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Hurtado MD, Saadedine M, Kapoor E, Shufelt CL, Faubion SS. Weight Gain in Midlife Women. Curr Obes Rep 2024; 13:352-363. [PMID: 38416337 PMCID: PMC11150086 DOI: 10.1007/s13679-024-00555-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/11/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE OF REVIEW To summarize the evidence and clinical implications of weight and body composition changes during midlife in women and provide an overview of weight gain prevention and management in this population. RECENT FINDINGS Aging-related changes such as decreased energy expenditure and physical activity are important culprits for weight gain in midlife women. The hormonal changes of menopause also influence body adiposity distribution and increase central adiposity. These body changes can have health consequences including the development of cardiometabolic diseases, osteoarthritis, cancer, worsening in cognition, mental health, and menopause symptoms. Midlife women experience changes related to aging, menopause, and lifestyle which favor weight gain. Clinical practice should focus on early counseling and anticipatory guidance on the importance of dietary changes and physical activity to attenuate this phenomenon. Future research should focus on the longitudinal relationship between weight trends in midlife and health consequences and mortality.
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Affiliation(s)
- Maria D Hurtado
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Jacksonville, FL, USA
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Mariam Saadedine
- Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Jacksonville, FL, USA
- Mayo Clinic Center for Women's Health, Rochester, MN, USA
| | - Ekta Kapoor
- Mayo Clinic Center for Women's Health, Rochester, MN, USA
- Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA
- Women's Health Research Center, Mayo Clinic, Rochester, MN, USA
| | - Chrisandra L Shufelt
- Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Jacksonville, FL, USA
- Mayo Clinic Center for Women's Health, Rochester, MN, USA
| | - Stephanie S Faubion
- Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Jacksonville, FL, USA.
- Mayo Clinic Center for Women's Health, Rochester, MN, USA.
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Wei L, Ahmadi MN, Chan H, Chastin S, Hamer M, Mishra GD, Stamatakis E. Association between device-measured stepping behaviors and cardiometabolic health markers in middle-aged women: The Australian Longitudinal Study on Women's Health. Scand J Med Sci Sports 2023; 33:1384-1398. [PMID: 36999303 PMCID: PMC10947396 DOI: 10.1111/sms.14363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 03/10/2023] [Accepted: 03/23/2023] [Indexed: 04/01/2023]
Abstract
The associations between different types and contexts of stepping behaviors and cardiometabolic (CM) health markers are unclear. This study aimed to examine the associations of daily total, walking, stair, incidental and purposeful steps with cardiometabolic risk. A total of 943 women (mean age ± SD = 44.1 ± 1.6 years) from the Australian Longitudinal Study on Women's Health (ALSWH) were included in this cross-sectional study. Daily total, walking, stair, incidental, and purposeful steps were measured using thigh-worn accelerometry. Outcomes comprised of CM markers of adiposity, blood pressure, resting heart rate, lipids, glycaemia, and the composite CM score. We used generalized linear modeling and multiple linear regression to assess the associations. We observed that all stepping behaviors were beneficial to CM health, for example, compared to the lowest quartile (Q1), the change of the composite CM score across low to high quartile of purposeful steps was -0.12 (Q2, 95% CI: -0.41, 0.17), -0.16 (Q3, -0.46, 0.14), and -0.36 (Q4, -0.66, -0.05). Stair steps showed linear associations with blood pressure and adiposity biomarkers, for example, the change of quartile of waist circumference was -1.45 cm (Q2, -4.35, 1.44), -3.56 cm (Q3, -6.52, -0.60), and -7.08 cm (Q4, -10.31, -3.86). Peak 30-min walking intensity showed independent association with adiposity biomarkers (p linear < 0.001 and p = 0.002 for waist circumference and BMI, respectively). Our study showed that all stepping forms were beneficial to CM health. Higher stair steps and peak 30-min walking cadence were associated with a steep decline of adiposity biomarkers. Purposeful steps showed more consistent associations with CM biomarkers than incidental steps.
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Affiliation(s)
- Le Wei
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and HealthUniversity of SydneySydneyAustralia
| | - Matthew N. Ahmadi
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and HealthUniversity of SydneySydneyAustralia
| | - Hsiu‐Wen Chan
- School of Public HealthThe University of QueenslandBrisbaneAustralia
| | - Sebastien Chastin
- School of Health and Life ScienceGlasgow Caledonian UniversityGlasgowUK
- Department of Movement and Sports ScienceGhent UniversityGhentBelgium
| | - Mark Hamer
- Division of Surgery and Interventional Science, Institute of Sport Exercise and HealthUniversity College LondonLondonUK
| | - Gita D. Mishra
- School of Public HealthThe University of QueenslandBrisbaneAustralia
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and HealthUniversity of SydneySydneyAustralia
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Li Y, Chen X, Gong X, He D, Cheng X, Prabahar K, Hernández-Wolters B, Velu P, Du W. The effect of 17beta-estradiol plus norethisterone acetate on anthropometric indices: A systematic review and meta-analysis of randomized controlled trials. Eur J Obstet Gynecol Reprod Biol 2023; 287:176-185. [PMID: 37364427 DOI: 10.1016/j.ejogrb.2023.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 06/12/2023] [Accepted: 06/19/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVE Little evidence exists on the effect of 17beta-estradiol plus norethisterone acetate on all the anthropometric indices. Hence, this systematic review and meta-analysis of Randomized Controlled Trials was conducted to give an evidence-based report on the effect of 17beta-estradiol plus norethisterone acetate on anthropometric indices. METHODS The literature search was executed in databases including PubMed/Medline, Web of Science, Scopus, Embase, and Google Scholar to recognize clinical trials that examined the influence of 17beta-estradiol plus norethisterone acetate on obesity indices from database inception to Jan 2023. RESULTS Combined findings were generated from 20 eligible articles. The meta-analysis showed that body weight (Weighted Mean Difference (WMD): -0.47 kg, 95% CI: -1.32, 0.37, p = 0.274), body fat (WMD: 0.16 kg, 95% CI: -1.26, 1.59, p = 0.821), WHR (WMD: 0.001 kg, 95% CI: -0.006, 1.15, p = 0.872), and LBM (WMD: -0.02 kg, 95% CI: -1.19, 1.15, p = 0.970) were not modified in DHEA group compared to the control, but BMI levels were significantly reduced in 17beta-estradiol plus norethisterone acetate group (WMD: -0.15 kg/m2, 95% CI: -0.30, -0.008, p = 0.039). Moreover, based on intervention duration (months), a more significant reduction in BMI was found in trials that were performed on studies with ˃3 months duration (WMD: -0.176 kg/m2) than studies with ≤ 3 months (WMD: 0.05 kg/m2). CONCLUSION Administration of 17beta-estradiol plus norethisterone acetate for more than 3 months results in a decrease in BMI, which helps to reduce cardiovascular disease risk.
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Affiliation(s)
- Yushan Li
- Department of Emergency Internal Medicine, The Affiliated Hospital of Qingdao University, Qingdao, 266000 Shandong, China
| | - Xiao Chen
- Department of Emergency Internal Medicine, The Affiliated Hospital of Qingdao University, Qingdao, 266000 Shandong, China
| | - Xingji Gong
- Department of Emergency Internal Medicine, The Affiliated Hospital of Qingdao University, Qingdao, 266000 Shandong, China
| | - Dongyong He
- Department of Emergency Internal Medicine, The Affiliated Hospital of Qingdao University, Qingdao, 266000 Shandong, China
| | - Xi Cheng
- Clinical Research Center for Oral Diseases of Zhejiang Province, Cancer Center of Zhejiang University, School of Medicine, Zhejiang University, Hangzhou 310002, China.
| | - Kousalya Prabahar
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
| | | | - Periyannan Velu
- Department of Biotechnology and Biochemistry, Annamalai University, Chidambaram, Tamil Nadu, India
| | - Wenjie Du
- Department of Emergency Internal Medicine, The Affiliated Hospital of Qingdao University, Qingdao, 266000 Shandong, China.
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Physical activity on cardiorespiratory fitness and cardiovascular risk in premenopausal and postmenopausal women: a systematic review of randomized controlled trials. Menopause 2022; 29:1222-1229. [PMID: 35969888 DOI: 10.1097/gme.0000000000002037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
IMPORTANCE The apparent cardioprotective effects of endogenous estrogens to prevent cardiovascular disease in premenopausal women are reduced with the loss of estrogen post-menopause. Cardiorespiratory fitness and cardiovascular risk factors are closely related to physical activity levels. OBJECTIVE This study conducted a critical assessment of studies for health prevention that analyze the effects of physical activity programs on cardiorespiratory fitness and cardiovascular risk factors in women, comparing premenopausal and postmenopausal states, through a systematic review of randomized controlled trials. EVIDENCE REVIEW A computerized literature search was performed to include articles up until December 2021 in the following online databases: PubMed, Cochrane, Scopus, SportDiscus, and Web of Science. Regarding physical activity intervention, women of all ages were engaged. The PEDro scale and Oxford's evidence levels were used for the assessment of the risk of bias in the included articles. FINDINGS Fourteen scientific articles met the inclusion criteria. Great variability was found in physical activity variables. All the studies found an improvement in at least one variable. The risk of bias was high, with all the articles obtaining a low methodological quality, except two with high methodological quality. Only one article considered the differences in the menopausal state observing the effects of physical activity intervention and highlighting the importance of physical activity in both states. CONCLUSIONS AND RELEVANCE To strengthen the evidence for the benefits of physical activity programs in women and to observe the effects depending on their menopausal state, there is an ongoing need for more rigorous randomized controlled trials of appropriate length and dose, with individualized exercise intensity.
