Intervention In Postmenopausal Women Research Articles

Effects of combined dietary intervention and physical-cognitive exercise on cognitive function and cardiometabolic health of postmenopausal women with obesity: a randomized controlled trial

BackgroundPostmenopausal women with obesity are markedly at risk of cognitive impairment and several health issues. Emerging evidence demonstrated that both diet and exercise, particularly physical-cognitive exercise are involved in cognitive and health benefits. However, the comparative effect of diet, exercise, and combined interventions in postmenopausal women with obesity on cognition and cardiometabolic health is still lacking. Identifying the effective health promotion program and understanding changes in cardiometabolic health linking these interventions to cognition would have important medical implications. This RCT aimed to examine the effect of single and combined interventions of diet and exercise on cognitive function and cardiometabolic health in postmenopausal women with obesity.MethodsNinety-two postmenopausal women with obesity were randomly assigned to diet group (intermittent fasting 2 days/week, 3 months), exercise group (physical-cognitive exercise 3 days/week, 3 months), combined group, or control group (n = 23/group). All cognitive outcomes and cardiometabolic outcomes were measured at baseline and post-3 months. Primary outcomes were executive functions, memory, and plasma BDNF levels. Secondary outcomes were global cognition, attention, language domain, plasma adiponectin levels, IL-6 levels, metabolic parameters, and physical function.ResultsAt the end of the 3-month intervention, the exercise and combined group demonstrated significant memory improvement which was accompanied by significant improvements in plasma BDNF level, insulin levels, HOMA-IR, %body fat, and muscle strength when compared to controls (p < 0.05). Only the combined intervention group demonstrated a significant improvement in executive function and increased plasma adiponectin levels when compared to control (p < 0.05). Surprisingly, no cognitive improvement was observed in the diet group (p > 0.05). Significant reduction in cholesterol levels was shown in the diet and combined groups when compared to controls (p < 0.05). Among the three intervention groups, there were no significant differences in all cognitive outcomes and cardiometabolic outcomes (p > 0.05). However, all three intervention groups showed significant improvements in plasma BDNF levels, weight, BMI, WHR, fat mass, and predicted VO2 max, when compared to control (p < 0.05).ConclusionThese findings suggest that combined physical-cognitive exercise and dietary intervention are promising interventions to improve cognition and obesity-related complications of postmenopausal women with obesity.Trial registrationNCT04768725 (https://clinicaltrials.gov) 24th February 2021.

Risk of endometrial polyp and surgical intervention in postmenopausal women with proliferative endometrium.

To study the long-term risks of postmenopausal women with proliferative endometrium developing benign uterine pathologies (endometrial polyps and uterine fibroids) and requiring future gynecological interventions, and to compare them with women with atrophic endometrium. Retrospective cohort study of all women aged 55 or over who underwent endometrial biopsy between 1/1997 and 12/2008. Outcome data were available through to 2/2018. Women with proliferative endometrium were compared with those with atrophic endometrium for the presence of endometrial polyps, uterine fibroids, future endometrial biopsy for recurrent vaginal bleeding, and future hysteroscopy or hysterectomy. Logistic regression models were used to evaluate the association of endometrial histology and other covariates with the risk of morbidities. Postmenopausal women with proliferative endometrium are at higher risk of developing endometrial polyps, uterine fibroids and need for surgical intervention. Of 1808 women who underwent endometrial biopsy during the study period, 962 met inclusion criteria: 278 had proliferative and 684 had atrophic endometrium. Length of surveillance was similar in the two groups (11.9 vs. 11.5years, p=0.2). Compared with women with atrophic endometrium, women with proliferative endometrium had significantly higher rates of endometrial polyps (17.3% vs 9.7% p=0.001). Multivariable logistic regression confirmed that women with proliferative endometrium had more fibroids on ultrasound (62.1% vs 50.3% 3=0.02), and had increased risks of developing endometrial polyps (aOR 1.9, 95% CI 1.28-3.07, p=0.002), repeat endometrial biopsy (34.9% vs. 16.8%p<0.001) and future hysterectomy or hysteroscopy (26.6% vs 16.2% p<0.001). In addition to the long-term increased risk of cancer, postmenopausal women with proliferative endometrium are more likely to have future bleeding, surgical interventions and diagnosis of endometrial polyps. Medical management to reduce estrogenic activity and associated risks may be considered in these cases.

Resistance training decreased abdominal adiposity in postmenopausal women.

