variable among the CG, NG, and ENG groups, with an effect size of η² = 0.174. Table 2 Assessment of Intergroup Differences in the Balance Variable Variables Groups Tests x̄±ss f p η 2 Cohen’s d Balance Pre-Test Post-test CG 249.6 ± 114.9 249.4 ± 109.4 40.852 .001 .689 0.953 NG 249.3 ± 114.4 209.4 ± 90.6 ENG 249.1 ± 113.9 155.7 ± 70.1 CG: Control Group, NG: Nutrition Group, ENG: Exercise and Nutrition Group As presented in Table 2 , there was a statistically significant difference (p < 0.05) between the pre-test and post-test scores of the Balance variable among the CG, NG, and ENG groups, with a reported effect size of η² = 0.689 Table 3 The Differences Between the Groups Regarding the Variables in Comparison with One Another Difference Variables Group 1 Group 2 and 3 x̄ Mean p η 2 f Weight CG NG -6.17000 * .001 .960 1043.8 ENG -6.09667 * .001 NG ENG .07333 1,000 BMI CG NG -2.01333 * .001 .719 111.2 ENG -1.96333 * .001 NG ENG .05000 1,000 Balance CG NG -39.66767 * .001 .484 40.8 ENG -93.26400 * .001 NG ENG -53.59633 * .001 CG: Control Group, NG: Nutrition Group, ENG: Exercise and Nutrition Group As shown in Table 3 , for the Weight variable, a significant difference was found in the difference of differences between the CG and NG groups (p < 0.05), as well as between the CG and ENG groups (p < 0.05). However, no significant difference was observed between the NG and ENG groups in terms of the difference of differences in the Weight variable. For the BMI variable, there was a significant difference in the difference of differences between the CG and NG groups (p < 0.05), and also between the CG and ENG groups (p < 0.05), whereas no significant difference was found between the NG and ENG groups. Regarding the Balance variable, significant differences in the difference of differences were observed between the CG and NG groups (p < 0.05), between the CG and ENG groups (p < 0.05), and also between the NG and ENG groups (p < 0.05). Discussion This study was conducted to examine the effects of weight loss resulting from a 12-week exercise and nutrition program on balance performance in sedentary women. The hypothesis of the study was that there may be changes in balance performance and body composition values in sedentary women who follow a 12-week resistance exercise and nutrition program, as well as in those who follow only a nutrition program. Furthermore, the study aimed to determine whether these potential changes differ from the balance performance and body composition values of women who do not participate in any program. The most significant findings of the study revealed that there were statistically significant differences in the balance performance and body composition values between the group that followed both the exercise and nutrition program (ENG) and the group that followed only the nutrition program (NG), as well as between both ENG and NG and the control group (CG), which did not participate in any program. As shown in Table 2 , the exercise program implemented for the Exercise and Nutrition Group (ENG), when supported by the nutrition program used in the study, resulted in an average improvement of 37.6% in balance performance. In contrast, the Nutrition Group (NG), which followed only the nutrition program, demonstrated an average improvement of 16.0% in balance performance, as also indicated in Table 8. These results suggest that the balance performance of the ENG, which followed both the exercise and nutrition programs for 12 weeks, improved by 21.6% more compared to the NG, which followed only the nutrition program. The question of whether exercise and nutrition programs influence balance performance was addressed through the findings of the study. The most prominent result and strength of the research is the conclusion that postural stability an important determinant of quality of life can be improved through regular exercise and nutrition programs. The exercise program implemented in the study primarily consisted of movements aimed at reducing fat mass. It remains unknown whether an exercise program designed to also promote increases in muscle mass would yield results consistent with the current findings. Moreover, it is uncertain whether the outcomes of this study would be replicated if the same exercise and nutrition programs were applied to athletes instead of sedentary women, to participants older than the 25–35 age group included in this research, or to men instead of women. An exercise program consisting of 45-second movements applied to young individuals led to improvements in balance performance among athletes ( 7 ). This finding appears to be consistent with the results of the present study. Impaired balance ability in sedentary individuals stems from ankle muscle contractions caused by physical inactivity ( 8 ). Their findings align with the improvements in balance performance observed in this study following the exercise intervention. A 12-week balance training program designed to enhance postural control resulted in a 146% increase in participants’ balance performance in older adults ( 9 ). These findings also show similarities with the results of the present research. An improvement in balance performance among tennis players was observed following an exercise program designed to develop both upper and lower extremities simultaneously ( 10 ). These results appear to be consistent with the findings of the present study. Similarly, resistance exercises, presented through quantitative dose–response relationships that enhance the effectiveness of balance-improving protocols, are an effective tool for improving proactive balance in healthy young adults aged 16–40 ( 11 ). Their findings also align with the outcomes of this research. Additionally, it was found that regular exercise improves trunk angular sway and postural alignment, further supporting the positive relationship between exercise and balance performance identified in the present study. These findings are consistent with the conclusion of the present study, which demonstrated that regular exercise improves balance performance ( 12 ). It was also reported that regular exercise is the most effective method for improving postural stability and balance, and their findings align with those of this study ( 13 ). Furthermore, previous research has shown that regular participation in resistance and aerobic exercises (such as continuous walking, running, and cycling) contributes to lowering both clinical and ambulatory blood pressure in individuals with hypertension, while also supporting improvements in overall health and reductions in cardiovascular risk factors ( 14 ). Conclusion As a result, the findings of this study highlight the importance of integrating exercise and nutrition programs