Caloric Restriction, Aerobic Exercise Training, and Soluble Lectin-like Oxidized LDL Receptor-1 Levels in Overweight and Obese Postmenopausal Women Physical activity and mental health outcomes during menopause: A randomized controlled trial Lifestyle intervention can prevent weight gain during menopause: Results from a 5-year randomized clinical trial Resistance exercise and lipoproteins in postmenopausal women. Strength training and adiposity in premenopausal women: strong, healthy, and empowered study. Exercise training and habitual physical activity: a randomized controlled trial. Reducing cardiovascular risk factors in postmenopausal women through a lifestyle change intervention. The effects of a combined strength and aerobic exercise program on glucose control and insulin action in women with type 2 diabetes Exercise program affects body composition but not weight in postmenopausal women Weight Loss is Correlated with an Improved Lipoprotein Profile in Obese Postmenopausal Women Dietary composition affects regional body fat distribution and levels of dehydroepiandrosterone sulphate (DHEAS) in post-menopausal women with Type 2 diabetes The clinical trial of Women On the Move through Activity and Nutrition (WOMAN) study. Effect of calcium supplementation on weight and fat loss in women. The effects of a higher protein intake during energy restriction on changes in body composition and physical function in older women. Self-Efficacy Targeted Treatments for Weight Loss in Postmenopausal Women Evaluating the effectiveness of a weight-loss program for perimenopausal women. Effect of hypocaloric diet-induced weight loss in obese women on plasma apelin and adipose tissue expression of apelin and APJ. Risk of bias versus quality assessment of randomised controlled trials: cross sectional study Lifestyle intervention and coronary heart disease risk factor changes over 18 months in postmenopausal women: the Women On the Move through Activity and Nutrition (WOMAN study) clinical trial. Benefits of Soy Isoflavone Therapeutic Regimen on Menopausal Symptoms Effect of soy protein supplementation on serum lipoproteins, blood pressure, and menopausal symptoms in perimenopausal women. Muscle Mass Gain After Resistance Training Is Inversely Correlated With Trunk Adiposity Gain in Postmenopausal Women Maintenance of cardiovascular risk factor changes among middle-aged women in a lifestyle intervention trial. Walking trials in postmenopausal women: effect of one vs two daily bouts on aerobic fitness. Isoflavone-rich soy protein prevents loss of hip lean mass but does not prevent the shift in regional fat distribution in perimenopausal women Effect of exercise intensity on abdominal fat loss during calorie restriction in overweight and obese postmenopausal women: a randomized, controlled trial. Changes in body composition following a dietary and lifestyle intervention trial: the postmenopausal health study. Preliminary study: soy milk as effective as skim milk in promoting weight loss. Physical training decreases waist circumference in postmenopausal borderline overweight women Effect of exercise training combined with phytoestrogens on adipokines and C-reactive protein in postmenopausal women: a randomized trial. The effect of dietary soy supplementation compared to estrogen and placebo on menopausal symptoms: a randomized controlled trial. Resistance training in postmenopausal women with and without hormone therapy. The effects of a soy rich diet on serum lipids: the Menfis randomized trial. A two-year randomized weight loss trial comparing a vegan diet to a more moderate low-fat diet. The effect of a mindful restaurant eating intervention on weight management in women.
Background : Elevated circulating levels of soluble lectin-like oxidized low-density lipoprotein receptor-1 ( sLOX-1 ) have been observed in obese persons and are reduced by weight loss . However , it is not known whether combining caloric restriction ( CR ) with exercise training is better in reducing sLOX-1 levels than CR alone . Objective : We examined whether the addition of aerobic exercise to a weight loss intervention differentially affects sLOX-1 levels in 61 abdominally obese post-menopausal women r and omly assigned to a CR only ( n=22 ) , CR+moderate-intensity exercise ( n=22 ) or CR+vigorous-intensity exercise ( n=17 ) intervention for 20 weeks . The caloric deficit was ∼2800 kcal per week for all groups . Results : The intervention groups were similar at baseline with respect to body weight , body composition , lipids and blood pressure . However , plasma sLOX-1 levels were higher in the CR-only group ( 99.90±8.23 pg ml−1 ) compared with both the CR+moderate-intensity exercise ( 69.39±8.23 pg ml−1 , P=0.01 ) and the CR+vigorous-intensity exercise ( 72.83±9.36 pg ml−1 , P=0.03 ) groups . All three interventions significantly reduced body weight ( ∼14 % ) , body fat and waist and hip circumferences to a similar degree . These changes were accompanied by a 23 % reduction in sLOX-1 levels overall ( −19.00±30.08 pg ml−1 , P<0.0001 ) , which did not differ among intervention groups ( P=0.13 ) . Changes in body weight , body fat and maximal oxygen consumption ( VO2 max ) were not correlated with changes in sLOX-1 levels . In multiple regression analyses in all women combined , baseline sLOX-1 levels ( β=−0.70±0.06 , P<0.0001 ) , age ( β=0.92±0.43 , P=0.03 ) and baseline body mass index ( BMI ) ( β=1.88±0.66 , P=0.006 ) were independent predictors of the change in sLOX-1 with weight loss . Conclusions : Weight loss interventions of equal energy deficit have similar effects on sLOX-1 levels in overweight and obese post-menopausal women , with the addition of aerobic exercise having no added benefit when performed in conjunction with CR Background : Many women experience detriments in mental health during the menopausal transition . Physical activity may attenuate these adverse outcomes but few studies investigating such effects exist . Purpose : This study examined the effects of a 4-month r and omized controlled exercise trial on mental health outcomes in 164 previously low-active middle-aged women ( M age=49.9 ; SD=3.6 ) . Methods and Results : Participants completed body composition and fitness assessment and a battery of psychological measures at the beginning and end of a 4-month r and omized controlled exercise trial with three arms : walking , yoga , control . The results indicated that walking and yoga were effective in enhancing positive affect and menopause-related QOL and reducing negative affect . Women who experienced decreases in menopausal symptoms across the trial also experienced improvements in all positive mental health and QOL outcomes and reductions in negative mental health outcomes . Whether menopausal symptoms increased or decreased across the trial appeared to be determined in part by whether there were increases or decreases in cardiorespiratory fitness . Conclusions : Physical activity appears to enhance mood and menopause-related QOL during menopause , however , other aspects of mental health may be affected only as a result of reduction in menopausal symptoms . Increasing cardiorespiratory fitness could be one way to reduce menopausal symptoms Context : Menopausal-related weight gain and increased waist circumference have major cardiovascular health implication s for older women . The efficacy of a dietary and physical activity lifestyle intervention to prevent weight gain and elevations in cardiovascular disease ( CVD ) risk factors from the peri- to postmenopause is unknown . Objective : To report the 54-month results of a lifestyle dietary and physical activity program on weight , body composition , physical activity , diet , and other CVD risk factors . Design : Data are from a 5-year r and omized clinical trial known as the Women ’s Healthy Lifestyle Project , conducted from 1992 to 1999 . Participants : 535 healthy , premenopausal women ages 44 to 50 at study entry enrolled into the trial . Intervention : Participants were r and omly assigned to either a lifestyle intervention group receiving a 5-year behavioral dietary and physical activity program or to an assessment -only control group . The lifestyle intervention group was given modest weight loss goals ( 5–15 lb , or approximately 2.3–6.8 kg ) to prevent subsequent gain above baseline weight by the end of the trial . To achieve weight loss and lower low-density lipoprotein cholesterol levels , intervention participants followed an eating pattern consisting of 1,300 kcal/day ( 25 % total fat , 7 % saturated fat , 100 mg of dietary cholesterol ) and increased their physical activity expenditure ( 1,000–1,500 kcal/week).Main Outcome Measures : Regarding weight gain prevention , 55 % ( 136/246 ) of intervention participants were at or below baseline weight compared with 26 % ( 68/261 ) of controls after 4.5 years , χ(2 , N = 507 ) = 45.0 , p < .001 . The mean weight change in the intervention group was 0.1 kg below baseline ( SD = 5.2 kg ) compared with an average gain of 2.4 kg ( SD = 4.9 kg ) observed in the control group . Waist circumference also significantly decreased more in the intervention group compared with controls ( M = −2.9 cm , SD = 5.3 vs. M = −0.5 cm , SD = 5.6 , p < .001 ) . Moreover , participants in the lifestyle intervention group were consistently more physically active and reported eating fewer calories and less fat than controls . Long-term adherence to physical activity and a low-fat eating pattern was associated with better weight maintenance . Conclusions : In healthy women , weight gain and increased waist circumference during the peri- to postmenopause can be prevented with a long-term lifestyle dietary and physical activity intervention The specific aims of this study were to quantify the effects of 12 weeks of resistance training , as well as a single session of resistance exercise on lipids and lipoproteins in obese , postmenopausal women . 