To investigate if abdominal adipose tissue volumes and ratios change after a 15-week structured resistance training intervention in postmenopausal women with vasomotor symptoms (VMS). Sixty-five postmenopausal women with VMS and low physical activity were randomized to either three days/week supervised resistance training or unchanged physical activity for 15weeks. Women underwent clinical anthropometric measurements and magnetic resonance imaging (MRI) at baseline and after 15weeks. MRI was done using a Philips Ingenia 3.0T MR scanner (Philips, Best, The Netherlands). The per protocol principle was used in the analysis of data. The absolute change from baseline to week 15 in visceral adipose tissue (VAT) volume and the relative ratio (VAT ratio) between VAT and total abdominal adipose tissue (TAAT), i.e. the sum of abdominal subcutaneous adipose tissue (ASAT) and VAT. There were no significant differences between the groups in characteristics, anthropometry or MRI measures at baseline. Women who were compliant with the intervention (i.e. participated in at least two of the three scheduled training sessions per week) had significantly different reduction over time in ASAT (p=0.006), VAT (p=0.002), TAAT (p=0.003) and fat ratio (p<0.001) compared with women in the control group. Implementation of a 15-week resistance training regimen in midlife may help women to counteract the abdominal fat redistribution associated with the menopausal transition. gov registered ID: NCT01987778.

Oestrogen therapy for treating pelvic organ prolapse in postmenopausal women.

Pelvic organ prolapse (POP) is the descent of a woman's uterus, bladder, or rectum into the vagina. It affects 50% of women over 50 years old who have given birth to at least one child, and recognised risk factors are older age, higher number of births, and higher body mass index. This review assesses the effects of oestrogen therapy, alone or in combination with other treatments, on POP in postmenopausal women. To assess the benefits and harms of local and systemic oestrogen therapy in the management of pelvic organ prolapse symptoms in postmenopausal women, and to summarise the principal findings of relevant economic evaluations. We searched the Cochrane Incontinence Specialised Register (up to 20 June 2022), which includes CENTRAL, MEDLINE, two trials registers, and handsearching of journals and conference proceedings. We also checked the reference lists of relevant articles for additional studies. We included randomised controlled trials (RCTs), quasi-RCTs, multi-arm RCTs, and cross-over RCTs that evaluated the effects of oestrogen therapy (alone or in combination with other treatments) versus placebo, no treatment, or other interventions in postmenopausal women with any grade of POP. Two review authors independently extracted data from the included trials using prespecified outcome measures and a piloted extraction form. The same review authors independently assessed the risk of bias of eligible trials using Cochrane's risk of bias tool. Had data allowed, we would have created summary of findings tables for our main outcome measures and assessed the certainty of the evidence using GRADE. We identified 14 studies including a total of 1002 women. In general, studies were at high risk of bias in terms of blinding of participants and personnel, and there were also some concerns about selective reporting. Owing to insufficient data for the outcomes of interest, we were unable to perform our planned subgroup analyses (systemic versus topical oestrogen, parous versus nulliparous women, women with versus without a uterus). No studies assessed the effects of oestrogen therapy alone versus no treatment, placebo, pelvic floor muscle training, devices such as vaginal pessaries, or surgery. However, we did identify three studies that assessed oestrogen therapy in conjunction with vaginal pessaries versus vaginal pessaries alone and 11 studies that assessed oestrogen therapy in conjunction with surgery versus surgery alone. There was insufficient evidence from RCTs to draw any solid conclusions on the benefits or harms of oestrogen therapy for managing POP symptoms in postmenopausal women. Topical oestrogen in conjunction with pessaries was associated with fewer adverse vaginal events compared with pessaries alone, and topical oestrogen in conjunction with surgery was associated with reduced postoperative urinary tract infections compared with surgery alone; however, these findings should be interpreted with caution, as the studies that contributed data varied substantially in their design. There is a need for larger studies on the effectiveness and cost-effectiveness of oestrogen therapy, used alone or in conjunction with pelvic floor muscle training, vaginal pessaries, or surgery, for the management of POP. These studies should measure outcomes in the medium and long term.

Effects of heavy metals on cardiovascular diseases in pre and post-menopausal women: from big data to molecular mechanism involved.

To assess the link between a mixed heavy metal (cadmium, lead, and mercury) and the 10-year risk of cardiovascular diseases (CVDs) in pre- and post-menopausal Korean women aged ≥20 years, as well as identify potential molecular mechanisms of mixed heavy metal-induced CVDs. Multivariate linear regression, weighted quantile sum (WQS) regression, quantile g-computation (gqcomp), and Bayesian kernel machine regression (BKMR) models were used to examine the effects of mixed heavy metals and the 10-year risk of CVDs. The Comparative Toxicogenomics Database, MicroRNA ENrichment TURned NETwork, and the microRNA sponge generator and tester were used as the key data-mining approaches. In our BKMR analysis, we found that the overall effect of mixed heavy metals was linked to the 10-year risk of CVDs in postmenopausal women in the upper 20th percentiles and in premenopausal women in the upper 55th percentiles. Mercury was identified as the key chemical for the 10-year risk of CVDs in pre- and postmenopausal women. In silico analysis revealed that a heavy metal mixture interacted with six genes associated with CVD development. Physical interactions (77.6%) were found to be the most common among CVD-related genes induced by the heavy metals studied. Several pathways have been identified as the main molecular mechanisms that could be affected by studied heavy metals and are implicated in the development of CVDs (e.g., lipid and lipoprotein metabolism, lipoprotein metabolism, cholesterol metabolism, and cardiovascular disease). ALB, APOE, ATF5, and CREB3L3 were the key genes and transcription factors related to CVDs induced by the mixture of the investigated heavy metals, respectively. The two miRNAs with the highest interaction and expression in the development of CVDs were hsa-miR-199a-5p and hsa-miR-199a-3p. We also designed and tested miRNA sponge sequences for these miRNAs. The cutoff thresholds for each heavy metal level linked with the 10-year risk of CVDs were described. A mixture of heavy metal exposures, especially mercury, was more strongly linked with the 10-year risk of CVDs in postmenopausal women than in premenopausal women. Early interventions in postmenopausal women should be considered to reduce CVD risks.

