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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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Guo J, Gelfand SB, Hennessy E, Aqeel MM, Eicher-Miller HA, Richards EA, Lin L, Bhadra A, Delp EJ. Cluster Analysis to Find Temporal Physical Activity Patterns Among US Adults. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.01.23.23284777. [PMID: 36747782 PMCID: PMC9901066 DOI: 10.1101/2023.01.23.23284777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Physical activity (PA) is known to be a risk factor for obesity and chronic diseases such as diabetes and metabolic syndrome. Few attempts have been made to pattern the time of physical activity while incorporating intensity and duration in order to determine the relationship of this multi-faceted behavior with health. In this paper, we explore a distance-based approach for clustering daily physical activity time series to estimate temporal physical activity patterns among U.S. adults (ages 20-65) from the National Health and Nutrition Examination Survey 2003-2006 (NHANES). A number of distance measures and distance-based clustering methods were investigated and compared using various metrics. These metrics include the Silhouette and the Dunn Index (internal criteria), and the associations of the clusters with health status indicators (external criteria). Our experiments indicate that using a distance-based cluster analysis approach to estimate temporal physical activity patterns through the day, has the potential to describe the complexity of behavior rather than characterizing physical activity patterns solely by sums or labels of maximum activity levels.
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Affiliation(s)
- Jiaqi Guo
- School of Electrical and Computer Engineering, Purdue University West Lafayette, IN, USA
| | - Saul B Gelfand
- School of Electrical and Computer Engineering, Purdue University West Lafayette, IN, USA
| | - Erin Hennessy
- Friedman School of Nutrition Science and Policy, Tufts University Boston MA, USA
| | - Marah M Aqeel
- Department of Nutrition Science Purdue University West Lafayette, IN, USA
| | | | | | - Luotao Lin
- Department of Nutrition Science Purdue University West Lafayette, IN, USA
| | - Anindya Bhadra
- Department of Statistics Purdue University West Lafayette, IN, USA
| | - Edward J Delp
- School of Electrical and Computer Engineering, Purdue University West Lafayette, IN, USA
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Guo J, Lin L, Aqeel MM, Gelfand SB, Eicher-Miller HA, Bhadra A, Hennessy E, Richards EA, Delp EJ. Joint Temporal Patterns By Integrating Diet and Physical Activity. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.01.23.23284780. [PMID: 36747820 PMCID: PMC9901045 DOI: 10.1101/2023.01.23.23284780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Both diet and physical activity are associated with obesity and chronic diseases such as diabetes and metabolic syndrome. Early efforts in connecting dietary and physical activity behaviors to generate patterns rarely considered the use of time. In this paper, we propose a distance-based cluster analysis approach to find joint temporal diet and physical activity patterns among U.S. adults ages 20-65. Dynamic Time Warping (DTW) generalized to multi-dimensions is combined with commonly used clustering methods to generate unbiased partitioning of the National Health and Nutrition Examination Survey 2003-2006 (NHANES) dataset. The clustering results are evaluated using visualization of the clusters, the Silhouette Index, and the associations between clusters and health status indicators based on multivariate regression models. Our experiments indicate that the integration of diet, physical activity, and time has the potential to discover joint temporal patterns with association to health.
