Physical activity and reduced intra-abdominal fat in midlife African-American and white women

Predictive Value of Abdominal Fat Distribution on Coronary Artery Disease Severity Stratified by Computed Tomography-Derived SYNTAX Score

This study aimed to evaluate the association between abdominal fat distribution (AFD) and coronary artery disease (CAD) complexities using the computed tomography (CT)-derived SYNTAX score (CT-SXscore). Coronary computed tomographic angiography (CCTA) was performed in patients with suspected CAD. Plain abdominal CT was performed to measure visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) areas. To assess AFD, VAT/SAT (V/S) ratios were calculated. The CT-SXscore was calculated in patients with significant stenoses assessed by CCTA. Of 942 enrolled patients, 310 (32.9%) had 1 or more significant stenoses. The CT-SXscore showed a positive correlation with the V/S ratio (r = 0.33, p < 0.001). In the multivariate regression analysis, the V/S ratio was the only independent predictor for CAD severity based on the CT-SXscore (β = 0.25; t = 4.14; p < 0.001), even though the absolute SAT and VAT areas showed no relationship to the CT-SXscore. Regarding the 4 CAD-patient groups divided according to their median VAT and SAT areas, the CT-SXscore was significantly higher for the high VAT/low SAT group than for any other group (19.6 ± 11.5 vs 13.3 ± 9.6 in the low VAT/low SAT, 10.1 ± 8.5 in the low VAT/high SAT, and 12.2 ± 8.7 in the high VAT/high SAT groups; p < 0.001 for all). In conclusion, it was found that the V/S ratio is a useful index for predicting CAD severity and that AFD may be a more important risk factor for CAD than the absolute amount of each abdominal fat.

Life course socioeconomic position and body composition in adulthood: a systematic review and narrative synthesis

INTRODUCTION

Multiple systematic reviews have investigated the relation between socioeconomic position (SEP) and body mass index (BMI) throughout the life course. However, BMI does not capture quantity and distribution of fat and muscle, which are better indicators of obesity than BMI, and have been independently linked to adverse health outcomes. Less is known about the relation between SEP and body composition, and the literature has not been reviewed. We therefore systematically reviewed the literature on the association between life course SEP and body composition in adulthood.

METHODS

A protocol was registered on PROSPERO (CRD42019119937), and the review followed PRISMA guidelines. An electronic search of three databases (MEDLINE, Embase Classic + Embase and SPORTDiscus) was conducted. Original studies in the English language were included that examine the association between any recognised measure of SEP at any age and body composition (fat mass, fat-free mass, ratio and distribution) in adulthood, measured using a direct technique, i.e., not an anthropometric measure. A narrative synthesis was conducted.

RESULTS

A total of 47 papers were included in the final review, none were from low-income countries (LICs). Greater advantage in childhood and adulthood was associated with lower fat levels in high-income countries (HICs). Associations in the opposite direction were found exclusively in middle-income countries (MICs). No studies in MICs reported associations for childhood SEP. For measures of lean mass, the majority of papers reported no association, or greater advantage in adulthood associated with higher lean mass, with little variation between HICs and MICs. Associations in HICs are more often observed in women than men.

CONCLUSION

The results indicate that fat measures follow similar patterns to those seen for BMI, and that women in HICs are more likely to experience inequalities in both fat and lean measures. Further research in LICs and MICs is needed.

Effects of High-Intensity Exercise Training on Adipose Tissue Mass, Glucose Uptake and Protein Content in Pre- and Post-menopausal Women

