Depressive symptoms and weight in midlife women: the role of stress eating and menopause status

A comprehensive investigation of the association between menopause symptoms and problematic eating behavior in peri- and post-menopause cisgender women

Midlife individuals assigned female at birth are at risk for problematic eating behavior, associated with negative health outcomes. Little is known about how menopausal symptoms may increase risk in this population. The current study aimed to understand how a comprehensive range of menopause symptoms were globally associated with problematic eating behaviors. A total of 281 cisgender women (176 post-menopause, 105 peri-menopause) from the United States aged 40 to 64 were recruited utilizing Prolific, an online survey platform. Participants answered questionnaires about menopause symptoms and problematic eating. Participants were selected using demographic and health information provided in a screener survey. Participants also completed the Eating Disorder Questionnaire (EDE-Q), Women's Health Questionnaire (WHQ), Patient Health Questionnaire-8 (PHQ-8), Generalized Anxiety Disorder-7 (GAD-7), and Pittsburgh Sleep Quality Index (PSQI). Using Structural Equation Modeling, menopause symptoms explained 16.7 percent of the variance in problematic eating. Higher frequency and severity of anxiety, depression, sleep concerns, cognitive complaints, pain, and vasomotor symptoms was associated with greater frequency and severity of problematic eating behaviors, β = .40, p < .001. Invariance testing showed no significant differences between peri- and postmenopausal women. These findings support the association between menopause symptoms and problematic eating in Midlife cisgender women and highlight the need for continued investigation.

A comprehensive evaluation of predictors of obesity in women during the perimenopausal period: A systematic review and narrative synthesis

INTRODUCTION

Obesity during perimenopausal transition can be attributed to various factors. Identifying these factors is crucial in preventing obesity and developing effective strategies to manage weight during this phase. This review aimed to systematically understand predictors of obesity during menopausal transition.

METHODS

The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and searched databases like PubMed, Wiley Online Library, and Cochrane Reviews. Cohort and cross-sectional studies in English language assessing obesity among menopausal women were included. The methodological quality was assessed using Joanna Briggs Checklist for critical appraisal. Risk of Bias (RoB) was generated using Review Manager 5.4.1 (RevMan). Identified predictors were assessed for overall quality of evidence using adopted Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

RESULTS

This review encompassed 42 studies, (21 cross-sectional and 21 cohort) with sample ranging from 164 to 107,243 across studies. Higher parity( ≥ 3 children) emerged as a strong predictor of obesity across seven studies, with good-quality evidence. Lower physical activity was another predictor, supported by eight studies with good-quality evidence. Sociodemographic factors like lower education(<8 years or < than college degree), socioeconomic background, menopausal transition, and older age at menarche showed associations with weight gain, with moderate-quality evidence. Lifestyle factors (high-fat consumption, sedentariness, active smoking status, and psychological difficulties) also showed moderate-quality evidence.

CONCLUSION

This review underscores the multifaceted factors associated with obesity during the perimenopausal transition. Identifying these factors will be helpful in prevention and management of obesity among these women.

Mechanisms of improved body composition among perimenopausal women practicing Meditative Movement: a proposed biobehavioral model

OBJECTIVES

Weight gain and unfavorable body composition are prevalent among midlife/older women throughout menopause. These shifts may negatively impact health, well-being, and longevity. Efforts to attenuate weight and body composition changes are traditionally driven by manipulation of diet and/or exercise; however, sustained results are limited, possibly because the full spectrum of biobehavioral systems is not addressed by diet and exercise alone. We propose a biobehavioral model detailing mechanisms of body composition decline among perimenopausal women and the associated components of Meditative Movement (ie, tai chi, qigong, yoga) that address each of these factors.