21 obese , postmenopausal women , not on hormone replacement therapy ( age=65.9 ± 0.5 yr ; BMI = 32.7 ± 0.8 kg/m(2 ) ) , were r and omly assigned to control ( n=12 ) and exercise ( n=9 ) groups matched for age and BMI . For 12 weeks , 3 days/week , the exercise group performed 10 whole body resistance exercises ( 3 sets at 8-RM ) . Fasting ( 10 h ) blood sample s were collected immediately prior to and 24 h after the first and last exercise and control session . Serum was assayed for concentrations of total cholesterol , triglycerides , LDL-C , HDL-C , HDL 2-C , HDL 3-C , non-HDL-C and TC : HDL and LDL : HDL ratios . The exercise group exhibited a significant ( P<0.01 ) improvement in muscular strength , but no change in BMI , body mass or body composition post-training . Total cholesterol , LDL-C and non-HDL-C were significantly ( P<0.05 ) lower in the exercise compared to the control group following the 12 weeks of resistance training . Whole body resistance training provides obese , postmenopausal women a non-pharmacological approach for the reduction of lipid and lipoprotein-cholesterol concentrations BACKGROUND American women aged 25 - 44 y gain 0.5 - 1 kg yearly , most of which is fat . Because few midlife women participate in strength training , this mode of activity may be a novel intervention for preventing age-associated fat increases in this population . OBJECTIVES The primary aim was to assess the efficacy of twice-weekly strength training to avoid increases in percentage body fat and intraabdominal fat . DESIGN A r and omized controlled trial was conducted in an ethnically diverse sample of 164 overweight and obese [ body mass index ( in kg/m2 ) : 25 - 35 ] women aged 25 - 44 y. The treatment group did twice-weekly strength training for 2 y. The st and ard care comparison group was given brochures recommending aerobic exercise . Assessment s at baseline , 1 , and 2 y included intraabdominal fat by computed tomography scan and body fat and fat-free mass by dual-energy X-ray absorptiometry . RESULTS During 2 y , percentage body fat changes were -3.68 + /- 0.99 % for the treatment group and -0.14 + /- 1.04 % for the control group , P = 0.01 . Two-year intraabdominal fat changes were 7.05 + /- 5.07 % for the treatment group and 21.36 + /- 5.34 % for the control group , P = 0.05 . CONCLUSION This study suggests that strength training is an efficacious intervention for preventing percentage body fat increases and attenuating intraabdominal fat increases in overweight and obese premenopausal women . This is relevant to public health efforts for obesity prevention because most weight gain can be assumed to be fat , including abdominal fat BACKGROUND Exercise training reduces adiposity and risk of cardiovascular disease . However , the combined effects of habitual free-living physical activity and aerobic training on waist circumference , weight , fitness , and blood pressure in postmenopausal women are unknown . PURPOSE To evaluate the effects of habitual physical activity levels during aerobic training on weight , waist circumference , fitness , and blood pressure . DESIGN Secondary analysis of an RCT . Original data collected April 2001 to June 2005 and analyzed in 2012 . SETTING / PARTICIPANTS Postmenopausal women in a supervised exercise trial . INTERVENTION Women ( n=325 ) were r and omized to 4 , 8 , or 12 kcal/kg per week of aerobic training or a control group for 6 months . All outcome measures were collected at baseline and follow-up . Changes in dependent variables within each training group were evaluated across tertiles of pedometer-determined habitual physical activity outside exercise training sessions . MAIN OUTCOME MEASURES Changes in waist circumference and weight . RESULTS Reductions in waist circumference were significantly greater with higher steps/day accumulated outside exercise training compared to lower levels in the 4 ( high : -4.8 cm vs low : -1.4 cm , p=0.03 ) ; 8 ( high : -4.2 cm vs low : -0.4 cm , p=0.03 ) , and 12 kcal/kg per week groups ( high : -4.1 cm vs low : -0.7 cm , p=0.05 ) . For all groups , p-trend≤0.03 . A trend was observed for greater weight reduction with higher steps/day in the 4 kcal/kg per week group ( p-trend=0.04 ) but not for the other exercise doses . No effects were observed for blood pressure or fitness measures ( all p>0.05 ) . CONCLUSIONS In