to improve daily movement performance, including postural stability and functional walking activities, in sedentary women. Standard balance exercises alone appear to be limited in enhancing daily functional movements and improving postural stability. Therefore, it is recommended that exercise programs be supported with appropriate nutritional strategies, and that balance-enhancing practices be incorporated into all rehabilitation and physical activity programs, given their direct impact on balance performance through dynamic exercises and movements. Abbreviations ENG Exercise and Nutrition Group NG Nutrition Group CG Control Group EGZ-A+ Exercise Readiness Questionnaire for All Individuals BMI Body Mass Index Declarations Ethics approval and consent to participate Ethical approval for the study was granted by the Ethics Committee of Çanakkale Onsekiz Mart University, Türkiye (Decision No: 2021-YÖNP-0515). All participants were informed about the purpose, procedures, and potential risks of the study, and written informed consent was obtained prior to participation, in accordance with the Declaration of Helsinki Consert for publication Not applicable. No identifying images or personal information of participants were included in this study. Competing interests The authors declare that they have no competing interests. Authors’ information (optional) 1* Tunay Dilican, Bursa Uludağ University 1 Ramiz Arabacı, Bursa Uludağ University Orcid id Tunay Dilican: 0000-0003-4686-6849 Ramiz Arabacı: 0000-0001-8403-5742 Funding No funding was received for this study. Author Contribution T.D. and R.A. jointly authored the main manuscript. The implementation of the study and the literature review were conducted by T.D., while the data analysis and interpretation of the results were carried out by R.A. Acknowledgement The authors thank all individuals who voluntarily participated in this study. Data Availability The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request. References Pines A. Sedentary women: sit less, live more! Climacteric. 2015;18(6):770–2. Menz HB. Biomechanics of the ageing foot and ankle: a mini-review. Gerontology. 2015;61(4):381–8. Muchna A, Najafi B, Wendel CS, Schwenk M, Armstrong DG, Mohler J. Foot problems in older adults: Associations with incident falls, frailty syndrome, and sensor-derived gait, balance, and physical activity measures. J Am Podiatr Med Assoc. 2018;108(2):126–39. Wang C, Goel R, Rahemi H, Zhang Q, Lepow B, Najafi B. Effectiveness of daily use of bilateral custom-made ankle-foot orthoses on balance, fear of falling, and physical activity in older adults: a randomized controlled trial. Gerontology. 2019;65(3):299–307. Schoenfeld BJ, Ogborn D, Krieger JW. Effects of resistance training frequency on measures of muscle hypertrophy: a systematic review and meta-analysis. Sports Med. 2016;46(11):1689–97. Kuller LH, Gabriel KKP, Kinzel LS, Underwood DA, Conroy MB, Chang Y, Kriska AM. The Women on the Move Through Activity and Nutrition (WOMAN) study: final 48-month results. Obesity. 2012;20(3):636–43. Yaggie JA, McGregor SJ. Effects of isokinetic ankle fatigue on the maintenance of balance and postural limits. Arch Phys Med Rehabil. 2002;83(2):224–8. Hiemstra LA, Lo IK, Fowler PJ. Effect of fatigue on knee proprioception: implications for dynamic stabilization. J Orthop Sports Phys Therapy. 2001;31(10):598–605. Wolfson L, Whipple R, Judge J, Amerman P, Derby C, King M. Training balance and strength in the elderly to improve function. J Am Geriatr Soc. 1993;41(3):341–3. Russell PJ, Swartz EE, Croce RV, Decoster LC. Poster: Knee Valgus in Self-Initiated Vertical Jump Landings. Developmental and Gender Comparisons; 2007. Lesinski M, Hortobágyi T, Muehlbauer T, Gollhofer A, Granacher U. Dose-response relationships of balance training in healthy young adults: a systematic review and meta-analysis. Sports Med. 2015;45(4):557–76. Lim SB, Horslen BC, Davis JR, Allum JH, Carpenter MG. Benefits of multi-session balance and gait training with multi-modal biofeedback in healthy older adults. Gait Posture. 2016;47:10–7. Prasertsakul T, Kaimuk P, Chinjenpradit W, Limroongreungrat W, Charoensuk W. The effect of virtual reality-based balance training on motor learning and postural control in healthy adults: a randomized preliminary study. Biomed Eng Online. 2018;17(1):1–17. Sharman JE, La Gerche A, Coombes JS. Exercise and cardiovascular risk in patients with hypertension. Am J Hypertens. 2015;28(2):147–58. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7065676","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":515518187,"identity":"38838a00-3dbf-4936-a6e9-8e1f94b8b3f4","order_by":0,"name":"Tunay DILICAN","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABBUlEQVRIiWNgGAWjYNACNgkZNhD9ocImASyQUIBbMQ9UCw9IC+OMM2kJDCBWggFBLRCambflMEQLAx4t9hK5Bz/zlFnw8LEffvZwZsP5PH757sQPDwwY5PnFDmC3RSIvWZrnHNBhPGnmBh933C6WbOPdLAF0mOHM2Qk4tOQYSPO2AbVIMJhJzjxzO3HDMd4NIC0JBrdxajH+DdHC/g2o9xxIy+YfBLSYQW3hATEOgLRsw2/LmTdmlnPAfskpk5xxJjlxZlvuNosEAwmcfmFvzzG+8aasTk6+/fg2iQ8Vdon9zGc33/xRYSPPL41dCwgw8WARlMCpHAQYf+CVHgWjYBSMghEPAOxbVU4r0zZRAAAAAElFTkSuQmCC","orcid":"","institution":"Bursa Uludağ Üniversitesi","correspondingAuthor":true,"prefix":"","firstName":"Tunay","middleName":"","lastName":"DILICAN","suffix":""},{"id":515518188,"identity":"bc9ab733-20b2-4fc4-973e-0bae7c744fc4","order_by":1,"name":"Ramiz ARABACI","email":"","orcid":"","institution":"Bursa Uludağ Üniversitesi","correspondingAuthor":false,"prefix":"","firstName":"Ramiz","middleName":"","lastName":"ARABACI","suffix":""}],"badges":[],"createdAt":"2025-07-07 12:53:39","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7065676/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7065676/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":91686326,"identity":"cc2c9508-355b-439f-a875-3ec45031ee91","added_by":"auto","created_at":"2025-09-19 07:41:34","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":607973,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7065676/v1/8def624d-0ff2-41ae-8115-a3629f7732e9.pdf"},{"id":91685379,"identity":"10443678-21f3-4a03-b80d-039b7fc0fe4a","added_by":"auto","created_at":"2025-09-19 07:33:29","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":33700,"visible":true,"origin":"","legend":"","description":"","filename":"CONSORT2025editablechecklist.docx","url":"https://assets-eu.researchsquare.com/files/rs-7065676/v1/118f940e717aeceacb3988d9.