METHODS

Based on our previous work and extensive review of the literature, we developed a multifactorial and multidimensional biobehavioral model including factors that most directly relate to body composition among perimenopausal women: 1) psychological (ie, stress and mood, mindfulness and self-compassion, body awareness), 2) behavioral (ie, sleep, physical activity, eating behaviors), and 3) physiological (ie, cortisol, estrogen). Relationships between each factor, Meditative Movement practice components, and predicted effects on body composition were explored in detail.

RESULTS

Our model describes select psychological, behavioral, and physiological factors, and potential mechanistic pathways of Meditative Movement practice driving improved changes in body composition and weight outcomes for perimenopausal women.

CONCLUSIONS

The proposed model details a novel, evidence-supported means to reduce the risk of deleterious shifts in body composition throughout perimenopause and menopause thereafter. We suggest that these changes may occur directly and/or indirectly through psychological, behavioral, and physiological mechanisms that facilitate the desired changes in body composition.

The COVID-19 Pandemic Impact on the Psychophysical Health of Post-Menopausal Women: A Cross-Sectional Study

Background and Objectives: The aim of this study was to investigate lifestyle, menopausal symptoms, depression, post-traumatic stress disorder (PTSD) and sleep disorders in post-menopausal women throughout the first wave of the COVID-19 pandemic, including the impact of menopause hormonal therapy (HT). Materials and Methods: Post-menopausal women were given the following questionnaires: socio-demographic characteristics; lifestyle; history of COVID-19; menopause-specific quality of life (MENQOL), the first part of which refers to the pre-pandemic period ("pre COVID-19") and the second refers to the current period ("during COVID-19"); Beck's depression inventory (BDI); the impact of event scale-revised (IES-R); and the Pittsburgh sleep quality index (PSQI). Results: One hundred and twenty-six women completed all questionnaires, with a mean age of 55.5 ± 6.0 years. The mean menopause duration was 5.7 ± 5.6 years. Twenty-four women were taking HT. A significant mean weight gain, a reduction in physical activity (respectively p < 0.001) and worsened quality of romantic relationships (p = 0.001) were reported during the pandemic. Menopausal symptoms did not vary significantly throughout the pandemic; however, women taking menopausal HT had lower physical (p = 0.003) and sexual (p = 0.049) MENQOL domain scores, lower depressive symptoms (p = 0.039) and better romantic relationships (p = 0.008). Conclusions: The COVID-19 pandemic caused reduced physical activity, worsened food habits and weight gain in post-menopausal women. They also reported a high rate of severe-moderate PTSD and a negative influence on their romantic relationships. Menopausal HT seems to be a potential protective factor for sexual and physical status and for symptoms of depression.

Marital quality and depression as mediators linking childhood maltreatment to adult physical health

BACKGROUND

Childhood maltreatment is known to influence adult physical health among midlife adults. Evidence suggests that depressive symptoms mediate the association. However, research has discounted the role of marital quality in understanding health outcomes among adults maltreated in childhood.

OBJECTIVE

To advance this line of inquiry, we examined the relationship between marital quality and depressive symptoms in a sequential mediation model linking childhood maltreatment to adult physical health over ten years.

PARTICIPANTS AND SETTING

Our sample consisted of midlife adults (n = 550) from three waves of the Midlife Development in the United States (MIDUS) study. The majority (n = 91.4 %) were white. At MIDUS 2, the mean age was 54.84 (SD = 10.78) and the mean age at MIDUS 3 was 63.96 (SD = 10.81).

METHODS

Structural equation modeling was used to examine the degree to which marital quality and depressive symptoms mediated the relationship between childhood maltreatment and adult physical outcomes. Bootstrapping procedures were used to estimate the indirect effects.

RESULTS

The serial mediation effects from maltreatment to adult physical health through marital quality and depressive symptoms were significant. Likewise, the simple indirect effects from maltreatment to subjective evaluations and the number of chronic health conditions through depressive symptoms were also significant.