postmenopausal women , higher habitual physical activity while participating in aerobic training was associated with greater reductions in central adiposity , and was supportive of weight loss compared to lower levels BACKGROUND The impact of a 6-month lifestyle change intervention on cardiovascular risk factors in obese , sedentary , postmenopausal women was examined . A secondary aim of this investigation was to determine whether the addition of self-control skills training to an empirically supported lifestyle change intervention would result in greater cardiovascular risk reduction . METHODS Forty-four women were r and omly assigned to receive either a lifestyle change or a lifestyle change with self-control skills intervention . Pretreatment and posttreatment weight loss , body composition , physical activity , cardiorespiratory fitness , diet , blood pressure ( BP ) , blood lipids , and psychosocial functioning were assessed . Also , at 1-year posttreatment , weight loss , body composition , self-reported physical activity , and psychosocial functioning were assessed . RESULTS The women significantly increased their physical activity ( + 39.6 % ) and cardiorespiratory fitness ( + 13.5 % ) and reduced their body weight ( -6.5 % ) , fat mass ( -7.4 % ) , body fat ( -2.4 % ) , BP ( SBP -6.2 % , DBP -9.2 % ) , total cholesterol ( -7.4 % ) , triglycerides ( -16.5 % ) , and low-density lipoprotein ( LDL ) cholesterol ( 9.1 % ) and improved their diet ( p < 0.05 ) . At the 1-year follow-up , women had regained approximately 63 % of their posttreatment weight loss ( p < 0.05 ) , but had maintained their previous increases in physical activity . Additionally , there were no significant changes in fat free mass , body fat , anxiety , or depression between the end of treatment and 1-year posttreatment . The addition of self-control skills training did not significantly improve cardiovascular risk reduction . CONCLUSIONS Lifestyle change interventions may be an effective means for reducing cardiovascular risk in obese , sedentary , postmenopausal women . However , greater attention should be devoted to the maintenance of these positive lifestyle changes The purpose of the present study was to investigate the short- and long-term effects of a combined strength and aerobic training program on glycemic control , insulin action , exercise capacity and muscular strength in postmenopausal women with type 2 diabetes . Nine postmenopausal women , aged 55.2 ( 6.7 ) years , with type 2 diabetes participated in a supervised training program for 4 months consisting of two strength training sessions ( 3 sets of 12 repetitions at 60 % one-repetition maximum strength ) and two aerobic training sessions ( 60–70 % of maximum heart rate at the beginning , and 70–80 % of maximum heart rate after 2 months ) . Anthropometrical measurements , percentage glycated hemoglobin , a 2-h oral glucose tolerance test , exercise stress testing and maximum strength were measured at the beginning , and after 4 and 16 weeks of the exercise program . Significant reductions were observed in both the glucose ( 8.1 % P<0.01 ) and insulin areas under the curve ( 20.7 % , P<0.05 ) after 4 weeks of training . These adaptations were further improved after 16 weeks ( glucose 12.5 % , insulin 38 % , P<0.001 ) . Glycated hemoglobin was significantly decreased after 4 weeks [ 7.7 ( 1.7 ) vs 7.1 (1.3)% , P<0.05 ] and after 16 weeks [ 7.7 ( 1.7 ) vs 6.9 (1.0)% , P<0.01 ] of exercise training . Furthermore , exercise time and muscular strength were significantly improved after 4 weeks ( P<0.01 ) as well as after 16 weeks ( P<0.001 ) of training . Body mass and body-mass index , however , were not significantly altered throughout the study . The results indicated that a combined training program of strength and aerobic exercise could induce positive adaptations on glucose control , insulin action , muscular strength and exercise tolerance in women with type 2 diabetes Objective : The aim of this study was to investigate the effect of a 12-month moderate-to-vigorous exercise program combining aerobic and muscle strength training on body composition among sedentary , postmenopausal women . Methods : A r and omized controlled trial was conducted . A total of 189 sedentary postmenopausal women ( age 50 - 69 y , body mass index 22 - 40 kg/m2 ) were r and omly assigned to an exercise ( n = 96 ) or a control group ( n = 93 ) . Study parameters measured at baseline , 4 months , and 12 months were as follows : body weight and body height ( body mass index ) , waist and hip circumference ( body fat distribution ) , and dual-energy x-ray absorptiometry ( total body fat and lean mass ) . Differences in changes in study parameters between exercise and control group were examined