The menopausal transition is accompanied by changes in adipose tissue storage, leading to an android body composition associated with increased risk of type 2 diabetes and cardiovascular disease in post-menopausal women. Estrogens probably affect local adipose tissue depots differently. We investigated how menopausal status and exercise training influence adipose tissue mass, adipose tissue insulin sensitivity and adipose tissue proteins associated with lipogenesis/lipolysis and mitochondrial function. Healthy, normal-weight pre- (n = 21) and post-menopausal (n = 20) women participated in high-intensity exercise training three times per week for 12 weeks. Adipose tissue distribution was determined by dual-energy x-ray absorptiometry and magnetic resonance imaging. Adipose tissue glucose uptake was assessed by positron emission tomography/computed tomography (PET/CT) by the glucose analog [18F]fluorodeoxyglucose ([18F]FDG) during continuous insulin infusion (40 mU·m⁻²·min⁻¹). Protein content associated with insulin signaling, lipogenesis/lipolysis, and mitochondrial function were determined by western blotting in abdominal and femoral white adipose tissue biopsies. The mean age difference between the pre- and the post-menopausal women was 4.5 years. Exercise training reduced subcutaneous (~4%) and visceral (~6%) adipose tissue masses similarly in pre- and post-menopausal women. Insulin-stimulated glucose uptake, assessed by [18F]FDG-uptake during PET/CT, was similar in pre- and post-menopausal women in abdominal, gluteal, and femoral adipose tissue depots, despite skeletal muscle insulin resistance in post- compared to pre-menopausal women in the same cohort. Insulin-stimulated glucose uptake in adipose tissue depots was not changed after 3 months of high-intensity exercise training, but insulin sensitivity was higher in visceral compared to subcutaneous adipose tissue depots (~139%). Post-menopausal women exhibited increased hexokinase and adipose triglyceride lipase content in subcutaneous abdominal adipose tissue. Physical activity in the early post-menopausal years reduces abdominal obesity, but insulin sensitivity of adipose tissue seems unaffected by both menopausal status and physical activity.

Is Midlife Metabolic Syndrome Associated With Cognitive Function Change? The Study of Women's Health Across the Nation

CONTEXT

Metabolic syndrome (MetS) affects cognitive function in late life, particularly in women. But longitudinal research is scarce on associations of MetS with cognitive function during midlife.

OBJECTIVE

To determine associations between MetS exposure and cognitive function trajectories in midlife women.

DESIGN AND SETTING

This is a 17-year prospective, longitudinal study of multiracial/ethnic women in 7 US communities, with annual/biennial assessments.

PARTICIPANTS

Participants were 2149 US women traversing menopause.

EXPOSURE

Exposure consisted of MetS assessments (median 4 assessments over 4 years).

MAIN OUTCOME MEASURES

Main outcome measures were assessments of cognitive function in 3 domains: perceptual speed (symbol digit modalities test, SDMT), episodic memory (East Boston Memory Test, EBMT), and working memory (Digit Span Backward Test, DSB).

RESULTS

By their first cognitive assessment (age 50.7 ± 2.9 years), 29.5% met the criteria for MetS. Women completed a median (interquartile range [IQR]) of 6 (IQR 4-7) follow-up cognitive assessments over 11.2 (IQR 9.2-11.5) years. Women with MetS, compared with those without, had a larger 10-year decline in SDMT z-score (estimate -0.087, 95% confidence interval, -0.150 to -0.024; P = 0.007), after adjustment for cognitive testing practice effects, sociodemographics, lifestyle, mood, and menopause factors. As such, MetS accelerated the 10-year loss of perceptual speed by 24%. MetS did not differentially affect the rate of decline in either immediate (P = 0.534) or delayed (P = 0.740) episodic memory or in working memory (P = 0.584).

CONCLUSIONS

In midlife women MetS exposure was associated with accelerated decline in perceptual speed, but not episodic or working memory.

Design of a lifestyle intervention to slow menopause-related progression of intra-abdominal adipose tissue in women: The Women in the Southside Health and Fitness (WISHFIT) study

Background

Changes in reproductive hormones during menopause are associated with accumulation of intra-abdominal adipose tissue (IAAT), a subclinical indicator of cardiometabolic disease risk. Independent of reproductive hormones, unhealthy lifestyle contributes to IAAT gain. The Women in the Southside Health and Fitness (WISHFIT) Study aims to develop a lifestyle approach to slowing IAAT accumulation as women begin the menopausal transition.

Methods

The primary aim is to develop and conduct a proof-of-concept test of a multi-component, multi-level behavioral intervention targeting jointly physical activity, diet, and psychological well-being. Participants attend group sessions over 2 years to experiment with healthy living through both experiential and didactic learning, cultivate a health network, and draw on community resources to sustain change. The primary endpoint is 2-year IAAT progression, assessed using computerized tomography. Behavioral targets of treatment and secondary endpoints will be evaluated at 6, 12, 18 and 24 months. Change in social networks and community support will be assessed at 2 years.

