Kelley K. Pettee

Weight Regain and Health‐related Quality of Life in Postmenopausal Women

Weight loss improves health‐related quality of life (HRQoL). However, regain after loss is common; little is known about the impact of weight regain on HRQoL in postmenopausal women. Woman on the Move through Activity and Nutrition (WOMAN) is a randomized lifestyle intervention trial of diet, physical activity, and weight loss in 508 postmenopausal women aged 52–62 years. This analysis focused on the women who lost ≥5 lb during the initial phase of the study, baseline to 6 months (n = 248). This cohort was divided into three groups based on subsequent weight change between 6 and 18 months: weight loss (WL; ≥5 lb loss), weight stable (WS; <±5 lb change), and weight regain (WR; ≥5 lb gain). HRQoL was measured at baseline, 6, and 18 months using the Short Form‐36. Of the 248 women studied, 51 (21%) continued to lose weight after initial weight loss, while 127 (51%) maintained a stable weight, and 70 (28%) regained weight. Between baseline and 6 months, women in WR group had decreased mental health and social‐functioning scores, while the WL and WS groups improved in these subscales. Between baseline and 18 months, energy improved most significantly in those with continued weight loss (P = 0.0003). Weight loss was correlated with a small to moderate improvement in perceived general health and energy, which was reversed by weight gain. Further study is needed to investigate the impact of a decline in mental health and social functioning on future weight regain.

The relationship between physical activity and lipoprotein subclasses in postmenopausal women: The influence of hormone therapy

Objective: This studys objective was to determine if the association between physical activity and lipids and lipoprotein subclasses in postmenopausal women varies by hormone therapy (HT) use. Design: The cross-sectional relationship between physical activity and lipid and lipoprotein subclass relationship was examined before group randomization in 485 postmenopausal (mean age 56.9 [2.9] y) white and African American women from the Woman On the Move through Activity and Nutrition study. This study is a randomized clinical trial designed to test whether a lifestyle intervention will reduce subclinical cardiovascular disease measures. Results: Hormone therapy users (n = 286) were significantly (P < 0.05) younger, less likely to be African American, reported higher levels of physical activity, large very low-density lipoprotein particles (VLDL-P), and medium high-density lipoprotein particles (HDL-P), had a larger mean HDL-P size, and lower levels of total cholesterol, low-density lipoprotein (LDL) cholesterol, small HDL-P, and small VLDL-P than nonusers (n = 196). Physical activity was significantly associated with favorable lipoprotein and lipid levels, regardless of HT use. Some relationships were found to vary significantly by HT use. In nonusers, mean HDL-P and LDL particles (LDL-P) size was significantly larger (P = 0.01 and 0.05, respectively) and total and small LDL-P were significantly lower (both P = 0.02) as activity increased. These relationship were not found in HT users. Conclusions: Physical activity was significantly related to some lipoprotein subclasses regardless of HT; however, several key lipoprotein subclasses were associated with higher levels of activity only among non-HT users.

Psychometric properties of the commitment to physical activity scale.

OBJECTIVE To assess psychometric properties of the Commitment to Physical Activity Scale (CPAS). METHODS Girls in third to fifth grades (n = 932) completed the CPAS before and after a physical activity intervention. Psychometric measures included internal consistency, factor analysis, and concurrent validity. RESULTS Three CPAS factors emerged: values, attitudes, and motivation, with reliability coefficients ranging from .429 to .821. Significant correlations existed between subscales and physical activity frequency. CONCLUSIONS The CPAS was reliable and valid and in a sample of third-to fifth-grade girls. Findings support using the CPAS for measuring overall commitment to physical activity in girls.

A Lifestyle Approach for Primary Cardiovascular Disease Prevention in Perimenopausal to Early Postmenopausal Women

Cardiovascular disease (CVD) is the leading cause of death among women in the United States. A large proportion of deaths attributable to CVD occur in asymptomatic women, making early detection and diagnosis difficult. As a result, women tend to be diagnosed at later stages of disease when compared with men. In addition, women have not experienced as great a decline in CVD mortality in recent decades as have men. Therefore, the development of primary CVD prevention strategies to decrease the CVD risk in women has become a major public health priority and creates the need for alternate strategies to be developed to decrease CVD risk in women. The success of a nonpharmacological, lifestyle approach for primary CVD prevention has recently been demonstrated in perimenopausal to early postmenopausal women. Two clinical trials, the Womens Healthy Lifestyle Project (WHLP) and Women On the Move through Activity and Nutrition (WOMAN) study, examined the role of lifestyle to prevent unfavorable CVD risk factor changes that typically occur as a woman transitions through menopause. In both studies, a lifestyle intervention approach, with modest dietary restrictions and increased leisure physical activity, was effective for weight loss and/or weight maintenance and CVD risk factor reduction. More research is needed to determine the long-term benefits of a lifestyle intervention to prevent CVD in women. The existing evidence suggests that the promotion of healthy lifestyle practices by health care providers is a valuable strategy for CVD risk factor reduction in women transitioning through menopause.