with generalized estimating equations analysis . Results : The exercise program did not result in significant effects on weight , body mass index , and hip circumference . The exercise group experienced a statistically significant greater loss in total body fat , both absolute ( −0.33 kg ) ( borderline ) as in a percentage ( −0.43 % ) compared with the control group . In addition , lean mass increased significantly ( + 0.31 kg ) , whereas waist circumference ( −0.57 cm ) decreased significantly compared with the control group . Conclusions : We conclude that a 12-month exercise program combining aerobic and muscle strength training did not affect weight but positively influenced body composition of postmenopausal women . Affecting body fat distribution and waist circumference may have important health implication s because it is an independent risk factor in obese but also in nonobese people . Therefore , this study gives further credence to efforts of public health and general practitioners aim ing to increase physical activity levels of postmenopausal women Background : Changes in plasma lipid and lipoprotein distributions that occur after menopause increase the risk of cardiovascular disease in women , especially in those who are overweight . Objective : The purpose of this study was to evaluate the impact of a nine-month weight reduction program on plasma lipids , dietary intake and abdominal fat obesity . Design : A partial crossover design was used to study a weight loss treatment consisting of Phentermine hydrochloride ( Fastin ® , SmithKline Beecham Pharmaceuticals , Philadelphia , PA ) therapy plus a low energy diet ( 5040 kJ/d ) . Forty-seven obese , postmenopausal Caucasian women ( BMI of 30–38 kg/m2 ) were r and omized into two groups , both of which received drug and diet treatment over six months . However , Group I started the intervention program three months later than Group II . Plasma total , HDL and LDL cholesterol and triacylglycerol were measured , body composition was assessed by anthropometry and dual energy x-ray absorptiometry , and food frequency records were collected at four timepoints . Results : Over nine months , women in Group II reduced body weight ( 14.4 % ) , lowered plasma concentrations of LDL cholesterol ( 14 % to 26 % ) and triacylglycerol ( 15 % ) and raised plasma HDL cholesterol concentration ( 15 % ) . These plasma lipid changes decreased the total cholesterol/HDL cholesterol ratio from 4.3 to 3.2 . All subjects decreased abdominal fat measurements and energy and cholesterol intakes , as well as percentage of energy derived from total and saturated fat during the study . Most subjects also increased dietary fiber consumption . Conclusion : Both weight loss and diet modifications are associated with an improved plasma lipid profile in obese postmenopausal women Objective : To compare effects of a high carbohydrate ( high-CHO ) and a monounsaturated fat diet ( high-MUFA ) on body fat distribution and sex hormones in post-menopausal women with Type 2 diabetes . Design : R and omised cross-over with no washout . Setting : Geelong Hospital outpatient . Subjects : Thirty four women were recruited , 30 completed the study , and data are presented for 21 women compliant to the high-CHO diet . Interventions : Women followed a high-CHO diet ( 20 % energy ( % E ) from fat , 60%E from carbohydrate and a high-MUFA diet ( 40%E from fat , half as monounsaturated fat , 40%E from carbohydrate ) in r and om order for 12 weeks each . Main outcome measures : Dietary compliance was measured by change in linoleic acid ( C18:2 , ω-6 ) in plasma cholesteryl esters . Body composition was measured by dual-energy X-ray absorptiometry . Fasting concentrations of glucose and insulin were measured in plasma . Steroid hormones and sex hormone binding globulin ( SHBG ) were measured in serum . Results : On the high-CHO diet C18:2 , ω-6 in plasma cholesteryl esters declined by 5.4 % ( 95 % confidence intervals ( CI ) , −2.5 % to −8.4 % , P=0.0015 ) . Fat was lost mainly from the lower body ( lower body loss −0.71 kg , 95 % CI , −0.43 to −1.00 kg , P=0.001 ; upper body loss −0.15 kg , 95 % CI , −0.76 to + 0.46 kg , P=0.6 ) . Yet on the high-MUFA  diet , lower body fat loss was minimal ( −0.22 kg , 95%CI , + 0.11 to −0.55 kg , P=0.2 ) . By general linear modelling ( GLM ) , differences in lower body fat loss were significantly related to diet ( P=0.04 ) . After adjustment for age , dehydroepi and rosterone sulphate ( DHEAS ) concentrations after the high-CHO diet were related to levels of lower body fat ( r=0.394 , P=0.04 ) . Conclusions : In women with Type 2 diabetes following a high-CHO diet for 12 weeks the disproportionate loss of lower body fat is related to a decline in DHEAS.Sponsorship : Supported by grant 950921 from the National Health and Medical Research Council of Australia The Women On the Move through Activity and Nutrition ( WOMAN ) study is the first r and omized clinical trial of nonpharmacological intervention design ed to modify lipoproteins , weight loss and exercise among postmenopausal women using noninvasive measures of atherosclerosis as the primary endpoint . The trial was initially design ed to test whether intervention as compared to health education would be more effective in slowing progression of sub clinical atherosclerosis among women on hormone therapy ( HT ) , estrogen or estrogen+progestin .  