Overweight Postmenopausal Women Research Articles

Green tea extract and catechol-O-methyltransferase genotype modify the post-prandial serum insulin response in a randomised trial of overweight and obese post-menopausal women.

Green tea extract (GTE) may be involved in a favourable post-prandial response to high-carbohydrate meals. The catechol-O-methyltransferase (COMT) genotype may modify these effects. We examined the acute effects of GTE supplementation on the post-prandial response to a high-carbohydrate meal by assessing appetite-associated hormones and glucose homeostasis marker concentrations in women who consumed 843mg of (-)-epigallocatechin-3-gallate (EGCG) or placebo capsules for 11-12months. Sixty Caucasian post-menopausal women (body mass index≥25.0kgm-2 ) were included in a randomised, double-blind feeding study. GTE was consumed with a breakfast meal [2784.0kJ (665.4kcal); 67.2% carbohydrate]. Blood samples were drawn pre-meal, post-meal, and every 30min for 4h. Participants completed six satiety questionnaires. Plasma leptin, ghrelin and adiponectin did not differ between GTE and placebo at any time point; COMT genotype did not modify these results. Participants randomised to GTE with the high-activity form of COMT (GTE-high COMT) had higher insulin concentrations at time 0, 0.5 and 1.0h post-meal compared to all COMT groups randomised to placebo. Insulin remained higher in the GTE-high COMT group at 1.5, 2.0 and 2.5h compared to Placebo-low COMT (P<0.02). GTE-high COMT had higher insulin concentrations at times 0, 0.5, 1.0, 1.5 and 2.0h compared to the GTE-low COMT (P≤0.04). Area under the curve measurements of satiety did not differ between GTE and placebo. GTE supplementation and COMT genotype did not alter acute post-prandial responses of leptin, ghrelin, adiponectin or satiety, although it may be involved in post-meal insulinaemic response of overweight and obese post-menopausal women.

Dietary Weight Loss and Exercise Effects on Serum Biomarkers of Angiogenesis in Overweight Postmenopausal Women: A Randomized Controlled Trial.

Obese and sedentary persons have an increased risk for cancer, but underlying mechanisms are poorly understood. Angiogenesis is common to adipose tissue formation and remodeling, and to tumor vascularization. A total of 439 overweight/obese, healthy, postmenopausal women [body mass index (BMI) > 25 kg/m(2)] ages 50-75 years, recruited between 2005 and 2008 were randomized to a 4-arm 12-month randomized controlled trial, comparing a caloric restriction diet arm (goal: 10% weight loss, N = 118), aerobic exercise arm (225 minutes/week of moderate-to-vigorous activity, N = 117), a combined diet + exercise arm (N = 117), or control (N = 87) on circulating levels of angiogenic biomarkers. VEGF, plasminogen activator inhibitor-1 (PAI-1), and pigment epithelium-derived factor (PEDF) were measured by immunoassay at baseline and 12 months. Changes were compared using generalized estimating equations, adjusting for baseline BMI, age, and race/ethnicity. Participants randomized to the diet + exercise arms had statistically significantly greater reductions in PAI-1 at 12 months compared with controls (-19.3% vs. +3.48%, respectively, P < 0.0001). Participants randomized to the diet and diet + exercise arms had statistically significantly greater reductions in PEDF (-9.20%, -9.90%, respectively, both P < 0.0001) and VEGF (-8.25%, P = 0.0005; -9.98%, P < 0.0001, respectively) compared with controls. There were no differences in any of the analytes in participants randomized to the exercise arm compared with controls. Increasing weight loss was statistically significantly associated with linear trends of greater reductions in PAI-1, PEDF, and VEGF. Weight loss is significantly associated with reduced circulating VEGF, PEDF, and PAI-1, and could provide incentive for reducing weight as a cancer prevention method in overweight and obese individuals. Cancer Res; 76(14); 4226-35. ©2016 AACR.