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Su J, Li Q, Mao P, Peng H, Han H, Wiley J, Guo J, Chen JL. Does the Association of Sedentary Time or Fruit/Vegetable Intake with Central Obesity Depend on Menopausal Status among Women? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10083. [PMID: 36011729 PMCID: PMC9407901 DOI: 10.3390/ijerph191610083] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 05/26/2023]
Abstract
(1) Background: The prevalence of central obesity is growing rapidly among women, and the prevalence differs by menopausal status. Longer sedentary time and less fruit/vegetable (F/V) intake increased the risk of central obesity. Among women of different menopausal statuses, controversy surrounds the association between sedentary time or F/V intake and central obesity. This study aimed to explore whether the independent and joint associations between sedentary time or F/V intake and menopausal status are correlated with central obesity, respectively. (2) Methods: This cross-sectional study was conducted in Hunan, China. Self-reported questionnaires were used to gather information on demographic characteristics, menopausal status, sedentary time, and F/V intake. Waist circumference was measured at the study site. Binary logistic regression and multiple interaction models were used to explore the independent and joint associations of menopausal status and the above two lifestyle variables with central obesity. (3) Results: A total of 387 women with a mean age of 47.7 ± 6.6 years old participated in the study. The prevalence of central obesity was 52.8%. Peri- and post-menopause statuses and not taking five servings of F/V per day were risk factors of central obesity (p < 0.05), whereas no significant association was found between sedentary time and central obesity (p > 0.05). Among peri-menopausal (mutual odds ratio (OR): 2.466, 95% confidence interval [CI]: 0.984−6.182; p < 0.05) and post-menopausal women (mutual OR: 2.274, 95% CI: 1.046−4.943; p < 0.05), more than 4 h of sedentary time per day was associated with a high risk of central obesity. Among pre-menopausal women, the consumption of five servings of F/V per day was associated with a low risk of central obesity (mutual OR: 0.444, 95%CI: 0.236−0.837, p < 0.05). (4) Conclusions: More than half of women in the central south of China presented with central obesity, spent >4 h of sedentary time per day, or did not engage in recommended F/V intake. Healthier lifestyle intervention is warranted to prevent central obesity development, including reducing the sedentary time to <4 h per day for peri- and post-menopausal women, while increasing taking five servings of F/V per day for pre-menopausal women.
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Affiliation(s)
- Jing Su
- Department of Nursing, Medical College, Shantou University, Shantou 515041, China
- Department of Nursing, School of Medicine, Zhejiang University City College, Hangzhou 310015, China
| | - Qingting Li
- Xiangya School of Nursing, Central South University, Changsha 410017, China
| | - Ping Mao
- Department of Nursing, The Third Xiangya Hospital of Central South University, Changsha 410013, China
| | - Hua Peng
- Department of Nursing, Xiangya Hospital of Central South University, Changsha 410013, China
| | - Huiwu Han
- Department of Nursing, Xiangya Hospital of Central South University, Changsha 410013, China
| | - James Wiley
- Institute for Health Policy Studies, University of California San Francisco (UCSF), San Francisco, CA 94158, USA
| | - Jia Guo
- Xiangya School of Nursing, Central South University, Changsha 410017, China
- Nursing School, Xinjiang Medical University, Urumqi 830054, China
| | - Jyu-Lin Chen
- Department of Family Health Care Nursing, School of Nursing, University of California San Francisco (UCSF), San Francisco, CA 94143, USA
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Frequency of Metabolic Syndrome and Study of Anthropometric, Clinical and Biological Characteristics in Peri- and Postmenopausal Women in the City of Ksar El Kebir (Northern Morocco). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106109. [PMID: 35627646 PMCID: PMC9140909 DOI: 10.3390/ijerph19106109] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/07/2022] [Accepted: 05/11/2022] [Indexed: 01/27/2023]
Abstract
This study aimed to determine the frequency of metabolic syndrome and to identify its predictive factors in peri- and post-menopausal women in the city of Ksar El Kebir, in northern Morocco. A total of 373 peri- and post-menopausal women between 45 and 64 years old participated in the study. Metabolic syndrome was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) definition. Body mass index (BMI) was calculated to assess the degree of obesity in women; anthropometric, clinical and biological parameters were collected during interviews. The mean ages of peri- and postmenopausal women were 48.84 ± 2.4 years and 56.65 ± 4.29 years, respectively. Postmenopausal women had higher means of anthropometric and biological parameters than peri-menopausal women. We also noted a predominance of metabolic syndrome in postmenopausal women (n = 158) compared to peri-menopausal women (n = 81). Waist circumference was the predominant marker in the subjects studied, whereas triglycerides were the lower marker. In the overall population, the incidence of metabolic syndrome and its associated factors were higher in postmenopausal women than in peri-menopausal women, from which it can be concluded that post menopause may be a predictor of metabolic syndrome.
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Kianfar M, Afshari P, Abedi P, Haghighizadeh M. The relationship of a weight-efficacy lifestyle with anthropometric indices among middle-aged Iranian women. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2022. [DOI: 10.1080/16070658.2022.2051305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Mahbobeh Kianfar
- Midwifery Department, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Poorandokht Afshari
- Midwifery Department, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Midwifery Department, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Parvin Abedi
- Midwifery Department, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Grisotto G, Raguindin PF, Glisic M, Bally L, Bano A, Franco OH, Marques-Vidal P, Muka T. Menopausal Transition Is Not Associated with Dietary Change in Swiss Women. J Nutr 2021; 151:1269-1276. [PMID: 33693728 DOI: 10.1093/jn/nxab003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/30/2020] [Accepted: 01/04/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Adherence to a healthy diet could contribute to maintaining adequate health throughout the menopausal transition, but data are scarce. OBJECTIVE We evaluated the association between menopausal status and changes in dietary intake in Swiss adult women. METHODS Cross-sectional (n = 2439) and prospective analyses (n = 1656) were conducted between 2009 and 2012 (first follow-up) among women (mean age ± SD, 58.2 ± 10.5 y) living in Lausanne, Switzerland. In both visits, dietary intake was assessed using a validated FFQ, and menopausal status was classified based on the presence or absence of menstruations. Multivariable linear and logistic regression models were used to investigate the cross-sectional association of menopausal status (postmenopausal compared with premenopausal) at the first follow-up with food intake and dietary recommendations. To examine whether menopausal status (premenopausal as reference group, menopausal transition, and postmenopausal) during 5 y of follow-up was associated with longitudinal changes in diet, including adherence to dietary Swiss recommendations, we applied multivariable linear and logistic mixed models adjusted for several covariates. RESULTS At the first follow-up, postmenopausal women consumed less (P < 0.002) meat [median (IQR) 57.2 (35-86.2) compared with 62.5 (41.2-95.2) g/d], pasta [61.8 (37.5-89.2) compared with 85 (57.8-128) g/d], and added sugar [0.1 (0-4) compared with 0.7 (0-8) g/d] and more dairy products [126 (65.4-214) compared with 109 (64.5-182) g/d] and fruit [217 (115-390) compared with 174 (83.2-319) g/d] than premenopausal women. However, linear regression analysis adjusted for potential confounding factors showed no independent (cross-sectional) associations of menopausal status with total energy intake (TEI) and individual macro- or micronutrient intakes. In the prospective analysis, compared with women who remained premenopausal during follow-up (n = 244), no differences were found in changes in TEI, dietary intakes, or adherence to the Swiss dietary recommendations in women transitioning from premenopausal to postmenopausal (n = 229) and who remained postmenopausal (n = 1168). CONCLUSION The menopausal transition is not associated with changes in dietary habits among Swiss women.
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Affiliation(s)
- Giorgia Grisotto
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.,Graduate School for Health Sciences, University of Bern, Bern, Switzerland.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Peter Francis Raguindin
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.,Graduate School for Health Sciences, University of Bern, Bern, Switzerland.,Swiss Paraplegic Research, 6207, Nottwil, Switzerland
| | - Marija Glisic
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.,Swiss Paraplegic Research, 6207, Nottwil, Switzerland
| | - Lia Bally
- Department of Diabetes, Endocrinology, Nutritional Medicine & Metabolism, Bern University Hospital, Bern, Switzerland
| | - Arjola Bano
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.,Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Oscar H Franco
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Taulant Muka
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
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Weight loss outcomes in premenopausal versus postmenopausal women during behavioral weight loss interventions: a systematic review and meta-analysis. ACTA ACUST UNITED AC 2020; 28:337-346. [PMID: 33350666 DOI: 10.1097/gme.0000000000001684] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
IMPORTANCE Weight loss may be difficult for young women with obesity to achieve due to competing priorities (caring for children and/or full-time work), limiting their ability to engage in weight loss interventions. Older or postmenopausal women may also face challenges to weight loss such as caring responsibilities and menopause. Menopausal status may reflect differences in weight loss. OBJECTIVE This study compared changes in weight, fat mass, and lean mass in premenopausal versus postmenopausal women in dietary weight loss trials. EVIDENCE REVIEW We reviewed publications from January 2000 to June 2020 evaluating a weight loss intervention with a dietary component, with or without exercise, and reporting weight loss of premenopausal and postmenopausal women. Where available, data on mean change from baseline for weight, fat mass, and lean mass of premenopausal and postmenopausal groups were entered into Review Manger for meta-analyses. Differences between menopausal groups were compared in subgroups of studies for intervention characteristics (diet-only vs diet and exercise; dietary modification vs meal replacement; < 24 wks vs ≥24 wks duration). FINDINGS Seven publications (10 interventions, n = 791) were included; three single-arm trials, two randomized controlled trials, and two comparative effectiveness trials. In meta-analyses, there were no statistically significant differences between premenopausal and postmenopausal women (shown as premenopausal minus postmenopausal) for change in weight (0.58 [95% confidence interval -0.12 to 1.28] kg, n = 7 interventions), fat mass (0.73 [-0.25 to 1.70] kg, n = 6 interventions), or lean mass (-0.5 6[-1.48 to 0.36] kg, n = 4 interventions). However, a statistically significant subgroup difference was observed for fat mass change between menopausal groups (premenopausal minus postmenopausal) when comparing diet-only (1.28 [0.23 to 2.33] kg, n = 4 interventions) versus diet and exercise interventions (-0.09 [-0.51 to 0.32]kg, n = 2 interventions). No differences were shown in any other subgroups. CONCLUSIONS AND RELEVANCE This review provides some evidence to suggest weight loss interventions may not need to be tailored to women's menopausal status. However, given the small number of studies, short intervention duration in most publications (≤ 6 mo) and unclear retention rates in premenopausal versus postmenopausal groups of some publications, menopausal group differences should be examined in existing and future trials where the appropriate data have been collected.