Results

WISHFIT recruited 71 pre- and peri-menopausal Caucasian and African American women (mean ± SD age = 47.6 ± 3.4 yrs; BMI = 33.6 ± 7.3 kg/m²; 52% African American). Baseline IAAT was 2104.1 ± 1201.3 cm³. IAAT, physical activity, BMI, and self-reported family income and resilience differed by ethnicity at baseline.

Conclusions

WISHFIT is a multi-component, multi-level intervention aimed at producing a sustained improvement in physical activity, diet, and psychological well-being early in the menopausal transition to slow menopause-related accumulation of IAAT. It provides a model for the process of developing a behavioral treatment to manage a chronic disease.

Association of health-related behaviors, attitudes, and appraisals to leisure-time physical activity in middle-aged and older women

Physical activity carries immediate and long-term benefits for middle-aged and older women; however, physical activity decreases in adulthood and aging in women. In this study, the authors investigate the relation of health behaviors, health attitudes, and health appraisals to leisure-time physical activity among middle-aged and older women in a cross-sectional analysis of the second wave of the Study of Midlife Development in the United States (MIDUS2) conducted during the period from 2004 to 2006. The sample consisted of 829 women, ranging in age from 40 to 75 years of age (Mean = 56 years). In multiple logistic regression analyses, controlling for socio-demographic factors and functional restrictions, most of the psychosocial variables examined showed unique associations with physical activity, including health behaviors of having a routine checkup and not smoking, health attitudes involving commitment to health and valuing physical fitness and strength, and the health appraisal that one's health is better compared to others of the same age. Older women (aged 61-75 years) were less active, but reported greater health commitment than middle-aged women (aged 40-60 years). Neither health commitment nor any other psychosocial variable interacted with age in relation to physical activity. Understanding characteristics of middle-aged and older women who are physically active is essential in tailoring interventions to this population.

Abdominal adiposity change in white and black midlife women: The study of women's health across the nation

OBJECTIVE

The principal objective of this investigation was to compare the naturalistic intra-abdominal adipose tissue (IAAT) change among black and white women during midlife.

METHODS

A cohort of 222 (56%) white and 171 (44%) black midlife women were investigated in the Fat Patterning Study at the Chicago site of the Study of Women's Health Across the Nation. The subjects' total body fat was assessed by dual-energy X-ray absorptiometry and IAAT by a planimetric computed tomography (at the level of L4 -L5 ) annually over up to 4 years.

RESULTS

The total body fat at initial evaluation was higher in black women (45.1% ± 8.2%) when compared with white women (41.3% ± 8.7%, P < 0.001) and did not significantly change over the longitudinal follow-up. No significant racial differences were found in the mean annualized gain of IAAT (4.4% ± 0.5%) in models adjusted for total body fat, initial IAAT, age, race, time and race interaction, physical activity, depressive symptoms, menopausal status, and menopausal hormone therapy.

CONCLUSIONS

During a naturalistic observation, black and white midlife women had similar abdominal fat gain adjusted for differences in baseline adiposity. These data inform future research aimed to prevent IAAT gain during the critical midlife period of rising cardiovascular risk.

Association of Habitual Patterns and Types of Physical Activity and Inactivity with MRI-Determined Total Volumes of Visceral and Subcutaneous Abdominal Adipose Tissue in a General White Population