Overweight postmenopausal women with different plasma estradiol concentrations present with a similar pattern of energy expenditure and substrate oxidation rate before and after a fatty meal challenge

Menopause-related withdrawal of ovarian estrogens is associated with reduced energy metabolism and overall impairment of substrate oxidation. Estradiol's withdrawal after menopause is associated with a reduction in energy metabolism and impaired substrate oxidation, which contributes to weight gain and visceral fat accumulation. Here we aimed to investigate the association between plasma estradiol concentrations and energy expenditure (EE)/substrate oxidation in a group of overweight postmenopausal women before and after a fatty meal challenge. Women were divided into three groups according to their plasma estradiol concentrations (E2): group 1 - E2≤39, group 2 - 40≤E2≤59, and group 3 - E2≥60pg/mL. VO2 and VCO2 volumes were collected following indirect calorimetry 5h following a single lipid overload meal (1100kcal, 72% of fat). For comparisons between groups and within the same group, a linear regression model with mixed effects was applied (P<0.05). Forty-four women aged 55±0.7 years-old, 8±1.1 years following menopause, with a BMI of 30.5±0.5kg/m2, and 41.9±0.7% of body fat were enrolled the study. Plasma E2 concentrations were: group 1 - 30.4±1.9, group 2 - 46.9±1.5, and group 3 - 91.3±12.0pg/mL (P<0.0001). EE at baseline and in the resting state was 1320±24.3kcal/d, and increased to 1440±27.0kcal/d 30min following ingestion of the fatty meal (P<0.0001), and rose again to an average of 1475±30.3kcal/d at the completion of experiment (P<0.0001). Carbohydrate oxidation (Chox) was 0.155±0.01g/min at resting, maintained as 0.133±0.00g/min 30min after ingestion of the fatty meal, and was 0.123±0.01g/min at the end of the testing period. Lipid oxidation (Lipox) was 0.041±0.003g/min at resting, increasing to 0.054±0.003g/min at 30min (P=0.01), and reaching 0.063±0.003g/min at the end of the experiment (P<0.0001). There was no difference between groups for EE, Chox or Lipox. Our data suggest that EE and substrate oxidation were modulated following a lipid-meal challenge equally in all groups and this did not differ with plasma E2 concentrations.

Effect of Weight Loss with or without Exercise on Inflammatory Markers and Adipokines in Postmenopausal Women: The SHAPE-2 Trial, A Randomized Controlled Trial.

We investigated the effect of equivalent weight loss, by a hypocaloric diet or mainly exercise, on inflammatory markers and adipokines in overweight postmenopausal women. Women were randomized to a diet (n = 97), mainly exercise (n = 98), or control group (n = 48). Goal of both interventions was to lose 5 to 6 kg bodyweight by a hypocaloric diet or an exercise program (4 hours/week) combined with a small caloric intake restriction. Outcomes after 16 weeks included serum high-sensitive C-reactive protein (hsCRP), IL6, adiponectin, and leptin. Both intervention groups achieved the target weight loss. Controls remained weight stable. Compared with control, hsCRP decreased with mainly exercise [treatment effect ratio (TER) = 0.64] and borderline statistically significant with diet (TER = 0.77). There was a suggestively larger effect of exercise, directly compared with diet (TER = 0.83). Leptin decreased with both interventions: mainly exercise (TER = 0.55) and diet (TER = 0.59), versus control. Effects attenuated and lost significance after adjusting for change in body fat percentage, and to a lesser extent when adjusting for fitness. No effects were seen on IL6 and adiponectin. A 16-week randomized intervention inducing comparable weight loss by a hypocaloric diet or mainly exercise, resulted in favorable effects on serum hsCRP and leptin. We found a possible more beneficial effect on hsCRP with mainly exercise versus diet. These effects of exercise were established by changes in body fat percentage and physical fitness. A modest amount of weight loss in postmenopausal women reduces hsCRP and leptin levels which might be associated with a lower breast cancer risk. Cancer Epidemiol Biomarkers Prev; 25(5); 799-806. ©2016 AACR.

Short-term Exercise Effects on the Arterial Stiffness of Overweight Postmenopausal Women

Short-term Exercise Effects on the Arterial Stiffness of Overweight Postmenopausal Women

Effects of Vitamin D3 Supplementation on Lean Mass, Muscle Strength, and Bone Mineral Density During Weight Loss: A Double-Blind Randomized Controlled Trial.