It was design ed and implemented prior to the results of the Women 's Health Initiative ( WHI ) . The trial was since modified to include women who had been on HT but went off after the results of the WHI were reported . Eligible women were between the ages of 52 - 62 , had waist circumference > or=80 cm , low density lipoprotein cholesterol between 100 - 160 mg% and controlled blood pressure . The intervention is low in total and saturated fat , trans fats , higher in fiber and promotes loss of 7 - 10 % of body weight and includes at least 150 min of physical activity per week . The study has recruited 508 women . The primary endpoints are change in extent of carotid intima-media wall thickness as measured by carotid ultrasound , pulse wave velocity as a measure of vascular stiffness and coronary artery calcium using electron beam computed tomography . Body composition is measured by dual-energy X-ray absorptiometry Data suggest that a diet deficient in calcium is associated with higher body weight and that augmenting calcium intake may reduce weight and fat gain or enhance loss . Our aim was to determine whether calcium supplementation during a weight loss intervention affects body fat or weight loss . Data were combined from three separate 25-wk r and omized , double blind , placebo-controlled trials of 1000 mg/d calcium supplementation in 100 premenopausal and postmenopausal women . The primary outcome measures were change in body weight and fat mass adjusted for baseline values . There were no significant differences in body weight or fat mass change between the placebo and the calcium-supplemented groups in the pooled analysis ( adjusted mean + /- SE ; body weight , placebo -6.2 + /- 0.7 vs. Ca -7.0 + /- 0.7 kg ; fat mass , placebo -4.5 + /- 0.6 vs. Ca -5.5 + /- 0.6 kg ) , and no significant interactions of calcium supplementation with menopausal/diet status . Analysis as separate trials also found no significant differences between the placebo and the calcium groups . Calcium supplementation did not significantly affect amount of weight or fat lost by women counseled to follow a moderately restricted diet for 25 wk . Nevertheless , the magnitude and direction of the differences for group means are consistent with a hypothesized small effect BACKGROUND The purpose of this double-blind r and omized clinical trial was to compare the relative effectiveness of a higher protein and conventional carbohydrate intake during weight loss on body composition and physical function in older women . METHODS Thirty-one overweight or obese , postmenopausal women ( mean ± SD : age 65.2 ± 4.6 years , body mass index 33.7 ± 4.9 kg/m(2 ) ) were prescribed a reduced calorie diet ( 1,400 kcal/day ; 15 % , 65 % , 30 % energy from protein , carbohydrate , and fat , respectively ) and r and omly assigned to 2 × 25 g/day whey protein ( PRO n = 15 ) or maltodextrin ( CARB n = 16 ) supplementation for 6 months  . Lean soft tissue ( LST ) via dual-energy X-ray absorptiometry ; thigh muscle , subcutaneous adipose tissue ( SAT ) , and intermuscular adipose tissue with magnetic resonance imaging ; knee strength with isokinetic dynamometry ; balance and physical function with a battery of performance tests . RESULTS PRO lost more weight than CARB ( -8.0 % ± 6.2 % , -4.1 % ± 3.6 % , p = .059 ; respectively ) . Changes in LST , % LST , and strength , balance , or physical performance measures did not differ between groups ( all p > .05 ) . Weight to leg LST ratio improved more in PRO versus CARB ( -4.6 ± 3.6 % , -1.8 ± 2.6 % , p = .03 ) . PRO lost 4.2 % more muscle ( p = .01 ) , 10.9 % more SAT ( p = .02 ) , and 8.2 % more intermuscular adipose tissue ( p = .03 ) than CARB . Relative to thigh volume changes , PRO gained 5.8 % more muscle ( p = .049 ) and lost 3.8 % greater SAT ( p = .06 ) than CARB . Weight to leg LST ratio ( r(2 ) = .189 , p = .02 ) and SAT ( r(2 ) = .163 , p = .04 ) predicted improved up and go , relative muscle ( r(2 ) = .238 , p = .01 ) and SAT ( r(2 ) = .165 , p = .04 ) predicted improved transfer test , and % LST predicted improved balance ( r(2 ) = .179 , p = .04 ) . CONCLUSIONS A