Population-based evidence for the role of habitual physical activity (PA) in the accumulation of visceral (VAT) and subcutaneous (SAAT) abdominal adipose tissue is limited. We investigated if usual patterns and types of self-reported PA and inactivity were associated with VAT and SAAT in a general white population. Total volumes of VAT and SAAT were quantified by magnetic resonance imaging in 583 men and women (61 ± 11.9 y; BMI 27.2 ± 4.4 kg/m2). Past-year PA and inactivity were self-reported by questionnaire. Exploratory activity patterns (APAT) were derived by principal components analysis. Cross-sectional associations between individual activities, total PA in terms of metabolic equivalents (PA MET), or overall APAT and either VAT or SAAT were analyzed by multivariable-adjusted robust or generalized linear regression models. Whereas vigorous-intensity PA (VPA) was negatively associated with both VAT and SAAT, associations between total PA MET, moderate-intensity PA (MPA), or inactivity and VAT and/or SAAT depended on sex. There was also evidence of a threshold effect in some of these relationships. Total PA MET was more strongly associated with VAT in men (B = -3.3 ± 1.4; P = 0.02) than women (B = -2.1 ± 1.1; P = 0.07), but was more strongly associated with SAAT in women (B = -5.7 ± 2.5; P = 0.05) than men (B = -1.7 ± 1.6; P = 0.3). Men (-1.52 dm3 or -1.89 dm3) and women (-1.15 dm3 or -2.61 dm3) in the highest (>6.8 h/wk VPA) or second (4.0-6.8 h/wk VPA) tertile of an APAT rich in VPA, had lower VAT and SAAT, respectively, than those in the lowest (<4.0 h/wk VPA) tertile (P ≤ 0.016; P trend ≤ 0.0005). They also had lower VAT and SAAT than those with APAT rich in MPA and/or inactivity only. In conclusion, our results suggest that in white populations, habitual APAT rich in MPA might be insufficient to impact on accumulation of VAT or SAAT. APAT including ≥ 4.0-6.8 h/wk VPA, by contrast, are more strongly associated with lower VAT and SAAT.

Aerobic Exercise Training Prevents the Onset of Endothelial Dysfunction via Increased Nitric Oxide Bioavailability and Reduced Reactive Oxygen Species in an Experimental Model of Menopause

OBJECTIVE

Previous studies have shown that estrogen deficiency, arising in postmenopause, promotes endothelial dysfunction. This study evaluated the effects of aerobic exercise training on endothelial dependent vasodilation of aorta in ovariectomized rats, specifically investigating the role of nitric oxide (NO) and reactive oxygen species (ROS).

METHODS

Female Wistar rats ovariectomized (OVX - n=20) or with intact ovary (SHAM - n=20) remained sedentary (OVX and SHAM) or performed aerobic exercise training on a treadmill 5 times a week for a period of 8 weeks (OVX-TRA and SHAM-TRA). In the thoracic aorta the endothelium-dependent and -independent vasodilation was assessed by acetylcholine (ACh) and sodium nitroprusside (SNP), respectively. Certain aortic rings were incubated with L-NAME to assess the NO modulation on the ACh-induced vasodilation. The fluorescence to dihydroethidium in aortic slices and plasma nitrite/nitrate concentrations were measured to evaluate ROS and NO bioavailability, respectively.

RESULTS

ACh-induced vasodilation was reduced in OVX rats as compared SHAM (Rmax: SHAM: 86±3.3 vs. OVX: 57±3.0%, p<0.01). Training prevented this response in OVX-TRA (Rmax: OVX-TRA: 88±2.0%, p<0.01), while did not change it in SHAM-TRA (Rmax: SHAM-TRA: 80±2.2%, p<0.01). The L-NAME incubation abolished the differences in ACh-induced relaxation among groups. SNP-induced vasodilation was not different among groups. OVX reduced nitrite/nitrate plasma concentrations and increased ROS in aortic slices, training as effective to restore these parameters to the SHAM levels.

CONCLUSIONS

Exercise training, even in estrogen deficiency conditions, is able to improve endothelial dependent vasodilation in rat aorta via enhanced NO bioavailability and reduced ROS levels.

Correlates of cardiovascular disease risk scores in women in Riyadh, Kingdom of Saudi Arabia

Saudi Arabia has a high prevalence of obesity and physical inactivity. We measured cardiovascular (CVD) risk scores and determined the factors associated with them in women in Riyadh, Saudi Arabia. A cross-sectional study using a self-administered questionnaire was conducted on 291 women aged ≥ 30 years. Information was collected on socio-demographics and physical health status. Anthropometric and blood pressure measurements were taken. Physical activity was measured using Kaiser's Physical Activity Survey and Godin's Leisure Time Exercise questionnaire. CVD risk scores were calculated using the non-laboratory-based Framingham Risk (FRS) prediction model for primary care. FRS scores ranged from 0.50 to 21.9. A total of 2.7% (n = 8) of women had a high FRS score (>20), 5.5% (n = 16) had intermediate scores (11-20), and 91.8% (n = 267) of women had low scores (<10) CVD risk scores. Multiple linear regression results indicated that a one-unit change in physical activity (household/caregiver index), strenuous exercise, waist circumference, number of children, television watching, and knee pain were significantly associated with -0.20 (p < .01), -0.12 (p = .03), 0.19 (p = .001), 0.29 (p < .01), 0.13 (p = .04), and 0.11 (p = .05) unit change in CVD risk scores, respectively. Household activities and strenuous exercise had a protective role in females in relation to CVD risk. Programs recommending physical activity at all levels should be encouraged.

