To compare the effects of aerobic exercise at maximal fat oxidation (FATmax) and FATmax intensity exercise combined with resistance training (RT), and dietary restriction on the body composition, vascular endothelial function and ferroptosis in obese female university students, so as to provide a reference for exploring the mechanisms by which exercise improves vascular endothelial function.

From February to May 2024, 70 obese female university students were recruited from Shanxi University and randomly divided into control group (n=24), FATmax group (n=24) and FATmax+RT group (n=22). From March 4 to May 26, 2024 control group maintained their normal living habits, FATmax group performed aerobic exercise at FATmax intensity three times per week for 60 minutes per session; FATmax +RT group performed combined aerobic and resistance exercise at FATmax intensity three times per week for 60 minutes per session. The daily dietary calorie intake for all groups was determined according to resting energy expenditure. Body composition, vascular endothelial function and ferroptosis were measured before and after the intervention.

After 12 weeks of intervention, there were statistically significant differences in body mass, BMI, body fat, waist-hip ratio and muscle mass among the three groups (F=10.93, 5.88, 65.28, 21.14, 2.25, all P < 0.05). Compared with the control group, participants in both the FATmax group and the FATmax+RT group showed significant reductions in body weight, BMI, body fat and waist-hip ratio (all P < 0.05). Body fat and waist-hip ratio in FATmax+RT group were lower than those in FATmax group, and muscle mass was higher than those in FATmax group and control group (both P < 0.05). After 12 weeks of intervention, significant differences were observed among the three groups in serum NO, GSH, serum ferritin levels and FMD (F=9.14, 9.67, 4.78, 135.70, all P < 0.05). Compared with the control group, the serum NO, GSH levels and FMD significantly increased, and the serum ferritin level decreased (all P < 0.05) of obese female university students in FATmax group and FATmax+RT group. Serum GSH level and FMD increased and serum ferritin level decreased in FATmax +RT group when compared with FATmax group (all P < 0.05).

With the same exercise training duration and frequency, FATmax intensity aerobic exercise, alone or combined with resistance and dietary restriction, can significantly improve the body composition, vascular endothelial function and inhibit ferroptosis of obese female university students. However, FATmax intensity aerobic exercise combined with resistance training has more pronounced effects.