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

Abdominal visceral adipose tissue over the menopause transition and carotid atherosclerosis: the SWAN heart study

OBJECTIVES

To characterize abdominal visceral adipose tissue (VAT) trajectory relative to the final menstrual period (FMP), and to test whether menopause-related VAT accumulation is associated with greater average, common carotid artery intima-media thickness (cIMT) and/or internal carotid artery intima-media thickness (ICA-IMT).

METHODS

Participants were 362 women (at baseline: age was (mean ± SD) 51.1 ± 2.8 y; 61% White, 39% Black) with no cardiovascular disease from the Study of Women's Health Across the Nation Heart study. Women had up to two measurements of VAT and cIMT over time. Splines revealed a nonlinear trajectory of VAT with two inflection points demarcating three time segments: segment 1: >2 years before FMP; segment 2: 2 years before FMP to FMP; and segment 3: after FMP. Piecewise-linear random-effects models estimated changes in VAT. Random-effects models tested associations of menopause-related VAT with each cIMT measure separately. Estimates were adjusted for age at FMP, body mass index, and sociodemographic, lifestyle, and cardiovascular disease risk factors.

RESULTS

VAT increased significantly by 8.2% (95% CI: 4.1%-12.5%) and 5.8% (3.7%-7.9%) per year in segments 2 and 3, respectively, with no significant change in VAT within segment 1. VAT predicted greater ICA-IMT in segment 2, such that a 20% greater VAT was associated with a 2.0% (0.8%-3.1%) greater ICA-IMT. VAT was not an independent predictor of ICA-IMT in the other segments or of the other cIMT measures after adjusting for covariates.

CONCLUSIONS

Women experience an accelerated increase in VAT starting 2 years before menopause. This menopause-related increase in VAT is associated with greater risk of subclinical atherosclerosis in the internal carotid artery.

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

INTRODUCTION

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

METHODS

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

RESULTS

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

CONCLUSION

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

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

Background

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

Methods

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

Results

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

Conclusions

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

Type II diabetes disparities in diverse women: the potential roles of body composition, diet and physical activity

The rates of diabetes in the USA are rapidly increasing, and vary widely across different racial/ethnic groups. This paper explores the potential contribution of body composition, diet and physical activity in explaining diabetes disparities across women of different racial and ethnic backgrounds. For body composition, racial/ethnic groups differ widely by BMI, distribution of body mass and quantity and type of adipose tissue. Dietary patterns that vary across race/ethnicity include consumption of meat, added sugars, high-glycemic carbohydrates and fast food. Additionally, physical activity patterns of interest include aerobic versus muscle-strengthening exercises, and the purpose of physical activity (leisure, occupation, or transportation). Overall, these variables provide a partial picture of the source of these widening disparities, and could help guide future research in addressing and reducing diabetes disparities.

Associations between diet, physical activity and body fat distribution: a cross sectional study in an Indian population

BACKGROUND

Obesity is a growing health problem in India and worldwide, due to changes in lifestyle. This study aimed to explore the independent associations between dietary and physical activity exposure variables and total body fat and distribution in an Indian setting.

METHODS

Individuals who had participated in the Indian Migration Study (IMS) or the Andhra Pradesh Children And Parents' Study (APCAPS), were invited to participate in the Hyderabad DXA Study. Total and abdominal body fat of study participants was measured using DXA scans. Diet and physical activity (PA) levels were measured using questionnaires.

RESULTS

Data on 2208 participants was available for analysis; mean age was 49 yrs in IMS, 21 yrs in APCAPS. Total energy intake was positively associated with total body fat in the APCAPS sample: a 100 kcal higher energy intake was associated with 45 g higher body fat (95% CI 22, 68). In the IMS sample no association was found with total energy intake, but there was a positive association with percent protein intake (1% higher proportion of energy from protein associated with 509 g (95% CI 138,880) higher total body fat). Broadly the same pattern of associations was found with proportion of fat in the abdominal region as the outcome. PA was inversely associated with total body fat in both populations (in APCAPS, one MET-hour higher activity was associated with 46 g (95% CI 12, 81) less body fat; in the IMS it was associated with 145 g less body fat (95% CI 73, 218)). An inverse association was observed between PA and percentage abdominal fat in the IMS but no association was seen in the APCAPS population.

CONCLUSIONS

In this Indian population, there was an inverse association between PA and body fat. Associations between body fat and dietary variables differed between the younger APCAPS population and older IMS population. Further longitudinal research is needed to elucidate causality and directions of these associations across the life course.

Stearoyl-CoA desaturase 1, elongase 6 and their fatty acid products and precursors are altered in ovariectomized rats with 17β-estradiol and progesterone treatment

Sex differences in monounsaturated fatty acid (MUFA) levels suggest ovarian hormones may affect MUFA biosynthesis. Sprague-Dawley rats (8 weeks of age) were ovariectomized or sham operated with ovariectomized rats implanted with a constant-release hormone pellet providing 17β-estradiol, progesterone, both or neither at 10 weeks of age. After 14 days, rats were fasted overnight and sacrificed to collect plasma and livers for analysis. Hepatic stearoyl-CoA desaturase (SCD1) expression was unchanged between ovariectomized and sham controls, as determined by microarray and immunoblotting. However, SCD1 protein was increased in rats treated with estradiol plus progesterone. Elongase 6 protein levels were increased with 17β-estradiol treatment compared with sham. Rats treated with 17β-estradiol and 17β-estradiol plus progesterone had increased 16:0, 18:0, 16:1n-7 and 18:1n-7 in hepatic and plasma phospholipids. Ovarian hormones appear to be involved with MUFA biosynthesis, but the relationship appears complex and involves elongase 6 and SCD1.