To compare the effects of 12 months of vitamin D3 supplementation with that placebo on lean mass, bone mineral density (BMD), and muscle strength in overweight or obese postmenopausal women completing a structured weight-loss program. Double-blind, placebo-controlled randomized clinical trial. Fred Hutchinson Cancer Research Center, Seattle, Washington. Postmenopausal women aged 50 to 75 with a body mass index (BMI) of 25 kg/m(2) or greater and a serum 25-hydroxyvitamin D (25(OH)D) concentration between 10.0 and 32.0 ng/mL (insufficient) (N = 218). Oral vitamin D3 2,000 IU/d or placebo in combination with a lifestyle-based weight loss intervention consisting of a reduction of 500 kcal to 1,000 kcal per day and 225 min/wk of moderate- to vigorous-intensity aerobic exercise. Serum 25(OH)D, body composition, and muscle strength were measured before randomization (baseline) and at 12 months. Mean changes of the groups were compared (intention to treat) using generalized estimating equations. Change in 25(OH)D was significantly different between the vitamin D and placebo groups at 12 months (13.6 ng/mL vs -1.3 ng/mL, P < .001), but no differences in change in lean mass (-0.8 kg vs -1.1 kg, P = .53) or BMD of the spine (-0.01 g/cm(2) vs 0.0 g/cm(2) , P = .82) or right femoral neck (both -0.01 g/cm(2) , P = .49) were detected between the groups. Leg strength decreased in the vitamin D group but not in the placebo group (-2.6 pounds vs 1.8 pounds, P = .03). In women randomized to vitamin D, achieving repletion (25(OH)D ≥ 32 ng/mL) did not alter results. Vitamin D3 supplementation during weight-loss decreased leg strength but did not alter changes in lean mass or BMD in postmenopausal women with vitamin D insufficiency.

Green tea extract and catechol‐O‐methyltransferase (COMT) genotype modify fasting serum insulin and plasma adiponectin concentrations in a randomized controlled trial of overweight and obese postmenopausal women.

BackgroundGreen tea consumption has been associated with favorable changes in body weight and obesity‐related hormones, though it is unknown if this is due to green tea polyphenols or caffeine.ObjectiveWe examined the impact of decaffeinated green tea extract (GTE) containing 843 mg (−)‐epigallocatechin‐3‐gallate (EGCG) on anthropometric variables, obesity‐associated hormones, and glucose homeostasis.MethodsThe Minnesota Green Tea Trial was a 12‐month randomized, double‐blind, placebo‐controlled clinical trial of 937 healthy postmenopausal women assigned to either GTE or placebo based on catechol‐O‐methyltransferase (COMT) genotype. This study was conducted in a subset of 237 overweight and obese participants (BMI ≥ 25 kg/m2).ResultsNo changes in energy intake, body weight, BMI, or waist circumference (WC) were observed over 12 months in women taking GTE (n=117) or placebo (n=120). No differences were seen in circulating leptin, ghrelin, adiponectin, or glucose concentrations at month 12. Participants randomized to GTE with baseline insulin ≥10 μIU/mL (n=23) showed a decrease in fasting serum insulin from baseline to month 12 (−1.43 ± 0.59 μIU/mL), while those randomized to placebo with baseline insulin ≥10 μIU/mL (n = 19) showed an increase in insulin over 12 months (0.55 ± 0.64 μIU/mL; P &lt; 0.01). Participants with the homozygous high‐activity (G/G) form of COMT showed significantly lower adiponectin (5.97 ± 0.50 vs. 7.58 ± 0.53 μg/mL, P = 0.03) and increased insulin concentrations (7.63 ± 0.53 vs. 6.18 ± 0.36 μIU/mL, P = 0.02) at month 12 as compared to those with the low‐activity (A/A) genotype, regardless of treatment group.ConclusionsDecaffeinated GTE was not associated with reductions in body weight, BMI, or WC and did not alter energy intake or mean hormone concentrations in healthy postmenopausal women over 12 months. GTE decreased fasting insulin concentrations in those with elevated baseline fasting concentrations. The high‐activity form of the COMT enzyme may be associated with elevations in insulin and reduction in adiponectin concentrations over time. This clinical trial was registered at http://www.clinicaltrials.gov as NCT00917735.Support or Funding InformationResearch reported in this publication was supported by the National Institutes of Health/National Cancer Institute grant R01 CA127236, Award Number T32CA132670 from the National Cancer Institute, the Department of Defense/U.S. Army Medical Research and Materiel Command Award Number W81XWH‐11‐1‐0013, the University of Minnesota Graduate School Doctoral Dissertation Fellowship, the University of Minnesota Agricultural Experiment Station Project Number MIN‐18‐103, and the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1TR000114. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health. The funding sources and study supplement provider did not contribute to the design or conduct of the study, nor to the writing or submission of this manuscript.