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Affiliation(s)
- Jiaqi Guo
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, USA
| | - Luotao Lin
- Department of Nutrition Science Purdue University, West Lafayette, IN, USA
| | - Marah M Aqeel
- Department of Nutrition Science Purdue University, West Lafayette, IN, USA
| | - Saul B Gelfand
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, USA
| | | | - Anindya Bhadra
- Department of Statistics Purdue University, West Lafayette, IN, USA
| | - Erin Hennessy
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | | | - Edward J Delp
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, USA
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Zak RS, Zitser J, Jones HJ, Gilliss CL, Lee KA. Sleep Self-Report and Actigraphy Measures in Healthy Midlife Women: Validity of the Pittsburgh Sleep Quality Index. J Womens Health (Larchmt) 2022; 31:965-973. [DOI: 10.1089/jwh.2021.0328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Rochelle S. Zak
- Sleep Disorders Center, University of California, San Francisco, California, USA
| | - Jennifer Zitser
- Department of Neurology, Memory and Aging Center, Global Brain Health Institute, University of California, San Francisco, San Francisco, California, USA
- Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Holly J. Jones
- College of Nursing, University of Cincinnati, Cincinnati, Ohio, USA
| | - Catherine L. Gilliss
- Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, California, USA
| | - Kathryn A. Lee
- Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, California, USA
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Cho JH, Ko J, Lim ST. Relationship between metabolic syndrome and moderate-to-vigorous physical activity among adults 18 years old and over. PLoS One 2021; 16:e0258097. [PMID: 34644321 PMCID: PMC8513823 DOI: 10.1371/journal.pone.0258097] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 09/20/2021] [Indexed: 12/16/2022] Open
Abstract
The prevalence of metabolic syndrome (MetS) risk factors among the Korean population requires effective health surveillance and examination of the effects of preventative behaviors. Thus, the objective of this study is to evaluate the relationships between the clustering of MetS and MVPA in a large sample of 36,987 Koreans ranging from 20 to 80 years of age. This study recruited a total of 36,987 adults (23,813 males and 13,174 females). All participants were assessed for moderate-to-vigorous physical activity (MVPA) using the Korean version short form of the International Physical Activity Questionnaire (IPAQ). The International Diabetes Federation and the Adult Treatment Panel III criteria for blood pressure, hyperglycemia, low high-density lipoprotein cholesterol (HDL-C), and high triglycerides (TG) defined MetS. Waist circumference (WC) was determined by Asian-Pacific region populations. According to the 150-minute MVPA, there were differences in MetS risk factors in young adult males, and only three factors (WC, HDL-C, and TG) were different males in ≥ 70 years old. In females, there was a difference in MetS risk factors in the elderly, and only three factors (WC, blood pressure, and TG) were different females in ≤ 29 years old. The males who did not met the recommended MVPA had a 1.16 to 3.14 -times increase in the MetS risk factors. The females who did not met the recommended MVPA had a 1.18 to 2.57 -times increase in the MetS risk factors. Our study provides evidence that Korean adults who do not engage in recommended MVPA levels increase the odds ratio for each of the MetS risk factors when compared to those who meet the recommendations.
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Affiliation(s)
- Ji-Hoon Cho
- Department of Sport and Leisure Studies, Shingyeong University, Hwaseong, Republic of Korea
| | - Jupil Ko
- Division of Health & Kinesiology, Incheon National University, Incheon, Republic of Korea
| | - Seung-Taek Lim
- Olympic Studies Center, Kangwon National University, Chuncheon, Gangwon-do, Republic of Korea
- * E-mail:
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Binkley HM, Phillips KL, Wise SL. Menopausal Women: Recognition, Exercise Benefits, Considerations, and Programming Needs. Strength Cond J 2021. [DOI: 10.1519/ssc.0000000000000606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Zhang Z, Reczek C, Colen CG. Intergenerational Coresidence and Mothers’ Body Weight at Midlife. POPULATION RESEARCH AND POLICY REVIEW 2020; 39:1051-1085. [DOI: 10.1007/s11113-020-09567-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Davis J, Camilleri M, Eckert D, Burton D, Joyner M, Acosta A. Physical activity is associated with accelerated gastric emptying and increased ghrelin in obesity. Neurogastroenterol Motil 2020; 32:e13879. [PMID: 32390274 PMCID: PMC7606341 DOI: 10.1111/nmo.13879] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 02/29/2020] [Accepted: 04/18/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Rapid gastric emptying, increased food intake, and alterations in gastrointestinal hormones are associated with obesity. The effect of regular physical activity (PA) on food intake, gastric emptying (GE), gastric accommodation, and gastrointestinal (GI) hormones in adults with obesity remains unclear. Our aim was to compare, at time of presentation, weight trends, eating behavior, GE, and GI hormone levels among individuals with obesity who engage in regular PA compared to those who do not. METHODS In 270 participants with obesity, we performed validated measurements of GI phenotypes: GE of solids and liquids, gastric volume (GV) during fasting and after consumption of 200 mL Ensure®, satiety by kcal intake (T-kcal) during a buffet meal, satiation (volume to fullness [VTF] and maximal tolerated volume [MTV]) of a liquid nutrient, and plasma levels of fasting and postprandial GLP-1, PYY, CCK, and ghrelin. Physical Activity Stages of Change Questionnaire was used to assess whether participants were regularly PA or not. KEY RESULTS PA was associated with lower BMI (Δ 2.01 kg/m2 , P = .001) and body weight (Δ 4.42 kg, P = .0278). GE of solids (T-50% Δ 7.54 min, P = .021) and liquids (T-50% Δ 2.99 min, P = .029%) was significantly more rapid in physically active participants. PA was also associated with relatively higher postprandial ghrelin AUC (Δ 10.4 pg/mL, P = .015). There was no significant difference in postprandial satiation, satiety, GV, or other GI hormones (CCK, PYY, or GLP-1) between groups. CONCLUSIONS & INFERENCES Physical activity is associated with lower BMI, but faster GE and higher postprandial ghrelin levels, two factors that are also associated with obesity.
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Affiliation(s)
- Judith Davis
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), and Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Michael Camilleri
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), and Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Deborah Eckert
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), and Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Duane Burton
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), and Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Michael Joyner
- Division of Anesthesia Research, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - Andres Acosta
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), and Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN
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Menopausal symptoms, physical activity level and quality of life of women living in the Mediterranean region. PLoS One 2020; 15:e0230515. [PMID: 32208445 PMCID: PMC7093012 DOI: 10.1371/journal.pone.0230515] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 03/02/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The main purpose of this study is to investigate the relationship between menopause related discomforts and the quality of life of Lebanese women correlated with the physical activity level, anthropometric, medical, sociodemographic and lifestyle variables, during mid-life. MATERIALS AND METHODS This cross-sectional study was conducted among 1113 women, recruited from different Lebanese regions. The Menopause-Specific Quality of Life Questionnaire (MENQOL) was used to assess menopause related symptoms. Menopausal status was classified according to the World Health Organization's definition of menopause. The International Physical Activity Questionnaire was used to evaluate the physical activity level of participants. Anthropometric measurements were taken by the research team. RESULTS Participants were 49.53 ± 5.74 years old and had a mean body mass index of 26.69 ± 5.37 Kg/m2. The highest mean scores of MENQOL were found in the physical and psychosocial domains (p<0.001). Peri-menopausal women had the highest mean scores in the vasomotor, physical and psychosocial domains (p<0.001), while postmenopausal and menopausal women in the sexual domain (p<0.001). Almost half the participants (45.4%) had low physical activity level, which was significantly and inversely correlated with vasomotor, psychosocial, physical and sexual MENQOL subdomains (p<0.001). Menopausal status, educational level, crowding and body mass indexes, marital status, smoking and alcohol intake were among the factors that were significantly associated with the frequency and the severity of menopause related symptoms. CONCLUSION Physical activity may play a protective role in attenuating climacteric symptoms and hence improve the quality of life of women during mid-life.
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Associations between sleep and obesity indices in older adults: results from the HELIAD study. Aging Clin Exp Res 2019; 31:1645-1650. [PMID: 30628048 DOI: 10.1007/s40520-018-01113-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 12/29/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Short sleep duration and low sleep quality are negatively associated with obesity in young adults, but in older people the results are inconsistent. AIMS The aim of the present study was to examine the associations between sleep duration and quality with both body mass index (BMI) and waist circumference (WC) and to investigate sex- and age-specific associations in a population-representative cohort of older adults. METHODS 1781 participants ≥ 65 years old from the HELIAD study were included. Sleep duration and quality were based on self-report, whereas BMΙ and WC were evaluated clinically. RESULTS Sleep duration was inversely related to WC, only in women, even after adjustment for age, sex, years of education, total energy intake and level of physical activity. Furthermore, sleep quality was negatively related to both BMI and WC in women. In men, however, no significant relationships were observed between these variables. Associations between sleep and weight did not differ between those aged < 73 and ≥ 73 years old. DISCUSSION To the best of our knowledge, this is the first study examining both sleep duration and quality with BMI and WC in older adults, performing by-sex analysis. Although additional studies are needed, improvements in sleep habits should be considered in weight management of older individuals. CONCLUSIONS Our results suggest that poor sleep is associated to adverse weight effects in older women, but not men.
