Quality of life in obese postmenopausal women

The aim of this review was to identify the ways in which obesity affects the health-related quality of life (HRQoL) of postmenopausal women. This was considered important because a growing body of literature has identified obesity as a significant predictor for a poor psychological wellbeing and negative HRQoL, particularly in women, and because during the transition through the menopause women tend to accumulate more body weight. After searching eight electronic databases, only nine papers appeared meaningful. Although a meta-analysis was not possible, we found that a body mass index (BMI) > 30 kg/m2 was associated with a poor HRQoL in postmenopausal women; particularly in the areas associated with physical functioning, energy and vitality, and health perceptions. Thus, clinical management of obese postmenopausal women should focus on weight reduction and exercise in an attempt to improve wellbeing in these areas. However, the paucity of research, the different instruments chosen to measure HRQoL and the methodological limitations of the studies identified, prevented firm conclusions being made about whether the relationship between BMI and HRQoL is linear in postmenopausal women. Further research is needed to explore this relationship; particularly in comparison with underweight postmenopausal women and obese premenopausal women, where a few papers have identified these women as having a worse HRQoL than their obese postmenopausal counterparts. Other measures of central adiposity, including waist circumference and waist-hip ratio are recommended as useful supplemental measures to BMI in future studies.     

The relationship between pedometer-determined and self-reported physical activity and body composition variables in college-aged men and women

Pedometer-determined physical activity (PA) is inversely related to body composition in middle-aged adults; however, researchers have not established such a relationship in college students. OBJECTIVE AND PARTICIPANTS: In this study, the authors attempted to characterize PA and examine its relationship with body composition in undergraduate college students (N = 88). METHODS: The authors measured the BC of 44 women (M age = 21 +/- 1 year, M body mass index [BMI] = 23.9 +/- 4 kg/m2) and 44 men (M age = 22 +/- 1 year, BMI = 26.9 +/- 0.9 kg/m2); participants also wore a pedometer for 7 days and completed a PA questionnaire. RESULTS: Men averaged significantly more steps/day (10,027 +/- 3,535) than did women (8,610 +/- 2,252). For women only, the authors observed significant correlations between steps/day and body composition variables. Men reported engaging in vigorous PA significantly more often than did women. CONCLUSIONS: These findings indicate that men engage in PA more often but that PA is related to body composition only in women. In addition, there is better agreement between pedometer-measured and self-reported PA in college-aged men than women.     

Body Image Development and Sexual Satisfaction: A Prospective Study From Adolescence to Adulthood

The aim of the current study was to explore whether developmental trajectories of body satisfaction from adolescence to young adulthood predicted measures of sexual satisfaction in young adulthood, even when controlling for important covariates such as gender, weight development, relationship status, mental health, and frequency of sexual intercourse and masturbation. Data were collected from a population-based prospective cohort of Norwegian adolescents (n = 2,587) over a period of 13 years in four waves (1992, 1994, 1999, and 2005; mean age = 14.9 in 1992, 57.3% women). Latent growth curves were estimated for body satisfaction and body mass index (BMI). Men reported higher sexual satisfaction, sexual activity, baseline body satisfaction, and BMI than women. The developmental trajectories revealed a slight increase in body satisfaction and BMI from adolescence to young adulthood in both genders. Moreover, structural equation models showed that baseline body satisfaction in both genders predicted sexual satisfaction as a young adult, independent of relationship status and frequency of sexual activity. Neither the development of BMI nor of body satisfaction predicted sexual satisfaction. The results elucidate the vital role of body satisfaction in sexual satisfaction in adults and the importance of addressing body dissatisfaction in childhood.     