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"The Effect Of Exercise And Nutritional Weight Loss On The Balance Performance Of Healthy Sedentary Women","fulltext":[{"header":"Introduction","content":"\u003cp\u003eA sedentary lifestyle is a defining characteristic of modern times. People increasingly rely on cars instead of walking, prefer phones and telecommunications over face-to-face interactions, and benefit from household technologies such as washing machines and robotic appliances that greatly ease daily life. However, the challenges associated with a sedentary lifestyle have increased proportionally (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). This lifestyle is linked to obesity, cardiovascular diseases, cancer, and various age-related disorders. Among these, balance problems closely associated with falls are of particular concern. Balance is a critical prerequisite for acquiring complex motor skills during childhood and serves as the foundation for effectively performing daily and sport-related activities throughout life.\u003c/p\u003e\u003cp\u003eIn the study, a training and nutrition program targeting overall physical development particularly of the lower extremities, which directly influence balance was implemented. Age-related biomechanical, physiological, and functional declines in the lower extremities such as elevated plantar pressure, reduced gait efficiency, foot deformities, and foot pain have been associated with impaired balance and, ultimately, increased risk of falls or a significant reduction in physical activity levels (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). The quality and extent of bodily changes vary depending on the type, intensity, and duration of exercise. Research has shown that resistance training can lead to improvements in various motor performance variables, including speed, balance, coordination, jumping ability, and flexibility (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). A review of the literature reveals that most studies examining factors influencing and improving balance have focused on elderly individuals, while research involving healthy sedentary women aged 25–35 is very limited underscoring the significance of this study.\u003c/p\u003e\u003cp\u003eStudies have shown that the combination of healthy nutrition and regular physical exercise constitutes a powerful lifestyle strategy that positively impacts lifelong health. It improves body composition, regulates steroid hormone levels, enhances physical performance in women, and contributes to the prevention of chronic diseases (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e"},{"header":"Method","content":"\u003cp\u003e This study was approved by the Ethics Committee of Çanakkale Onsekiz Mart University, Türkiye (Decision No: 2021-YÖNP-0515). All procedures were conducted in accordance with the Declaration of Helsinki, Informed consent was obtained from all individual participants included in the study. This study was conducted and reported in accordance with the CONSORT 2025 guidelines for randomized controlled trials.\u003c/p\u003e\u003ch3\u003e1. Participants\u003c/h3\u003e\u003cp\u003eA total of 90 women aged between 25 and 35, residing in the Çanakkale province, participated in this study. The participants were randomly assigned to three equal groups: the Control Group (CG), the Nutrition Group (NG), and the Exercise and Nutrition Group (ENG). To examine the differences in the groups’ pre-intervention variables, a Levene’s test was conducted. The analysis revealed that the groups were homogeneous prior to the start of the study.\u003c/p\u003e\u003cp\u003eIn this study, the sample size estimation was performed using the G*Power 3.1 program. Based on the analysis, with an effect size of f = 0.25, α = 0.05 (5% Type I error rate), and power β = 0.95, the minimum required sample size was calculated to be 66 participants.\u003c/p\u003e\u003cp\u003eTo account for potential participant dropout during the study, a sample size 50% larger than that calculated in the power analysis (n = 99) was initially planned. Consequently, the study began with 99 participants. However, due to participant withdrawals for reasons such as discontinuing the diet, being unable to adhere to the diet or exercise program, or relocating to another city, the study was completed with 90 participants.\u003c/p\u003e\u003cp\u003e This study is derived from the doctoral dissertation of the first author and was approved by the Scientific Research Ethics Committee of the Graduate Education Institute at Çanakkale Onsekiz Mart University, with the decision number 2021-YÖNP-0515, dated 02.07.2021.\u003c/p\u003e\u003ch3\u003e2. Experimental Procedure\u003c/h3\u003e\u003cp\u003eThe “Readiness for Exercise Questionnaire for Everyone” (EGZ-A+) was administered to all participants, and only those deemed suitable for exercise based on the questionnaire results were included in the study. Initially, the groups’ balance performance levels and body composition values were assessed. Subsequently, the Exercise and Nutrition Group (ENG) followed a regular physical exercise and nutrition program, the Nutrition Group (NG) received only a nutrition program, and no intervention was applied to the Control Group (CG). At the end of the 12-week intervention period, the balance performance levels and body composition values of the groups were reassessed. The study aimed to investigate the effect of weight loss resulting from exercise and nutrition on balance performance.\u003c/p\u003e\u003cp\u003eFor all participants in the ENG, NG, and CG groups, measurements including height, weight, body mass index (BMI), and body composition (analyzed using a Tanita device) were recorded. Balance performance was then assessed using the Technobody Prokin PK 200 WL balance measurement system. Following the 12-week exercise and nutrition program, final assessments were conducted, and the relationship between weight loss resulting from the exercise and nutrition interventions and balance performance was evaluated.\u003c/p\u003e\u003cp\u003eBefore the start of the exercise program, the exercises were introduced to the participants by the researcher through explanations and preparatory sessions. During the trial phase, all participants’ maximum performance levels were assessed both before the intervention and at the end of the sixth week. The training sessions were then conducted at 50% of each participant’s maximum capacity.\u003c/p\u003e\u003ch3\u003e3. Tests\u003c/h3\u003e\u003cp\u003eBody composition and balance measurements were conducted for all study groups. A combined nutrition and exercise program was implemented for the Exercise and Nutrition Group, while only a nutrition program was administered to the Nutrition Group. Detailed information regarding the tests and measurements is provided below.\u003c/p\u003e\u003ch2\u003e3.1. Body Composition Measurement\u003c/h2\u003e\u003cp\u003eParticipants’ height was first measured using a Mesitaş brand stadiometer tape measure. Subsequently, body composition was assessed using the Tanita BC-418 MA device. For each measurement, the participant’s age and measured height were individually entered into the Tanita Body Composition Analyzer, and the body type was selected as \"Female-Standard.