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Dugan SA, Gabriel KP, Lange-Maia BS, Karvonen-Gutierrez C. Physical Activity and Physical Function: Moving and Aging. Obstet Gynecol Clin North Am 2018; 45:723-736. [PMID: 30401553 PMCID: PMC6226270 DOI: 10.1016/j.ogc.2018.07.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Evidence supports that the physical disablement process starts earlier than previously thought, in midlife when women still have many years to live. Physical activity participation and interventions have been successful in preventing disability in older adults and may be promising for maintaining function at younger ages. Changing the conversation to more relevant topics in midlife, like positive changes in body composition, sleep, and improved mood, may move the dial on participation, as midlife women do not meet guidelines for physical activity. Exploring the role of reproductive aging beyond chronologic aging may provide gender-specific insights on both disablement and participation.
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Affiliation(s)
- Sheila A Dugan
- Department of Physical Medicine and Rehabilitation, Rush University Medical Center, 1725 W. Harrison Street, Suite 885, Chicago, IL 60612, USA; Department of Preventive Medicine, Rush University Medical Center, 1700 W. Van Buren, Suite 470, Chicago, IL 60612, USA.
| | - Kelley Pettee Gabriel
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston, School of Public Health, Austin Campus, Michael and Susan Dell Center for Healthy Living, 1616 Guadalupe Street, Suite 6.300, Austin, TX 78701, USA; Department of Women's Health, The University of Texas at Austin, Dell Medical School, Medical Park Tower, 1301 W. 38th Street, Suite 705, Austin, TX 78705, USA
| | - Brittney S Lange-Maia
- Department of Preventive Medicine, Rush University Medical Center, 1700 W. Van Buren, Suite 470, Chicago, IL 60612, USA; Rush University Medical Center, Center for Community Health Equity, 600 S. Paulina Street, Suite 480, AAC, Chicago, IL 60612, USA
| | - Carrie Karvonen-Gutierrez
- Department of Epidemiology, University of Michigan, School of Public Health, 1415 Washington Heights, Room 6618, Ann Arbor, MI 48109-2029, USA
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The Relationships Between Physical Activity and Cardiometabolic Risk Factors Among Women Participating in a University-Based Worksite Wellness Program. J Occup Environ Med 2018; 60:1098-1107. [PMID: 30188493 DOI: 10.1097/jom.0000000000001439] [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
OBJECTIVE Associations between changes in physical activity (PA) and cardiometabolic risk factors among women with overweight/obesity enrolled in a university-based worksite wellness program (WWP) were examined. METHODS Data from 173 women who completed a 26-week WWP were analyzed retrospectively. Participants completed diet and PA assessments and received client-centered diet/lifestyle counseling at baseline, and 12 and 26 weeks thereafter. Anthropometrics, blood pressure, and total cholesterol were measured; PA was self-reported using the International Physical Activity Questionnaire-short form at each visit. RESULTS Significant improvements in anthropometrics (P < 0.001), blood pressure (P < 0.001), total cholesterol (P = 0.014), and PA (P = 0.007) were found at 26 weeks. In adjusted linear regression models, a 10 metabolic-equivalent-minute increase in PA was associated with 0.01% corresponding decreases in weight and waist circumference. CONCLUSION Among women who completed this WWP, increased PA was associated with reductions in anthropometric measures.
