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Purpose: The association between the energy density (ED) of foods and adiposity has been reported previously. However, whether the contribution of ED to adiposity remains significant when controlled for energy intake (EI) and physical activity energy expenditure (PAEE) remains to be clearly established. We aimed to investigate the independent contribution of ED to variations in body composition in women during the menopausal transition., Methods: Sixty-seven women from the MONET cohort study were analyzed. Seven-day food records were used to assess EI and ED. Body composition (body fat mass (FM) and trunk-fat mass (TFM)) was measured with dual-energy X-ray absorptiometry; PAEE was assessed with accelerometers. This secondary analysis of data included measurements obtained at years 1 and 5 of the study., Results: Mean ED was correlated with FM (r = 0.22; P = 0.04) and TFM (r = 0.22; P = 0.04) at year 1, but not at year 5. The multiple regression analysis showed that EI and ED contributed to 14% of the variance in FM and TFM at year 1., Conclusion: These results suggest that ED is a modest but inconsistent determinant of adiposity in healthy women at the time of the menopause transition.

Introduction: Conflicting results have been reported concerning the prevalence of cardiometabolic risk factors in women experiencing vasomotor symptoms (VMS)., Objectives: To compare cardiometabolic risk factors between women with and without VMS during the menopause transition and to determine the influence of physical activity on the prevalence of VMS., Methods: Yearly assessment of women transitioning through menopause included self-reported VMS (hot flushes and night sweats), body composition and fat distribution, fasting glucose, insulin and lipids, and physical activity levels., Results: Eighty-five of the 102 premenopausal women at baseline were included (age: 49.9 ± 2.0 years; body mass index: 23.2 ± 2.2 kg/m(2)). According to linear mixed model analyses, no statistically significant differences were observed for fat mass, lean body mass, body fat distribution indices and cardiometabolic risk factors, when comparing symptomatic vs. asymptomatic women. Neither physical activity levels nor intensity were associated with the prevalence of VMS., Conclusion: Our results suggest that women transitioning through menopause who reported VMS did not show greater deteriorations in body composition, body fat distribution and cardiometabolic risk factors. Furthermore, physical activity levels were not associated with lower prevalence of vasomotor symptoms in the present cohort.

Objective: This study aims to assess middle-aged women's needs when making body weight management decisions and to evaluate a knowledge translation tool for addressing their needs., Methods: A mixed-methods study used an interview-guided theory-based survey of professional women aged 40 to 65 years. The tool summarized evidence to address their needs and enabled women to monitor actions taken. Acceptability and usability were reported descriptively., Results: Sixty female participants had a mean body mass index of 28.0 kg/m(2) (range, 17.0-44.9 kg/m(2)), and half were premenopausal. Common options for losing (82%) or maintaining (18%) weight included increasing physical activity (60%), eating healthier (57%), and getting support (40%). Decision-making involved getting information on options (52%), soliciting others' decisions/advice (20%), and being self-motivated (20%). Preferred information sources included written information (97%), counseling (90%), and social networking websites (43%). Five professionals (dietitian, personal trainer, occupational therapist, and two physicians) had similar responses. Of 53 women sent the tool, 27 provided acceptability feedback. They rated it as good to excellent for information on menopause (96%), body weight changes (85%), and managing body weight (85%). Most would tell others about it (81%). After 4 weeks of use, 25 women reported that the wording made sense (96%) and that the tool had clear instructions (92%) and was easy to use across time (88%). The amount of information was rated as just right (64%), but the tool had limited space for responding (72%)., Conclusions: When making decisions about body weight management, women's needs were "getting information" and "getting support." The knowledge translation tool was acceptable and usable, but further evaluation is required.

Objectives: It is unknown whether the satiety quotient (SQ) differs across the menopausal transition, and whether changes in SQ are related to changes in anthropometric/body composition variables. The objective of this study was to evaluate the changes in SQ and its association with energy intake and changes in anthropometric/body composition variables across the menopausal transition., Methods: At baseline, 102 premenopausal women (aged 49.9 ± 1.9 years, body mass index 23.3 ± 2.2 kg/m(2)) took part in a 5-year observational, longitudinal study. Body composition (DXA), appetite (visual analog scales), energy and macronutrient intakes (ad libitum lunch and 7-day food diary) were assessed annually. The SQ (mm/100 kcal) was calculated at 60 and 180 min post-breakfast consumption., Results: Overall, the SQ increased at years 3 and 4 (p = 0.01-0.0001), despite no significant differences between menopausal status groups. Lower fullness, prospective food consumption and mean SQ values predicted overall increases in lunch energy and macronutrient intakes (p = 0.04-0.01), whereas only prospective food consumption and fullness SQ predicted energy intake and carbohydrate intake, respectively, when assessed with food diaries (p = 0.01). Delta SQs were negatively correlated with changes in waist circumference (p = 0.03-0.02), whereas delta SQs were positively (p = 0.04) and negatively (p = 0.02) associated with delta fat mass between years 1 and 5, and years 4 and 5, respectively., Conclusion: These results suggest that variations in SQ across the menopausal transition are related to energy and macronutrient intakes and coincide with changes in body composition and waist circumference.