Cumulative glucocorticoid exposure in patients receiving epidural steroid injections: A single-centre retrospective evaluation on 581 procedures against existing clinical recommendations

BackgroundThe purpose of the study was to review the cumulative corticosteroid doses received from epidural and non-epidural-based pain interventions in a cohort of patients undergoing epidural steroid injections (ESIs) with comparison to safe dosing recommendations. MethodsRetrospective analysis was undertaken for all 349 patients who underwent a total of 581 ESIs at a single-centre, tertiary hospital in South Australia between 2017 and 2019. The primary outcome was the yearly dose analysis of cumulative steroid doses in methylprednisolone equivalents (MDPE) administered from epidural and non-epidural interventions in post-menopausal women, interpreted against maximum recommended doses. ResultsThe annual limit of 200 ​mg for postmenopausal women was exceeded in 4.7% of the time (11/235) from ESIs alone, with a significant rise to 15.3% (46/300) when non-ESI injections were included in cumulative dose totals(p ​< ​0.001). Of the 173 participants of post-menopausal female age, 4.1% (7/173) received cumulative corticosteroid doses above the 3-year 400 ​mg MPDE limit from ESIs alone, with a statistically significant increase to 13.9% (24/173) when non-epidural steroid injections were again included in cumulative dose totals (p ​< ​0.001). The mean ​± ​standard deviation administered MPDE per epidural steroid injection across the whole study cohort was 72 ​± ​22 ​mg, nearly double the recommended dose of 40 ​mg. ConclusionsOur study underpins the need for vigilance when considering steroid-based pain interventions, wherein both the individual and cumulative steroid exposure should be considered.

Modulation of Bone and Joint Biomarkers, Gut Microbiota, and Inflammation Status by Synbiotic Supplementation and Weight-Bearing Exercise: Human Study Protocol for a Randomized Controlled Trial.

BackgroundThere is strong evidence suggesting that prebiotics and probiotics regulate gut microbiota, reducing inflammation and thereby potentially improving bone health status. Similarly, mechanistic evidence suggests that either low-impact or high-impact weight-bearing exercises improve body composition and consequently increase bone mineral density in individuals with osteoporosis and osteoarthritis.ObjectiveThis study aims to investigate the effects of a synbiotic (probiotic+prebiotic) supplementation, an exercise intervention, or a combination of both on gut microbiota, inflammation, and bone biomarkers in postmenopausal women.MethodsA total of 160 postmenopausal women from New Zealand will be recruited and randomized to one of four interventions or treatments for 12 weeks: control, synbiotic supplementation, exercise intervention, or synbiotic supplementation and exercise. The primary outcome measure is the bone and joint biomarkers at baseline and week 12, whereas the gut microbiota profile and inflammatory cytokine measurements will serve as the secondary outcome measures at baseline and week 12. Baseline data and exercise history will be used to assess, allocate, and stratify participants into treatment measures.ResultsRecruitment of participants will begin in September 2021, and the anticipated completion date is June 2022.ConclusionsTo the best of our knowledge, this will be the first randomized controlled trial to analyze the effects of both a synbiotic supplement and an exercise intervention in postmenopausal women. On the basis of the results obtained, a combination of synbiotic supplements and exercise might serve as a noninvasive approach to manage and/or improve body composition and bone health in postmenopausal women.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12620000998943p; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380336&isClinicalTrial=False

Breast Cancer-related Biomarkers And Weight Regain Following An Exercise Intervention In Postmenopausal Women

