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Lifestyle intervention can prevent weight gain during menopause: Results from a 5-year randomized clinical trial

  • Published:
Annals of Behavioral Medicine

Abstract

Context: Menopausal-related weight gain and increased waist circumference have major cardiovascular health implications for older women. The efficacy of a dietary and physical activity lifestyle intervention to prevent weight gain and elevations in cardiovascular disease (CVD) risk factors from the peri- to postmenopause is unknown.Objective: To report the 54-month results of a lifestyle dietary and physical activity program on weight, body composition, physical activity, diet, and other CVD risk factors.Design: Data are from a 5-year randomized clinical trial known as the Women’s Healthy Lifestyle Project, conducted from 1992 to 1999.Participants: 535 healthy, premenopausal women ages 44 to 50 at study entry enrolled into the trial.Intervention: Participants were randomly assigned to either a lifestyle intervention group receiving a 5-year behavioral dietary and physical activity program or to an assessment-only control group. The lifestyle intervention group was given modest weight loss goals (5–15 lb, or approximately 2.3–6.8 kg) to prevent subsequent gain above baseline weight by the end of the trial. To achieve weight loss and lower low-density lipoprotein cholesterol levels, intervention participants followed an eating pattern consisting of 1,300 kcal/day (25% total fat, 7% saturated fat, 100 mg of dietary cholesterol) and increased their physical activity expenditure (1,000–1,500 kcal/week).Main Outcome Measures: Regarding weight gain prevention, 55% (136/246) of intervention participants were at or below baseline weight compared with 26% (68/261) of controls after 4.5 years, χ(2, N = 507) = 45.0, p < .001. The mean weight change in the intervention group was 0.1 kg below baseline (SD = 5.2 kg) compared with an average gain of 2.4 kg (SD = 4.9 kg) observed in the control group. Waist circumference also significantly decreased more in the intervention group compared with controls (M = −2.9 cm, SD = 5.3 vs. M = −0.5 cm, SD = 5.6, p < .001). Moreover, participants in the lifestyle intervention group were consistently more physically active and reported eating fewer calories and less fat than controls. Long-term adherence to physical activity and a low-fat eating pattern was associated with better weight maintenance.Conclusions: In healthy women, weight gain and increased waist circumference during the peri- to postmenopause can be prevented with a long-term lifestyle dietary and physical activity intervention.

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References

  1. Pi-Sunyer FX: Medical hazards of obesity.Annals of Internal Medicine.1993,119:655–660.

    PubMed  CAS  Google Scholar 

  2. National Institutes of Health:Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, NIH Publication No. 98-4083. Bethesda, MD: 1998.

  3. Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL: Over-weight and obesity in the United States: Prevalence and trends, 1960-1994.International Journal of Obesity. 1998,22:39–47.

    Article  PubMed  CAS  Google Scholar 

  4. Wing RR, Matthews KA, Kuller LH, Meilahn EN, Plantinga PL: Weight gain at the time of menopause.Archives of Internal Medicine. 1991,151:97–102.

    Article  PubMed  CAS  Google Scholar 

  5. Simkin-Silverman LR, Wing RR: Weight gain during menopause: Is it inevitable or can it be prevented?Postgraduate Medicine. 2000,108:47–56.

    PubMed  CAS  Google Scholar 

  6. Heymsfield SB, Gallagher D, Poehlman ET, et al.: Menopausal changes in body composition and energy expenditure.Experimental Gerontology. 1994,29:377–389.

    Article  PubMed  CAS  Google Scholar 

  7. Poehlman ET, Toth MJ, Gardner AW: Changes in energy balance and body composition at menopause: A controlled longitudinal study.Annals of Internal Medicine. 1995,123:673–675.

    PubMed  CAS  Google Scholar 

  8. Jeffery RW, French SA: Preventing weight gain in adults: The pound of prevention study.American Journal of Public Health. 1999,89:747–751.

    Article  PubMed  CAS  Google Scholar 

  9. Boraz MA, Simkin-Silverman LR, Wing RR, Meilhan EN, Kuller LH: HRT use and menopausal symptoms among women participating in a behavioral lifestyle intervention.Preventive Medicine. 2001,33:108–114.

    PubMed  CAS  Google Scholar 

  10. Salamone LM, Cauley JA, Black DM, et al.: Effect of a lifestyle intervention on bone mineral density in premenopausal women: A randomized trial.American Journal of Clinical Nutrition. 1999,70:97–103.

    PubMed  CAS  Google Scholar 

  11. Simkin-Silverman L, Wing RR, Hansen DH, et al: Prevention of cardiovascular risk factor elevations in healthy premenopausal women.Preventive Medicine. 1995,24:509–517.

    Article  PubMed  CAS  Google Scholar 

  12. Simkin-Silverman LR, Wing RR, Boraz MA, Meilahn EN, Kuller LH: Maintenance of cardiovascular risk factor changes among middle-aged women in a lifestyle intervention trial.Women’s Health: Research on Gender, Behavior, and Policy. 1998,4:255–271.

    CAS  Google Scholar 

  13. Kuller LH, Simkin-Silverman LR, Wing RR, Meilahn EN, Ives DG: Women’s healthy lifestyle project: A randomized clinical trial: Results at 54 months.Circulation. 2001,103:32–37.