Body Image Disturbances and Predictors of Body Dissatisfaction Among Hispanic and White Preadolescents

This study assessed ethnic and gender differences in ideal body size, body dissatisfaction (BD), and the relationship between BD and various predictors (e.g., body composition indicators and cardiorespiratory fitness). The sample consisted of 190 White and Hispanic preadolescents aged 10–13 years. Demographic, percent body fat (%BF), body mass index (BMI), body image variables, and cardiorespiratory fitness (CRF) were examined. A significant Gender × Ethnicity interaction was found for ideal body size (p < .05), with Hispanic girls preferring the thinnest figures and Hispanic boys the largest figures, compared to their counterparts. No significant gender or ethnic differences in BD were observed. After controlling for demographic and cultural variables, increased %BF and BMI scores predicted greater BD, whereas CRF did not.     

Slimness and self‐rated sexual attractiveness: Comparisons of men and women in two cultures

The relationship between body mass index (BMI) and self‐rated sexual attractiveness was studied on the basis of representative surveys of adult populations in Finland and in St. Petersburg in order to find out whether the body ideals related to sexuality differ in the two cultures. Data were analyzed by calculating correlations and by conducting regression analyses. In both countries, the connection between BMI and sexual attractiveness was stronger for women than men. St. Petersburg men were the only group in which thin people did not rate themselves as sexually more attractive than corpulent people. Regression analyses showed that (a) the impact of BMI on sexual attractiveness was not totally caused by the controlling variable age; (b) the hypothesized mediating variables, sexual activity and satisfaction, did not diminish the relationship between BMI and sexual attractiveness; and (c) the relationship was stronger in Finland than in St. Petersburg.     

Prevention of osteoporosis: one step forward, two steps back

For many years, hormone replacement therapy (HRT) was the mainstay for osteoporosis prevention in postmenopausal women until a large randomized clinical trial raised serious safety concerns. This resulted in a big drop in HRT use and its demotion by regulatory authorities to second-line treatment. Many clinicians now feel that HRT is not safe to use, and recommend various alternatives for the treatment of osteoporosis. But how effective are these alternative therapies, are they any safer than HRT, and how do their costs compare? This review questions the validity of the safety concerns about HRT, and highlights the safety concerns about alternative therapies. It concludes that HRT is as safe as the other treatment options, and its efficacy and low cost demand that it be restored as a first-line treatment for the prevention of postmenopausal osteoporosis. Other therapies are available for use in osteoporosis, and the bisphosphonates are particularly effective for the treatment of the established disease. However, they must be used selectively and with caution, and are best restricted to those patients who are elderly or have severe disease. New treatments are emerging, but again caution must be taken until any long-term adverse effects have been identified.     

Ethnic differences in eating disorder symptoms among college students: the confounding role of body mass index.

Eating disorders are among the most common psychopathologies on college campuses. Research on ethnic differences in eating disorder symptoms and prevalence has resulted in conflicting conclusions. Some studies find that particular ethnic groups have a higher prevalence of a symptom; others find that members of that ethnic group have a lower prevalence of the same symptom. The authors explored the role of body mass index (BMI), one potential confound. They used a reliable measure of eating disorder symptoms to assess differences between Hispanic, Asian, and non-Hispanic White college women from two separate samples. After controlling for BMI, ethnic differences in eating disorder symptoms of concern about weight and shape disappeared, but differences in restrained eating remained. Inconsistent findings in the ethnic-difference literature on eating disorders may result from systematic group differences in BMI. Implications for college health programs, counseling, and case finding are discussed.     

The College Health Advisor and the College Age Adoptee

Abstract

Eating disorders are among the most common psychopathologies on college campuses. Research on ethnic differences in eating disorder symptoms and prevalence has resulted in conflicting conclusions. Some studies find that particular ethnic groups have a higher prevalence of a symptom; others find that members of that ethnic group have a lower prevalence of the same symptom. The authors explored the role of body mass index (BMI), one potential confound. They used a reliable measure of eating disorder symptoms to assess differences between Hispanic, Asian, and non-Hispanic White college women from two separate samples. After controlling for BMI, ethnic differences in eating disorder symptoms of concern about weight and shape disappeared, but differences in restrained eating remained. Inconsistent findings in the ethnic-difference literature on eating disorders may result from systematic group differences in BMI. Implications for college health programs, counseling, and case finding are discussed.     