higher protein intake during caloric restriction maintains muscle relative to weight lost , which in turn enhances physical function in older women Matching behavioral treatment programs to different types of obese clients is a rarely studied strategy , thus guidelines for identifying who might benefit most from which program remain elusive . This study categorized the weight control self-efficacy beliefs of obese , postmenopausal women , and determined the effects of self-efficacy targeted versus non-targeted ( control ) treatment on weight loss outcomes ( body habitus , physical conditioning , affect , and eating behaviors ) . Obese ( BMI 33 ± 5 ) , postmenopausal ( 60 ± 6 years old ) women ( n= 59 ) participated in a 6-month weight loss program . The 37 women categorized by Q methodology as Assured ( self-confident , independent ) were r and omized to Assured ( AT ) or Non-Targeted ( NT ) treatment ; the 22 Disbelievers ( doubtful , wavering ) were r and omized to Disbeliever ( DT ) or NT treatment . At baseline , the Assureds had significantly smaller body girths and reported significantly greater self-esteem , fewer symptoms of binge eating , and less negative affect overeating than the Disbelievers . Improvement in these variables with weight loss erased significant differences between the groups and was a desired outcome . Treatment delivery type may have influenced attrition rate , since significantly more Assureds dropped from NT than AT and significantly more Disbelievers dropped from DT than NT . Thus , the self-efficacy type may serve as a means to identify different types of treatment needs ( flexible vs. rigid ) to sustain women ’s adherence and success in the program . The significant weight loss outcomes for women in all groups argues for the incorporation of strategies to enhance self-efficacy but not the need for specific treatments that directly target self-efficacy types In this study , we set out to perform a comparative evaluation of variations in body weight and volume between two groups of women , one young adult and the other perimenopausal , each of which followed a specific weight loss program for the same period of time . The evaluation was based on the weight and volume data obtained from a clinical and anthropometric study . From the anthropometric values obtained , we conclude that in both groups of women , the diet followed was found to be effective in reducing weight and volume , but with respect to time , the weight loss was more noticeable among the younger women , while among the menopausal women it took place more slowly . The difference between the two groups might be explained by diverse hormonal effects , such that metabolism ( and therefore caloric expenditure ) is higher among the younger women OBJECTIVE Apelin is a novel adipokine acting on APJ receptor , regulated by insulin and tumor necrosis factor-alpha ( TNF-alpha ) in adipose tissue ( AT ) . Plasma apelin levels are increased in obese hyperinsulinemic subjects . The aim was to investigate whether the hypocaloric diet associated with weight loss modifies the elevated plasma apelin levels and the expression of apelin and APJ receptor in AT in obese women . DESIGN AND METHODS Fasting plasma levels of apelin and TNF-alpha  as well as mRNA levels of apelin and APJ in AT were measured before and after a 12-week hypocaloric weight-reducing diet in 20 obese women ( body mass index ( BMI ) before diet 32.2+/-6.4 kg/m(2 ) ) . Twelve healthy women with a BMI of 20.7+/-0.6 kg/m(2 ) served as reference . RESULTS Plasma levels of apelin and TNF-alpha were higher in obese compared with lean controls . The hypocaloric diet result ed in a significant decrease of BMI to 29.8+/-6.3 kg/m(2 ) , plasma insulin ( 8.16+/-0.73 to 6.58+/-0.66 mU/l ) , apelin ( 369+/-25 pg/ml to 257+/-12 pg/ml ) , TNF-alpha levels ( 0.66+/-0.04 pg/ml to 0.56+/-0.04 pg/ml ) , and AT mRNAs of apelin and APJ . In addition , changes in AT mRNA apelin were related to changes in AT mRNA APJ levels . CONCLUSION The hypocaloric diet associated with weight loss reduces the increased plasma and AT expression of apelin in obese women . This reduced apelin expression in AT could contribute to decreased circulating apelin levels Objectives To evaluate the risk of bias tool , introduced by the Cochrane Collaboration for assessing the internal validity of r and omised trials , for inter-rater agreement , concurrent validity compared with the Jadad scale and Schulz approach to allocation concealment , and the relation between risk of bias and effect estimates . Design Cross sectional study . Study sample 163 trials in children . Main outcome measures Inter-rater agreement between review ers assessing trials using the risk of bias tool ( weighted κ ) , time to apply the