Exercise as a Non-Drug Intervention to Improve Body Composition and Cardiometabolic Health in Middle-Aged Saudi Men: A Community-Based Study in Al-Ahsa

<title>Abstract</title> <p> <bold>Background:</bold> Obesity and sedentary behavior among Saudi men pose a critical public health threat, contradicting the preventive health goals of Saudi Vision 2030. This study examines whether a structured, community-based exercise program can serve as an effective non-pharmacological intervention to improve body composition, physical fitness, and cardiometabolic health in middle-aged Saudi men. <bold>Methods</bold> : A quasi-experimental pre-post controlled trial was conducted with 30 sedentary, overweight or obese men (aged 40–55 years) from Al-Ahsa, Saudi Arabia. Participants were assigned to an experimental group (n = 15) that completed a 12-week progressive combined exercise program (aerobic, resistance, and flexibility; 4 sessions/week, 60–75 min/session) or a control group (n = 15) that maintained usual routines. Assessments included anthropometry, body composition (via bioelectrical impedance), muscular strength and endurance, agility, blood pressure, and fasting blood biomarkers (lipid profile, glucose, HbA1c). <bold>Results</bold> : At baseline, groups were comparable (all p &gt; 0.05). After 12 weeks, the experimental group showed significant improvements: body weight (−5.34 kg), BMI (−1.82 kg/m²), body fat% (−4.26%), and fat mass (−5.38 kg) (all p &lt; 0.001). Physical fitness markedly increased in grip strength (+4.74 kg), leg strength (+17.82 kg), plank endurance (+27.16 s), and agility (−1.68 s) (all p &lt; 0.001). Cardiometabolic markers improved significantly: systolic BP (−8.16 mmHg), total cholesterol (−22.58 mg/dL), triglycerides (−28.36 mg/dL), HDL-C (+6.38 mg/dL), fasting glucose (−12.82 mg/dL), and HbA1c (−0.42%) (all p ≤ 0.002). The control group showed no significant changes. Between-group differences were highly significant across all outcomes (p &lt; 0.001). <bold>Conclusion</bold> : A 12-week community-based combined exercise program induces clinically meaningful improvements in adiposity, fitness, and metabolic health, supporting its integration into national preventive health strategies under Saudi Vision 2030. </p>