Amelioration of Cardiometabolic Risk Factors With a Pecan‐rich Diet in Overweight and Obese Adults

Evidence from in vitro and observational studies indicates tree nuts may reduce the risk of cardiovascular diseases (CVD) and type 2 diabetes mellitus (T2DM), though support from controlled feeding trials is limited. Most nut intervention studies to date have counseled subjects to incorporate nuts into their usual diet, an approach that can neither control for inter‐individual variability in the background diet, nor fully account for the intake of other food/beverage components that can influence CVD and T2DM risk, e.g., antioxidants, fatty acids, and fiber. We conducted a 12 wk randomized, controlled, cross‐over feeding trial to examine the effects of pecans in overweight and obese men and postmenopausal women ≥45 y with central adiposity. Subjects (n=25) were randomized to either a diet resembling the average American diet (control) or the same diet with whole pecans (intervention) incorporated at ~15% of energy (1.5 oz/2000 kcal) for 4 wk, and then the opposite diet for the final 4 wk. Total fat and fiber in these isocaloric diets were similar, and all meals/snacks were provided. During the 2 wk run‐in and 4 wk washout periods, subjects were counseled to consume the control diet. A multivariate multilevel model was used to simultaneously analyze change in z‐scores of insulin, glucose, total cholesterol, triglycerides, and LDL. An interim analysis (n=18) yielded a mean increase of 0.11 SD in the control arm and a decrease of 0.23 SD in the intervention arm (mean difference between arms = 0.34 SD, P=0.047). Although differences in favor of the intervention arm were observed for all individual cardiometabolic risk factors, the sample size was too small for them to reach statistical significance. Preliminary evidence suggests a pecan‐rich diet may have a benefit in modifying cardiometabolic risk factors.Support or Funding InformationSupported by USDA and the National Pecan Shellers Association

Acute renal effects of the GLP-1 receptor agonist exenatide in overweight type 2 diabetes patients: a randomised, double-blind, placebo-controlled trial.

Aims/hypothesisThis study aimed to investigate the acute renal effects of the glucagon-like peptide-1 receptor agonist (GLP-1RA) exenatide in type 2 diabetes patients.MethodsWe included overweight (BMI 25–40 kg/m2) men and postmenopausal women, aged 35–75 years with type 2 diabetes (HbA1c 48–75 mmol/mol; 6.5–9.0%) and estimated GFR ≥ 60 ml min−1 1.73 m−2. Exenatide or placebo (NaCl solution, 154 mmol/l) was administrated intravenously in an acute, randomised, double-blind, placebo-controlled trial conducted at the Diabetes Center VU University Medical Center (VUMC). GFR (primary endpoint) and effective renal plasma flow (ERPF) were determined by inulin and para-aminohippurate clearance, respectively, based on timed urine sampling. Filtration fraction (FF) and effective renal vascular resistance (ERVR) were calculated, and glomerular hydrostatic pressure (PGLO) and vascular resistance of the afferent (RA) and efferent (RE) renal arteriole were estimated. Tubular function was assessed by absolute and fractional excretion of sodium (FENa), potassium (FEK) and urea (FEU), in addition to urine osmolality, pH and free water clearance. Renal damage markers, BP and plasma glucose were also determined.ResultsOf the 57 patients randomised by computer, 52 were included in the final analyses. Exenatide (n = 24) did not affect GFR (mean difference +2 ± 3 ml min−1 1.73 m−2, p = 0.489), ERPF, FF, ERVR or PGLO, compared with placebo (n = 28). Exenatide increased RA (p < 0.05), but did not change RE. Exenatide increased FENa, FEK, urine osmolality and pH, while FEU, urinary flow and free water clearance were decreased (all p < 0.05). Osmolar clearance and renal damage makers were not affected. Diastolic BP and mean arterial pressure increased by 3 ± 1 and 6 ± 2 mmHg, respectively, whereas plasma glucose decreased by 1.4 ± 0.1 mmol/l (all p < 0.05).Conclusions/interpretationExenatide infusion does not acutely affect renal haemodynamics in overweight type 2 diabetes patients at normal filtration levels. Furthermore, acute GLP-1RA administration increases proximal sodium excretion in these patients.Trial registrationClincialTrials.gov NCT01744236FundingThe research leading to these results has been funded from: (1) the European Community’s Seventh Framework Programme (FP7/2007-2013) under grant agreement number 282521 – the SAFEGUARD project; and (2) the Dutch Kidney Foundation, under grant agreement IP12.87.Electronic supplementary materialThe online version of this article (doi:10.1007/s00125-016-3938-z) contains peer-reviewed but unedited supplementary material, which is available to authorised users.