CONCLUSIONS

Childhood maltreatment is linked to adult physical health problems through marital quality and depressive symptoms, suggesting that the quality of adult marriages may play a critical role in health outcomes. Improving the quality of marriages may reduce risk factors, such as depression, that potentate future physical health problems.

Examining the Health-Related Needs of Females during Menopause: A Systematic Review Study

Menopause is one the most crucial stages in a female's life. Identifying the education gaps regarding menopause is important, thus this study aims to explain the health-related needs of females during menopause. Scopus, PubMed, Scientific Information Database, and Web of Science databases were searched for the available observational (cohort, case-control, and cross-sectional), systematic review, meta-analysis, and clinical trial studies (2007-2021) using keywords, such as 'Educational Needs Assessment,' 'Assessment of Healthcare Needs,' 'menopause,' 'climacteric,' 'premenopause,' and 'postmenopause.' A total of 180 out of 5,705 papers were evaluated after considering the inclusion and exclusion criteria. The educational needs of females during menopause in the reviewed studies include osteoporosis, oral and dental problems, metabolic disorders, cardiovascular diseases, hypertension, lung diseases, infectious diseases, musculoskeletal problems, urinary problems, breast cancer, defecation problems, genital disorders, special diseases such as eye diseases and hypothyroidism and hormone therapy, mental disorders, cognitive function, sleep disorders, sexual disorders, physical activity, supplement consumption, public health issues, health education, fall, and nutrition. The study results reveal that females during postmenopause require training, counseling, and support in all aspects to get through this challenging time, and providing these services, infrastructure, appropriate policy, and the use and support of the medical team's capacity are all required.

Weight management strategies in Middle-Aged Women (MAW): Development and validation of a questionnaire based on the Oxford Food and Activity Behaviors Taxonomy (OxFAB-MAW) in a Portuguese sample

Background

The Oxford Food and Activity Behaviors (OxFAB) taxonomy systematize the cognitive-behavioral strategies adopted by individuals who are attempting to manage their weight. The present study aimed to (1) develop a questionnaire based on the OxFAB taxonomy, specifically adapted for middle-aged women-the OxFAB-MAW-stage of life and sex, which present a high incidence of obesity, (2) assess the psychometric properties of this tool, and (3) evaluate the discriminative power of the OxFAB-MAW (normal weight vs. obesity).

Methods

Overall, 1,367 Portuguese middle-aged women between 45 and 65 years (M = 52.3, SD = 5.15) filled in a sociodemographic, health, and menopause-related questionnaire, as well as the OxFAB-MAW.

Results

Confirmatory factor analysis demonstrated an acceptable model fit (comparative fit index = 0.928, Tucker-Lewis index = 0.913, root mean square error of approximation = 0.072, and standardized root mean square residual = 0.054). Five domains with one item were grouped into other domains, and the Weight Management Aids domain was also removed. The OxFAB-MAW showed factorial, convergent, discriminant, and external validity, as well as composite reliability.

Conclusion

The OxFAB-MAW questionnaire is a valid, reliable, and theory-driven tool for assessing weight management strategies in middle-aged women, being able to discriminate between clinical and non-clinical groups (normal weight vs. obesity) in several domains. This instrument can be used to gather valid and reliable data, useful in both research and clinical settings (especially focused on structuring interventions and preventive obesity programs within this specific life cycle stage).

The association between mental health and obesity in postmenopausal women: A systematic review

Postmenopausal women are at great risk of mental health deterioration, which may lead to morbidity and mortality. The decrement of mental health with aging is attributed to hormonal changes, lowered physical activity, sleep disturbances, economic factors, as well as modifiable variables such as smoking and obesity. Studies have shown controversial results on the association between obesity and mental health in postmenopausal women. This study is a systematic review of the evidence available on the association between obesity and mental health in postmenopausal women with the aim to identify the most reliable obesity measure that has been shown in association with mental health as well as the effective measures that have been practiced for improving mental health in postmenopausal obese women. CINAHL, Scopus, Science Direct and PubMed including Medline databases were searched. Out of 3,766 articles, 23 studies of average to good quality were included, out of which 17 were cross-sectional and 6 interventional. Out of the 17 studies, 12 showed a positive association between obesity and deterioration of mental health, 3 showed a negative association and two showed no association. From the interventional studies, 4 showed positive and two not significant impact of the intervention used on obesity and mental health. In conclusion, more studies showed a positive association between obesity, especially visceral obesity, and mental health issues particularly depression, anxiety, and sleep disorders. Combination of caloric restriction and exercise seems to have a better impact on the mental health of the postmenopausal in comparison with other interventions.