\" Participants stepped onto the device barefoot and held the grip electrodes with both their right and left hands. Once the device stabilized the participant’s weight, the measurement was completed. The printouts generated by the device were recorded.\u003c/p\u003e\u003ch2\u003e3.2. Balance Measurement\u003c/h2\u003e\u003cp\u003eTo assess the balance abilities of the participants, a balance performance test was administered twice—once as a pre-test and once as a post-test using the Technobody Prokin PK 200WL device. The test was performed with participants standing on the platform with both feet and their eyes open. During the test, they stood on an unstable balance platform and attempted to maintain their balance by following a circular guide displayed on the monitor. The device was set up and connected to the monitor prior to the measurements. The device includes easy, medium, and hard difficulty levels; for this study, the “easy” level was selected. Prior to testing, participants were informed about the procedure, and each participant completed the test individually. The monitor was positioned at a height and distance that allowed for clear visibility. After stabilizing their posture, participants notified the test administrator when they were ready, and the measurement began. The test lasted 30 seconds, during which participants stood with both feet on the platform and their arms extended laterally. If a participant lost balance or stepped off the platform before the time elapsed, the test was stopped and repeated. Each participant completed the balance test twice, and the better result was recorded.\u003c/p\u003e\u003ch2\u003e3.3. Nutrition Programme\u003c/h2\u003e\u003cp\u003eAccording to the World Health Organization’s energy formula, the daily caloric requirement for individuals with moderate physical activity and an average body weight of 65 kg is 2,350 kcal. For individuals with no physical activity and the same average body weight, the daily caloric requirement is 1,850 kcal. The exercise program followed by the Exercise and Nutrition Group (ENG) resulted in a daily caloric deficit of approximately 500–600 kcal. In the Nutrition Group (NG), since no physical activity was performed, no caloric deficit occurred. Both nutrition programs were designed to achieve a weight loss of 500 grams per week, leading to a total weight loss of approximately 6 kilograms by the end of the 12-week period.\u003c/p\u003e\u003cp\u003eSince the Nutrition Group did not follow any exercise program, they adhered to the following nutrition plan: For breakfast, they consumed 1 slice of whole wheat or multigrain bread (25 g), low-fat cheese (30 g), 1 boiled egg (50 g), 2 teaspoons of honey (14 g), tomatoes, cucumber, and greens (200 g), 6–7 black olives (28 g), and tea (70 g). At lunch, the meal included 1 bowl of vegetable soup (100 g), a vegetable dish (100 g), 5–6 tablespoons of rice or pasta (100 g), salad (100 g), and either yogurt (100 g) or 2 glasses of ayran (200 g). For dinner, they had meat or chicken equivalent to 2 meatballs (60 g), 8 tablespoons of a vegetable dish (200 g), 6–8 tablespoons of rice or pasta (120 g), salad (300 g), and 3–4 tablespoons of low-fat yogurt (45 g). Alternatively, the meal could consist of 8 tablespoons of legumes (100 g), 1 slice of whole grain bread (25 g), 1 medium-sized fish or 20 anchovies (200 g), and baked potatoes (150 g).\u003c/p\u003e\u003cp\u003eSince the Exercise and Nutrition Group followed a 12-week resistance training program, they adhered to a nutrition plan designed to compensate for the resulting calorie deficit. For breakfast, they consumed 3 slices of whole wheat or multigrain bread (75 g), low-fat cheese (30 g), 1 boiled egg (50 g), 2 teaspoons of honey (14 g), tomatoes, cucumber, and greens (200 g), 6–7 black olives (28 g), and tea (70 g). At lunch, the meal included 1 bowl of vegetable soup (100 g), a vegetable dish (100 g), 5–6 tablespoons of rice or pasta (100 g), salad (100 g), yogurt (100 g) or 2 glasses of ayran (200 g), and 1 serving of fruit (100 g). For dinner, they had meat or chicken equivalent to 4 meatballs (120 g), 8 tablespoons of a vegetable dish (200 g), 6–8 tablespoons of rice or pasta (120 g), salad (100 g), and low-fat yogurt (45 g). As alternatives, the meal could consist of 10 tablespoons of legumes (125 g), 3 slices of whole grain bread (75 g), 2 medium-sized fish or 40 anchovies (400 g), and baked potatoes (150 g). A night snack included 1 serving of fruit (100 g) and 1 glass of milk (200 g).\u003c/p\u003e\u003cp\u003eThese plans support a balanced intake of carbohydrates, protein, and fat. The nutrition list was updated according to individuals' eating habits and was prepared and monitored in collaboration with a professional dietitian.\u003c/p\u003e\u003ch2\u003e3.4. Exercise Programme\u003c/h2\u003e\u003cp\u003eThe 12-week exercise program used in the study was designed to strengthen both the lower and upper extremities, which are essential for balance performance. The duration and repetition count for each exercise were specified in a table, and the exercise intensity was maintained at 50%. Participants were expected to burn approximately 500–600 kcal per day on each training day. Repetitive movements were performed according to the given sets and repetitions, while time-based exercises were executed for the specified duration, with 30-second rest intervals between movements. In the first week, chest muscles were targeted with Pectoral Fly and Chest Press Machine, while Midrow and Highrow focused on the back; Body Weight Squat and Step-Up strengthened the legs, and Plank and Side Plank worked the core. The second week focused on shoulder muscles with Shoulder Press Machine and Dumbbell Lateral Raises, legs with Leg Extension and Leg Curl, and core with Lying Knee Up and Leg Raises. In the third week, dynamic exercises such as Sumo Squat and Split Squat were added; cardiovascular endurance was improved with High Knees and 200m Rowing; Push-Up and TRX Row worked the upper body, and core exercises included Superman and V Sit-Up. The fourth week emphasized strength, using Smith Machine Bench Press and Incline Dumbbell Fly for the chest, Lat Pull Down and Seated Row for the back, Arnold Press and Dumbbell Front Raise for the shoulders, Leg Press and Abduction Machine for the legs, and Hyperextension and Bicycle Crunch for the core. In the fifth week, functional movements like Madison Ball Wall Squat and Dumbbell Deadlift were performed, Ski Erg 300m supported cardio endurance, and Shoulder Taps