Abstract C44: Cancer staging and body mass index in Latina breast cancer survivors

Abstract Introduction: Cancer stage is one of the strongest predictors of survival in patients with breast cancer. Body mass index (BMI), is used to assess body weight and size, and is associated with cancer incidence, prognosis, and mortality. More advanced stages of breast cancer are observed in overweight postmenopausal women. The association of cancer staging with BMI has not been investigated in Latino women. Breast cancer is more common among white women, but Latino women experience poorer breast cancer outcomes, a later stage at presentation of breast cancer, and an increased risk of death from breast cancer. Comorbidities related to obesity that are detrimental to cancer prognosis are more prevalent among Latinas compared to their white counterpart. The purpose of this study was to examine the association between BMI and stage at presentation of breast cancer in Latino women diagnosed with breast cancer. Methods: Eligible participants (n=40; including 16 premenopausal and 24 postmenopausal cases) included sedentary Latino women diagnosed with stage I-III breast cancer who were enrolled in a larger ongoing exercise intervention trial. Height and weight measurements were collected at baseline (within 6 months from the completion of chemotherapy and/or radiation) and used to calculate BMI (kg/m2). BMI was categorized into the following classifications based on the World Health Organization: underweight (&amp;lt;18.5), normal (18.5-24.9), and overweight (25-29.9), and obese (&amp;gt;30). Cancer stage at presentation was obtained from medical records at the time of study enrollment. Chi-square analysis was used to explore the associations between stage and BMI. Results: Average BMI for the study population was 30.7±5.1 kg/m2. Frequency of cancer staging is as follows; 19- Stage I, 13- Stage II, and 8- Stage III. Study participants categorized with a normal BMI (n=5) included: 60% Stage I and 40% Stage II. Participants categorized as overweight (n=15) included: 40% Stage I, 26.7% Stage II, and 33.3% Stage III. Participants categorized as obese (n=20) included: 50% Stage I, 35% Stage II, and 15% Stage III. No association was found between cancer stage and BMI (p=0.52). Results did not differ based on menopausal status. Conclusion: The results of this exploratory study found no significant association between cancer stage and BMI in Latino women diagnosed with breast cancer. As the majority of study participants were classified as overweight and obese, the distribution of BMI may have led to the negative results. Further investigations should continue in this area to determine whether this association exists in a larger sample of Latino women diagnosed with breast cancer. Citation Format: Breanna Orozco, Joanne E. Mortimer, Darcy Spicer, Debu Tripathy, Christina M. Dieli-Conwright. Cancer staging and body mass index in Latina breast cancer survivors. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr C44.

ZumBeat: Evaluation of a Zumba Dance Intervention in Postmenopausal Overweight Women

Physical inactivity is a major public health concern since it increases individuals’ risk of morbidity and mortality. A subgroup at particular risk is postmenopausal overweight women. The aim of this study was to assess the feasibility and effect of a 12-week ZumBeat dance intervention on cardiorespiratory fitness and psychosocial health. Postmenopausal women with a body mass index (BMI) >30 kg/m2 or a waist circumference >94 cm who were not regularly physically active were asked to complete a 12-week ZumBeat dance intervention with instructed and home-based self-training sessions. Before and after the intervention, peak oxygen consumption (VO2peak) was assessed on a treadmill; and body composition and several psychometric parameters (including quality of life, sports-related barriers and menopausal symptoms) were investigated. Of 17 women (median age: 54 years; median BMI: 30 kg/m2) enrolled in the study, 14 completed the study. There was no apparent change in VO2peak after the 12-week intervention period (average change score: −0.5 mL/kg/min; 95% confidence interval: −1.0, 0.1); but, quality of life had increased, and sports-related barriers and menopausal symptoms had decreased. A 12-week ZumBeat dance intervention may not suffice to increase cardiorespiratory fitness in postmenopausal overweight women, but it increases women’s quality of life.