Changes in Life Circumstances and Mental Health Symptoms during the COVID-19 Pandemic among Midlife Women with Elevated Risk for Cardiovascular Disease

Cardiovascular disease (CVD) remains the leading cause of death among women. During midlife (ages 40-60), universal aging processes, sex-specific factors such as menopause, psychological distress, and conditions such as hypertension substantially increase women's risk for CVD. The onset of the COVID-19 pandemic has impacted employment, social interactions, caregiving responsibilities, and overall well-being worldwide; however, little research has investigated how COVID-19 has affected women in midlife. The present study was designed to determine how COVID-19 has affected women in midlife with elevated risk for CVD, by examining changes in their mental health symptoms and life domains across three time points: prior to COVID-19 (2019), during stay-at-home orders (April-June 2020), and during initial reopening (August 2020). Women in midlife with one or more CVD risk conditions (e.g., hypertension; n = 35) responded to questions related to COVID-19, changes in life circumstances, and mental health symptoms at each time point. Findings showed meaningful changes in caregiving, medical visits, and employment status, as well as significant changes in depression and sleep quality scores across time. However, the findings also showed that women were distressed prior to COVID-19 and did not exhibit changes in perceived stress, body dissatisfaction, or anxiety symptoms over time. Findings from this study highlight the impact of the COVID-19 pandemic on an at-risk group of women, which may be used to help guide future health promotion efforts specifically tailored to this population.

Depressive symptoms and suicidality by menopausal stages among middle-aged Korean women

AIMS

There has been increasing evidence of hormonal changes during reproductive events that lead to mood changes. However, studies on the severity of psychological problems according to the menopausal stage are limited. Thus, this study aimed to investigate the association between menopausal stages, depression and suicidality.

METHODS

A total of 45 177 women who underwent regular health check-ups between 2015 and 2018 at Kangbuk Samsung Hospital were included. Participants were stratified into four groups (pre-menopause, early transition, late transition and post-menopause) based on the Stages of Reproductive Aging Workshop Criteria. The Center for Epidemiological Studies-Depression scale (CESD) was used to evaluate depressive symptoms, and the degree of depressive symptoms was classified as moderate (CESD score 16-24) or severe (CESD score ⩾ 25). To measure suicide risk, we administered questionnaires related to suicidal ideation.

RESULTS

Overall, the prevalence of CESD scores of 16-24 and ⩾ 25 was 7.6 and 2.8%, respectively. Menopausal stages were positively associated with depressive symptoms in a dose-dependent manner. Multivariable-adjusted prevalence ratios (PRs, 95% confidence intervals) for CESD scores of 16-24 comparing the stages of the early menopausal transition (MT), late MT and post-menopause to pre-menopause was 1.28 (1.16-1.42), 1.21 (1.05-1.38) and 1.58 (1.36-1.84), respectively. The multivariable-adjusted PRs for CESD scores ⩾ 25 comparing the stages of the early MT, late MT and post-menopause to pre-menopause were 1.31 (1.11-1.55), 1.39 (1.12-1.72), 1.86 (1.47-2.37), respectively. In addition, the multivariable-adjusted PRs for suicidal ideation comparing the early MT, late MT and post-menopause stages to the pre-menopause stage were 1.24 (1.12-1.38), 1.07 (0.93-1.24) and 1.46 (1.25-1.70) (p for trend <0.001), respectively.

