Precision Exercise prescription in women for the Prevention and Treatment of Cardio-Metabolic Diseases

Metabolic diseases such as obesity, type 2 diabetes, and cardiometabolic syndrome are strongly associated with impaired aerobic capacity, autonomic imbalance, and altered ventilatory control. Exercise training is a cornerstone of prevention and treatment, yet exercise prescription remains largely non-individualized (and breathing-based interventions are underexplored) despite their strong physiological rationale.

Also, exercise prescription may represent a powerful strategy to prevent or attenuate cardiovascular risk in women. Therfore fluctuations in ovarian hormones across the menstrual cycle and the transition to peri-menopause and its modulatory impact on vascular function, autonomic regulation, and exercise capacity, should be further investigated.

This project could include personalized exercise-training and breathing-exercise strategies grounded in advanced cardio-respiratory phenotyping. The approach integrates:

• Cardio-pulmonary exercise testing (CPET) to characterize aerobic capacity, ventilatory efficiency, and limiting factors

• Heart rate variability analysis to monitor internal load, fatigue, and autonomic regulation during training (DFA α1 )

• Breathing control and respiratory center assessments (e.g. ventilatory responses, breathing pattern analysis) to identify dysfunctional breathing and autonomic dysregulation

• Targeted breathing interventions (slow breathing, controlled ventilation, inspiratory muscle training) combined with individualized aerobic exercise programs

A focus on women hormonal context shoulld be integrated.

The goal is to highlight the importance of exercise and/or breathing interventions, tailored to physiological profiles, by more effectively improve metabolic control, autonomic balance, exercise tolerance, and long-term adherence specific to women in the context of her hormonal status.