Effects of a 6-week Nordic walking training on changes in 25(OH)D blood concentration in women aged over 55.

Nordic walking is a form of physical activity recommended for people of all ages and it is used in disease prevention and health promotion. The study was aimed to determine if and in what ways a six-week Nordic walking training program in late autumn may affect 25(OH)D concentration in postmenopausal overweight women. Two series of measurements were carried out in a group of 17 women aged 57±4.20 years with low physical activity level. The first series encompassed a 6-week Nordic walking training program at the intensity of 60-70% VO2max. Before and after the training program body composition was determined with a densitometer, and biochemical indices were measured in blood samples drawn at rest. After a year a second series of measurements at rest was carried out to determine whether changes in the vitamin D (25(OH)D) blood level were season-induced or modified by physical activity. The Nordic walking training program contributed to a significant reduction of body mass, percentage fat volume and BMI in the examined women. The mean 25(OH)D concentration in the examined women significantly decreased after 6 weeks of training. No similar vitamin D level changes were observed in the II measurement series. A six-week Nordic walking training program in late autumn contributed to the lowering of 25(OH)D blood concentration in women after 55 years of age. The decreased 25(OH)D concentration may have been a result of reduced dermal biosynthesis of vitamin D or due to vitamin D contribution to muscle metabolism. This is an indication that vitamin D3 supplementation should be recommended in periods of intense physical activity during months with little insolation, especially to overweight postmenopausal women.

The Impact of Long-Term Physical Activity Interventions for Overweight/Obese Postmenopausal Women on Adiposity Indicators, Physical Capacity, and Mental Health Outcomes: A Systematic Review.

Physical activity interventions have recently become a popular strategy to help postmenopausal women prevent and manage obesity. The current systematic review evaluates the efficacy of physical activity interventions among overweight and obese postmenopausal women and sheds light on the behavioral change techniques that were employed in order to direct future research. Method. Five electronic databases were searched to identify all prospective RCT studies that examine the impact of physical activity on adiposity indicators, physical capacity, and/or mental health outcomes among healthy, sedentary overweight, and obese postmenopausal women in North America. The behavior change technique taxonomy was used to identify the various strategies applied in the programs. Results. Five RCTs met the inclusion criteria. The findings showed that adiposity indicators and physical capacity outcomes significantly improved following long-term interventions; however, mental health outcomes showed nonsignificant changes. Furthermore, 17 behavior change techniques were identified with the taxonomy across all trials. The intrapersonal-level techniques were the most common. Conclusion. Physical activity interventions had a positive effect on adiposity measures and physical capacity. Future research should focus on testing the effectiveness of physical activity interventions on mental health and incorporate strategies at the individual and environmental level to maximize the health impact on the population.

Assessment of Nutritional Status and Antioxidant Intake in Obesity and Overweight Postmenopausal Women: A Pilot Trial

Assessment of Nutritional Status and Antioxidant Intake in Obesity and Overweight Postmenopausal Women: A Pilot Trial

Body Mass Index Is Positively Associated with Endometrial Cancer in Chinese Women, Especially Prior to Menopause.

Objective: Obesity is a well-known risk factor for developing endometrial cancer. However, the incidence and survival rate of endometrial cancer are associated with ethnicity and geographical area. In addition, whether menopausal status is associated with developing endometrial cancer in obese women and whether obesity is associated with subtypes of endometrial cancer have not been fully investigated. Here, we investigated the effect of BMI on developing endometrial cancer in Chinese women taking into account menopausal status and cancer subtypes.Methods: Data on 1,127 women with endometrial cancer including body mass index (BMI), age at diagnosis, parity, menopausal status and cancer subtype were collected from the largest obstetrics & gynaecology hospital in China and analysed.Results: After adjusting for age and parity, the odds for developing endometrial cancer in overweight or obese perimenopausal women was significantly higher than that in women with normal weight (OR=2.6 with 95%CI:1.9-3.5, and OR=3.5 with 95%CI: 2.2-5.4, respectively). The odds of developing endometrial cancer in overweight postmenopausal women were significantly higher than that in women who were normal weight (OR=2.4 with 95%CI: 1.8-3.1), however this was not the case for obese postmenopausal women. We further found that BMI, menopausal status, age and parity were not associated with subtypes of endometrial cancer.Conclusion: Our data demonstrate that obesity is positively associated with the incidence of developing endometrial cancer in Chinese women, with more significant effects in perimenopausal women.

