Tabriz University of Medical Sciences Journal of Research in Clinical Medicine 2717-0616 14 1 2026 01 01 Synergistic Effect of Nordic Walking Training and Fenugreek Supplementation on Adiponectin and Asprosin in Diabetic Older Adult Women; Simultaneously Using a Multivariate Longitudinal Model: Randomized Clinical Trial 35337 35337 10.34172/jrcm.35337 EN Rouhollah Haghshenas https://orcid.org/0000-0002-0560-6306 Neda Gilani https://orcid.org/0000-0002-5399-0277 Jamileh Malakouti https://orcid.org/0000-0002-1448-6940 Journal Article 10.34172/jrcm.35337 2025 04 19 2025 10 09 Introduction: This study aimed to evaluate the synergistic effect of Nordic walking (NW) training and fenugreek supplementation (FS) on plasma adiponectin and asprosin concentrations in elderly women with diabetes. Methods: In a randomized, double-blind, placebo-controlled clinical trial, a total of 48 elderly women with type 2 diabetes (mean age of 66.73±1.52 years) were randomly allocated into six groups of equal size: control group (n=8), FS group (n=8), placebo group (n=8), NW+FS group (n=8), NW+placebo group (n=8), and NW group (n=8). The exercise protocol was NW training, administered on non-consecutive days over eight weeks, at a frequency of three days per week. The NW+FS and FS groups were administered a daily dosage of six capsules, each containing 300 mg of phytophage herbal tablet (equivalent to 220 mg of standardized dried fenugreek extract). Results: The synergistic effect of exercise and supplementation significantly reduced FBS by an average of 16.88 mmHg, HOMA-IR by 1.74 units, and asprosin by 0.61 ng/dl compared to the control (β=-16.88, P<.001; β=-2.74, P=.009; and β=-0.61, P=.007, respectively). So, the synergistic effect of exercise and supplementation on FBS, HOMA-IR, and asprosin was 2.42, 1.44, and 3.86, respectively. However, this synergistic effect on insulin was not statistically significant (β=-2.10, P<.065). On the other hand, the combined intervention resulted in a significant increase in adiponectin levels (β=13.00, P<.001). Conclusion: Both NW training and FS have beneficial effects on inflammatory and anti-inflammatory factors in older women with diabetes.