BACKGROUND: Many people, although they may recognise the positive effects of exercise, do not exercise regularly owing to lack of time. This study aimed to investigate the effects of prolonged single-session exercise and multiple short sessions of exercise on the risk of metabolic syndrome and the atherogenic index in middle-aged obese women. METHODS: Thirty-six participants were divided into the single-session group, multiple-session group, and control group. The single-session group engaged in one session of treadmill exercise for 30 min a day; the multiple-session group had three sessions of 10 min a day. Both groups exercised 3 days/week for 12 weeks. The control group did not perform any exercise. RESULTS: The single-session group showed decreases in weight (0.97 kg (95% CI 0.09 to 1.83), p < 0.05), body mass index (0.43 kg/m2 (95% CI 0.03 to 0.81), p < 0.05), and fat mass (1.65 kg (95% CI 0.78 to 2.51), p < 0.01). Systolic blood pressure dropped in the single-session group (6.66 mmHg (95% CI 1.44 to 11.88), p < 0.05), and diastolic blood pressure dropped in the multiple-session group (3.38 mmHg (95% CI 1.44 to 5.88), p < 0.01). High-density lipoprotein cholesterol rose in the single-session group (4.08 mg/dL (95% CI -8.08 to -0.07), p < 0.05) and dropped in the control group (10.75 mg/dL (95% CI 1.95 to 19.54), p < 0.01). According to post hoc analysis, high-density lipoprotein cholesterol increased more in the single-session group than the control group (95% CI 0.61 to 21.88, p < 0.05). Glucose levels decreased in both the single-session group (16 mg/dL (95% CI 5.64 to 26.35), p < 0.01) and the multiple-session group (12.16 mg/dL (95% CI 2.18 to 22.14), p < 0.05). Waist circumference decreased in the single-session group (2.65 cm (95% CI 1.46 to 3.83), p < 0.001) and multiple-session group (2.04 cm (95% CI 1.51 to 2.73), p < 0.001). Low-density lipoprotein cholesterol levels rose in both the multiple-session group (-15.79 mg/dL (95% CI -34.24 to -3.78), p < 0.05) and the control group (-22.94 mg/dL (95% CI -44.63 to -1.24), p < 0.05). The atherogenic index increased in the control group (-1.06 (95% CI -1.69 to -0.41), p < 0.01). CONCLUSIONS: The findings indicate that prolonged exercise is superior to multiple short sessions for improving the risk of metabolic syndrome and the atherogenic index in middle-aged obese women. However, multiple short sessions can be recommended as an alternative to prolonged exercise when the goal is to decrease blood glucose or waist circumference.

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