Correlates of 15-year maintenance of physical activity in middle-aged women

BACKGROUND

Interventions to increase sustained physical activity are needed and should be based on proven theories.

PURPOSE

To gain a better understanding of the correlates of sustained physical activity in midlife women, we used longitudinal epidemiologic data to investigate links between sustained physical activity and constructs advocated by three basic behavioral and social science theories: (1) self-determination, (2) social cognitive, and (3) social networks. A random sample of 90 midlife women, stratified by level of physical activity over 15 years, was selected from the Chicago cohort of the Longitudinal Study of Women's Health Across the Nation (SWAN).

METHODS

Using data on self-reported physical activity collected over 15 years, women were categorized into consistently active, sporadically active, and sedentary. New data were collected on theory-relevant constructs, i.e., autonomous motivation (assessed by the Treatment Self-Regulation Questionnaire) and self-efficacy (assessed by the Self-Efficacy and Exercise Habits Survey). Every SWAN woman identified a close female friend who also completed the physical activity questionnaire.

RESULTS

SWAN women with higher autonomous motivation (p = 0.002) and higher self-efficacy (p < 0.001) were more likely to be consistently physically active in analyses adjusted for age, race, and socioeconomic status. Sixty-one percent of SWAN women with a history of consistent physical activity had a friend who is currently highly active, versus 38 and 23 % for sporadically active and sedentary women, respectively (test for trend p = 0.008).

CONCLUSION

In midlife women, constructs advocated by basic behavioral and social science theories were consistent with long-term patterns of physical activity behavior. Special focus should be given to these basic theories in the design of interventions to promote sustained physical activity in mid-life women.

Moderate wine consumption is associated with lower hemostatic and inflammatory risk factors over 8 years: The study of women's health across the nation (SWAN)

Moderate wine consumption has been associated with reduced cardiovascular (CV) risk, but most investigations have been conducted in Caucasian populations. To investigate the relationship of wine consumption to CV risk markers, we studied a multi-ethnic sample of middle-aged, healthy women (N = 2900; 48% white, 28% black, 7% Hispanic, 8% Chinese, 9% Japanese) participating in SWAN over 7 years with repeated assessments of CV risk factors. Consumption of wine was stable and common with 20% reporting none, 69% light (<1/day), 7% moderate ( = 1/day), and 4% heavy (>1/day). To guard against underreporting, we took the maximum reported wine consumption over 7 years as the predictor. We used mixed models with a random intercept and random time to assess the relationship between wine consumption and CV risk factors with moderate consumption as the reference. Outcome variables were log-transformed where necessary. Longitudinal models were adjusted for ethnicity, age, and time-varying menopausal status, hormone therapy use, overall alcohol consumption, high density lipoprotein (HDL), statin use, and a healthy lifestyle score based on physical activity, not smoking, and weight maintenance. Interactions of wine consumption with time were not significant. Moderate wine consumers had significantly lower levels of C-reactive protein (CRP, p < .001), fibrinogen (p < .001), factor VII (p < .01), and plasminogen activator inhibitor (PAI-1, p < .05) than women who drank no or little wine. These associations were independent of significant effects of healthy lifestyle and overall alcohol consumption and similar across ethnic groups. Moderate wine consumption may protect against CVD via inflammatory and clotting pathways.

Associations between accelerometer-derived physical activity and regional adiposity in young men and women

OBJECTIVE

Empirical evidence supports an inverse relationship between physical activity (PA) and adiposity, but studies using detailed measures of both are scarce. The relationship between regional adiposity and accelerometer-derived PA in men and women are described.