Physiological Responses to Indoor Versus Outdoor Training in Postmenopausal Women

Chronic effects of two different exercise environments on self-chosen intensity and physiological adaptations were examined in postmenopausal women. Twenty-three healthy to overweight (body mass index [BMI] 22-29 kg/m2) postmenopausal women performed three weekly training sessions during 12 weeks and were assigned to either: (1) indoor training or (2) outdoor training. Body composition, metabolic profile, and physical fitness (including Vo2max, maximal strength, and endurance) were assessed pre- and postintervention. Exercise intensity was measured every week during the training. Maximum intensity decreased significantly in time only in outdoor training (p ≤ .05). Body composition and VO2max were significantly improved indoors (p ≤ .05), whereas resting blood pressure and upper body maximal strength and endurance were improved outdoors (p ≤ .05). Indoor training is associated with maintaining intensity over time and slightly higher physiological improvements than outdoor training. However, outdoor training seems promising from a long-term perspective, due to its positive effects on health parameters and exercise adherence.

Diets with high-fat cheese, high-fat meat, or carbohydrate on cardiovascular risk markers in overweight postmenopausal women: a randomized crossover trial

Heart associations recommend limited intake of saturated fat. However, effects of saturated fat on low-density lipoprotein (LDL)-cholesterol concentrations and cardiovascular disease risk might depend on nutrients and specific saturated fatty acids (SFAs) in food. We explored the effects of cheese and meat as sources of SFAs or isocaloric replacement with carbohydrates on blood lipids, lipoproteins, and fecal excretion of fat and bile acids. The study was a randomized, crossover, open-label intervention in 14 overweight postmenopausal women. Three full-diet periods of 2-wk duration were provided separated by 2-wk washout periods. The isocaloric diets were as follows: 1) a high-cheese (96-120-g) intervention [i.e., intervention containing cheese (CHEESE)], 2) a macronutrient-matched nondairy, high-meat control [i.e., nondairy control with a high content of high-fat processed and unprocessed meat in amounts matching the saturated fat content from cheese in the intervention containing cheese (MEAT)], and 3) a nondairy, low-fat, high-carbohydrate control (i.e., nondairy low-fat control in which the energy from cheese fat and protein was isocalorically replaced by carbohydrates and lean meat (CARB). The CHEESE diet caused a 5% higher high-density lipoprotein (HDL)-cholesterol concentration (P = 0.012), an 8% higher apo A-I concentration (P < 0.001), and a 5% lower apoB:apo A-I ratio (P = 0.008) than did the CARB diet. Also, the MEAT diet caused an 8% higher HDL-cholesterol concentration (P < 0.001) and a 4% higher apo A-I concentration (P = 0.033) than did the CARB diet. Total cholesterol, LDL cholesterol, apoB, and triacylglycerol were similar with the 3 diets. Fecal fat excretion was 1.8 and 0.9 g higher with the CHEESE diet than with CARB and MEAT diets (P < 0.001 and P = 0.004, respectively) and 0.9 g higher with the MEAT diet than with the CARB diet (P = 0.005). CHEESE and MEAT diets caused higher fecal bile acid excretion than did the CARB diet (P < 0.05 and P = 0.006, respectively). The dominant type of bile acids excreted differed between CHEESE and MEAT diets. Diets with cheese and meat as primary sources of SFAs cause higher HDL cholesterol and apo A-I and, therefore, appear to be less atherogenic than is a low-fat, high-carbohydrate diet. Also, our findings confirm that cheese increases fecal fat excretion. This trial was registered at clinicaltrials.gov as NCT01739153.