Objective: To investigate the relationship between time spent performing physical activity (PA) and adiposity across the menopausal transition., Methods: Body weight and body composition were analyzed in 65 women (47-54 years old; body mass index 23.2 ± 2.4 kg/m(2)) in a 5-year prospective study. Time spent in PA of varying intensities (sedentary, light, moderate and vigorous) was determined from 7-day accelerometer measurement and energy intake with a 7-day food diary., Results: Significant negative correlations were observed between the time spent in light-intensity PA and fat mass (FM) (r = -0.38, p < 0.005), central FM (r = -0.36, p < 0.005), peripheral FM (r = -0.33, p < 0.01), and percent body fat (r = -0.42, p < 0.001) at year 1, respectively. No significant correlations were noted between measures of adiposity and time spent performing either moderate or vigorous PA. Analyses using tertiles of time spent in light PA at year 1 showed that FM (20.7 ± 4.0 vs. 20.3 ± 6.6 vs. 16.6 ± 4.6 kg, p < 0.05), central FM (10.1 ± 2.6 vs. 10.0 ± 3.8 vs. 7.8 ± 2.4 kg; p < 0.05) and percent body fat (34.5 ± 5.1 vs. 32.2 ± 7.7 vs. 28.1 ± 6.2%, p < 0.01) were all significantly lower in women in the highest tertile. These differences remained significant after covariate analyses using time spent in moderate- and high-intensity PA and total energy intake. Finally, lower levels of FM, percent body fat, central and peripheral FM persisted in women who spent more time in light PA (highest tertiles) over the 5-year follow-up., Conclusion: Our results suggest that the time spent performing light PA may have a greater impact on adiposity than moderate and/or vigorous PA, an observation independent of the menopausal status.

Background/objective: The purpose of this study was to investigate changes in dietary intake and appetite across the menopausal transition., Subjects/methods: This was a 5-year observational, longitudinal study on the menopausal transition. The study included 94 premenopausal women at baseline (age: 49.9±1.9 years; BMI: 23.3±2.3 kg/m2). Body composition (dual-energy X-ray absorptiometry), appetite (visual analogue scale), eating frequency, energy intake (EI) and macronutrient composition (7-day food diary and buffet-type meal) were measured annually., Results: Repeated-measures analyses revealed that total EI and carbohydrate intake from food diary decreased significantly over time in women who became postmenopausal by year 5 (P>0.05) compared with women in the menopausal transition. In women who became postmenopausal by year 5, fat and protein intakes decreased across the menopausal transition (0.05>P<0.01). Although a decrease in % fat intake was observed during the menopausal transition (P<0.05), this variable was significantly increased in the postmenopausal years (P<0.05). Spontaneous EI and protein intake also declined over time and were higher in the years preceding menopause onset (P<0.05). Desire to eat, hunger and prospective food consumption increased during the menopausal transition and remained at this higher level in the postmenopausal years (0.05>P<0.001). Fasting fullness decreased across the menopausal transition (P<0.05)., Conclusion: These results suggest that menopausal transition is accompanied with a decrease in food intake and an increase in appetite.

Objectives: Factors that influence weight gain during the menopausal transition are not fully understood. The purpose of this study was to investigate changes in energy expenditure (EE) across the menopausal transition., Methods: In all, 102 premenopausal women (age: 49.9 ± 1.9 years; body mass index: 23.3 ± 2.2 kg/m(2)) were followed for 5 years. Body composition (dual-energy X-ray absorptiometry), physical activity EE (accelerometer), resting EE and thermic effect of food (indirect calorimetry) were measured annually., Results: Total EE decreased significantly over time in postmenopausal women (P<0.05), which was mostly due to a decrease in physical activity EE (P<0.05). Although average resting EE remained stable over time in postmenopausal women, a significant increase, over the 5-year period, was noted in women who were in the menopausal transition by year 5 (P<0.05). Finally, the time spent in moderate physical activity decreased and the time spent in sedentary physical activity increased during the menopausal transition (P<0.05)., Conclusion: These results suggest that menopausal transition is accompanied with a decline in EE mainly characterized by a decrease in physical activity EE and a shift to a more sedentary lifestyle.