Physical activity and hormone-replacement therapy: interactive effects on cognition?

The purpose of this study was to examine the interactive effects of hormone-replacement therapy (HRT) and physical activity (PA) on the cognitive performance of older women. Postmenopausal women (n = 101) were recruited to complete a PA questionnaire, provide demographic information, and perform the digit-symbol substitution task (DSST) and the trail-making tests (TMT). Regression analyses were conducted for participants with complete data for each cognitive test (DSST n = 62; TMT n = 69). For both tasks, results indicated that PA and education were positively related and age was negatively related to cognitive performance. The interaction of HRT with PA did not add to the predicted variance of either measure of cognitive performance. This was true even after limiting the HRT users to women using unopposed estrogen. It is concluded that the beneficial relationship between PA and these two measures of cognitive performance in postmenopausal women exists irrespective of HRT use.     

Harnessing hormonal signaling for cardioprotection

Cardiovascular disease is the leading cause of death in women in the Western world and is predominant among the elderly. A large body of evidence suggests that hormonal signaling plays a critical role in the regulation of cardioprotective mechanisms, as premenopausal women are at significantly lower risk of heart disease compared with men, but the risk greatly increases with the onset of menopause. This association indicates that estrogen may protect the heart from cardiovascular disease. Whereas a number of analyses of the effects of hormone replacement therapy (HRT) on postmenopausal women supported the idea that estrogen is a cardioprotective factor, the findings of the more recent Women's Health Initiative (WHI) study suggested that HRT may actually increase the risk of cardiovascular events. These conflicting reports have left both patients and clinicians reluctant to continue using current HRT regimes. The WHI findings do not, however, negate the epidemiological link between menopause and increased cardiovascular risk. Hence, the identification of the specific actions of estrogen that promote cardioprotective pathways without enhancing deleterious vascular mechanisms may provide novel estrogen-based alternatives to current HRT strategies. In this Review, we outline the known actions of estrogen on the cardiovascular system, focusing on cardioprotective mechanisms that may be targeted for the development of new therapeutic approaches.     

Race‐Ethnicity,Union Status,and Change in Body Mass Index in Young Adulthood

This study used data from three waves of the National Longitudinal Study of Adolescent to Adult Health and fixed effects regression to consider whether associations between change in union status and change in body mass index (BMI) were moderated by race‐ethnicity. The results indicated that intimate unions were differentially associated with gains in BMI along racial‐ethnic lines, especially for women. When compared with White women, marriage was associated with larger increases in BMI for Black, Hispanic, and Multiracial women, and cohabitation was associated with larger increases for Black and Hispanic women. In contrast, marriage and cohabitation were associated with less weight gain for Asian when compared with White women. Among men, racial‐ethnic differences in the relationship between union status and BMI were similarly patterned but less pronounced. The results suggest that marital status further exacerbates racial‐ethnic disparities in BMI from adolescence to young adulthood.     

Relationship between body image and body mass index in college men

OBJECTIVE AND PARTICIPANTS: The authors examined cognitive and affective dimensions of body image of a randomized sample of 188 college men on the basis of body mass index (BMI). METHODS: They conducted chi-square tests and ANOVAs to determine differences between 4 BMI groups (underweight, normal weight, overweight, and obese) on demographics and body image measures. RESULTS: The authors found significant differences in regard to total body image (p < .001), weight or shape concern (p < .001), and body dissatisfaction (p < .001). BMI was significantly correlated with negative body image. Overweight and obese participants reported significantly higher levels of negative body image than did normal- and underweight participants. Overweight participants reported significantly higher weight and shape concerns than did underweight, normal-weight, and obese participants. In regard to body dissatisfaction, underweight, overweight, and obese participants reported significantly higher levels of body dissatisfaction than that reported by normal-weight participants. CONCLUSIONS: BMI may be an important factor in identifying potential body image disorders in college-aged men.     