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Mediterranean diet as tool to manage obesity in menopause: A narrative review. Nutrition 2020; 79-80:110991. [PMID: 32979767 DOI: 10.1016/j.nut.2020.110991] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 07/27/2020] [Accepted: 07/31/2020] [Indexed: 01/22/2023]
Abstract
Menopause is a physiological event in a woman's life characterized by the cessation of spontaneous menstrual cycles caused by a reduction in the sex hormones estrogen and progesterone and a consequent increase of gonadotropins, which occurs when the stocks of ovarian follicles end. Weight gain is a common phenomenon in menopause and age of onset is influenced by several factors. Among modifiable risk factors are sedentary lifestyle and unhealthy nutritional patterns, which often result in obesity that in turn contributes to an increase in cardiovascular risk in menopause, mostly through low-grade inflammation. The Mediterranean diet (MedD) is a healthy dietary pattern characterized by an adequate consumption of vegetables, fruits, whole grains, and legumes with a reduction of saturated animal fats in favor of unsaturated vegetable fats and a high intake of bioactive compounds including polyphenols and ω-3 fatty acids with anti-inflammatory and antioxidant potency. Because of its palatability and long-term sustainability, the MedD, especially if hypocaloric, combined with physical activity, has shown promising results in terms of weight loss in individuals with obesity, as well as similar beneficial effects in menopause-related obesity. It has been observed that greater adherence to the MedD in menopause is associated with reduced risk for becoming overweight/obese, better cardiometabolic profile, and an improvement in menopausal symptoms. Although it is necessary to confirm these data with future large intervention trials, the MedD can be considered a safe and healthy approach in the management of menopause-related obesity and its cardiometabolic complications.
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Lombardo M, Perrone MA, Guseva E, Aulisa G, Padua E, Bellia C, Della-Morte D, Iellamo F, Caprio M, Bellia A. Losing Weight after Menopause with Minimal Aerobic Training and Mediterranean Diet. Nutrients 2020; 12:nu12082471. [PMID: 32824413 PMCID: PMC7468767 DOI: 10.3390/nu12082471] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 08/10/2020] [Accepted: 08/14/2020] [Indexed: 12/11/2022] Open
Abstract
Objective: It is a common belief that menopausal women have greater difficulty losing weight. The aim of this study was to assess the efficacy of a Mediterranean diet (MD) to promote weight loss in postmenopausal women. All participants were prescribed a hypocaloric traditional MD, tailored to the individual. Subjects were asked not to begin any kind of physical activity. Body composition was measured at the beginning and after 8 weeks of treatment. In total, 89 women (age 52.8 ± 4.5 years, BMI 30.0 ± 5.2 kg/m2, fat mass 31.6 ± 10.5 kg) were divided into two groups: the first group consisted of fertile women over 45 years of age, the second group consisted of those diagnosed as menopausal. All women had an improvement in body composition (fat mass −2.3 ± 2.1 kg, p < 0.001; protein −0.1 ± 0.7 kg, p = 0.190) and blood pressure values. No differences were found between the two groups except for a higher reduction of low-density lipoprotein in the menopausal group (p = 0.035). A positive significant correlation between plant to animal protein ratio and fat-free mass variation was found in the menopausal group. These data suggest that a high adherence to a traditional MD would enable menopausal women to lose fat mass and maintain muscle mass with no significant difference to younger women. Fat mass reduction provides menopausal women with improved cardiovascular and metabolic risk factors.
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Affiliation(s)
- Mauro Lombardo
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy; (E.G.); (G.A.); (E.P.); (D.D.-M.); (M.C.); (A.B.)
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
- Correspondence:
| | | | - Elena Guseva
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy; (E.G.); (G.A.); (E.P.); (D.D.-M.); (M.C.); (A.B.)
| | - Giovanni Aulisa
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy; (E.G.); (G.A.); (E.P.); (D.D.-M.); (M.C.); (A.B.)
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy; (E.G.); (G.A.); (E.P.); (D.D.-M.); (M.C.); (A.B.)
- School of Human Movement Science, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Chiara Bellia
- Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy;
| | - David Della-Morte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy; (E.G.); (G.A.); (E.P.); (D.D.-M.); (M.C.); (A.B.)
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
- The Evelyn F. McKnight Brain Institute, Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Ferdinando Iellamo
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
- Division of Cardiology, University of Rome Tor Vergata, 00133 Rome, Italy;
- School of Human Movement Science, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Massimiliano Caprio
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy; (E.G.); (G.A.); (E.P.); (D.D.-M.); (M.C.); (A.B.)
- Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele Pisana, 00166 Rome, Italy
| | - Alfonso Bellia
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy; (E.G.); (G.A.); (E.P.); (D.D.-M.); (M.C.); (A.B.)
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
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12
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The Metabolic Benefits of Menopausal Hormone Therapy Are Not Mediated by Improved Nutritional Habits. The OsteoLaus Cohort. Nutrients 2019; 11:nu11081930. [PMID: 31426347 PMCID: PMC6722637 DOI: 10.3390/nu11081930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 08/14/2019] [Indexed: 11/24/2022] Open
Abstract
Menopause alters body composition by increasing fat mass. Menopausal hormone therapy (MHT) is associated with decreased total and visceral adiposity. It is unclear whether MHT favorably affects energy intake. We aimed to assess in the OsteoLaus cohort whether total energy intake (TEI) and/or diet quality (macro- and micronutrients, dietary patterns, dietary scores, dietary recommendations)—evaluated by a validated food frequency questionnaire—differ in 839 postmenopausal women classified as current, past or never MHT users. There was no difference between groups regarding TEI or consumption of macronutrients. After multivariable adjustment, MHT users were less likely to adhere to the unhealthy pattern ‘fat and sugar: Current vs. never users [OR (95% CI): 0.48 (0.28–0.82)]; past vs. never users [OR (95% CI): 0.47 (0.27–0.78)]. Past users exhibited a better performance in the revised score for Mediterranean diet than never users (5.00 ± 0.12 vs. 4.63 ± 0.08, p < 0.04). Differences regarding compliance with dietary recommendations were no longer significant after adjustment for covariates. Overall, these results argue against a major role of TEI and diet quality as possible mediators of the MHT metabolic benefits. Future research on this relationship should focus on other potential targets of MHT, such as resting energy expenditure and physical activity.
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Buniam J, Chukijrungroat N, Khamphaya T, Weerachayaphorn J, Saengsirisuwan V. Estrogen and voluntary exercise attenuate cardiometabolic syndrome and hepatic steatosis in ovariectomized rats fed a high-fat high-fructose diet. Am J Physiol Endocrinol Metab 2019; 316:E908-E921. [PMID: 30807216 DOI: 10.1152/ajpendo.00466.2018] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The prevalence of cardiometabolic syndrome (CMS) is increased in women after menopause. While hormone replacement therapy has been prescribed to relieve several components of CMS in postmenopausal women, some aspects of cardiometabolic dysfunction cannot be completely restored. The present study examined the effectiveness of estrogen replacement alone and in combination with exercise by voluntary wheel running (VWR) for alleviating the risks of CMS, insulin-mediated skeletal muscle glucose transport, and hepatic fat accumulation in ovariectomized Sprague-Dawley rats fed a high-fat high-fructose diet (OHFFD). We compared a sham-operated group with OHFFD rats that were subdivided into a sedentary, estradiol replacement (E2), and E2 plus VWR for 12 wk. E2 prevented the development of insulin resistance in skeletal muscle glucose transport and decreased hepatic fat accumulation in OHFFD rats. Furthermore, E2 treatment decreased visceral fat mass and low-density lipoprotein (LDL)-cholesterol in OHFFD rats, while VWR further decreased LDL-cholesterol and increased the ratio of high-density lipoprotein-cholesterol to total cholesterol to a greater extent. Although E2 treatment alone did not reduce serum triglyceride levels in OHFFD rats, the combined intervention of E2 and VWR lowered serum triglycerides in E2-treated OHFFD rats. The addition of VWR to E2-treated OHFFD rats led to AMPK activation and upregulation of peroxisome proliferator-activated receptor-γ (PPARγ) coactivator-1α and PPARδ in skeletal muscle along with increased fatty acid oxidation and suppressed fatty acid synthesis in the liver. Collectively, our findings indicate that, to achieve greater health benefits, physical exercise is required for E2-treated individuals under ovarian hormone deprivation with high-energy consumption.