PURPOSE: To assess the strength of the associations between breast cancer-related biomarkers and weight regain following exercise-induced weight loss in postmenopausal women. METHODS: The Breast Cancer and Exercise Trial in Alberta (BETA) included 400 participants that were randomized to either 150 or 300 minutes/week of aerobic exercise over 12 months with follow-up measurements at 24 months. During the follow-up period, no exercise intervention was prescribed. For these secondary analyses, we included participants who lost weight during the intervention and who had follow-up blood samples, body composition and covariate measurements (n = 214). Outcomes were measured at baseline, 12 months and 24 months. Linear regression models were used to explore associations between changes in body weight during follow-up, with changes in serum levels of breast-cancer related biomarkers: estradiol, free estradiol, estrone, sex hormone-binding globulin (SHBG), insulin, homeostasis model assessment-estimated insulin resistance (HOMA-IR), and C-reactive protein (CRP). RESULTS: Weight regain during follow-up was significantly associated with increases in estradiol (treatment effect ratio (TER) = 1.03, 95% CI: 1.01, 1.04), estrone (TER = 1.02, 95% CI: 1.01, 1.03), free estradiol (TER = 1.04, 95% CI: 1.02, 1.05), HOMA-IR (TER = 1.03, 95% CI: 1.02, 1.05), insulin (TER = 1.03, 95% CI: 1.01, 1.04), and decreases in SHBG (TER = 0.98, 95% CI: 0.97, 0.99) levels. Non-statistically significant associations were found for glucose and CRP. Furthermore, categorical results revealed increases in estradiol, free estradiol, insulin, HOMA-IR and CRP for participants who regained any amount of weight compared with those who continued to lose or maintained weight loss during follow-up. CONCLUSION: Weight regain after an exercise intervention is associated with increases in estradiol, free estradiol, estrone, insulin, and decreases in SHBG in postmenopausal women. Future studies should analyze other blood biomarkers and tissue-specific markers that increase breast cancer risk, and their associations with weight regain following exercise-induced weight loss. Sources of funding: Research Grant No. 24404 from the Alberta Cancer Foundation and No. 2011-701000 by the Canadian Cancer Society.

Predicting osteoporosis with body compositions in postmenopausal women: a non-invasive method

BackgroundThe prevalence of osteoporosis is rising steadily as the aging population increases. Bone mineral density (BMD) assessment is a golden standard to establish the diagnosis of osteoporosis. However, the accessibility and radiation exposure limited its role in community screening. A more convenient approach for screening is suggested.MethodsA total of 363 postmenopausal women over the age of 50 were included in this study and assessed with the body composition [including fat-free mass (FFM), fat mass (FM), and basal metabolic rate (BMR)] and BMD. Normal distributions and correlation coefficients among variables were calculated using the Shapiro-Wilk test and Pearson’s correlation analysis, respectively. A receiver operating characteristic (ROC) curve was plotted, and the area under ROC curves (AUC) was determined to obtain the optimal cutoff values of the body composition variables for osteoporosis prediction.ResultsThe correlation coefficient of FFM, FM, FM ratio, and BMR with femur neck T-score was 0.373, 0.266, 0.165, and 0.369, respectively, while with spine T-score was 0.350, 0.251, 0.166, and 0.352, respectively (p < 0.01 for all). FFM, FM, and BMR showed an optimal cutoff value of 37.9 kg, 18.6 kg, and 1187.5 kcal, respectively, for detecting osteoporosis.ConclusionsThe present study provided a model to predict osteoporosis in postmenopausal women, and the optimal cutoff value of FFM, FM, and BMR could be calculated in the Asian population. Among these factors, BMR seemed a better predictor than others. The BMR could be a target for exercise intervention in postmenopausal women for maintaining or improving BMD.Trial registrationClinicalTrials.gov, NCT02936336. Retrospectively registered on13 October 2016.

Weight Regain and Breast Cancer-Related Biomarkers Following an Exercise Intervention in Postmenopausal Women.

Epidemiologic studies have reported associations between weight fluctuations and postmenopausal breast cancer risk; however, the biological markers involved in this association are unknown. This study aimed to explore the associations between breast cancer-related biomarkers and weight regain following exercise-induced weight loss. From the 400 participants included in the Breast Cancer and Exercise Trial in Alberta, a total of 214 lost weight during the intervention and had follow-up blood samples, body composition, and covariate measurements. Outcomes were measured at baseline, 12 months (end of the study), and 24 months (follow-up). During follow-up, weight regain was 1.80 kg [95% confidence interval (CI): -0.40-3.90], and was significantly associated with increases in estradiol [treatment effect ratio (TER) = 1.03; 95% CI, 1.01-1.04], estrone (TER = 1.02; 95% CI, 1.01-1.03), free estradiol (TER = 1.04; 95% CI, 1.02-1.05), the homeostatic model assessment for insulin resistance (TER = 1.03; 95% CI, 1.02-1.05), and insulin (TER = 1.03; 95% CI, 1.01-1.04), and decreases in sex hormone-binding globulin (SHBG; TER = 0.98; 95% CI, 0.97-0.99) levels. Nonstatistically significant associations were found for glucose and C-reactive protein. Furthermore, a statistically significant linear trend of increasing levels for all biomarkers, and decreasing SHBG, across weight regain categories was found. These results suggest that weight regain following exercise-induced weight loss is associated with breast cancer-related biomarker changes in postmenopausal women. These findings provide evidence to support the importance of developing effective strategies to prevent weight regain and, consequently, decrease postmenopausal breast cancer risk via changes in adiposity-related biomarkers.

Obesity among postmenopausal women: what is the best anthropometric index to assess adiposity and success of weight-loss intervention?