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Jones HJ, Zak R, Lee KA. Sleep Disturbances in Midlife Women at the Cusp of the Menopausal Transition. J Clin Sleep Med 2018; 14:1127-1133. [PMID: 29991421 DOI: 10.5664/jcsm.7208] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/14/2018] [Indexed: 12/15/2022]
Abstract
STUDY OBJECTIVES To compare causes of sleep disturbance and to compare self-reported sleep duration among groups of late premenopausal women and early perimenopausal women. METHODS In a longitudinal study of a community-based sample of healthy women 40 to 50 years of age, menstrual cycle and symptom data were collected every 2 months; anthropometric measures, a urine sample for follicle stimulating hormone (FSH), and the Pittsburgh Sleep Quality Index (PSQI) measures were collected every 6 months. RESULTS At 12 to 18 months, 206 women remained premenopausal and 69 women became perimenopausal. Poor sleep quality (PSQI score > 5) was experienced by 42% of the total cohort. Awakening to use the bathroom was the most frequent reason (81%) for sleep disturbance in the entire cohort, followed by feeling too hot (26%). However, premenopausal women were significantly more likely to awaken to use the bathroom than perimenopausal women (P = .047), and perimenopausal women were more likely than premenopausal women to awaken because of feeling too hot (P = .002). Women in early perimenopause reported shorter sleep duration (P = .007) and worse sleep quality (P = .05) than premenopausal women of similar age. CONCLUSIONS Sleep disturbance is a significant issue for midlife women regardless of age or reproductive stage. Identification of salient factors that disrupt sleep, such as nocturia prior to menopausal transition or feeling too hot early in menopausal transition, will provide direction for developing tailored intervention strategies to improve sleep and quality of life. COMMENTARY A commentary on this article appears in this issue on page 1095.
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Affiliation(s)
- Holly J Jones
- College of Nursing, University of Cincinnati, Cincinnati, Ohio
| | - Rochelle Zak
- Sleep Disorders Center, University of California, San Francisco, California
| | - Kathryn A Lee
- Department of Family Health Care Nursing, University of California, San Francisco, California
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Jones HJ, Sternberg RM, Janson SL, Lee KA. A Qualitative Understanding of Midlife Sources of Stress and Support in African-American Women. JOURNAL OF NATIONAL BLACK NURSES' ASSOCIATION : JNBNA 2016; 27:24-30. [PMID: 29932540 PMCID: PMC6090538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
African-American women suffer from disproportionate adverse health outcomes compared to women of other ethnicities living in the United States. It is suggested in the literature that chron- ic stress can be an antecedent to health disparity. The purpose of this study was to evaluate changes in perceived stress from late pre-menopause to post-menopause and to identify significant life stressors perceived by a cohort of African-American women. Retrospective and current data were used to evaluate perceived stress over time, sources of stress, and resources in a cohort of 15 African-American women. Mixed methodologies were utilized. Perceived stress scores were consistent over time. Six themes were identified in responses about stress: finances, caringforfamily members, relationships, personal health and aging, race and discrimination, and raising children. Understanding the role that unique life stressors play in the lives of African-American women is essential in anticipating the need for assistance and in implementing preventive strategies.