DESIGN AND METHODS

Cross-sectional analysis included 253 participants from a weight loss study limited to ages 20-45 years and BMI 25-39.9 kg m(-2) . PA data were collected with accelerometers and expressed as total accelerometer counts and average amount of time per day accumulated in different intensity levels [sedentary, light-, and moderate-to-vigorous intensity PA (MVPA)]. Accumulation of time spent above 100 counts was expressed as total active time. Computed tomography (CT) was used to measure abdominal and adipose tissue (AT). Multivariate linear regression analyses were used to assess the relationship between regional adiposity (dependent variable) and the various PA levels (independent variable), and were executed separately for men and women, adjusting for wear time, age, race, education, and BMI.

RESULTS

Among males, light activity was inversely associated with total AT (β = -0.19; P = 0.02) as well as visceral AT (VAT) (β = -0.30; P = 0.03). Among females sedentary time was positively associated with VAT (β = 0.11; P = 0.04) and total active time was inversely associated with VAT (β = -0.12; P = 0.04).

CONCLUSIONS

Findings from this study suggest that PA intensity level may influence regional adiposity differently in men and women. Additional research is needed in larger samples to clarify the difference in these associations by sex, create recommendations for the frequency, duration and intensity of PA needed to target fat deposits, and determine if these recommendations should differ by sex.

[Level of physical activity in the prevention of excess visceral fat in postmenopausal women: how much is needed?]

OBJECTIVE

To analyze the level of physical activity (kcal/week) needed to prevent excess visceral fat in postmenopausal women.

SUBJECTS AND METHODS

The sample included 239 women with a mean age of 57.2 years. Visceral fat area (VFA) was measured by octopolar bioelectrical impedance, and physical activity, by the long version IPAQ. ROC Curves (Receiver Operating Characteristic) were drawn, and a 95% confidence interval was used.

RESULTS

The areas under the ROC curve for moderate physical activity and walk proved to be significant. Weekly expenditure of 1,601 kcal in walking, or 2,283 kcal in moderate physical activity were identified as good cutoff values to prevent excess VFA.

CONCLUSION

Mild to moderate physical activity, with a caloric expenditure between 1,601 and 2,283 kcal/week, prevents excess central adiposity in postmenopausal women.

Understanding weight gain at menopause

OBJECTIVE

The aim of this review was to summarize the literature regarding the impact of the menopause transition on body weight and body composition.

METHODS

We conducted a search of the literature using Medline (Ovid, 1946-present) and PubMed (1966-2012) for English-language studies that included the following search terms: 'menopause', 'midlife', 'hormone therapy' or 'estrogen' combined with 'obesity', 'body weight' or 'body composition'.

RESULTS

Whereas weight gain per se cannot be attributed to the menopause transition, the change in the hormonal milieu at menopause is associated with an increase in total body fat and an increase in abdominal fat. Weight excess at midlife is not only associated with a heightened risk of cardiovascular and metabolic disease, but also impacts adversely on health-related quality of life and sexual function. Animal and human studies indicate that this tendency towards central abdominal fat accumulation is ameliorated by estrogen therapy. Studies mostly indicate a reduction in overall fat mass with estrogen and estrogen-progestin therapy, improved insulin sensitivity and a lower rate of development of type 2 diabetes.

CONCLUSION

The hormonal changes across the perimenopause substantially contribute to increased abdominal obesity which leads to additional physical and psychological morbidity. There is strong evidence that estrogen therapy may partly prevent this menopause-related change in body composition and the associated metabolic sequelae. However, further studies are required to identify the women most likely to gain metabolic benefit from menopausal hormone therapy in order to develop evidence-based clinical recommendations.

Physical activity and health during the menopausal transition

The benefits of regular physical activity are well established, but evidence for a protective effect against the adverse health consequences accompanying the menopausal transition is limited. This article reviews that evidence, concluding that more physical activity is generally associated with fewer somatic and mood symptoms. Physical activity seems to minimize weight gain and changes in body composition and fat distribution experienced at midlife and might attenuate the rapid bone density loss that occurs. Given these benefits, clinicians treating perimenopausal women should encourage their patients to follow guidelines for physical activity (≥150 minutes a week of moderate-intensity activity).