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Affiliation(s)
- Jariya Buniam
- Exercise Physiology Laboratory, Department of Physiology, Faculty of Science, Mahidol University , Bangkok , Thailand
| | - Natsasi Chukijrungroat
- Exercise Physiology Laboratory, Department of Physiology, Faculty of Science, Mahidol University , Bangkok , Thailand
| | - Tanaporn Khamphaya
- Toxicology Graduate Program, Faculty of Science, Mahidol University , Bangkok , Thailand
| | - Jittima Weerachayaphorn
- Exercise Physiology Laboratory, Department of Physiology, Faculty of Science, Mahidol University , Bangkok , Thailand
| | - Vitoon Saengsirisuwan
- Exercise Physiology Laboratory, Department of Physiology, Faculty of Science, Mahidol University , Bangkok , Thailand
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14
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Lu S, Xu F, Hu W, Niu Z, Cai H, Chen Y, Tu Q, Zhang Y, Chen W, Liu W, Tang S, Zhang Z. SCD1 methylation in subcutaneous adipose tissue associated with menopausal age. Climacteric 2019; 22:395-402. [PMID: 30777456 DOI: 10.1080/13697137.2019.1571028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- S. Lu
- Department of Obstetrics and Gynecology, Hangzhou Women’s Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, China
| | - F. Xu
- Department of Gastroenterology, Hangzhou Third People's Hospital, Hangzhou, China
| | - W. Hu
- Department of Obstetrics and Gynecology, Hangzhou Women’s Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, China
| | - Z. Niu
- Department of Obstetrics and Gynecology, The Affiliated Hangzhou Hospital of Nanjing Medical University, Hangzhou, China
| | - H. Cai
- Department of Obstetrics and Gynecology, The Affiliated Hangzhou Hospital of Nanjing Medical University, Hangzhou, China
| | - Y. Chen
- Laboratory of Gene Diagnosis, The Affiliated Hangzhou Hospital of Nanjing Medical University, Hangzhou, China
| | - Q. Tu
- Laboratory of Gene Diagnosis, The Affiliated Hangzhou Hospital of Nanjing Medical University, Hangzhou, China
| | - Y. Zhang
- Department of Obstetrics and Gynecology, Hangzhou Women’s Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, China
| | - W. Chen
- Department of Obstetrics and Gynecology, The Second People's Hospital of Tonglu, Hangzhou, China
| | - W. Liu
- Department of Obstetrics and Gynecology, Hangzhou Women’s Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, China
| | - S. Tang
- Department of Obstetrics and Gynecology, Hangzhou Women’s Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, China
| | - Z. Zhang
- Department of Obstetrics and Gynecology, Hangzhou Women’s Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, China
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15
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França AP, Marucci MDFN, Silva MDLDND, Roediger MDA. [Factors associated with general obesity and the percentage of body fat of women during the menopause in the city of São Paulo, Brazil]. CIENCIA & SAUDE COLETIVA 2018; 23:3577-3586. [PMID: 30427431 DOI: 10.1590/1413-812320182311.26492016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 12/15/2016] [Indexed: 11/22/2022] Open
Abstract
To verify the association between obesity and demographic, clinical and lifestyle variables in climacteric women, a cross-sectional study was conducted in outpatient clinics, with 469 women aged 40 to 65 years in the city of São Paulo, Brazil. The dependent variables were: obesity according to body mass index (BMI) and obesity according to percentage of body fat (% BF). The main explanatory variable was: climacteric phase (pre or postmenopausal); and control variables were: age; years of formal study; parity; menopausal hormone therapy (MHT) use; physical activity practice and smoking habit. Multiple regression analysis was performed using the Stata 9.2 software. According to the BMI, obesity was positively associated with parity (RR = 1.62, 95% CI = 1.11-2.37) and, negatively, with years of formal study (RP = 0.71, CI 95% = 0.55-0.91) and with physical activity practice (PR = 0.45, 95% CI = 0.33-0.61). According to the % BF, obesity was positively associated with parity (PR = 1.60, 95% CI = 1.03-2.49) and negatively with physical activity practice (PR = 0.43; 95% CI = 0.29-0.63). While being active physically was protective, multiparity was a risk factor for developing obesity for women in this study.
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Affiliation(s)
- Ana Paula França
- Faculdade de Saúde Pública, Universidade de São Paulo. Av. Dr. Arnaldo 715, Cerqueira César. 01246-904 São Paulo SP Brasil.
| | - Maria de Fátima Nunes Marucci
- Faculdade de Saúde Pública, Universidade de São Paulo. Av. Dr. Arnaldo 715, Cerqueira César. 01246-904 São Paulo SP Brasil.
| | | | - Manuela de Almeida Roediger
- Faculdade de Saúde Pública, Universidade de São Paulo. Av. Dr. Arnaldo 715, Cerqueira César. 01246-904 São Paulo SP Brasil.
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16
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Correa-Rodríguez M, Schmidt-RioValle J, Ramírez-Vélez R, Correa-Bautista JE, González-Jiménez E, Rueda-Medina B. Influence of Calcium and Vitamin D Intakes on Body Composition in Children and Adolescents. Clin Nurs Res 2018; 29:243-248. [DOI: 10.1177/1054773818797878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Identifying nutritional strategies to maintain a healthy body weight and reduce the comorbidities associated with obesity is extremely important. We aimed to investigate whether calcium and vitamin D intakes are associated with body composition measurements in a population of children and adolescents. A cross-sectional study was conducted involving 1,060 children and adolescents (65.8% females; 34.2% males) aged 9 to 19 years. Fat mass, percentage of fat mass, and fat-free mass were measured using a body composition analyzer (TANITA BC-418MA®). The mean dietary calcium and vitamin intakes were 829.66 ± 328.34 mg/day and 200.78 ± 400.91 IU/day. Linear regression analysis revealed a lack of significant association between daily calcium and vitamin D intakes and body composition measurements, after adjusting the model for age, sex, maturation status, and energy intake. Dietary calcium and vitamin D intakes do not appear to be associated with higher adiposity measurements in children and adolescents.
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17
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Papavagelis C, Avgeraki E, Augoulea A, Stamatelopoulos K, Lambrinoudaki I, Yannakoulia M. Dietary patterns, Mediterranean diet and obesity in postmenopausal women. Maturitas 2018; 110:79-85. [DOI: 10.1016/j.maturitas.2018.02.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 01/31/2018] [Accepted: 02/01/2018] [Indexed: 11/24/2022]
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18
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Zhu D, Chung HF, Pandeya N, Dobson AJ, Kuh D, Crawford SL, Gold EB, Avis NE, Giles GG, Bruinsma F, Adami HO, Weiderpass E, Greenwood DC, Cade JE, Mitchell ES, Woods NF, Brunner EJ, Simonsen MK, Mishra GD. Body mass index and age at natural menopause: an international pooled analysis of 11 prospective studies. Eur J Epidemiol 2018; 33:699-710. [PMID: 29460096 DOI: 10.1007/s10654-018-0367-y] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 02/14/2018] [Indexed: 10/18/2022]
Abstract
Current evidence on the association between body mass index (BMI) and age at menopause remains unclear. We investigated the relationship between BMI and age at menopause using data from 11 prospective studies. A total of 24,196 women who experienced menopause after recruitment was included. Baseline BMI was categorised according to the WHO criteria. Age at menopause, confirmed by natural cessation of menses for ≥ 12 months, was categorised as < 45 years (early menopause), 45-49, 50-51 (reference category), 52-53, 54-55, and ≥ 56 years (late age at menopause). We used multinomial logistic regression models to estimate multivariable relative risk ratios (RRRs) and 95% confidence intervals (CI) for the associations between BMI and age at menopause. The mean (standard deviation) age at menopause was 51.4 (3.3) years, with 2.5% of the women having early and 8.1% late menopause. Compared with those with normal BMI (18.5-24.9 kg/m2), underweight women were at a higher risk of early menopause (RRR 2.15, 95% CI 1.50-3.06), while overweight (1.52, 1.31-1.77) and obese women (1.54, 1.18-2.01) were at increased risk of late menopause. Overweight and obesity were also significantly associated with around 20% increased risk of menopause at ages 52-53 and 54-55 years. We observed no association between underweight and late menopause. The risk of early menopause was higher among obese women albeit not significant (1.23, 0.89-1.71). Underweight women had over twice the risk of experiencing early menopause, while overweight and obese women had over 50% higher risk of experiencing late menopause.
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Affiliation(s)
- Dongshan Zhu
- School of Public Health, University of Queensland, Brisbane, QLD, 4006, Australia
| | - Hsin-Fang Chung
- School of Public Health, University of Queensland, Brisbane, QLD, 4006, Australia
| | - Nirmala Pandeya
- School of Public Health, University of Queensland, Brisbane, QLD, 4006, Australia
| | - Annette J Dobson
- School of Public Health, University of Queensland, Brisbane, QLD, 4006, Australia
| | - Diana Kuh
- Medical Research Council Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Sybil L Crawford
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Ellen B Gold
- Department of Public Health Sciences, University of California, Davis, Davis, CA, USA
| | - Nancy E Avis
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Graham G Giles
- Cancer Epidemiology and Intelligence Division Centre, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Fiona Bruinsma
- Cancer Epidemiology and Intelligence Division Centre, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Clinical Effectiveness Research Group, University of Oslo, Oslo, Norway
| | - Elisabete Weiderpass
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland.,Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.,Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Darren C Greenwood
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Janet E Cade
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Ellen S Mitchell
- Family and Child Nursing, School of Nursing, University of Washington, Seattle, WA, USA
| | - Nancy F Woods
- Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington, Seattle, WA, USA
| | - Eric J Brunner
- Department of Epidemiology and Public Health, University College London, London, UK
| | | | - Gita D Mishra
- School of Public Health, University of Queensland, Brisbane, QLD, 4006, Australia.
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19
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Coltman CE, Steele JR, McGhee DE. Breast volume is affected by body mass index but not age. ERGONOMICS 2017; 60:1576-1585. [PMID: 28532249 DOI: 10.1080/00140139.2017.1330968] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND This study aimed to establish normative breast volume data for women of varying ages, body masses and breast sizes, and to determine the effect of age and body mass index (BMI) on breast volume. METHODS The breast volume of 356 women (age range: 18.1-83.7 years; BMI range: 18.4-54.5 kg/m²) was measured using three-dimensional scanning in a prone position. RESULTS Breast volumes ranged from 48 to 3100 mL. Although breast volume was not significantly affected by age, it was significantly affected by BMI, with the breast volume of overweight and obese women being two-to-three times greater than women with normal BMI's. CONCLUSION It is recommended that bra cups must be designed to support the wide range and increasing magnitude of breast volumes exhibited by women. Practitioner summary: This original research provides evidence for bra designers and manufacturers on the range of breast volumes of women and the significant effect of BMI on breast volume. Bra cups need to be designed to support the wide range and increasing magnitude of breast volumes exhibited by women.