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O’Connor DL, Blake J, Bell R, Bowen A, Callum J, Fenton S, Gray-Donald K, Rossiter M, Adamo K, Brett K, Khatri N, Robinson N, Tumback L, Cheung A. Consensus canadien sur la nutrition féminine : adolescence, reproduction, ménopause et au-delà. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2016; 38:555-609.e19. [DOI: 10.1016/j.jogc.2016.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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O'Connor DL, Blake J, Bell R, Bowen A, Callum J, Fenton S, Gray-Donald K, Rossiter M, Adamo K, Brett K, Khatri N, Robinson N, Tumback L, Cheung A. Canadian Consensus on Female Nutrition: Adolescence, Reproduction, Menopause, and Beyond. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2016; 38:508-554.e18. [PMID: 27368135 DOI: 10.1016/j.jogc.2016.01.001] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To provide health care professionals in Canada with the basic knowledge and tools to provide nutrition guidance to women through their lifecycle. OUTCOMES Optimal nutrition through the female lifecycle was evaluated, with specific focus on adolescence, pre-conception, pregnancy, postpartum, menopause, and beyond. The guideline begins with an overview of guidance for all women, followed by chapters that examine the evidence and provide recommendations for the promotion of healthy nutrition and body weight at each life stage. Nutrients of special concern and other considerations unique to each life stage are discussed in each chapter. EVIDENCE Published literature, governmental and health agency reports, clinical practice guidelines, grey literature, and textbook sources were used in supporting the recommendations made in this document. VALUES The quality of evidence was rated using the criteria described in the report of the Canadian Task Force on Preventive Health Care. CHAPTER 2: GENERAL FEMALE NUTRITION: Summary Statements Recommendations CHAPTER 3: ADOLESCENCE NUTRITION: Summary Statements Recommendations CHAPTER 4: PRE-CONCEPTUAL NUTRITION: Summary Statement Recommendations CHAPTER 5: NUTRITION IN PREGNANCY: Summary Statements Recommendations CHAPTER 6: POSTPARTUM NUTRITION AND LACTATION: Summary Statements Recommendations CHAPTER 7: NUTRITION DURING MENOPAUSE AND BEYOND: Summary Statement Recommendations.
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Holahan CK, Holahan CJ, Li X, Chen YT. Association of health-related behaviors, attitudes, and appraisals to leisure-time physical activity in middle-aged and older women. Women Health 2016; 57:121-136. [PMID: 26909556 DOI: 10.1080/03630242.2016.1157127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Physical activity carries immediate and long-term benefits for middle-aged and older women; however, physical activity decreases in adulthood and aging in women. In this study, the authors investigate the relation of health behaviors, health attitudes, and health appraisals to leisure-time physical activity among middle-aged and older women in a cross-sectional analysis of the second wave of the Study of Midlife Development in the United States (MIDUS2) conducted during the period from 2004 to 2006. The sample consisted of 829 women, ranging in age from 40 to 75 years of age (Mean = 56 years). In multiple logistic regression analyses, controlling for socio-demographic factors and functional restrictions, most of the psychosocial variables examined showed unique associations with physical activity, including health behaviors of having a routine checkup and not smoking, health attitudes involving commitment to health and valuing physical fitness and strength, and the health appraisal that one's health is better compared to others of the same age. Older women (aged 61-75 years) were less active, but reported greater health commitment than middle-aged women (aged 40-60 years). Neither health commitment nor any other psychosocial variable interacted with age in relation to physical activity. Understanding characteristics of middle-aged and older women who are physically active is essential in tailoring interventions to this population.
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Affiliation(s)
- Carole K Holahan
- a Department of Kinesiology and Health Education , University of Texas at Austin , Austin , Texas , USA
| | - Charles J Holahan
- b Department of Psychology , University of Texas at Austin , Austin , Texas , USA
| | - Xiaoyin Li
- a Department of Kinesiology and Health Education , University of Texas at Austin , Austin , Texas , USA
| | - Yen T Chen
- a Department of Kinesiology and Health Education , University of Texas at Austin , Austin , Texas , USA
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Jones HJ, Huang AJ, Subak LL, Brown JS, Lee KA. Bladder Symptoms in the Early Menopausal Transition. J Womens Health (Larchmt) 2016; 25:457-63. [PMID: 26741199 DOI: 10.1089/jwh.2015.5370] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Bladder symptoms are common in women and result in use of healthcare resources and poor quality of life. Bladder symptoms have been linked to age and menopause, but debate exists in the literature. This article examines factors associated with bladder symptoms and compares women in late reproductive stage with those in menopausal transition. MATERIALS AND METHODS We analyzed cross-sectional data from a prospective cohort study of midlife women (mean age, 48; range, 44-54 years) in northern California. The sample consisted of 158 women in late reproductive stage or menopause transition. Assessments included anthropometrics, menstrual cycle lengths and symptoms, urine samples for follicle-stimulating hormone level, and self-reported health perception and depressive symptoms. Analyses included descriptive bivariate statistics, group comparisons, and regression models. RESULTS The most common bladder symptoms were nocturia (72%) at least once per night and urinary incontinence (50%) at least once per week. Incontinence was less prevalent in African American women compared to European Americans and Latinas (p = 0.001) and more prevalent in late reproductive stage than in menopause transition (p = 0.024). Controlling for age, women in late reproductive stage were more likely to report nocturia compared to those in menopause transition. Reproductive stage (p = 0.016), higher body mass index (p = 0.007), and race (p = 0.017) contributed to the variance in weekly nighttime urinary frequency. CONCLUSION Bladder symptoms were associated with reproductive stage. Women in late reproductive stage were more likely to experience nocturia and incontinence than those in menopause transition. The higher rates of nocturia and incontinence in late reproductive stage are intriguing. Future studies should include analysis of pelvic organ prolapse degree and other structural differences.