No sustained effect of aerobic or resistance training on insulin sensitivity in nonobese, healthy older women

It is unclear whether long-term aerobic (AT) or resistance (RT) training can improve insulin sensitivity (IS) beyond the residual effect of the last training bout in older women (54-78 years). Therefore, a group of nonobese, healthy older women underwent 6 months of AT (n = 8) or RT (n = 10), and the authors measured IS 4 days after the last training bouts using the hyperinsulinemic-euglycemic clamp technique. Women trained 3 days/week. AT consisted of 25- to 60-min sessions of walking/jogging at 60-95% of maximal heart rate. RT consisted of three sets of nine exercises repeated 10 times at 80% of 1 repetition maximum. AT decreased fat mass, whereas both AT and RT increased fat-free mass. Neither training program, however, improved absolute or relative rates of glucose disposal. The authors therefore concluded that nonobese, healthy older women should perform AT or RT on a daily basis in order to improve IS and maintain the improvement.     

Energy expenditure during physically interactive video game playing in male college students with different playing experience

OBJECTIVE: Researchers have yet to explore the effect of physically interactive video game playing on energy expenditure, despite its potential for meeting current minimal daily activity and energy expenditure recommendations. PARTICIPANTS AND METHODS: Nineteen male college students -- 12 experienced Dance Dance Revolution (DDR) players and 7 inexperienced players -- completed maximal oxygen uptake assessments and a 30-minute DDR gaming session. The authors recorded heart rate (HR), rating of perceived exertion (RPE), respiratory exchange rate (RER), oxygen consumption (VO2), and total steps (TS30). RESULTS: Experienced participants showed higher exercise HR, RPE, RER, VO2, total and relative energy expenditure, exercise intensity, TS30, and average steps per minute, and less time and steps to expend 150 kilocalories (p < .05). CONCLUSIONS: Participants with greater playing experience can work at higher intensities, promoting greater energy expenditure.     

Body Size and Sexual Behavior in a Community-Based Sample of Women

ABSTRACT. Women's body size is closely related to their social and sexual experiences. Clinical research has found that women's lifetime sexual behaviors may vary based on body mass index (BMI). Objectives: This study examined the relationship between BMI and recent solo and partnered sexual repertoire in a community-based, non-clinical sample of women. Methods: Two hundred thirty-eight sexually active women completed an online survey measuring age, sexual relationship status, BMI, gender of sexual partners, and engagement in sexual behaviors in the previous 4 weeks. Logistic regression analyses were conducted to determine whether BMI predicted engagement in behaviors after controlling for age and sexual relationship variables. Results: Participant age ranged from 18 to 56 years (M = 30.4, SD = 7.8). Participants were predominantly in exclusive sexual relationships (62.9%, n = 146) with men (82.8%, n = 197). Mean BMI for the sample was 29.33 (SD = 9.28). Participation in self-masturbation, masturbating a partner, performing oral sex on a partner, receiving oral sex from a partner, and penile–vaginal intercourse were not predicted by BMI after controlling for age and partner variables. Conclusions: BMI did not impact sexual repertoire during the previous 4 weeks, with the exception of an increased odds ratio for penile–anal intercourse (OR = 1.06; 95% CI [1.02, 1.10]). Researchers and practitioners working with women should not assume limitations on women's sexual repertoires because of larger body size.     

National Osteoporosis Society's Position statement on hormone replacement therapy in the prevention and treatment of osteoporosis

Hormone replacement therapy (HRT) has been shown to increase bone density, reduce the risk of fracture and can successfully relieve menopausal symptoms. From a time when HRT was the major therapeutic option for the management of osteoporosis, women and their clinicians now have a range of treatments available. Following the publication of the Women's Health Initiative (WHI) and the Million Women Study highlighting potential side-effects, such as breast cancer, heart disease and stroke, many doctors and women are now reluctant to use HRT. The National Osteoporosis Society felt that the role of HRT in the management of osteoporosis needed to be clarified. Using the Charity's expert clinical and scientific advisers, and through public consultation with members and key stakeholders, a Position Statement has been published. We conclude that HRT has a role to play in the management of osteoporosis in postmenopausal women below the age of 60 years. The key recommendations of the Position Statement are presented in this paper.     