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Affiliation(s)
- Celeste E Coltman
- a Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine & Health , University of Wollongong , Wollongong , Australia
| | - Julie R Steele
- a Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine & Health , University of Wollongong , Wollongong , Australia
| | - Deirdre E McGhee
- a Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine & Health , University of Wollongong , Wollongong , Australia
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20
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Kapoor E, Files JA, Faubion SS. Management of Weight Gain in Midlife Women: Hormone Therapy and Beyond. J Womens Health (Larchmt) 2017; 26:396-398. [PMID: 28410015 DOI: 10.1089/jwh.2017.6324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ekta Kapoor
- 1 Division of General Internal Medicine, Women's Health Clinic, Mayo Clinic , Rochester, Minnesota.,2 Division of Endocrinology, Metabolism and Nutrition, Mayo Clinic , Rochester, Minnesota
| | - Julia A Files
- 3 Division of Women's Health-Internal Medicine, Mayo Clinic in Arizona , Scottsdale, Arizona
| | - Stephanie S Faubion
- 1 Division of General Internal Medicine, Women's Health Clinic, Mayo Clinic , Rochester, Minnesota
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21
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Hirose A, Terauchi M, Hirano M, Akiyoshi M, Owa Y, Kato K, Kubota T. Higher intake of cryptoxanthin is related to low body mass index and body fat in Japanese middle-aged women. Maturitas 2017; 96:89-94. [DOI: 10.1016/j.maturitas.2016.11.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 10/05/2016] [Accepted: 11/14/2016] [Indexed: 01/01/2023]
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Boucher S, Edwards O, Gray A, Nada-Raja S, Lillis J, Tylka TL, Horwath CC. Teaching Intuitive Eating and Acceptance and Commitment Therapy Skills Via a Web-Based Intervention: A Pilot Single-Arm Intervention Study. JMIR Res Protoc 2016; 5:e180. [PMID: 27742602 PMCID: PMC5086025 DOI: 10.2196/resprot.5861] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 07/05/2016] [Accepted: 07/20/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Middle-aged women are at risk of weight gain and associated comorbidities. Deliberate restriction of food intake (dieting) produces short-term weight loss but is largely unsuccessful for long-term weight management. Two promising approaches for the prevention of weight gain are intuitive eating (ie, eating in accordance with hunger and satiety signals) and the development of greater psychological flexibility (ie, the aim of acceptance and commitment therapy [ACT]). OBJECTIVES This pilot study investigated the usage, acceptability, and feasibility of "Mind, Body, Food," a Web-based weight gain prevention intervention prototype that teaches intuitive eating and psychological flexibility skills. METHODS Participants were 40 overweight women (mean age 44.8 [standard deviation, SD, 3.06] years, mean body mass index [BMI] 32.9 [SD 6.01] kg/m2, mean Intuitive Eating Scale [IES-1] total score 53.4 [SD 7.46], classified as below average) who were recruited from the general population in Dunedin, New Zealand. Module completion and study site metrics were assessed using Google Analytics. Use of an online self-monitoring tool was determined by entries saved to a secure online database. Intervention acceptability was assessed postintervention. BMI, intuitive eating, binge eating, psychological flexibility, and general mental and physical health were assessed pre- and postintervention and 3-months postintervention. RESULTS Of the 40 women enrolled in the study, 12 (30%) completed all 12 modules (median 7.5 [interquartile range, IQR, 2-12] modules) and 4 (10%) used the self-monitoring tool for all 14 weeks of the intervention period (median 3 [IQR 1-9] weeks). Among 26 women who completed postintervention assessments, most women rated "Mind, Body, Food" as useful (20/26, 77%), easy to use (17/25, 68%) and liked the intervention (22/25, 88%). From pre- to postintervention, there were statistically significant within-group increases in intuitive eating (IES-2 total score P<.001; all IES-2 subscale scores: P ≤.01), psychological flexibility (P=.01), and general mental health (P<.001) as well as significant decreases in binge eating (P=.01). At the 3-month follow-up, IES-2 improvements were maintained, and there were further improvements in binge eating (P<.001) and general mental health (P=.03), and a marginal yet nonsignificant tendency for further improvement in psychological flexibility (P=.06). There were no significant within-group changes in BMI from pre- to postintervention and postintervention to 3-month follow-up (P=.46 and P=.93, respectively). CONCLUSIONS The "Mind, Body, Food" prototype Web-based intervention is appealing to middle-aged women and may be a useful tool to help women learn intuitive eating and ACT skills, reduce binge eating, and maintain weight over 3 months. Further work to improve the user experience and engagement is required before testing the online intervention in a randomized controlled trial.
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Affiliation(s)
- Sara Boucher
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
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Karvonen-Gutierrez C, Kim C. Association of Mid-Life Changes in Body Size, Body Composition and Obesity Status with the Menopausal Transition. Healthcare (Basel) 2016; 4:healthcare4030042. [PMID: 27417630 PMCID: PMC5041043 DOI: 10.3390/healthcare4030042] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 06/29/2016] [Accepted: 07/08/2016] [Indexed: 12/16/2022] Open
Abstract
The mid-life period is a critical window for increases in body weight and changes in body composition. In this review, we summarize the clinical experience of the menopausal transition by obesity status, and examine the evidence regarding the menopausal transition and reproductive hormones effects on body weight, body composition, or fat distribution. Mid-life obesity is associated with a different menopausal experience including associations with menstrual cycle length prior to the final menstrual period (FMP), age at the FMP, and higher prevalence of vasomotor symptoms. The menopausal transition is associated with weight gain and increased central body fat distribution; the majority of evidence suggests that changes in weight are due to chronological aging whereas changes in body composition and fat distribution are primarily due to ovarian aging. Continuous and regular physical activity during mid-life may be an efficacious strategy to counteract the age-related and menopause-related changes in resting energy expenditure and to prevent weight gain and abdominal adiposity deposition.
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Affiliation(s)
- Carrie Karvonen-Gutierrez
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Catherine Kim
- Departments of Medicine and Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI 48109, USA.
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We JS, Han K, Kwon HS, Kil K. Effect of Maternal Age at Childbirth on Obesity in Postmenopausal Women: A Nationwide Population-Based Study in Korea. Medicine (Baltimore) 2016; 95:e3584. [PMID: 27175656 PMCID: PMC4902498 DOI: 10.1097/md.0000000000003584] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The object of this study was to assess the obesity in postmenopausal women, according to age at childbirth.We analyzed the association between age at first childbirth, age at last childbirth, parity, and subject obesity status (general obesity; BMI >25 kg/m, nongeneral obesity; BMI ≤25 kg/m, abdominal obesity; waist circumference >85 cm, nonabdominal obesity; waist circumference ≤85 cm), using data from a nationwide population-based survey, the 2010 to 2012 Korean National Health and Nutrition Examination Survey. Data from a total of 4382 postmenopausal women were analyzed using multivariate regression analysis with complex survey design sampling. And, the subjects were subdivided into groups according to obesity or not. Age, smoking, alcohol consumption, exercise, education, income level, number of pregnancies, oral contraceptive uses, breast feeding experience were adjusted as the confounders.The prevalence of general obesity among Korean postmenopausal women was 37.08%. Women with general obesity and abdominal obesity were significantly younger at first childbirth compared with women with nongeneral obesity and no abdominal obesity (23.89 ± 0.1 vs. 23.22 ± 0.1, P <0.001). Age at first childbirth was inversely associated with obesity, while age at last childbirth was not associated with obesity or abdominal obesity. Women with a higher number of pregnancies were also more likely to have obesity and abdominal obesity. Age at first childbirth remained significantly associated with obesity, after adjusting for confounding factors.Obesity in postmenopausal women is associated with first childbirth at a young age, and higher parity. Further research is needed to clarify the association between obesity and reproductive characteristics.
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Affiliation(s)
- Ji-Sun We
- From the Department of Obstetrics and Gynecology (J-SW, KK), Yeouido St. Mary's Hospital; Department of Medical Statistics (KH), College of Medicine; and Division of Endocrinology and Metabolism (H-SK), Department of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
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25
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Pate RR, Taverno Ross SE, Liese AD, Dowda M. Associations among physical activity, diet quality, and weight status in US adults. Med Sci Sports Exerc 2015; 47:743-50. [PMID: 25058328 DOI: 10.1249/mss.0000000000000456] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE Nearly 70% of adult Americans are overweight or obese, but the associations between physical activity, diet quality, and weight status have not been examined in a representative sample of US adults. The purpose of this study was to examine the associations among moderate-to-vigorous physical activity (MVPA), diet quality, and weight status within and across age groups in US adults. METHODS Participants included 2587 men and 2412 women age 20 to ≥70 yr from the National Health and Nutrition Examination Survey 2003-2004 and 2005-2006. Physical activity was measured by accelerometry. Diet quality was assessed with overall Healthy Eating Index-2005 scores. Measures of weight status, body mass index (BMI), and waist circumference were assessed using standard National Health and Nutrition Examination Survey protocols. RESULTS Across age groups, MVPA was lower in the older age groups for both men and women, whereas diet quality was higher (P < 0.001). BMI and waist circumference were also higher in the older age groups (P < 0.05). Within age groups, MVPA was inversely associated with BMI and waist circumference for men and women in nearly every age group (P < 0.05). Diet quality was inversely associated with the weight status variables only in men age 30-39, 40-49 (BMI only), and 50-59 yr and women age 50-59 yr (P < 0.05). CONCLUSIONS We observed clear age-related trends for measures of weight status, physical activity, and diet quality in US men and women. MVPA was very consistently related to weight status in both genders. The relation between diet quality and weight status was less consistent. These findings provide support for public health efforts to prevent obesity by promoting increased physical activity in adult Americans.