Push-Up and Swiss Ball Plank targeted upper body strength and balance. The sixth week revisited upper body exercises such as Pectoral Fly, Chest Press Machine, Midrow, and Highrow, supported by Dumbbell Lateral Raises, Shoulder Press Machine, and Leg Curl. In the seventh week, strength and cardiovascular endurance were increased with Sumo Squat, Split Squat, High Knees, and Push-Up. The eighth week focused on both upper and lower body muscles through Smith Machine Bench Press, Incline Dumbbell Fly, Lat Pull Down, Seated Row, and Abs Machine. The ninth week emphasized balance and strength with Madison Ball Wall Squat, Dumbbell Deadlift, and Swiss Ball Plank. In the tenth week, upper body development was targeted with Dumbbell Bench Press, Cable Fly, Dumbbell Biceps Curl, Push Down, and Leg Raises. In the eleventh week, functional strength was enhanced with Sumo Squat, High Knees, Push-Up, and Superman. Finally, in the twelfth week, muscular endurance in the upper body was improved with Chest Press Machine, Pectoral Fly, Highrow, and Midrow, while lower body strength was developed with Leg Extension and Leg Curl. Overall, the program was designed to work all major muscle groups in a balanced manner, with varied weekly exercises to ensure comprehensive full-body development.\u003c/p\u003e\u003ch3\u003e4. Analyze\u003c/h3\u003e\u003cp\u003eThe statistical analyses were performed using the SPSS 26.0 for Windows software package (IBM Corp., Armonk, New York, USA). The Shapiro-Wilk test was used to assess the normality of data distribution. As the data were normally distributed, a Two-Way Analysis of Variance (Two-Way ANOVA) was employed to evaluate differences between groups. To examine the differences among the variables across the groups, a One-Way ANOVA test was used, and Bonferroni was selected as the Post Hoc test. The effect size of the differences (Cohen’s d) was reported based on Cohen’s classification (small effect: 0.1–0.3, medium effect: 0.3–0.5, and large effect: 0.5 and above), along with partial eta squared (ƞp²) values. In all tests, statistical significance was set at p \u0026lt; 0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cem\u003eAssessment of Between-Group Differences in Dependent Variables\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" 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colname=\"c4\"\u003e\u003cp\u003e23.44\u0026thinsp;\u0026plusmn;\u0026thinsp;4.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e111.233\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.719\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.809\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e23.98\u0026thinsp;\u0026plusmn;\u0026thinsp;2.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e21.75\u0026thinsp;\u0026plusmn;\u0026thinsp;2.43\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eENG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e23.76\u0026thinsp;\u0026plusmn;\u0026thinsp;3.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e21.57\u0026thinsp;\u0026plusmn;\u0026thinsp;3.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003eFat %\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e27.5\u0026thinsp;\u0026plusmn;\u0026thinsp;6.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e28.2\u0026thinsp;\u0026plusmn;\u0026thinsp;6.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003e9.166\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003e.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003e.174\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003e0.604\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e29.4\u0026thinsp;\u0026plusmn;\u0026thinsp;6.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e26.5\u0026thinsp;\u0026plusmn;\u0026thinsp;5.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eENG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e29.7\u0026thinsp;\u0026plusmn;\u0026thinsp;6.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e25.3\u0026thinsp;\u0026plusmn;\u0026thinsp;8.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e34.2\u0026thinsp;\u0026plusmn;\u0026thinsp;2.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e31.8\u0026thinsp;\u0026plusmn;\u0026thinsp;2.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eENG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e34.1\u0026thinsp;\u0026plusmn;\u0026thinsp;2.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e32.3\u0026thinsp;\u0026plusmn;\u0026thinsp;2.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"8\"\u003eCG: Control Group, NG: Nutrition Group, ENG: Exercise and Nutrition Group\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eAs shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, there was a statistically significant difference (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) between the pre-test and post-test measurements of the Weight and BMI variables in the CG (Control Group), NG (Nutrition Group), and ENG (Exercise and Nutrition Group). The effect size for the Weight variable was determined as η\u0026sup2; = 0.980, and for the BMI variable, it was η\u0026sup2; = 0.719. Additionally, a significant difference (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) was found in the Body Fat Percentage variable among the CG, NG, and ENG groups, with an effect size of η\u0026sup2; = 0.174.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cem\u003eAssessment of Intergroup Differences in the Balance Variable\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGroups\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eTests\u003c/p\u003e\u003cp\u003ex̄\u0026plusmn;ss\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ef\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eη\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eCohen\u0026rsquo;s d\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eBalance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003ePre-Test\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003ePost-test\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c8\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e249.6\u0026thinsp;\u0026plusmn;\u0026thinsp;114.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e249.4\u0026thinsp;\u0026plusmn;\u0026thinsp;109.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e40.852\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.689\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.953\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e249.3\u0026thinsp;\u0026plusmn;\u0026thinsp;114.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e209.4\u0026thinsp;\u0026plusmn;\u0026thinsp;90.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eENG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e249.1\u0026thinsp;\u0026plusmn;\u0026thinsp;113.