The Association between Self-Reported Energy Intake and Intra-Abdominal Adipose Tissue in Perimenopausal Women

We have previously shown that physical activity predicts intra-abdominal adipose tissue (IAT), but it is unknown whether energy intake predicts IAT independently of physical activity in a community-based, naturalistic environment. The association of energy intake with IAT was explored cross-sectionally in women, recruited between 2002 and 2005 for a study of fat patterning in midlife. IAT at L(4)-L(5) vertebral interspace was assessed by computed tomography, energy intake by the Block Food Frequency Questionnaire, and physical activity by the Kaiser Physical Activity Survey. Linear regression models were used for the principal analyses. Among the 257 women, 48% were African American and 52% were Caucasian. Women were 52 ± 3 years old, and 49% were postmenopausal. Every 500 kcal increase in energy intake was associated with a 6% higher IAT (P = 0.02), independent of physical activity (P = 0.02), after adjustment for ethnicity, menopausal status, age, smoking, income, and DXA-assessed percent body fat. Energy intake had a significant interaction with ethnicity (P = 0.02), but not with physical activity. Models using the IAT to subcutaneous abdominal adipose tissue ratio as an outcome had similar associations. In conclusion, self-reported EI was associated with preferential IAT accumulation in midlife women, independent of physical activity. This association was significantly stronger in Caucasian than African American women. Future longitudinal studies are needed to explore lifestyle predictors of IAT accumulation during the menopausal transition.

Cardiovascular risk factors in middle age obese Indians: a cross-sectional study on association of per cent body fat and intra-abdominal fat mass

OBJECTIVES

To determine the association of per cent total body fat (TBF), intra-abdominal fat (IAF) mass and subcutaneous abdominal fat with cardiovascular risk factors in middle age obese Indians.

DESIGN

Cross-sectional study.

SETTING

Hydrostatic Laboratory, Department of Sports Medicine and Physiotherapy, Guru Nanak Dev University, India.

PARTICIPANTS

51 subjects aged 30-55 years with a body mass index value 23 and above.

METHODOLOGY

In all the participants, TBF was estimated by underwater weighing machine and IAF and subcutaneous fat were measured by ultrasonography. Lipid profile was determined by a semiautomated analyser. Main outcome measures were: IAF, per cent body fat to TBF ratio, lipid profile and risk of developing cardiovascular diseases.

RESULTS

IAF was found to be significantly associated with lipid variables (95% CI, p<0.01) and risk of developing cardiovascular diseases (95% CI, p≤0.05) in both male and female subjects. TBF and subcutaneous fat thickness showed no significant results (95% CI, p>0.05) with either lipid variables or risk of developing cardiovascular diseases (tables 1 and 2). IAF mass showed significant association with age (95% CI, p<0.01) and significant negative association with physical activity (95% CI, p<0.05) in male subjects (tables 3 and 4).

CONCLUSION

An ultrasonic measurement of IAF is a better predictor of the risk of developing cardiovascular diseases in middle aged Indian population. In male subjects, physical activity of 5 or more days a week showed lesser amount of IAF as compared with those with physical activity <5 days a week.

Self-reported experiences of discrimination and visceral fat in middle-aged African-American and Caucasian women

The authors examined the association between self-reported experiences of discrimination and subtypes of abdominal fat (visceral, subcutaneous) in a population-based cohort of African-American and Caucasian women. Prior studies examining associations between discrimination and abdominal fat have yielded mixed results. A major limitation of this research has been the reliance on waist circumference, which may be a poor marker of visceral fat, particularly for African-American women. Participants were 402 (45% African-American, 55% Caucasian) middle-aged women from the Chicago, Illinois, site of the Study of Women's Health Across the Nation. Visceral and subcutaneous fat were assessed via computed tomography scans between 2002 and 2005. Linear regression models were conducted to test associations among discrimination and visceral and subcutaneous fat. After adjustment for age and race, every one-point increase on the discrimination scale was associated with a 13.03-cm(2) higher amount of visceral fat (P = 0.04). This association remained significant after further adjustments for total body fat and relevant risk factors, including depressive symptoms. Discrimination was not associated with subcutaneous fat in minimally (P = 0.95) or fully adjusted models. Associations did not differ by race. Findings suggest that visceral fat may be one potential pathway through which experiences of discrimination increase cardiovascular risk.