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Affiliation(s)
- Russell R Pate
- 1Department of Exercise Science, University of South Carolina, Columbia, SC; and 2Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
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Hollis JL, Williams LT, Morgan PJ, Collins CE. The 40-Something Randomised Controlled Trial improved fruit intake and nutrient density of the diet in mid-age women. Nutr Diet 2015. [DOI: 10.1111/1747-0080.12215] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Jenna L. Hollis
- Nutrition and Dietetics, School of Health Sciences; Faculty of Health and Medicine; The University of Newcastle; Newcastle New South Wales Australia
- Priority Research Centre in Physical Activity and Nutrition; The University of Newcastle; Newcastle New South Wales Australia
| | - Lauren T. Williams
- Nutrition and Dietetics, School of Health Sciences; Faculty of Health and Medicine; The University of Newcastle; Newcastle New South Wales Australia
- Priority Research Centre in Physical Activity and Nutrition; The University of Newcastle; Newcastle New South Wales Australia
- Griffith Research Institute; Griffith University; Southport Queensland Australia
| | - Philip J. Morgan
- Priority Research Centre in Physical Activity and Nutrition; The University of Newcastle; Newcastle New South Wales Australia
- School of Education; Faculty of Education and Arts; The University of Newcastle; Newcastle New South Wales Australia
| | - Clare E. Collins
- Nutrition and Dietetics, School of Health Sciences; Faculty of Health and Medicine; The University of Newcastle; Newcastle New South Wales Australia
- Priority Research Centre in Physical Activity and Nutrition; The University of Newcastle; Newcastle New South Wales Australia
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Obesity and Menopause. Best Pract Res Clin Obstet Gynaecol 2015; 29:548-53. [DOI: 10.1016/j.bpobgyn.2014.12.002] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 12/13/2014] [Indexed: 11/18/2022]
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Körpergewicht und Körperzusammensetzung. GYNAKOLOGISCHE ENDOKRINOLOGIE 2014. [DOI: 10.1007/s10304-014-0637-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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McNeil J, Prud'homme D, Strychar I, Rabasa-Lhoret R, Brochu M, Lavoie JM, Doucet É. Satiety quotient linked to food intake and changes in anthropometry during menopause: a MONET Study. Climacteric 2014; 17:449-55. [DOI: 10.3109/13697137.2014.895320] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Williams LT, Hollis JL, Collins CE, Morgan PJ. Can a relatively low-intensity intervention by health professionals prevent weight gain in mid-age women? 12-Month outcomes of the 40-Something randomised controlled trial. Nutr Diabetes 2014; 4:e116. [PMID: 24799163 PMCID: PMC4042310 DOI: 10.1038/nutd.2014.12] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Revised: 02/11/2014] [Accepted: 02/19/2014] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Weight gain in perimenopausal women results in increased visceral adipose tissue, leading to metabolic syndrome and associated comorbidities. Despite a high prevalence of weight gain at this life stage, interventions to prevent menopausal obesity are lacking. AIM To test the effectiveness of an intervention delivered by health professionals using a motivational interviewing (MI) counselling style in preventing weight gain in non-obese (body mass index (BMI) 18.5 and 29.9 kg m(-2)) women in late premenopause. METHODS In a randomised controlled trial, 54 women (mean (s.d.) age 47.3 (1.8) years; BMI 25.1 (2.4) kg m(-2)) who had menstruated within the preceding 3 months were randomly assigned to an MI intervention (n=28) (five health professional MI counselling sessions) or a self-directed intervention (SDI) (print materials only) (n=26). The primary outcome, body weight (kg) and secondary outcomes (blood lipids, glucose, body fat %, lean mass % and waist circumference) were measured at baseline and postintervention (12 months), and intention-to-treat analysis was conducted. RESULTS Forty women completed all measures and adhered to all protocols. The weight at 12 months for the MI group of 65.6 kg (95% CI: 64.5; 66.8) was significantly different (P=0.034) from the SDI group of 67.4 kg (95% CI: 66.2; 68.6). When stratified by baseline BMI category, the MI group lost significantly more weight (-2.6 kg; 95% CI: -3.9; -1.2) than the SDI group (-0.1 kg; 95% CI: -1.2; 1.0, P=0.002) for the healthy weight women. The overweight women lost weight regardless of the intervention group, with no between-group difference (-3.5 kg; 95% CI: -6.1, -1.0 and -2.3; 95% CI: -4.1, -0.5, P=0.467). CONCLUSION This relatively low-intensity intervention, incorporating MI into health professional counselling, not only effectively prevented weight gain but also achieved significant weight loss and decreased diastolic blood pressure. Further refinements are required to optimise outcomes for overweight women.
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Affiliation(s)
- L T Williams
- 1] Nutrition and Dietetics, School of Allied Health Sciences, Faculty of Health, Griffith University, Southport, QLD, Australia [2] Nutrition and Dietetics, Faculty of Health, University of Canberra, Bruce, ACT, Australia [3] School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
| | - J L Hollis
- 1] School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia [2] Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia
| | - C E Collins
- 1] School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia [2] Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia
| | - P J Morgan
- 1] Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia [2] School of Education, Faculty of Education and Arts, University of Newcastle, Callaghan, NSW, Australia
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Association between habitual physical activity and lower cardiovascular risk in premenopausal, perimenopausal, and postmenopausal women: a population-based study. Menopause 2014; 20:525-31. [PMID: 23615643 DOI: 10.1097/gme.0b013e318271b388] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Menopause is associated with an increased risk of cardiovascular disease. Habitual physical activity, defined as any form of body movement with energy expenditure above resting levels, may improve health parameters. We assessed the level of habitual physical activity and its effect on anthropometric measures and cardiovascular risk factors in a cohort of premenopausal, perimenopausal, and postmenopausal women. METHODS This cross-sectional study is nested on a longitudinal population-based study that was begun in 1995 in the city of Passo Fundo, Brazil. For the present analysis, 292 women were included. Anthropometric and metabolic profile was evaluated. Habitual physical activity was assessed by a digital pedometer for 7 days, and participants were stratified into active and inactive (≥6,000 and <6,000 steps/day, respectively). RESULTS The mean (SD) age was 57.1 (5.4) years. The average number of steps per day for the total sample was 5,250.7 (3,372.9): 3,472.4 (1,570.2) in the inactive group (61.8%) and 9,055.9 (3,033.4) in the active group (31.9%). A negative and statistically significant correlation was found between physical activity and smoking (P = -0.019), body mass index (P = -0.006), waist circumference (P = -0.013), and waist-to-hip ratio of 0.85 or higher (P = -0.043). Inactive women presented a higher risk of overweight/obesity (odds ratio [OR], 2.1; 95% CI, 1.233-3.622; P = 0.006) and waist circumference larger than 88 cm (OR, 1.7; 95% CI, 1.054-2.942; P = 0.03), even after adjustment for age, menopause status, smoking, and hormone therapy. Inactive women also had a higher risk of diabetes mellitus (OR, 2.7; 95% CI, 1.233-6.295; P = 0.014) and metabolic syndrome (OR, 2.5, 95% CI, 1.443-4.294; P = 0.001). CONCLUSIONS Habitual physical activity, specifically walking 6,000 or more steps daily, was associated with a decreased risk of cardiovascular disease and diabetes in middle-aged women, independently of menopause status.
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Silva TR, Alves BC, Maturana MA, Spritzer PM. Healthier Dietary Pattern and Lower Risk of Metabolic Syndrome in Physically Active Postmenopausal Women. J Am Coll Nutr 2013; 32:287-95. [DOI: 10.1080/07315724.2013.826111] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Effects of the menopausal transition on dietary intake and appetite: a MONET Group Study. Eur J Clin Nutr 2013; 68:271-6. [PMID: 24065065 PMCID: PMC4954773 DOI: 10.1038/ejcn.2013.171] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Revised: 07/09/2013] [Accepted: 07/12/2013] [Indexed: 01/30/2023]
Abstract
Objective The purpose of this study was to investigate changes in dietary intake and appetite across the menopausal transition. Methods This was a 5-year observational, longitudinal study on the menopausal transition. The study included 94 premenopausal women at baseline (age: 49.9 ± 1.9 yrs; BMI: 23.3 ± 2.3 kg/m2). Body composition (DXA), appetite (visual analogue scale), eating frequency, energy intake (EI) and macronutrient composition (7-day food diary and buffet-type meal) were measured annually. Results Repeated-measures analyses revealed that total EI and carbohydrate intake from food diary decreased significantly over time in women who became postmenopausal by year 5 (P > 0.05) compared to women in the menopausal transition. In women who became postmenopausal by year 5, fat and protein intakes decreased across the menopausal transition (0.05 > P < 0.01). Although a decrease in % fat intake was observed during the menopausal transition (P < 0.05), this variable was significantly increased in the postmenopausal years (P < 0.05). Spontaneous EI and protein intake also declined over time and were higher in the years preceding menopause onset (P < 0.05). Desire to eat, hunger and prospective food consumption increased during the menopausal transition and remained at this higher level in the postmenopausal years (0.05 > P< 0.001). Fasting fullness decreased across the menopausal transition (P < 0.05). Conclusion These results suggest that menopausal transition is accompanied with a decrease in food intake and an increase in appetite.