First, to establish the respective ability of body mass index (BMI), waist circumference (WC), and relative fat mass index (RFM), to estimate body fat (BF%) measured by DXA (DXA-BF%) and correctly identify postmenopausal women living with obesity (BF% > 35). Second, to identify the best indicator of successful weight-loss intervention in postmenopausal women living with obesity. A total of 277 women (age: 59.8 ± 5.3 y; BF%: 43.4 ± 5.3) from five weight-loss studies with complete data for anthropometric measurements [BMI = weight/height (kg/m2); WC (cm)] and BF% were pooled together. Statistical performance indicators were determined to assess ability of RFM [64-(20 × height/waist circumference) + (12 × sex)], BMI and WC to estimate BF% before and after weight-loss intervention and to correctly identify postmenopausal women living with obesity. Compared with RFM (r = 0.51; r2 = 0.27; RMSE = 4.4%; Lin's CCC = 0.46) and WC (r = 0.49; r2 = 0.25; RMSE = 4.8%; Lin's CCC = 0.41), BMI (r = 0.73; r2 = 0.52; RMSE = 3.7%; Lin's CCC = 0.71) was the best anthropometric index to estimate DXA-BF% and correctly identify postmenopausal women living with obesity (sensitivity + specificity: BMI = 193; RFM = 152; WC = 158), with lower misclassification error, before weight-loss intervention. After weight-loss, the change in BMI was strongly correlated with change in DXA-BF%, indicating that the BMI is the best indicator of success weight-loss intervention. In the absence of more objective measures of adiposity, BMI is a suitable proxy measure for BF% in postmenopausal women, for whom a lifestyle intervention is relevant. Furthermore, BMI can be used as an indicator to assess success of weight-loss intervention in this subpopulation.

Abstract PD11-02: Randomized trial of 12 months of omega-3 fatty acids vs placebo during a weight loss intervention in post-menopausal women at increased risk for breast cancer

Abstract Objectives: The primary objective was to determine tolerability of ω-3 fatty acids (2150 mg of eicosapentaenoic acid (EPA) and 1050 docosahexaenoic acid (DHA) ethyl esters) vs placebo in women in undergoing a behavioral weight loss intervention (6 months loss and 6 months maintenance). Secondary objectives were to explore potential differences in modulation of blood and benign breast tissue risk biomarkers, satiety and quality of life indices, and weight loss. Results: 46 peri and postmenopausal women were randomized and 42 completed the 6 months of the weight loss intervention and were biomarker evaluable (22 placebo and 20 ω-3 FA). Median baseline BMI in the 42 evaluable women was 31 kg/m2 with a median 6-month relative weight loss of 11% and relative fat mass loss of 20% (DXA). Median 12-month relative mass loss was 10% in the 35 women completing 12 months of the intervention. ω-3 fatty acids increased the ratio of (EPA+DHA): arachidonic acid 2.6-fold (median, range 1.8 - 3.8) vs no change for placebo. There was no difference by randomization group in relative weight or fat mass loss at 6 or 12 months, grade 2 and 3 adverse events, early discontinuation, satiety or other quality of life measures. More serum biomarkers exhibited significant within-group improvement at 6 and 12 months for evaluable women randomized to ω-3 FA than to placebo. At 6 months, significant change (P&amp;lt;0.05) was observed for adiponectin, leptin, adiponectin:leptin ratio, insulin, lipocalin-2, resistin, PAI-1, HGF, CRP, SHBG, and bioavailable testosterone in women randomized to ω-3 FA but only for leptin, adiponectin: leptin ratio and SHBG in those randomized to placebo. At 6 months, the 21 women who lost &amp;gt;10% weight (median 15%) showed significant within-group improvement in adiponectin, leptin, adiponectin:leptin ratio, insulin, lipocalin-2, resistin, PAI-1, HGF, CRP, SHBG, bioavailable estradiol and bioavailable testosterone. For women with &amp;lt;10% weight loss (median 6%) there was significant within-group improvement only for leptin, the adiponectin: leptin ratio, and SHBG. Little change was observed for inflammatory cytokines IL-6, TNF-alpha, MCP-1 or FABP4, or FGF-21 with ω-3 FA or &amp;gt;10% weight loss. Given the dramatic effect of weight loss on biomarkers, we examined within-group and between-group change from baseline to 6 and 12 months for the four subgroups (10-11 women in each) defined by ω-3 FA or placebo and &amp;lt; or &amp;gt; 10% weight loss at 6 months. The subgroup of &amp;gt;10% loss + ω-3 FA had the greatest within-group change in the proportion of significantly modulated biomarkers at 6 months. &amp;gt;10% loss + ω-3 FA was the only subgroup with a significant within-group increase in adiponectin at both 6 and 12 months and achievement of a beneficial ratio of adiponectin (ug/ml) to leptin (ng/ml) of &amp;gt; 1.0 in 100% of participants. There was a significant between-group effect for adiponectin for &amp;gt;10% loss + ω-3 FA vs each of the other groups. Biomarkers were assessed in tissue acquired by random periareolar fine needle aspiration (RPFNA). There were no significant differences in change in cytomorphology or Ki-67 between women randomized to ω-3 FA or placebo but there were significant within-group increases in benign breast adiponectin (pg/ug protein) at 12 months (p=0.014) for women randomized to ω-3 FA. Conclusions: EPA + DHA ethyl esters (3150 mg/day), added to a behavioral weight loss program in overweight women at increased risk for breast cancer, is well-tolerated and may further improve risk biomarker modulation. The increase in adiponectin when ω-3 FA is added to weight loss is of particular interest given that adiponectin opposes the oncogenic effect of leptin and is associated with improved insulin sensitivity and reduced mTOR signaling. Further study is warranted with enough subjects to detect between-group differences. Citation Format: Carol J Fabian, Christie A Befort, Debra K Sullivan, Susan E Carlson, Jennifer L Nydegger, Amy L Kreutzjans, Kandy R Powers, Teresa A. Phillips, Trina Metheny, Carola M Zalles, Erin D Giles, Stephen D Hursting, Bruce F Kimler. Randomized trial of 12 months of omega-3 fatty acids vs placebo during a weight loss intervention in post-menopausal women at increased risk for breast cancer [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PD11-02.