CONCLUSIONS

These findings indicate that the prevalence of depressive symptoms and suicidal ideation increases with advancing menopausal stage, even pre-menopause.

A Stepwise Approach to Prescribe Dietary Advice for Weight Management in Postpartum and Midlife Women

Weight retention and weight gain during the postpartum and midlife period subsequently increase the risk of chronic health conditions, thereby deteriorating the overall health. Dietary intervention is the pivotal component of sustainable weight management. However, in resource restricted settings, where dietitians may not be present, other healthcare professionals such as physicians, obstetricians, and paediatricians should play a vital role in providing timely weight management advice to these women. Therefore, this article provides dietary advice including the setting of realistic weight loss goals, identifying an individual's calorie needs, distribution of macronutrients and consideration of important micronutrients. Healthcare professionals can follow the stepwise approach to prescribe dietary advice to postpartum and midlife women for their weight management. Various dietary principles such as cultural and regional preferences of an individual, portion size, hypocaloric diets, nutrient-dense meals, eating habits, cultural beliefs and myths along with co-morbid conditions should be taken into consideration by healthcare professionals while providing the dietary prescription.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13224-022-01643-w.

The association of sleep duration and quality with depressive symptoms in older Chinese women

Poor sleep quality or short and long sleep duration are associated with many negative health outcomes, such as diabetes, hypertension, and fatigue, which may directly or indirectly correlate with poor mental health. Although, the association between sleep duration and quality, and depressive symptoms has been examined, the results of these studies were inconsistent and evidence specifically on older women is lacking. Therefore, we designed a cross-sectional study to evaluate the association between sleep duration and quality, and depressive symptoms in a relatively large sample of older Chinese women. The data were collected from 1,429 older women aged ≥60 years during bone-health examinations in Shanghai. Information on sleep duration and quality were assessed using a self-reported questionnaire. Depressive symptoms were assessed using the Zung self-rating depression scale (SDS), and depressive symptoms were considered present for SDS scores ≥ 45. Logistic regression models were used to analyze the association between sleep and depressive symptoms. After adjusting for all potential confounding factors, a J-shaped association was found between sleep duration and depressive symptoms. When a sleep duration of 6–8 hours was set as a reference, the odds ratios and 95% confidential intervals of short and long sleep duration were 1.31 (0.99, 1.73) and 2.10 (1.40, 3.16), respectively. Moreover, sleep quality was inversely associated with the prevalence of depressive symptoms (p for trend = 0.040). When the SDS cut-off score defining depressive symptoms was changed to 40 and 50, these associations were somewhat weakened, but the trend did not change. This study replicated and extended prior research findings that sleep duration and quality may influence mental health in older women.

The relationship between sunlight exposure duration and depressive symptoms: A cross-sectional study on elderly Chinese women

Sunlight has been reported to have various beneficial effects on human health. Although research indicates an association between sunlight exposure and depressive symptoms, no study has examined it among the older adult population, especially among elderly Chinese women. This cross-sectional study addresses the aforesaid gap by investigating this association in 1,429 Chinese women aged 60 years and older. Information on their sunlight exposure was collected through a self-reported questionnaire. Depressive symptoms were assessed using the Zung Self-Rating Depression Scale (SDS). The logistic regression models revealed that greater exposure to sunlight is associated with a lower prevalence of depressive symptoms. In the final adjusted model, when the short sunlight exposure category (reference) was compared with the medium and long ones, the odds ratios and 95% confidence intervals for the prevalence of depressive symptoms (SDS cutoff ≥ 45) were 0.84 (0.60, 1.19) and 0.62 (0.43, 0.91), respectively (p-value for trend = 0.01). This significant association did not change when the SDS cutoff points were altered to ≥ 40 and ≥ 50. Findings indicate that an increased sunlight exposure duration is associated with a lower prevalence of depressive symptoms in elderly women.