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Racial differences in perception of healthy body weight in midlife women: results from the Do Stage Transitions Result in Detectable Effects study. Menopause 2013; 20:269-73. [PMID: 23435023 DOI: 10.1097/gme.0b013e31826e7574] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Perception of healthy body weight may influence health behaviors, including physical activity level, nutritional habits, and health outcomes, and these perceptions may vary importantly by race. Midlife is a critical period for women that typically includes weight gain. We assessed the associations between perception of healthy body weight and body mass index (BMI) and whether they vary by race. METHODS In the Do Stage Transitions Result in Detectable Effects study, BMI and perception of body weight (healthy, underweight, or overweight) were measured at baseline examination. Multinomial logistic regression models examined the associations, with race (white vs black) as moderator variable. RESULTS Of 729 women enrolled, 689 women (95%; black, n = 145; white, n = 544) were included in these analyses. Even though the average BMI was higher for black women than for white women (33.1 vs 29.2 kg/m, respectively; P < 0.0001), black women were less likely to report that they weighed too much (relative risk ratio, 0.4; 95% CI, 0.2-0.9; P = 0.022) and more likely to think that they did not weigh enough (relative risk ratio, 14.2; 95% CI, 1.8-110; P = 0.011). CONCLUSIONS Although black women, in general, face a greater threat of morbidity from weight-related chronic diseases, they are more likely to be accepting of their weight at higher BMIs relative to whites. Weight loss interventions and counseling about healthy body size may influence healthy behavior and reduce the risk of chronic diseases.
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Gudmundsdottir SL, Flanders WD, Augestad LB. Physical activity and cardiovascular risk factors at menopause: the Nord-Trøndelag health study. Climacteric 2013; 16:438-46. [PMID: 23347190 DOI: 10.3109/13697137.2013.768231] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Lowered physical activity levels may partially explain changes in metabolic risk factors in women after menopause. OBJECTIVES To evaluate the association between physical activity and metabolic risk factors at baseline and after 11 years, as well as the change in that association over time in women who were premenopausal and ≥ 40 years at baseline. METHODS Subjects in a Norwegian population-based health survey answered questionnaires and had body and serum measurements during 1995-1997 (HUNT 2) and in a follow-up study during 2006-2008 (HUNT 3). Repeated-measures analyses were used to estimate the association between physical activity and metabolic factors, adjusting for age, smoking status, education, alcohol intake, and parity. Adjustment for hormonal treatment and medication was made, as appropriate. RESULTS In women remaining premenopausal, a higher physical activity score in HUNT 3 was associated with lower weight (p < 0.01) and waist-hip ratio (p < 0.01) and higher high density lipoprotein (HDL) cholesterol in HUNT 3 (p < 0.01). In women that were postmenopausal by the time of follow-up, a higher physical activity score in HUNT 3 was associated with lower weight (p < 0.01), waist-hip ratio (p < 0.01), triglycerides (p < 0.01), and higher total cholesterol (p < 0.05), HDL cholesterol (p < 0.01), and diastolic blood pressure (p < 0.05) in HUNT 3. The association of total physical activity score with weight and waist-hip ratio was stronger in HUNT 3 than in HUNT 2 (p < 0.01). CONCLUSION Increased physical activity may reduce the risk of adverse outcomes and use of pharmacological management in women of menopausal age.
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Affiliation(s)
- S L Gudmundsdottir
- Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
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Duval K, Prud'homme D, Rabasa-Lhoret R, Strychar I, Brochu M, Lavoie JM, Doucet E. Effects of the menopausal transition on energy expenditure: a MONET Group Study. Eur J Clin Nutr 2013; 67:407-11. [PMID: 23422924 PMCID: PMC4977179 DOI: 10.1038/ejcn.2013.33] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Objectives Factors that influence weight gain during the menopausal transition are not fully understood. The purpose of this study was to investigate changes in energy expenditure (EE) across the menopausal transition. Methods One hundred and two premenopausal women (age: 49.9 ± 1.9 yrs; BMI: 23.3 ± 2.2 kg/m2) were followed for 5 years. Body composition (DXA), physical activity EE (accelerometer), resting EE and thermic effect of food (indirect calorimetry) were measured annually. Results Total EE decreased significantly over time in postmenopausal women (P < 0.05), which was mostly due to a decrease in physical activity EE (P < 0.05). Although average resting EE remained stable over time in postmenopausal women, a significant increase, over the 5-year period, was noted in women who were in the menopausal transition by year 5 (P < 0.05). Finally, the time spent in moderate physical activity decreased and the time spent in sedentary physical activity increased during the menopausal transition (P < 0.05). Conclusion These results suggest that menopausal transition is accompanied with a decline in EE mainly characterized by a decrease in physical activity EE and a shift to a more sedentary lifestyle.
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Affiliation(s)
- K Duval
- Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada
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Choi J, Guiterrez Y, Gilliss C, Lee KA. Physical activity, weight, and waist circumference in midlife women. Health Care Women Int 2013; 33:1086-95. [PMID: 23153345 DOI: 10.1080/07399332.2012.673658] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
During midlife years, women are at risk of increasing body weight and waist circumference. We evaluated changes in weight and waist circumference from enrollment to 2 years later and examined the influence of physical activity level on those changes among 232 women aged between 40 and 50. Weight increased significantly for the entire sample. Those who increased their physical activity from enrollment to 2 years later had the smallest increase in weight and had a slight decrease in waist circumference. To maintain ideal weight and waist circumference, midlife women should be encouraged to increase physical activity before and during the menopausal transition.
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Affiliation(s)
- JiWon Choi
- Department of Social & Behavioral Sciences, University of California, San Francisco, 94118, USA.
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Fogelholm M, Anderssen S, Gunnarsdottir I, Lahti-Koski M. Dietary macronutrients and food consumption as determinants of long-term weight change in adult populations: a systematic literature review. Food Nutr Res 2012; 56:19103. [PMID: 22893781 PMCID: PMC3418611 DOI: 10.3402/fnr.v56i0.19103] [Citation(s) in RCA: 129] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Revised: 06/02/2012] [Accepted: 06/29/2012] [Indexed: 01/29/2023] Open
Abstract
This systematic literature review examined the role of dietary macronutrient composition, food consumption and dietary patterns in predicting weight or waist circumference (WC) change, with and without prior weight reduction. The literature search covered year 2000 and onwards. Prospective cohort studies, case–control studies and interventions were included. The studies had adult (18–70 y), mostly Caucasian participants. Out of a total of 1,517 abstracts, 119 full papers were identified as potentially relevant. After a careful scrutiny, 50 papers were quality graded as A (highest), B or C. Forty-three papers with grading A or B were included in evidence grading, which was done separately for all exposure-outcome combinations. The grade of evidence was classified as convincing, probable, suggestive or no conclusion. We found probable evidence for high intake of dietary fibre and nuts predicting less weight gain, and for high intake of meat in predicting more weight gain. Suggestive evidence was found for a protective role against increasing weight from whole grains, cereal fibre, high-fat dairy products and high scores in an index describing a prudent dietary pattern. Likewise, there was suggestive evidence for both fibre and fruit intake in protection against larger increases in WC. Also suggestive evidence was found for high intake of refined grains, and sweets and desserts in predicting more weight gain, and for refined (white) bread and high energy density in predicting larger increases in WC. The results suggested that the proportion of macronutrients in the diet was not important in predicting changes in weight or WC. In contrast, plenty of fibre-rich foods and dairy products, and less refined grains, meat and sugar-rich foods and drinks were associated with less weight gain in prospective cohort studies. The results on the role of dietary macronutrient composition in prevention of weight regain (after prior weight loss) were inconclusive.
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Affiliation(s)
- Mikael Fogelholm
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
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McGrother CW, Donaldson MMK, Thompson J, Wagg A, Tincello DG, Manktelow BN. Etiology of overactive bladder: a diet and lifestyle model for diabetes and obesity in older women. Neurourol Urodyn 2012; 31:487-95. [PMID: 22374635 DOI: 10.1002/nau.21200] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Accepted: 07/06/2011] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To evaluate a coherent, evidence-based hypothesis that specific modifiable lifestyle factors implicated in the development of diabetes and associated obesity are related to the onset of OAB. METHODS A hypothetical causative model for OAB involving modifiable lifestyle factors implicated in the development of diabetes and obesity was constructed, based on a systematic literature review. Secondary analysis of data was undertaken in a prospective cohort of women aged 40 and over, living in Leicestershire, UK. Subjects included 3,411 women free from OAB at baseline and 277 incident cases of OAB. Reported diet, lifestyle, morbid, and social factors were measured at baseline and incident cases at 1-year follow-up. Graphical chain modeling was used to estimate the associations between variables and identify likely pathways involved. RESULTS All hypothesized lifestyle factors (physical activity, high glycemic index, and high energy intake) plus diabetes and obesity were retained within the graph as potential contributors. However, low physical activity was the only direct risk factor linked prospectively to the onset of OAB (RR 2.47; 95% CI 1.82, 3.36), in addition to older age. CONCLUSIONS Poor lifestyle factors causally linked to diabetes and obesity may contribute to the onset of OAB; low physical activity appears to be an important modifiable causal factor for OAB operating directly as well as indirectly via pathways involving obesity or diabetes. Further research is needed to demonstrate a causal link between lifestyle and OAB.
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Sternfeld B, Dugan S. Physical activity and health during the menopausal transition. Obstet Gynecol Clin North Am 2012; 38:537-66. [PMID: 21961719 DOI: 10.1016/j.ogc.2011.05.008] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
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).
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Affiliation(s)
- Barbara Sternfeld
- Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA 94612, USA.