Mini-Trampoline Jumping as an Exercise Intervention in Postmenopausal Women to Improve Women Specific Health Risk Factors.

Background:Women tend to outlive men and are at higher risks of functional disability compared to men. Specifically, women are more likely to develop conditions like osteoporosis and stress urinary incontinence which can further increase the risk of functional disability. Regular physical activity and/or exercise programs can minimize the physiological decline that occurs during aging and can improve overall physical fitness, bone health, and pelvic floor muscle function; however, exercise programs tend to focus on only one parameter. Mini-trampoline jumping is a highly beneficial low-impact aerobic exercise capable of improving aerobic fitness, balance, muscle strength, and potentially bone health as well as pelvic floor muscle functioning. The aim of the proposed research project is to examine the benefits of a 3-month mini-trampoline exercise intervention on physical fitness, bone health, and pelvic floor muscle functioning in postmenopausal women.Methods:Fifty postmenopausal healthy women aged 50–69 years will be recruited. Assessments on physical fitness (aerobic fitness, walking speed, balance, lower extremity strength, flexibility), bone health, and pelvic floor muscle functioning will occur within 1 week before and after the exercise intervention, including a 3-month follow-up assessment. The exercise intervention will last 12 weeks, with three sessions of 40 min each per week.Conclusions:The proposed research has the potential to improve functional ability and women-specific risk factors in older women with an innovative and fun exercise program.

Feasibility, safety and effectiveness of a pilot 16-week home-based, impact exercise intervention in postmenopausal women with low bone mineral density.

The feasibility and efficacy of impact exercise in postmenopausal women with low bone mineral density (BMD) are unclear. We aimed to determine adherence, safety and changes in BMD, bone microarchitecture and physical function following a pilot home-based, impact exercise intervention in postmenopausal women with low BMD. Fifty community-dwelling postmenopausal women with BMD T-scores < - 1.0 participated in 16 weeks of home-based impact exercise progressively increasing to 50 multi-directional unilateral hops on each leg daily. Bone density and structure were assessed by lumbar spine and hip dual-energy X-ray absorptiometry (DXA), 3D modelling (3D-SHAPER) of hip DXA scans and distal tibial high-resolution peripheral quantitative computed tomography scans. Physical performance was assessed by repeated chair stand time and stair climb time. Forty-four women (mean ± SD age 64.5 ± 7.5 years) completed the intervention, with adherence of 85.3 ± 17.3%. Reasons for withdrawal were related soreness (n = 2), unrelated injury (n = 1) and loss of interest (n = 3). Femoral neck areal BMD increased by 1.13 ± 3.76% (p = 0.048). Trabecular volumetric BMD (vBMD) increased at the total hip (2.27 ± 7.03%; p = 0.038) and femoral neck increased (3.20 ± 5.39%; p < 0.001). Distal tibia total vBMD increased by 0.32 ± 0.88% (p = 0.032) and cortical cross-sectional area increased by 0.55 ± 1.54% (p = 0.034). Chair stand and stair climb time improved by 2.34 ± 1.88 s (p < 0.001) and 0.27 ± 0.49 s (p < 0.001), respectively. A 16-week home-based, impact exercise was feasible and may be effective in improving femoral neck areal BMD, total hip and distal tibial vBMD and physical function in postmenopausal women. Appropriately designed randomised controlled trials are now required to determine whether such interventions can reduce fracture risk in older populations.

Effects of isoflavone interventions on bone mineral density in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials.