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Affiliation(s)
- Holly J Jones
- 1 College of Nursing, University of Cincinnati , Cincinnati, Ohio
| | - Alison J Huang
- 2 Department of Medicine, University of California , San Francisco, California
| | - Leslee L Subak
- 3 Departments of Obstetrics, Gynecology and Reproductive Science, Epidemiology and Biostatistics, and Urology, University of California , San Francisco, California
| | - Jeanette S Brown
- 3 Departments of Obstetrics, Gynecology and Reproductive Science, Epidemiology and Biostatistics, and Urology, University of California , San Francisco, California
| | - Kathryn A Lee
- 4 Department of Family Health Care Nursing, University of California , San Francisco, California
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Risk factors for weight gain: a longitudinal study in non-weight loss treatment-seeking overweight adults. Eat Weight Disord 2015; 20:371-8. [PMID: 25604245 DOI: 10.1007/s40519-014-0174-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 12/23/2014] [Indexed: 10/24/2022] Open
Abstract
PURPOSE To study some psycho-social variables in a sample of non-weight loss treatment-seeking overweight adults and to evaluate the weight outcome and the possible risk factors for weight gain over a 1-year period. METHODS 167 Overweight (BMI range 25-29.9) subjects (66 % females, age 50 ± 10 years, BMI 28 ± 1.49) were recruited randomly in the surgeries of primary care physicians (PCPs). Data were collected through an ad hoc questionnaire with personal details and medical history. The following tests were administered: Binge Eating Scale (BES), Beck's Depression Inventory (BDI) and Body Uneasiness Test (BUT). Weight and height were measured using a mechanical balance with a stadiometer in standard conditions. At follow-up, 1 year after, updated data were collected for 125 subjects (75 %). RESULTS At follow-up, there was remarkable weight instability: only 16 % of the subjects maintained their baseline weight, 40.8 % showed a decrease, and 43.2 % gained weight. In 14.4 % of cases, weight gain led to obesity (BMI ≥30). 18 individuals (14.4 %) reported having followed weight loss treatments in the last year, 11 among people with stable/decreased weight and 7 among those with weight gain. Lifetime comorbidity for anxiety and intense body uneasiness at baseline were the most important factors significantly associated with weight gain. Living with someone and habitually practicing sport resulted to play a protective role against weight increase. CONCLUSIONS Our study highlights the importance of a multidimensional assessment (medical and psycho-social) of overweight patients, aimed to identify individuals at greater risk of weight gain. They should receive targeted interventions.