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e155.7\u0026thinsp;\u0026plusmn;\u0026thinsp;70.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"8\"\u003eCG: Control Group, NG: Nutrition Group, ENG: Exercise and Nutrition Group\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"8\"\u003eAs presented in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, there was a statistically significant difference (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) between the pre-test and post-test scores of the Balance variable among the CG, NG, and ENG groups, with a reported effect size of η\u0026sup2; = 0.689\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cem\u003eThe Differences Between the Groups Regarding the Variables in Comparison with One Another\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDifference Variables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGroup 1\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eGroup 2 and 3\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ex̄ Mean\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eη\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003ef\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eWeight\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eCG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-6.17000\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.960\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e1043.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eENG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-6.09667\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eENG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.07333\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1,000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eBMI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eCG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-2.01333\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.719\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e111.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eENG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-1.96333\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eENG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.05000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1,000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eBalance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eCG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-39.66767\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.484\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e40.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eENG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-93.26400\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eENG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-53.59633\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"7\"\u003eCG: Control Group, NG: Nutrition Group, ENG: Exercise and Nutrition Group\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eAs shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, for the Weight variable, a significant difference was found in the difference of differences between the CG and NG groups (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), as well as between the CG and ENG groups (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). However, no significant difference was observed between the NG and ENG groups in terms of the difference of differences in the Weight variable. For the BMI variable, there was a significant difference in the difference of differences between the CG and NG groups (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), and also between the CG and ENG groups (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), whereas no significant difference was found between the NG and ENG groups. Regarding the Balance variable, significant differences in the difference of differences were observed between the CG and NG groups (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), between the CG and ENG groups (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), and also between the NG and ENG groups (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study was conducted to examine the effects of weight loss resulting from a 12-week exercise and nutrition program on balance performance in sedentary women. The hypothesis of the study was that there may be changes in balance performance and body composition values in sedentary women who follow a 12-week resistance exercise and nutrition program, as well as in those who follow only a nutrition program. Furthermore, the study aimed to determine whether these potential changes differ from the balance performance and body composition values of women who do not participate in any program. The most significant findings of the study revealed that there were statistically significant differences in the balance performance and body composition values between the group that followed both the exercise and nutrition program (ENG) and the group that followed only the nutrition program (NG), as well as between both ENG and NG and the control group (CG), which did not participate in any program. As shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, the exercise program implemented for the Exercise and Nutrition Group (ENG), when supported by the nutrition program used in the study, resulted in an average improvement of 37.6% in balance performance. In contrast, the Nutrition Group (NG), which followed only the nutrition program, demonstrated an average improvement of 16.0% in balance performance, as also indicated in Table\u0026nbsp;8. These results suggest that the balance performance of the ENG, which followed both the exercise and nutrition programs for 12 weeks, improved by 21.6% more compared to the NG, which followed only the nutrition program.\u003c/p\u003e\u003cp\u003eThe question of whether exercise and nutrition programs influence balance performance was addressed through the findings of the study. The most prominent result and strength of the research is the conclusion that postural stability an important determinant of quality of life can be improved through regular exercise and nutrition programs. The exercise program implemented in the study primarily consisted of movements aimed at reducing fat mass. It remains unknown whether an exercise program designed to also promote increases in muscle mass would yield results consistent with the current findings. Moreover, it is uncertain whether the outcomes of this study would be replicated if the same exercise and nutrition programs were applied to athletes instead of sedentary women, to participants older than the 25\u0026ndash;35 age group included in this research, or to men instead of women.