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Bush NC, Alvarez JA, Choquette SS, Hunter GR, Oster RA, Darnell BE, Gower BA. Dietary calcium intake is associated with less gain in intra-abdominal adipose tissue over 1 year. Obesity (Silver Spring) 2010; 18:2101-4. [PMID: 20203630 PMCID: PMC2902577 DOI: 10.1038/oby.2010.39] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Calcium intake is reported to enhance weight loss with a preferential loss in trunk fat. Discrepant findings exist as to the effects of calcium intake on longitudinal changes in total fat mass and central fat deposition. Therefore, the purpose of this study was to determine associations between dietary calcium intake and 1-year change in body composition and fat distribution, specifically intra-abdominal adipose tissue (IAAT). A total of 119 healthy, premenopausal women were evaluated at baseline and 1 year later. Average dietary calcium was determined via 4-day food records. Total fat was determined by dual-energy X-ray absorptiometry (DXA) and subcutaneous abdominal adipose tissue (SAAT) and IAAT by computed tomography. Over the study period, participants' reported daily calcium and energy intakes were 610.0 ± 229.9 mg and 1,623.1 ± 348.5 kcal, respectively. The mean change in weight, total fat, IAAT, and SAAT was 4.9 ± 4.4 kg, 5.3 ± 4.0 kg, 7.7 ± 19.5 cm(2), and 49.3 ± 81.1 cm(2), respectively. Average calcium intake was significantly, inversely associated with 1-year change in IAAT (standardized β: -0.23, P < 0.05) after adjusting for confounding variables. For every 100 mg/day of calcium consumed, gain in IAAT was reduced by 2.7 cm(2). No significant associations were observed for average calcium intake with change in weight, total fat, or SAAT. In conclusion, dietary calcium intake was significantly associated with less gain in IAAT over 1 year in premenopausal women. Further investigation is needed to verify these findings and determine the calcium intake needed to exert beneficial effects on fat distribution.
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Affiliation(s)
- Nikki C Bush
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA.
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Astrup A, Chaput JP, Gilbert JA, Lorenzen JK. Dairy beverages and energy balance. Physiol Behav 2010; 100:67-75. [PMID: 20152844 DOI: 10.1016/j.physbeh.2010.01.039] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Revised: 01/28/2010] [Accepted: 01/30/2010] [Indexed: 12/26/2022]
Abstract
High dairy intakes have been associated with lower rates of obesity in observational studies, but mechanisms to explain the association are lacking. A high intake of dairy protein reduces spontaneous food intake and may be one important mechanism, but more specific effects of dairy calcium seem to exist. We have found that high versus low calcium intakes from dairy products had no effect on 24-h energy expenditure or substrate oxidation rates, but fecal fat excretion increased approximately 2.5-fold on the high-calcium diets. In a meta-analysis of intervention studies we found that increasing dairy calcium intake by 1200mg/day resulted in increased fecal fat excretion by 5.2 (1.6-8.8) g/day. Newer research shows that humans possess taste receptors for calcium in the gastrointestinal tract and that signaling may be linked to appetite regulation. A new line of evidence suggests that an inadequate calcium intake during an energy restricted weight loss program may trigger hunger and impair compliance to the diet. These mechanisms may be part of the explanation for the protective effects of dairy products with regard to obesity and metabolic syndrome.
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Affiliation(s)
- Arne Astrup
- Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Copenhagen, Denmark
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Lecerf JM. Les produits laitiers et le risque cardiovasculaire. CAHIERS DE NUTRITION ET DE DIÉTÉTIQUE 2010. [DOI: 10.1016/j.cnd.2009.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
Obesity has reached epidemic proportions in the United States, with 35.1% of adults being classified as obese. Obesity affects every segment of the US population and continues to increase steadily, especially in children. Obesity increases the risk for many other chronic diseases, including diabetes mellitus, cardiovascular disease, and nonalcoholic fatty liver disease, and decreases overall quality of life. The current US generation may have a shorter life expectancy than their parents if the obesity epidemic is not controlled, and there is no indication that the prevalence of obesity is decreasing. Because of the complexity of obesity, it is likely to be one of the most difficult public health issues our society has faced.
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Affiliation(s)
- Victoria A Catenacci
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Colorado Denver, Denver, CO 80220, USA
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46
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Past and current weight change and forearm bone loss in middle-aged women: the Nord-Trøndelag Health Study, Norway. Menopause 2010; 16:1197-204. [PMID: 19455067 DOI: 10.1097/gme.0b013e3181a6cbb1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the association between bone loss and weight change before and concurrently to the assessment of forearm bone loss over 4.6 years in a population-based cohort of middle-aged women followed for more than 15 years. METHODS Among 8,856 women aged 45 to 60 years attending the first Nord-Trøndelag Health Study study, Norway (1984-1986), a 35% random sample was invited for forearm densitometry at Nord-Trøndelag Health Study 2 (1995-1997), and 2,188 women (78%) attended. After an average period of 4.6 years, they were subsequently invited for follow-up densitometry in 2001, and 1,421 women (67.8%) met. Weight and height were measured on all three occasions. RESULTS During the total period of observation since baseline (15.5 y), the mean weight had increased by 3.4 kg, mostly in the youngest women. Weight loss had an accelerating and weight gain a decelerating effect on bone loss, and this was observed both for weight change occurring before the bone mineral density follow-up and for concurrent weight change. The relationship between prior weight gain or loss and bone loss seemed to persist, independent of the weight change observed during the period of bone loss assessment. CONCLUSIONS Despite no mechanical impact of body weight on the forearm, weight loss in midlife women seems to be associated with a long-lasting negative effect on bone and vice versa for weight gain. This is presumably explained by humoral factors.
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Abstract
Overweight and obesity are the foremost public health problems in the U.S., other industrialized countries, and is rapidly increasing in developing countries. Obesity is a multifaceted disease which requires multiple approaches to successfully combat its increase. Nutritional factors play a key role and include modification of energy balance, intake and expenditure, as well as other factors. Emerging scientific evidence over the past decade suggests that dairy foods may be beneficial when included in a moderate energy restricted diet and possibly for weight maintenance as well. This paper provides a review of some of the scientific evidence that has examined the effect of dairy foods and dietary calcium on weight management. Topic areas presented are observational or retrospective studies with adults as well as children and adolescents; randomized clinical trials on body weight and composition, energy expenditure, substrate oxidation and fecal fat loss; research from animal and in vitro studies provide possible mechanisms of action.
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48
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Alonso A, Zozaya C, Vázquez Z, Alfredo Martínez J, Martínez-González MA. The effect of low-fat versus whole-fat dairy product intake on blood pressure and weight in young normotensive adults. J Hum Nutr Diet 2009; 22:336-42. [PMID: 19486260 DOI: 10.1111/j.1365-277x.2009.00967.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Epidemiologic and experimental studies suggest that higher intake of dairy products could be associated with lower risk of hypertension and obesity. Differences in nutrient composition of distinct dairy products suggest that their effect on these outcomes might be heterogeneous. However, little experimental research has examined the potentially different effects of low- and whole-fat dairy products on blood pressure (BP) and weight change. The present study aimed to assess whether supplementing diets with low- or whole-fat dairy products would differentially affect BP levels and weight. METHODS A randomised crossover trial in 45 normotensive volunteers (18-24 years old, 49% female) was conducted. Participants alternatively received 3.5 servings/day of whole-fat or low-fat dairy products (milk and yogurt) in addition to their usual diet during two 8-week periods, with a 4-week washout period between both interventions. Weight and BP were measured at the beginning and end of each intervention. RESULTS Whole-fat dairy supplementation significantly increased systolic BP [2.1 mmHg, 95% confidence interval (CI) = 0.1-4.0, P = 0.04] and weight (1.0 kg, 95% CI = 0.5-1.5, P = 0.0002), but not diastolic BP (P = 0.34). Weight and BP did not change significantly after the low-fat dairy intervention (P > 0.10). There were no significant differences in the effect of low-fat or whole-fat dairy products on BP (P > 0.60), but whole-fat dairy increased weight significantly compared to low-fat dairy (1.2 kg, 95% CI = 0.5-1.8, P = 0.0007). CONCLUSIONS In a young nonhypertensive population, dietary supplementation with whole-fat dairy products, compared to low-fat dairy, was associated with weight gain. No differential effects were observed for levels of BP.
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Affiliation(s)
- A Alonso
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA.
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49
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Heaney RP, Rafferty K. Preponderance of the evidence: an example from the issue of calcium intake and body composition. Nutr Rev 2009; 67:32-9. [PMID: 19146504 DOI: 10.1111/j.1753-4887.2008.00132.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Meta-analysis is typically applied to studies developed in fairly mature fields, but may be ill-suited for younger fields in which most of the evidence comes from studies that were designed for other endpoints entirely and that are often significantly underpowered for the effect in question. Here, there are no generally accepted methods for getting a grasp on the preponderance of the evidence. In this review, one way of doing so is proposed and the recently emergent literature concerning calcium intake and body composition is used as an illustration of how such an approach might be used.
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Affiliation(s)
- Robert P Heaney
- Creighton University Medical Center, Osteoporosis Research Center, Omaha, Nebraska 68131, USA.
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50
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Abstract
BACKGROUND Hypertension is a major cardiovascular risk factor possibly explaining the excessive cardiovascular morbidity and mortality in postmenopausal women. Cross-sectional and longitudinal studies have explored this issue with diverging results. Our study sought to elucidate the impact of the menopause on blood pressure in a representative population sample. METHODS The study involved randomly selected 908 female residents of a Prague district, aged 45-54 years (respondence rate, 63.9%). Three definitions of the menopause were used: self-reported menstrual characteristics (premenopausal with the final menstrual period less than 60 days; late menopausal transition, with final menstrual period 60-365 days; and postmenopausal, final menstrual period more than 365 days before the examination), levels of follicle-stimulating hormone (< or = 40 IU/l for premenopausal and more than 40 IU/l for postmenopausal women), and both. RESULTS Age-adjusted and BMI-adjusted systolic blood pressure and diastolic blood pressure did not differ among the groups regardless of the definition of menopause. There was also no difference in the prevalence of hypertension and in the age-adjusted and BMI-adjusted odds ratio for hypertension. Multiple regression analysis testing the association between systolic blood pressure and diastolic blood pressure, and age, BMI, heart rate, smoking, and antihypertensive medication explained a rather small proportion of the BP variation. No correlation was found between BP and age in either subgroup; the closest correlation was always found between BP and BMI. CONCLUSION In our rather homogeneous representative population random sample of women around the menopause, the rise in blood pressure after the menopause appeared to be due to increased BMI rather than to ovarian failure per se.
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