This study aimed to determine the efficacy of isoflavone interventions on bone density outcomes and the safety of isoflavone interventions in postmenopausal women by means of systematic review and meta-analysis. A systematic search was performed on three databases (PubMed, Scopus, and Cochrane Library). Included studies were limited to randomized controlled trials (RCTs) assessing the effects of isoflavone intervention on bone mineral density (BMD) in postmenopausal women. Mean difference (MD) in BMD or relative risk for adverse outcomes was used as a summary effect measure; pooled-effect estimates were calculated using a random-effects model. A total of 63 RCTs, involving 6427 postmenopausal women, were included in the meta-analysis. Statistically significant differences in BMD at the last follow-up visit between the two groups (isoflavones vs. control) were found at the lumbar spine (MD = 21.34 mg/cm2, 95% CI = 8.21 to 34.47 mg/cm2, p = 0.001), the femoral neck (MD = 28.88 mg/cm2, 95% CI = 15.05 to 42.71 mg/cm2, p < 0.0001), and the distal radius (MD = 19.27 mg/cm2, 95% CI = 5.65 to 32.89 mg/cm2, p = 0.006). The positive effects in improved BMD were primarily associated with two formulations, i.e., genistein 54 mg/day and ipriflavone 600 mg/day. Isoflavone interventions were generally safe and well tolerated. Isoflavone interventions, genistein (54 mg/day) and ipriflavone (600 mg/day) in particular, have beneficial effects on BMD outcomes and are safe in postmenopausal women. They may be considered as a complementary or alternative option in the prevention and treatment of menopause-related osteoporosis.

Does resistance training have an effect on levels of ferritin and atherogenic lipids in postmenopausal women? \u2013 A pilot trial

The objective of this study was to determine if 15 weeks of resistance training (RT) can alter the levels of blood lipids, body iron status, and oxidative stress in postmenopausal women with vasomotor symptoms. Postmenopausal women enrolled in a randomised controlled trial were allocated to either a sedentary control group (n = 29) or a RT group (n = 26). Blood samples were taken at week-0 and week-15 for all participants. Blood lipids and iron status were measured via routine clinical analyses. Immunoassays were used to measure oxidative stress markers. The RT group, with good compliance, was associated with significant reductions in ferritin, total cholesterol, low-density lipoprotein, and non-high-density lipoprotein cholesterol. Moreover, ferritin was positively correlated with atherogenic lipids while negatively correlated with high-density lipoprotein in RT women. This occurred without alterations in serum iron, transferrin, transferrin-saturation, C-reactive protein and oxidative stress markers. No differences were found in control women. This study suggests that RT in postmenopausal women both reduces levels of ferritin and counteracts atherogenic lipid profiles independent of an apparent oxidative mechanism. RT may be a beneficial intervention in postmenopausal women via an interaction between ferritin and lipids; however, further investigation in a larger cohort is essential.

Eating behaviors and weight loss outcomes in a 12-month randomized trial of diet and/or exercise intervention in postmenopausal women

BackgroundCertain eating behaviors are common among women with obesity. Whether these behaviors influence outcomes in weight loss programs, and whether such programs affect eating behaviors, is unclear.MethodsOur aim was to examine the effect of baseline eating behaviors on intervention adherence and weight among postmenopausal women with overweight or obesity, and to assess intervention effects on eating behaviors.Four hundred and 39 women (BMI ≥25 kg/m2) were randomized to 12 months of: i) dietary weight loss with a 10% weight loss goal (‘diet’; n = 118); ii) moderate-to-vigorous intensity aerobic exercise for 225 mins/week (‘exercise’; n = 117); iii) combined dietary weight loss and exercise (‘diet + exercise’; n = 117); or iv) no-lifestyle change control (n = 87). At baseline and 12 months, restrained eating, uncontrolled eating, emotional eating and binge eating were measured by questionnaire; weight and body composition were assessed. The mean change in eating behavior scores and weight between baseline and 12 months in the diet, exercise, and diet + exercise arms were each compared to controls using the generalized estimating equation (GEE) modification of linear regression adjusted for age, baseline BMI, and race/ethnicity.ResultsBaseline restrained eating was positively associated with change in total calories and calories from fat during the dietary intervention but not with other measures of adherence. Higher baseline restrained eating was associated with greater 12-month reductions in weight, waist circumference, body fat and lean mass. Women randomized to dietary intervention had significant reductions in binge eating (− 23.7%, p = 0.005 vs. control), uncontrolled eating (− 24.3%, p < 0.001 vs. control), and emotional eating (− 31.7%, p < 0.001 vs. control) scores, and a significant increase in restrained eating (+ 60.6%, p < 0.001 vs. control); women randomized to diet + exercise reported less uncontrolled eating (− 26.0%, p < 0.001 vs. control) and emotional eating (− 22.0%, p = 0.004 vs. control), and increased restrained eating (+ 41.4%, p < 0.001 vs. control). Women randomized to exercise alone had no significant change in eating behavior scores compared to controls.ConclusionsA dietary weight loss intervention helped women modify eating behaviors. Future research should investigate optimal behavioral weight loss interventions for women with both disordered eating and obesity.Trial registrationNCT00470119 (https://clinicaltrials.gov). Retrospectively registered May 7, 2007.

