The observed decrease in metabolic syndrome was mediated by significant improvements in exercise efficiency for the AER and AER + RES training groups ( P < 0.05 ) , which was more strongly related to TTE ( 25 % -30 % ; r = -0.38 , 95 % CI = -0.55 to -0.19 ) than VO2peak ( 5 % -6 % ; r = -0.24 , 95 % CI = -0.45 to -0.01 ) .