Physical Exercise Behaviors and Depressive Symptoms Among Elderly Chinese Women: Focus on Exercise Components

Purpose

Several studies have investigated the association between physical exercise and depressive symptoms in the elderly population. However, the relationship between components of physical exercise such as frequency, intensity, duration, and depressive symptoms remains unclear. This study was conducted on elderly Chinese women to investigate the association between each component of physical exercise and depressive symptoms and to examine the association between physical exercise patterns and depressive symptoms.

Patients and Methods

A total of 1429 Chinese women aged ≥60 years were enrolled in this cross-sectional study and provided information on their exercise behaviors through a self-reported questionnaire. Depressive symptoms were assessed using the Zung Self-Rating Depression Scale. Multiple logistic regression analysis was used to estimate adjusted odds ratios (ORs) to measure the association between exercise behaviors and depression.

Results

High frequency, moderate intensity, long duration, and exercise habits were significantly associated with lower levels of depressive symptoms. Furthermore, participants with more than one optimal exercise behavior were more likely to have a lower risk of depressive symptoms. These associations were not changed after adjustment for confounding factors.

Conclusion

This study shows that exercise behaviors were significantly associated with the risk of developing depression. This finding suggests that keeping an optimal exercise behavior may be associated with a lower risk of depressive symptoms in elderly Chinese women.

Association of depression, anxiety and menopausal-related symptoms with demographic, anthropometric and body composition indices in healthy postmenopausal women

Background

The termination of the menstrual cycle is correlated with a number of physiological alterations and symptoms that can negatively impact emotion and mood. We aimed to investigate the association of anxiety, depression, and menopausal related symptoms with demographic, anthropometric, and body composition indices in healthy postmenopausal women.

Methods

A total of 320 menopausal women were selected randomly from referrals of health centers between January and June 2018 in Tabriz/Iran. All participants completed a demographic questionnaire. Bioelectrical impedance analysis was applied to evaluate body fat mass (BFM), soft lean mass (SLM), and lean body mass (LBM) of participants. The modified Kupperman index, Beck's depression inventory-II, and Spielberger’s state-trait anxiety inventory were applied to measure the severity of menopausal-related symptoms, the frequency, and severity of the symptoms of depression and state (SA) and trait anxiety (TA), respectively.

Results

Finally, 245 postmenopausal women with age of 55.33 ± 4.48 years and body mass index (BMI) of 27.96 ± 3.22 kg/m² were studied. Women with the age of 55 years and older (OR 3.928, 95% CI 1.504–10.256) and also women with mild physical activity (OR 10.104, 95% CI 3.785–26.976) had a greater possibility of having mild and moderate depression in comparison with women less than 50 years old and women with moderate and severe physical activity. Moderate and severe physical activity was correlated with a lower possibility of having medium upward, relatively severe and severe TA in comparison with participants with mild physical activity in these women (OR 0.372, 95% CI 0.151–0.917). Women with higher BMI and BFM had and more severe menopause-related symptoms (r = 0.143, p = 0.025 and r = 0.139, p = 0.030, respectively) and more severe TA symptoms (r = 0.198, p = 0.018 and r = 0.151, p = 0.021, respectively). Women with lower LBM (r =  − 0.139, p = 0.031) and lower SLM (r =  − 0.128, p = 0.047) had more severe depressive symptoms.

Conclusion

Postmenopausal women with higher age and lower physical activity had a greater possibility of having mild and moderate depression. Lower physical activity was also correlated with a greater possibility of having medium upward to severe TA symptoms. Postmenopausal women with higher BMI and BFM had more severe menopause-related and TA symptoms. Women with lower LBM and SLM had more severe depressive symptoms.

