Effects of body composition and menopause characteristics on maximal oxygen uptake of postmenopausal women

Socioecological factors influencing physical activity engagement for women across the menopausal transition: a systematic review

IMPORTANCE

Physical activity during menopause can be effective in reducing the physiological changes associated with reproductive aging that increase risks for noncommunicable diseases, yet many women do not meet the recommendations for physical activity.

OBJECTIVE

This study aimed to synthesize factors influencing physical activity for women across menopausal transition phases using a socioecological approach.

EVIDENCE REVIEW

The Preferred Reporting Items for Systematic Reviews and Meta-Analysis was used to systematically search 10 databases between 2001 and 2021. A comprehensive search strategy was used to identify studies on physical activity of women in various stages of menopause. A socioecological model was used to categorize the reported barriers and enablers.

FINDINGS

Twenty studies met the inclusion criteria. The findings highlight several intrapersonal barriers such as existing health complaints versus enablers such as awareness of the health benefits of physical activity during menopause. Ensuring women's safety, preventing injury, and enhancing exercise self-efficacy were important components of programs. Social support was also an important enabler of women's engagement in activities.

CONCLUSIONS AND RELEVANCE

Several barriers and enablers were identified and can inform practitioners and future interventions to encourage physical activity among women in various stages of menopause. For instance, when encouraging physical activity during menopause, practitioners should consider other health complaints, safety, and injury prevention while discussing the benefits of physical activity related to managing menopausal symptoms. There was a lack of theoretically informed studies exploring the barriers and enablers to physical activity for women in various stages of menopause; thus, research designs may not have fully accounted for influences. Future research that combines socioecological and individual theories of behavior is needed to comprehensively understand the complexity of physical activity among women across the menopausal transition.

Long-term continuous exercise training counteracts the negative impact of the menopause transition on cardiometabolic health in hypertensive women - a 9-year RCT follow-up

PURPOSE

The study examined effects of 9-yrs of multicomponent exercise training during the menopause interval on cardiometabolic health in hypertensive women.

METHODS

Sedentary, middle-aged women (n = 25) with mild-to-moderate arterial hypertension were randomized into a soccer training (multicomponent exercise; EX; n = 12) or control group (CON; n = 13). EX took part in 1-h football training sessions, 1-3 times weekly, for a consecutive 9-years, totaling ∼800 training sessions, while CON did not take part in regular exercise training. 22 participants entered menopause during the intervention.

RESULTS

A time×group interaction effect (P = 0.04) of 8.5 mmHg in favour of EX was observed for changes in mean arterial pressure (MAP) (EX: -4.8 [-10.7;1.1] mmHg, CON +3.7 [-2.0;9.3] mmHg). Time×group interaction effects in favour of EX were also observed for total body weight (4.6 kg, P = 0.008, EX: +0.7 [-1.7;3.0] kg, CON: +5.3 [3.0;7.6] kg, total fat percentage (5.7%-points, P = 0.02; EX (-1.9 [-4.4;0.6] %-points; P = 0.13), CON +3.8 [1.4;6.2] %-points and for total cholesterol (1.2 mmol/l, P = 0.03, EX: -0.5 [-1.0;-0.1] mmol/l, CON: +0.7 [0.2;1.1] mmol/l. EX reduced (P = 0.02) plasma low-density lipoprotein cholesterol by -0.4 [-0.8;-0.1] mmol/l, whereas an increase (P = 0.01) of 0.4 [0.1;0.8] mmol/l occurred in CON (interaction. P < 0.001). A time×group interaction (P = 0.004) existed for changes in exercise capacity in favour of EX. Fasting glucose remained unchanged in EX and increased (P < 0.001) by 0.7 [0.4;1.0] mmol/l in CON (time×group interaction P = 0.02).

CONCLUSION

In conclusion, long-term multicomponent exercise training fully counteracts the detrimental effects of the menopause transition on cardiometabolic health in hypertensive women.