Predicting 1-year change in body mass index among college students

OBJECTIVE: Despite beliefs about weight gain in college, few researchers have evaluated this phenomenon. PARTICIPANTS: Participants were 18- to 31-year-old students at a midwestern university. The dependent variable was body mass index (BMI) change. METHODS: The authors extracted predictor variables from a Health Risk Appraisal. These included clinical, medical history, medical usage, medications, pain or chronic conditions, perceptual measures, and behavioral factors. The authors performed an ordinal regression technique separately by gender. RESULTS: No predictors were significant for men. Women in the BMI gain group were (1) more likely to consume alcohol, use maladaptive coping behaviors, eat foods low in fiber, and consume caffeine; and (2) less likely to be stress-free, to eat cruciferous vegetables, and to refrain from eating high-cholesterol foods. CONCLUSIONS: The lack of research on predictors of and interventions for reducing BMI gain among college students warrants more research.     

Systemic lupus erythematosus and hormone replacement therapy

The indications for hormone replacement therapy (HRT) in postmenopausal women is the treatment of climacteric symptoms and the prevention of osteoporosis. Women with systemic lupus erythematosus (SLE) are more likely to have a premature menopause, osteoporosis and cardiovascular disease. HRT can induce SLE flares and cardiovascular or venous thromboembolic events. Therefore it should not be used in women with active disease or those with antiphospholipid (aPL) antibodies. In general, it should be used only for patients without active disease, a history of thrombosis or aPL antibodies. Non-oral administration of estrogen is recommended because of its lesser effect on coagulation. With regard to the progestogen, progesterone or pregnane derivatives are preferred. Otherwise, non-estrogen-based strategies should be used.     

Differences in Emerging-Adult Women's Body Image and Sexuality Outcomes According to BMI and Dating Status

ABSTRACT. Emerging adulthood is a crucial time for the development of body image and sexuality concerns among women. We collected self-reported data from 184 women to determine possible differences according to body mass index (BMI) classification and dating status. Multivariate analyses of variance and follow-up univariate analyses of variance were conducted to determine differences in body image and sexuality outcomes according to both BMI (normal weight vs. overweight) and dating status (dating vs. not dating) as well as interaction effects of BMI and dating status. First, results indicated differences between normal-weight and overweight women for body satisfaction, body self-consciousness, and body image avoidance. Overweight women had lower satisfaction, higher self-consciousness, and more avoidance. Differences were also found between women who were dating and those who were not dating for body satisfaction and self-consciousness: Women not dating had lower satisfaction and higher self-consciousness. Second, whereas results indicated that women of varying BMIs did not differ on sexuality outcomes, differences were found according to dating status for sexual attitudes, esteem, and self-schema, such that women not dating had more conservative sexual attitudes, less sexual esteem, and lower self-schemas. No significant interaction effects were found.     

Energy Expenditure During Physically Interactive Video Game Playing in Male College Students With Different Playing Experience

Objective: Researchers have yet to explore the effect of physically interactive video game playing on energy expenditure, despite its potential for meeting current minimal daily activity and energy expenditure recommendations. Participants and Methods: Nineteen male college students-12 experienced Dance Dance Revolution (DDR) players and 7 inexperienced players- completed maximal oxygen uptake assessments and a 30-minute DDR gaming session. The authors recorded heart rate (HR), rating of perceived exertion (RPE), respiratory exchange rate (RER), oxygen consumption (VO₂), and total steps (TS₃₀). Results: Experienced participants showed higher exercise HR, RPE, RER, VO₂, total and relative energy expenditure, exercise intensity, TS₃₀, and average steps per minute, and less time and steps to expend 150 kilocalories (p < .05). Conclusions: Participants with greater playing experience can work at higher intensities, promoting greater energy expenditure.