Role Stress and Sense of Control Predict Using Food to Cope With Stress in Midlife Women

Objective: The current study examined the association between role stress and using food to cope with stress in midlife women and examined sense of control as a potential underlying mechanism. Methods: An archival analysis was performed using data from 638 midlife women from the Midlife in the United States II study. Results: Hierarchical linear regression analyses demonstrated that work stress (β = .180, p < .001) and family stress (β = .138, p < .05) significantly predicted using food to cope with stress. Sense of control was a significant mediator between work stress and using food to cope with stress (b = 0.02, 95% CI [.0014, .0314]). Discussion: Midlife women with higher role stress related to work and family are more likely to use food to cope with stress, and sense of control seems to be the link between work stress and using food to cope.

Identifying the Factors That Affect Depressive Symptoms in Middle-Aged Menopausal Women: A Nationwide Study in Korea

Depressive symptoms do not persistently negatively affect functioning throughout the life span, but they may affect quality of life (QOL), especially in middle-aged women. Therefore, this study aimed to investigate the factors associated with depressive symptoms in premenopausal and postmenopausal women. This descriptive study was a secondary analysis of the data from the seventh Korea National Health and Nutrition Examination Survey that was conducted in 2016. Of the 8150 participants, the analysis included 644 premenopausal women and 459 postmenopausal women aged 40-60 years. The factors associated with depressive symptoms in the participants were examined using multivariate regression analysis. It was found that the depressive symptoms of postmenopausal middle-aged women were greater than those of premenopausal women. While a high perceived stress status and high pain-related discomfort were factors that influenced depressive symptoms among the premenopausal group, a high level of discomfort due to anxiety/depression, a poor perceived health status, shortened weekend sleep time, and smoking were associated with depressive symptoms in the postmenopausal group. Thus, it is necessary to develop an intervention to decrease depressive symptoms in postmenopausal women that considers their QOL, which is associated with depression, their subjective health status, sleep time, and smoking cessation.

Effectiveness of SaBang-DolGi Walking Exercise Program on Physical and Mental Health of Menopausal Women

Objective: We investigated the effectiveness of a 12-week SaBang-DolGi walking exercise program on the physical and mental health of menopausal women and aimed to provide the basic data needed to develop health promotion programs for the active and healthy aging of menopausal women. Materials and methods: The participants comprised 40 women aged 50–65 years who were divided into two randomly selected groups in training sessions (exercising group, n = 21 and control group, n = 19). A physical (grip, muscle and endurance) test and mental health test (simple mental health test II) were conducted using questionnaires with the aim of examining subjects’ physical and mental health before and after exercise. Results: After the intervention, the participants experienced positive changes in the physical dimension, with significant enhancements particularly in mental well-being and menopause-related health and subdomains. Controlled and regular exercise for 12 weeks was significantly correlated with a positive change in vitality and mental health. Conclusions: We found that the SaBang-DolGi walking exercise program helps to promote the physical and mental health of menopausal women who are exposed to the various stresses and depressions that accompany physical deterioration; the program was found to encourage active and healthy aging.

Relationships between depression and food intake in climacteric women

Objective: This study evaluated the associations between food intake - especially omega-3 (n-3) - and depressive symptoms in climacteric women.Methods: Four hundred climacteric women were included in this research. The Kupperman Index, the Center for Epidemiologic Studies Depression Scale, and a 3-day food diary were used to investigate climacteric symptoms, depressive symptoms, and food intake, respectively. Sociodemographic, clinical, and anthropometric variables were also explored.Results: Statistically significant associations were observed between depression and climacteric symptoms, climacteric phase, previous history of depression, antidepressant drug use, family income, sleep pattern, and consumption of carbohydrates, fiber, polyunsaturated fatty acids, magnesium, zinc, and vitamins C, D, and B12. No association was observed between n-3 consumption and depression.Conclusion: Climacteric symptoms and food intake are important factors linked to depression during the climacteric period. Further studies are needed to clarify the changes in this phase of women's lives, as well as to investigate the role of the diet in the depression treatment or prevention.