Abstract 937: Soluble receptor for advanced glycation end-products is a player in obesity-related colorectal cancer

Abstract Insulin resistance, adiposity, and chronic inflammation contribute to colorectal cancer (CRC) development. Nϵ-(carboxymethyl)-lysine (CML) is a well-characterized type of advanced glycation end product (AGE). It can bind to the receptor for AGEs (RAGE) and trigger insulin resistance and sustained chronic inflammation. Soluble RAGE (sRAGE) mitigates the detrimental effect of RAGE by acting as a decoy receptor for its ligands. In a case-cohort study within the Women's Health Initiative Observational study, we examined the association between CML-AGE, sRAGE and risk of CRC among 447 cases and 802 subcohort controls. Information on lifestyle, anthropometry, medical history, and diet were collected at baseline. Levels of CML-AGE and sRAGE were measured by ELISA using fasting blood collected at baseline. Circulating levels of adipokines, insulin, glucose, estradiol, and C-reactive protein were previously measured for the study subjects. Multivariate Cox proportional hazard regression model accounting for the case-cohort design was used to estimate hazard ratio (HR) and 95% confidence interval (CI) for CRC according to quartile (Q) of biomarkers with adjustment for age, race, waist circumstance, smoking, family history of colorectal cancer, NASID, energy intake, physical activity, alcohol consumption, saturated fat intake, available carbohydrate intake, hypertension, hormone replacement therapy, calcium, folate equivalent, red meat, insulin, and adiponectin. Average participant follow-up was 7.8 years. Among 802 subcohort controls, CML-AGE and sRAGE were both significantly inversely correlated with BMI, waist circumference, serum insulin, glucose, and leptin, but positively correlated with adiponectin (P values &amp;lt; 0.05). sRAGE levels were inversely associated with CRC (HRQ2 vs Q1:0.53; 95% CI: 0.31-0.90; HRQ4 vs Q1: 0.81; 95% CI: 0.46-1.42) (Ptrend = 0.95). This inverse association was evident among women who had BMI ≥ 25 kg/m2 (HRQ2 vs Q1: 0.49; 95% CI: 0.25-0.99; HRQ4 vs Q1: 0.43, 95% CI: 0.19-0.97) (Ptrend = 0.22), but not among women with normal BMI (BMI &amp;lt; 25) (HRQ4 vs Q1: 1.72, 95% CI:0.53-5.55) (P value for interaction was 0.01). CML-AGE was not associated with CRC risk (HRQ4 vs Q1: 0.78, 95% CI: 0.48-1.37) (Ptrend = 0.18). We found pre-diagnostic sRAGE levels were inversely associated with risk of CRC among overweight and obese postmenopausal women. This study identifed the RAGE pathway as a potential etiological factor in obesity-associated CRC. Citation Format: Liang Chen, Zhigang Duan, Lesley Tinker, Haleh Sangi-Haghpeykar, Howard Strickler, Gloria Ho, Thomas Rohan, Marc Gunter, Craig Logsdon, Donna White, Kathryn Royse, Hashem El-Serag, Li Jiao. Soluble receptor for advanced glycation end-products is a player in obesity-related colorectal cancer. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 937. doi:10.1158/1538-7445.AM2015-937

Effects of aerobic exercise on blood pressure and lipids in overweight hypertensive postmenopausal women.

Menopause may increase risk of hypertension and abnormal lipid profile. The aim of the study was to examine the effects of morning and afternoon aerobic exercises on hypertension and lipids in overweight hypertensive postmenopausal women. Forty five women aged from 49 to 60 years were randomly assigned into three groups. Group (A) 15 patients received medicine, (B) 15 patients performed morning aerobic exercises and received medicine, and group (C) 15 patients performed afternoon aerobic exercises and received medicine. Blood pressure measurement and lipid profile tests were performed before and after the study. The results showed that there was a statistical significant difference among all groups in systolic and diastolic blood pressure, favoring group C. Also there was a statistical significant difference among all groups in lipid levels, favoring group C. Therefore, it can be concluded that morning aerobic exercises were more effective in reducing the blood pressure and lipids than afternoon exercises in overweight hypertensive postmenopausal women.

Effect of a high cheese intake compared to high-fat meat or carbohydrate on cardiovascular risk markers in overweight postmenopausal women

Background: Effects of saturated fat on LDL-C concentration might depend on nutrients and specific saturated fatty acids in the food. A recent observational study found dairy saturated fat to be inversely associated and meat saturated fat to be positively associated with CVD risk.