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Pettee Gabriel K, Mason JM, Sternfeld B. Recent evidence exploring the associations between physical activity and menopausal symptoms in midlife women: perceived risks and possible health benefits. Womens Midlife Health 2015; 1:1. [PMID: 30766688 PMCID: PMC6214216 DOI: 10.1186/s40695-015-0004-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 06/22/2015] [Indexed: 01/18/2023] Open
Abstract
Although the health benefits of physical activity are well established, the prevalence of midlife women accumulating sufficient physical activity to meet current physical activity guidelines is strikingly low, as shown in United States (U.S.) based surveillance systems that utilize either (or both) participant-reported and device-based (i.e., accelerometers) measures of activity. For midlife women, these low prevalence estimates may be due, in part, to a general lack of time given more pressing work commitments and family obligations. Further, the benefits or "reward" of allocating limited time to physical activity may be perceived, by some, as too distant for immediate action or attention. However, shifting the health promotion message from the long term benefits of physical activity to the more short-term, acute benefits may encourage midlife women to engage in more regular physical activity. In this article, we review the latest evidence (i.e., past 5 years) regarding the impact of physical activity on menopausal symptoms. Recent studies provide strong support for the absence of an effect of physical activity on vasomotor symptoms; evidence is still inconclusive regarding the role of physical activity on urogenital symptoms (vaginal dryness, urinary incontinence) and sleep, but consistently suggestive of a positive impact on mood and weight control. To further advance this field, we also propose additional considerations and future research directions.
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Affiliation(s)
- Kelley Pettee Gabriel
- Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center at Houston: School of Public Health -- Austin Regional Campus, Austin, TX USA
- School of Public Health, Austin Regional Campus, 1616 Guadalupe Street, Suite 6.300, Austin, TX 78701 USA
- Michael & Susan Dell Center for Healthy Living; University of Texas Health Science Center in Houston, Houston, TX USA
| | - Jessica M. Mason
- Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center at Houston: School of Public Health -- Austin Regional Campus, Austin, TX USA
- School of Public Health, Austin Regional Campus, 1616 Guadalupe Street, Suite 6.300, Austin, TX 78701 USA
- Michael & Susan Dell Center for Healthy Living; University of Texas Health Science Center in Houston, Houston, TX USA
| | - Barbara Sternfeld
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612 USA
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Many GM, Lutsch A, Connors KE, Shearer J, Brown HC, Ash G, Pescatello LS, Gordish-Dressman H, Barfield W, Dubis G, Houmard JA, Hoffman EP, Hittel DS. Examination of Lifestyle Behaviors and Cardiometabolic Risk Factors in University Students Enrolled in Kinesiology Degree Programs. J Strength Cond Res 2015; 30:1137-46. [PMID: 25647655 DOI: 10.1519/jsc.0000000000000871] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Preventing physical inactivity and weight gain during college is critical in decreasing lifelong obesity and associated disease risk. As such, we sought to compare cardiometabolic risk factors and lifestyle behaviors between college students enrolled in kinesiology and non-kinesiology degree programs to assess whether health and exercise degree programs may influence health behaviors and associated disease risk outcomes. Anthropometrics, fasting blood glucose, insulin, lipid profiles and HbA1c%, blood pressure, and peak oxygen consumption (V[Combining Dot Above]O2peak) were assessed in 247 healthy college students. The homeostasis model assessment of insulin sensitivity (HOMA) was calculated using glucose and insulin levels. Self-reported physical activity from the Paffenbarger questionnaire was collected to estimate the average caloric expenditure due to different types of physical activities. Despite no significant differences in body mass index or waist circumference between groups, kinesiology majors presented with ∼20% lower fasting insulin levels and HOMA (p = 0.01; p < 0.01, respectively) relative to nonmajors. Kinesiology majors reported increased weekly participation in vigorous-intensity sport and leisure activities and, on average, engaged in >300 metabolic equivalent-h·wk, whereas non-kinesiology majors engaged in <300 MET-h wk (p = 0.01). Our data suggest that students enrolled in kinesiology degree programs display improved healthy behaviors and associated outcomes (parameters of glucose homeostasis). Practical outcomes of this research indicate that implementing components of a comprehensive kinesiology curriculum encourages improved health behaviors and associated cardiometabolic risk factors.
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Affiliation(s)
- Gina M Many
- 1Children's National Medical Center, Research Center for Genetic Medicine, Washington, District of Columbia; 2Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; 3Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada; 4Human Performance Laboratory, College of Agriculture, Health and Natural Resources, University of Connecticut, Storrs, Connecticut; and 5Human Performance Laboratory, East Carolina University, Greenville, North Carolina
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