    PubMed  CAS  Google Scholar 

  14. Wing RR: Behavioral approaches to the treatment of obesity. In Bray G, Bouchard C, James PT (eds),Handbook of Obesity. New York: Dekker, 1998, 855–871.

    Google Scholar 

  15. Lohman TG, Roche AF, Martorell R:Anthropometric Standardization Reference Manual. Campaign, IL: Human Kinetics, 1988.

    Google Scholar 

  16. Paffenbarger RS, Wing AL, Hyde RT: Physical activity as an index of heart attack risk in college alumni.American Journal of Epidemiology. 1978,108:161–175.

    PubMed  Google Scholar 

  17. Block G, Hartman AM, Dresser CM, et al.: A data-based approach to diet questionnaire design and testing.American Journal of Epidemiology. 1986,124:453–469.

    PubMed  CAS  Google Scholar 

  18. Allain CC, Poon LS, Chan CS, Richmond W, Fu PC: Enzymatic determination of total serum cholesterol.Clinical Chemistry. 1974,20:470–475.

    PubMed  CAS  Google Scholar 

  19. Bonder RJL, Mead DC: Evaluation of glucose-6-phosphate dehydrogenase from Leuconostoc mesenteroides in the hexokinase method for determining glucose in serum.Clinical Chemistry. 1974,20:586.

    Google Scholar 

  20. Bucolo G, David H: Quantitative determination of serum triglycerides by the use of enzymes.Clinical Chemistry. 1973,19:476–482.

    PubMed  CAS  Google Scholar 

  21. Warnick GR, Albers JJ: A comprehensive evaluation of the heparin-manganese precipitation procedure for estimating high density lipoprotein cholesterol.Journal of Lipid Research. 1978,19:65–76.

    PubMed  CAS  Google Scholar 

  22. Friedewald WT, Levy RI, Fredrickson DS: Estimation of the concentration of low density lipoprotein cholesterol in plasma, without the use of the preparative ultracentrifuge.Clinical Chemistry. 1972,18:499–502.

    PubMed  CAS  Google Scholar 

  23. Dischinger P, DuChene AG: Quality control aspects of blood pressure measurements in the Multiple Risk Factor Intervention Trial.Controlled Clinical Trials. 1986,7(Suppl.):137S-157S.

    Article  PubMed  CAS  Google Scholar 

  24. Garrow JS: Zero-muddler for unprejudiced sphygmomanometry.Lancet. 1963,2:1205.

    Article  PubMed  CAS  Google Scholar 

  25. Klem ML, Wing RR, Simkin-Silverman L, Kuller LH: The psychological consequences of weight gain prevention in healthy, premenopausal women.International Journal of Eating Disorders. 1997,21:167–174.

    Article  PubMed  CAS  Google Scholar 

  26. Dunn AL, Marcus BH, Kampert JB, et al.: Comparison of lifestyle and structured interventions to increase physical activity and cardiorespiratory fitness: A randomized trial.Journal of the American Medical Association. 1999,281:327–334.

    Article  PubMed  CAS  Google Scholar 

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Author notes

  1. Rena R. Wing Ph.D.

    Present address: Wing is now at Brown University School of Medicine/The Miriam Hospital, USA

Authors and Affiliations

  1. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, 15261, Pittsburgh, PA

    Laurey R. Simkin-Silverman Ph.D., Rena R. Wing Ph.D., Miriam A. Boraz Ph.D. & Lewis H. Kuller M.D., Dr.PH

Authors
  1. Laurey R. Simkin-Silverman Ph.D.
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  2. Rena R. Wing Ph.D.
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  3. Miriam A. Boraz Ph.D.
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  4. Lewis H. Kuller M.D., Dr.PH
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Additional information

This research was supported through a grant from the National Heart, Lung, and Blood Institute, National Institutes of Health awarded to Lewis H. Kuller, M.D., Dr. PH. (HL 45167-03).

We thank the participants of Women’s Healthy Lifestyle Project for their enduring dedication and the investigators and staff for their valuable contributions to the study (listed in alphabetical order): Michelle Berry, Alhaji Buhari, Michele Burnette, Jane Cauley, Yuefang Chang, David Chernew, DJ Conner-Beatty, Debbi Cusick, Aileen Faulkner, Shannon FitzGerald, Rich Foran, Sara Friel, Ed Gregg, Donna Hansen, Beth Hauth, Diane Ives, Ja Kielty, Mary Lou Klem, Andrea Kriska, Jean Lennon, Araxi Macaulay, Mehran Massoudi, Nancy Mazzei, Eileen McMahon, Elaine Meilahn, Marguerite Meyer, N. Carole Milas, Joann Naujelus, Pam Carter-Nolan, Mary Parker, Annette Rexroad, Loran Salamone, Danit Shahar, Siao Mei Shick, Maria Smith, Pam Vincent, Michelle Volansky, Charlene Walter, Marie Wilkerson, and Randi Wolf.

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Simkin-Silverman, L.R., Wing, R.R., Boraz, M.A. et al. Lifestyle intervention can prevent weight gain during menopause: Results from a 5-year randomized clinical trial. ann. behav. med. 26, 212–220 (2003). https://doi.org/10.1207/S15324796ABM2603_06

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  • DOI: https://doi.org/10.1207/S15324796ABM2603_06

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