Cardiorespiratory fitness and body composition in postmenopausal women

The object of the study was to analyze the relationship between aerobic fitness and body composition in postmenopausal women. We hypothesized that postmenopausal women that had higher adiposity had lower cardiorespiratory capacity, regardless of the characteristics of menopause. The sample included 208 women (57.57 ± 6.62 years), whose body composition and the basal metabolic rate were evaluated by octopolar bioimpedance (InBody 720) and the oxygen uptake by the modified Bruce protocol. Most of the sample showed obesity and a high visceral fat area. The visceral fat area and the basal metabolic rate explained 30% of the variation of oxygen uptake, regardless of age, time, nature or hormone therapy. The values of the latter variables were reduced in the presence of high central adiposity (−6.16 ml/kg/min) and the basal metabolic rate of less than 1238 kcal/day (−0.18 ml/kg/min). The women with oxygen uptake above 30.94 ml/kg/min showed lower values of total and central adiposity when compared with other groups. With an increase of aerobic fitness, there was a growing tendency of the average values of the soft lean mass index, with differences between the groups low-high and moderate-high. These results suggest worsening of the cardiorespiratory condition with an increase of central adiposity and a decrease of the BMR, regardless of age and menopause characteristics.

Should menopausal characteristics be considered during cardiorespiratory exercise prescription in postmenopausal women?

OBJECTIVE

Menopausal characteristics (i.e. the nature of menopause, hormone therapy, and time elapsed since menopause) are known to affect women's health-related quality of life. The purpose of this study was to determine whether menopausal characteristics affect the cardiorespiratory exercise response and which characteristics should be considered for exercise prescription.

METHODS

Fifty-eight postmenopausal women (60.21 ± 4.49 years of age; 66.26 ± 8.99 kg body weight; 157.09 ± 4.92 cm in height; 29.70 ± 4.79 ml·kg(-1)·min(-1) maximal oxygen uptake) participated in this study. A graded 25-W/min(2) cycle ergometer exercise protocol was applied to assess aerobic power and ventilatory thresholds. Participants' heart rates and gas-exchange variables were measured continuously using a COSMED K4b(2) portable gas analyzer system. The first and the second ventilatory thresholds were determined by the time-course curves of ventilation and oxygen and carbon dioxide ventilatory equivalents. Using age as a covariate, an analysis of covariance was performed to assess the effect of menopause characteristics upon the data.

RESULTS

Regardless of the nature of menopause, use of hormone therapy, time elapsed since menopause, and the interaction between these characteristics, the participants presented no differences in maximal oxygen uptake values, neither on submaximal variables often used in evaluations of exercise prescription, such as percent of maximal oxygen uptake, maximal heart rate, and heart rate reserve, nor in respiratory exchange ratio and gas exchange energy expenditure at aerobic and anaerobic ventilatory thresholds.

CONCLUSIONS

These data suggest that a personalized cardiorespiratory target zone for this population should be set according to the published literature, and that consideration of the individual menopausal characteristics seems to be unnecessary.

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

OBJECTIVE

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

SUBJECTS AND METHODS

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

RESULTS

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

CONCLUSION

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

The upper limit of the cardiorespiratory training zone (40-84%HRR) is overestimated for postmenopausal women

OBJECTIVE

The purpose of this study was to examine the heart rate reserve (HRR) at first and second ventilatory thresholds (VT's) in postmenopausal women and compare it with optimal intensity range recommended by the ACSM (40-84%HRR). An additional aim was to evaluate whether a higher aerobic power level corresponded to a higher HRR at VT's.

METHODS

Fifty-eight postmenopausal women participated in this study (aged 48-69). A graded 25 Wmin(-2) cycle ergometer (Monark E839) exercise protocol was performed in order to assess aerobic power. The heart rate and gas-exchange variables were measured continuously using a portable gas analyzer system (Cosmed K4b). The first (VT1) and the second (VT2) VT's were determined by the time course curves of ventilation and O2 and CO2 ventilatory equivalents. A K-means clustering analysis was used in order to identify VO2max groups (cut-off of 30.5 mlkg(-1)min(-1)) and differences were evaluated by an independent sample t-test. Bland-Altman plots were performed to illustrate the agreement between methods.

RESULTS

The women's HRR values at VT1 were similar to 40% HRR in both VO2max groups. At VT2 both VO2max groups exhibited negative differences (P<0.01) for the predicted 84%HRR intensity (-14.46% in the lower VO2max group and -16.32% in the higher VO2max group).

CONCLUSIONS

An upper limit of 84% overestimates the %HRR value for the second ventilatory threshold, suggesting that the cardiorespiratory target zone for this population should be lower and narrower (40-70%HRR).