\u003c/p\u003e\u003cp\u003eAn exercise program consisting of 45-second movements applied to young individuals led to improvements in balance performance among athletes (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). This finding appears to be consistent with the results of the present study. Impaired balance ability in sedentary individuals stems from ankle muscle contractions caused by physical inactivity (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Their findings align with the improvements in balance performance observed in this study following the exercise intervention. A 12-week balance training program designed to enhance postural control resulted in a 146% increase in participants\u0026rsquo; balance performance in older adults (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). These findings also show similarities with the results of the present research. An improvement in balance performance among tennis players was observed following an exercise program designed to develop both upper and lower extremities simultaneously (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). These results appear to be consistent with the findings of the present study. Similarly, resistance exercises, presented through quantitative dose\u0026ndash;response relationships that enhance the effectiveness of balance-improving protocols, are an effective tool for improving proactive balance in healthy young adults aged 16\u0026ndash;40 (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Their findings also align with the outcomes of this research. Additionally, it was found that regular exercise improves trunk angular sway and postural alignment, further supporting the positive relationship between exercise and balance performance identified in the present study. These findings are consistent with the conclusion of the present study, which demonstrated that regular exercise improves balance performance (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). It was also reported that regular exercise is the most effective method for improving postural stability and balance, and their findings align with those of this study (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Furthermore, previous research has shown that regular participation in resistance and aerobic exercises (such as continuous walking, running, and cycling) contributes to lowering both clinical and ambulatory blood pressure in individuals with hypertension, while also supporting improvements in overall health and reductions in cardiovascular risk factors (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e).\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eAs a result, the findings of this study highlight the importance of integrating exercise and nutrition programs to improve daily movement performance, including postural stability and functional walking activities, in sedentary women. Standard balance exercises alone appear to be limited in enhancing daily functional movements and improving postural stability. Therefore, it is recommended that exercise programs be supported with appropriate nutritional strategies, and that balance-enhancing practices be incorporated into all rehabilitation and physical activity programs, given their direct impact on balance performance through dynamic exercises and movements.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eENG\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eExercise and Nutrition Group\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eNG\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eNutrition Group\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eCG\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eControl Group\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eEGZ-A+\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eExercise Readiness Questionnaire for All Individuals\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eBMI\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eBody Mass Index\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003ch2\u003eEthics approval and consent to participate\u003c/h2\u003e\n\u003cp\u003eEthical approval for the study was granted by the Ethics Committee of \u0026Ccedil;anakkale Onsekiz Mart University, T\u0026uuml;rkiye (Decision No: 2021-Y\u0026Ouml;NP-0515). All participants were informed about the purpose, procedures, and potential risks of the study, and written informed consent was obtained prior to participation, in accordance with the Declaration of Helsinki\u003c/p\u003e\n\u003ch2\u003eConsert for publication\u003c/h2\u003e\n\u003cp\u003eNot applicable. No identifying images or personal information of participants were included in this study.\u003c/p\u003e\n\u003ch2\u003eCompeting interests\u003c/h2\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003ch2\u003eAuthors\u0026rsquo; information (optional)\u003c/h2\u003e\n\u003cp\u003e\u003csup\u003e1*\u003c/sup\u003eTunay Dilican, Bursa Uludağ University\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003eRamiz Arabacı, Bursa Uludağ University\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOrcid id\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTunay Dilican: 0000-0003-4686-6849\u003c/p\u003e\n\u003cp\u003eRamiz Arabacı: 0000-0001-8403-5742\u003c/p\u003e\n\u003ch2\u003eFunding\u003c/h2\u003e\n\u003cp\u003eNo funding was received for this study.\u003c/p\u003e\n\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\n\u003cp\u003eT.D. and R.A. jointly authored the main manuscript. The implementation of the study and the literature review were conducted by T.D., while the data analysis and interpretation of the results were carried out by R.A.\u003c/p\u003e\n\u003ch2\u003eAcknowledgement\u003c/h2\u003e\n\u003cp\u003eThe authors thank all individuals who voluntarily participated in this study.\u003c/p\u003e\n\u003ch2\u003eData Availability\u003c/h2\u003e\n\u003cp\u003eThe datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003ePines A. Sedentary women: sit less, live more! Climacteric. 2015;18(6):770\u0026ndash;2.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMenz HB. Biomechanics of the ageing foot and ankle: a mini-review. Gerontology. 2015;61(4):381\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMuchna A, Najafi B, Wendel CS, Schwenk M, Armstrong DG, Mohler J. Foot problems in older adults: Associations with incident falls, frailty syndrome, and sensor-derived gait, balance, and physical activity measures. J Am Podiatr Med Assoc. 2018;108(2):126\u0026ndash;39.