Impact of calcium, vitamin D, vitamin K, oestrogen, isoflavone and exercise on bone mineral density for osteoporosis prevention in postmenopausal women: a network meta-analysis

AbstractThe aim of this network meta-analysis is to compare bone mineral density (BMD) changes among different osteoporosis prevention interventions in postmenopausal women. We searched MEDLINE, Embase and Cochrane Library from inception to 24 February 2019. Included studies were randomised controlled trials (RCT) comparing the effects of different treatments on BMD in postmenopausal women. Studies were independently screened by six authors in three pairs. Data were extracted independently by two authors and synthesised using Bayesian random-effects network meta-analysis. The results were summarised as mean difference in BMD and surface under the cumulative ranking (SUCRA) of different interventions. A total of ninety RCT (10 777 participants) were included. Ca, vitamin D, vitamin K, oestrogen, exercise, Ca + vitamin D, vitamin D + vitamin K and vitamin D + oestrogen were associated with significantly beneficial effects relative to no treatment or placebo for lumbar spine (LS). For femoral neck (FN), Ca, exercise and vitamin D + oestrogen were associated with significantly beneficial intervention effects relative to no treatment. Ranking probabilities indicated that oestrogen + vitamin D is the best strategy in LS, with a SUCRA of 97·29 % (mean difference: +0·072 g/cm2 compared with no treatment, 95 % credible interval (CrI) 0·045, 0·100 g/cm2), and Ca + exercise is the best strategy in FN, with a SUCRA of 79·71 % (mean difference: +0·029 g/cm2 compared with placebo, 95 % CrI –0·00093, 0·060 g/cm2). In conclusion, in postmenopausal women, many interventions are valuable for improving BMD in LS and FN. Different intervention combinations can affect BMD at different sites diversely.

General characteristics of anemia in postmenopausal women and elderly men

In present study, we aimed to investigate anemia etiologies, underlying causes, laboratory markers of anemia, required interventions in postmenopausal women and elderly men. The medical data of the anemic subjects were recorded from the patients' files and computerized database of the institution and retrospectively analyzed. Study population grouped into two according to the gender; men and women. Medical data of men and women were compared. A total of 113 subjects enrolled to the study; 78 women and 35 men. 51 (65%) of women and 21 (60%) of men had iron deficiency anemia, 5 (6.4%) of women and 1 (2.9%) of men had anemia of chronic disease, 2 (2.6%) of women and 10 (28.6%) of men had vitamin B12 deficiency anemia. Forty seven (60.3%) of the women and 30 (85.7%) of the men had comorbidities. 47% of colonoscopies were normal in study population (44% of women and 50% of men). Etiology and causes of anemia should be carefully investigated in subjects with advanced age. Physicians should kept in mind that B12 deficiency and comorbidities were more common in elderly men and about half of the colonoscopy procedures in this population is unnecessary.

PO-237 MSTN gene polymorphism influence on WBV-induced changes on body composition in Chinese postmenopausal women

Objective To explore the association between MSTN rs3791783 polymorphism and body composition response to 3-month whole body vibration (WBV) intervention in postmenopausal women and to probe into the molecular regulatory mechanisms behind it.&#x0D; Methods A total of 90 postmenopausal women participated in the study, and 30 of them served as non-trained control group, 60 of them trained on a vibration platform for 3 months. Body composition included FM% (percentage of fat mass) and LM% were assessed by dual-energy X-ray absorptiometry at the baseline and 3 months. The rs3791783 polymorphism was genotyped by PCR–restriction fragment length polymorphism, and association analysis with the body composition changes induced-by WBV training was performed. The regulatory mechanisms of the rs3791783 polymorphism were explored through the dual-luciferase reporter assay.&#x0D; Results In the WBV group, LM% significant increased through 3-month WBV training (60.87±5.35, 61.63±5.05, P&lt;0.05), meanwhile, FM% significant decreased (35.65±5.47, 34.86±5.16, P&lt;0.05). In the CON group, no significant difference within group was detected in LM% and FM%, and significant group by time interactions were found in LM% and FM% (P &lt;0.05). The subjects with an AA allele had significantly greater increase in LM% (60.27±5.28, 61.42±4.93, P&lt;0.01) and decreases in FM% (36.35±5.35, 35.18±4.99, P&lt;0.01) than those with GA allele (61.97±5.72, 62.13±5.59, P&gt;0.05; 34.38±5.90, 34.19±5.79, P&gt;0.05). The relative luciferase activity of the reporter gene in recombinant vector carrying the A allele was 3.302±1.121, markedly higher than that in recombinant vector carrying the G allele (1.760±0.920, p&lt;0.05).&#x0D; Conclusions Three-month WBV training is beneficial for body composition among postmenopausal women and the individual with AA genotype of the rs3791783 polymorphism were more sensitive to WBV-induced body composition changes. The A allele can improve reporter gene expression level, indicating the effects of rs3791783 on gene expression.&#x0D;