Abstract

Background: Muscle health decline is a major concern in postmenopausal women; however, most interventions have focused on exercise as an isolated component. It remains unclear whether embedding exercise within a broader lifestyle framework enhances muscle-related outcomes. Methods: A total of 100 postmenopausal women took part in this randomized controlled trial and were randomly assigned to three groups: Nordic walking combined with high-protein intake and time-restricted eating (NW+HP+TRE, n = 36), Nordic walking combined with time-restricted eating (NW+TRE, n = 33), and a control group (n = 31). The intervention lasted 12 weeks. The primary outcome was handgrip strength, and the secondary outcomes included physical performance (6 m gait speed and five times chair-stand time) and lean mass-related measures. Adherence to all intervention components was monitored throughout the study. Results: During the intervention, four participants did not complete the post-intervention assessment, resulting in 96 participants being included in the final analysis. Handgrip strength improved in both intervention groups, with the largest increase observed in the NW+HP+TRE group. Physical performance outcomes showed a similar pattern. In contrast, the NW+TRE group showed less favorable changes in lean mass-related measures, whereas the control group showed minimal overall changes. Adherence to Nordic walking, time-restricted eating, and protein intake was high in the intervention groups. Conclusions: A Nordic walking-based integrated lifestyle intervention was associated with a more favorable overall pattern of change in muscle strength, physical performance, and lean mass-related outcomes in postmenopausal women. These findings should be interpreted as differences between intervention packages rather than as evidence for the isolated effect of any single lifestyle component. Further research is needed to examine the long-term sustainability of such interventions and to clarify the contribution of individual components.

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