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWang C, Goel R, Rahemi H, Zhang Q, Lepow B, Najafi B. Effectiveness of daily use of bilateral custom-made ankle-foot orthoses on balance, fear of falling, and physical activity in older adults: a randomized controlled trial. Gerontology. 2019;65(3):299\u0026ndash;307.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSchoenfeld BJ, Ogborn D, Krieger JW. Effects of resistance training frequency on measures of muscle hypertrophy: a systematic review and meta-analysis. Sports Med. 2016;46(11):1689\u0026ndash;97.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKuller LH, Gabriel KKP, Kinzel LS, Underwood DA, Conroy MB, Chang Y, Kriska AM. The Women on the Move Through Activity and Nutrition (WOMAN) study: final 48-month results. Obesity. 2012;20(3):636\u0026ndash;43.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eYaggie JA, McGregor SJ. Effects of isokinetic ankle fatigue on the maintenance of balance and postural limits. Arch Phys Med Rehabil. 2002;83(2):224\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHiemstra LA, Lo IK, Fowler PJ. Effect of fatigue on knee proprioception: implications for dynamic stabilization. J Orthop Sports Phys Therapy. 2001;31(10):598\u0026ndash;605.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWolfson L, Whipple R, Judge J, Amerman P, Derby C, King M. Training balance and strength in the elderly to improve function. J Am Geriatr Soc. 1993;41(3):341\u0026ndash;3.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRussell PJ, Swartz EE, Croce RV, Decoster LC. Poster: Knee Valgus in Self-Initiated Vertical Jump Landings. Developmental and Gender Comparisons; 2007.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLesinski M, Hortob\u0026aacute;gyi T, Muehlbauer T, Gollhofer A, Granacher U. Dose-response relationships of balance training in healthy young adults: a systematic review and meta-analysis. Sports Med. 2015;45(4):557\u0026ndash;76.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLim SB, Horslen BC, Davis JR, Allum JH, Carpenter MG. Benefits of multi-session balance and gait training with multi-modal biofeedback in healthy older adults. Gait Posture. 2016;47:10\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePrasertsakul T, Kaimuk P, Chinjenpradit W, Limroongreungrat W, Charoensuk W. The effect of virtual reality-based balance training on motor learning and postural control in healthy adults: a randomized preliminary study. Biomed Eng Online. 2018;17(1):1\u0026ndash;17.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSharman JE, La Gerche A, Coombes JS. Exercise and cardiovascular risk in patients with hypertension. Am J Hypertens. 2015;28(2):147\u0026ndash;58.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-sports-science-medicine-and-rehabilitation","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ssmr","sideBox":"Learn more about [BMC Sports Science, Medicine and Rehabilitation](http://bmcsportsscimedrehabil.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ssmr/default.aspx","title":"BMC Sports Science, Medicine and Rehabilitation","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Balance, Exercise, Nutrition","lastPublishedDoi":"10.21203/rs.3.rs-7065676/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7065676/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThe aim of this study is to investigate the effect of weight loss, resulting from a 12-week resistance exercise and nutrition program, on 30-second static balance performance in healthy sedentary young women aged 25\u0026ndash;35. A total of 90 sedentary women who met the inclusion criteria participated voluntarily and were randomly assigned into three groups: exercise and nutrition group (ENG), nutrition group (NG), and control group (CG). The balance performance of all participants was measured using the Tecnobody Prokin Pk 200 WL device. Subsequently, a 12-week exercise and nutrition program was applied to the ENG, only a nutrition program was administered to the NG, and no intervention was applied to the CG. After completing the 12-week programs, balance performance measurements were repeated to identify the differences. Before the study and at the end of the first six weeks, participants\u0026rsquo; maximum strength levels were determined using the 1RM calculation method, and exercises were performed at 50% of these maximums. The analyses revealed that after the 12-week intervention, balance performance improved by 37.6% in the ENG and by 16.0% in the NG. The balance performance improvement in the ENG was found to be 21.6% higher compared to the NG. In conclusion, the combination of an exercise program supported by a nutrition plan has a more significant effect on balance performance than a nutrition program alone. These findings suggest that such interventions can positively impact daily life and improve the quality of life in sedentary women. Thai Clinical Trials Registry (TCTR), Trial registration: Current Controlled Trials TCTR20250721002 (21.07.2025), Retrospectively registered.\u003c/p\u003e","manuscriptTitle":"The Effect Of Exercise And Nutritional Weight Loss On The Balance Performance Of Healthy Sedentary Women","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-19 07:25:25","doi":"10.21203/rs.3.rs-7065676/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-10-02T21:37:14+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-29T23:15:27+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"294128172964614665620622009933181200004","date":"2025-09-27T18:56:44+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"218838526048666056126183210435545039889","date":"2025-09-23T08:32:49+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-09-12T12:45:25+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-07-24T08:33:10+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-07-23T08:04:18+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Sports Science, Medicine and Rehabilitation","date":"2025-07-23T08:01:26+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-sports-science-medicine-and-rehabilitation","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ssmr","sideBox":"Learn more about [BMC Sports Science, Medicine and Rehabilitation](http://bmcsportsscimedrehabil.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ssmr/default.aspx","title":"BMC Sports Science, Medicine and Rehabilitation","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e4a15266-6969-47ab-b127-c25ead297059","owner":[],"postedDate":"September 19th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-09-19T07:25:25+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-19 07:25:25","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7065676","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7065676","identity":"rs-7065676","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}