Objective: Cardiovascular disease is the first cause of mortality in women in North America. The risk of cardiovascular disease increases sharply after middle age in women, especially after menopause. The aim was to investigate changes in body composition and cardiometabolic profile throughout the menopausal transition., Methods: This was a 5-year observational, longitudinal study on the menopausal transition. The study included 102 premenopausal women at baseline (age, 49.9 ± 1.9 y; body mass index, 23.3 ± 2.2 kg/m). Outcome measures include menopause status, body composition by dual-energy x-ray absorptiometry (total fat mass [FM], trunk FM, and total fat-free mass), waist circumference, visceral and abdominal subcutaneous fat, fasting glucose and insulin levels, homeostasis model assessment of insulin resistance, plasma lipid levels (triglycerides, total cholesterol, and high- and low-density lipoprotein cholesterol), and resting blood pressure., Results: Repeated-measure analyses revealed significant increases for FM, percentage FM, trunk FM, visceral fat, plasma fasting glucose, and high-density lipoprotein cholesterol (0.05 > P < 0.01) and a significant decrease for plasma glucose levels after follow-up. Those who were in perimenopause or postmenopause by year 3 of the study showed a significant increase in visceral fat (P < 0.01) compared with baseline. Despite some significant changes in the metabolic profile among the menopause statuses, the women did not show any cardiometabolic deterioration by the end of the study., Conclusions: Our results suggest that changes in body composition and fat distribution can occur in nonobese women as they go through the menopausal transition. However, these changes were not accompanied by cardiometabolic deteriorations in the present study.

Objective: To examine the association between weight gain since menopause and weight regain after a weight loss program., Methods: Participants were 19 obese women who participated in a 15-week weight loss program and a 12-month follow-up. Main outcomes were: body composition, resting metabolic rate, energy intake, energy expenditure, and weight regain at follow-up., Results: All body composition measures significantly decreased after intervention (all P ≤ 0.01) while all measures of fatness increased significantly after the 12-month follow-up (P ≤ 0.01). Body weight gain since menopause was associated with body weight regain (r = 0.65; P = 0.003) after follow-up even after adjustment for confounders., Conclusion: Weight gain since menopause is associated with body weight regain following the weight loss program. Therefore, weight gain since menopause should be considered as a factor influencing weight loss maintenance in older women.

Purpose: After menopause, women gain abdominal fat and become less sensitive to insulin. We sought to determine whether hormone replacement therapy (HRT) reduced intraabdominal and sc abdominal fat and improved insulin sensitivity in early menopausal women., Methods: Seventy-six postmenopausal women, age 51.6 +/- 3.9 yr with body mass index of 24.9 +/- 3.2 kg/m2, were randomized to conjugated estrogens (0.625 mg) plus medroxyprogesterone acetate (2.5 mg) or placebo daily. Women received a computed tomography scan at the L4-L5 vertebral disk space, a dual x-ray absorptiometry scan, and a euglycemic hyperinsulinemic clamp at baseline, 6 months, 1 yr, and 2 yr., Results: Fifty-one women completed the trial and were analyzed (n = 26 on HRT and n = 25 on placebo). Intraabdominal fat, sc abdominal fat, total fat, percent fat, fat-free mass, and weight did not differ between treatment groups by time. Insulin sensitivity did not change in the placebo group, but decreased by 17% in the HRT group by 6 months and persisted at 2 yr (P < 0.01 for treatment by time effect). One year after the trial, insulin sensitivity increased by 25% in women who had taken HRT (P = 0.006 for treatment by time effect), to a level similar to those women in the placebo group., Conclusions: Conjugated estrogens plus medroxyprogesterone acetate reduce insulin sensitivity in menopausal women without affecting body composition or body fat distribution. The reduction in insulin sensitivity is reversible after discontinuing HRT.

Objective:Central fat mass (CFM) correlates with insulin resistance and increases the risk of type 2 diabetes and cardiovascular complications. On the other hand, increased peripheral fat mass (PFM) is associated with higher insulin sensitivity. Thus, we examined the contribution of adipose tissue distribution, as assessed by the PFM/CFM ratio, to insulin sensitivity in overweight and obese postmenopausal women.Design and methods:A total of 124 nondiabetic overweight and obese postmenopausal women underwent an oral glucose tolerance test (OGTT) and a hyperinsulinemic/euglycemic (HI) clamp. Body composition was determined using computed tomography for visceral adipose tissue (VAT) and dual X-ray absorptiometry for fat mass, lean body mass and their respective proportions. Participants were divided by tertiles of the PFM/CFM ratio.Results:Participants with preferential CFM (group 1) had higher fasting insulin levels and insulin area under the curve (AUC) during OGTT, as well as lower glucose infusion rates during the HI clamp, whether it was expressed per kg of body weight (M) or per kg of fat-free mass (Mm), compared with the other two groups. The PFM/CFM ratio also correlated significantly with fasting insulin (r=−0.32, P<0.001), the insulin AUC (r=−0.42 P<0.001), M (r=0.39 P<0.001) and Mm (r=0.37 P<0.001). Using hierarchical regression, we demonstrated that the PFM/CFM ratio was an independent predictor of insulin AUC, M and Mm and that its sequential addition to CFM and VAT improved significantly the predictive value of the model for insulin sensitivity for all variables except fasting insulin.Conclusion:The PFM/CFM ratio, which integrates the antagonistic effects of both central and peripheral depots on insulin sensitivity, added substantially to the prediction of insulin sensitivity over VAT and CFM alone.International Journal of Obesity (2008) 32, 1626–1632; doi:10.1038/ijo.2008.163; published online 7 October 2008 [ABSTRACT FROM AUTHOR]

A correction to the article "Effects of the menopausal transition on energy expenditure: a MONET group study" that was published a 2013 issue is presented.