risk of bias tool compared with other approaches to quality assessment ( paired t test ) , degree of correlation for overall risk compared with overall quality scores ( Kendall ’s τ statistic ) , and magnitude of effect estimates for studies classified as being at high , unclear , or low risk of bias ( metaregression ) . Results Inter-rater agreement on individual domains of the risk of bias tool ranged from slight ( κ=0.13 ) to substantial ( κ=0.74 ) . The mean time to complete the risk of bias tool was significantly longer than for the Jadad scale and Schulz approach , individually or combined ( 8.8 minutes ( SD 2.2 ) per study v 2.0 ( SD 0.8 ) , P<0.001 ) . There was low correlation between risk of bias overall compared with the Jadad scores ( P=0.395 ) and Schulz approach ( P=0.064 ) . Effect sizes differed between studies assessed as being at high or unclear risk of bias ( 0.52 ) compared with those at low risk ( 0.23 ) . Conclusions Inter-rater agreement varied across domains of the risk of bias tool . Generally , agreement was poorer for those items that required more judgment . There was low correlation between assessment s of overall risk of bias and two common approaches to quality assessment : the Jadad scale and Schulz approach to allocation concealment . Overall risk of bias as assessed by the risk of bias tool differentiated effect estimates , with more conservative estimates for studies at low risk OBJECTIVES In this paper , we present the results of changes in risk factors by use of hormone therapy ( HT ) at 18 months in the Women On the Move through Activity and Nutrition ( WOMAN ) r and omized trial . METHODS The trial was design ed to test the hypothesis that aggressive dietary changes and increased physical activity to reduce weight , waist circumference ( WC ) , glucose , insulin , and lipoproteins would reduce progression of sub clinical atherosclerosis , carotid intimal media thickness and plaque , coronary artery calcification , and pulse wave velocity ( PWV ) . The study focused on postmenopausal women ( n = 508 ) , mean age of 57 , who were r and omized to the Lifestyle Change ( LC ) or Health Education ( HE ) group .  RESULTS At 18 months of follow-up , there was significant , 17 lb , weight loss and 10 cm WC decrease in the LC group . There were significant differences in changes in low-density lipoprotein cholesterol ( LDL-C ) , insulin , glucose , large LDL , and LDL particles between the LC and HE groups . Risk factor changes were greater for women in the LC who lost a significant amount of weight ( > or=18.8 lb ) . Participants at 18 months were subdivided into women who had stayed on HT , 125 ( 28 % ) ; stopped HT after r and omization , 145 ( 33 % ) ; and not on HT at baseline but stopped an average of 7 months prior to r and omization , 173 ( 39 % ) . Weight loss in the LC was similar for all three groups , but LDL lipoprotein response was better for women who stopped HT after r and omization or were not on HT at baseline . CONCLUSIONS The trial has been successful in increasing exercise and diet changes and reduction in weight and WC and variables related to metabolic syndrome OBJECTIVE To examine the change in menopausal symptoms and cardiovascular risk factors in response to 4 months of daily 100‐mg soy isoflavone in postmenopausal women . METHODS In this double‐blind , placebo‐controlled study , 80 women were r and omly assigned to isoflavone ( n = 40 ) and placebo ( n = 40 ) treatment . The menopausal Kupperman index was used to assess change in menopausal symptoms at baseline and after 4 months of treatment . Cardiovascular risk factors were assessed by evaluating plasma lipid levels , body mass index , blood pressure , and glucose levels in the participants . To examine the effects of this regime on endogenous hormone levels , follicle‐stimulating hormone ( FSH ) , luteinizing hormone ( LH ) , and 17β‐estradiol  were measured . Transvaginal sonography was performed to quantify endometrial thickness . RESULTS The data showed a decrease in menopausal symptoms ( P < .01 , paired t test , two‐tailed , between baseline and isoflavone groups , and P < .01 , unpaired t test , between placebo and isoflavone groups ) . Total cholesterol and low‐density lipoprotein decreased significantly in the isoflavone group compared with the baseline or placebo group ( P < .001 , paired t test , two‐tailed , between baseline and isoflavone groups , and P < .01 , unpaired t test , between placebo and isoflavone groups ) . The isoflavone treatment appeared to have no effect on blood pressure , plasma glucose , and high‐density lipoprotein and triglyceride levels . CONCLUSION This study suggests that isoflavone 100‐mg regime treatment may be a safe and effective alternative therapy for menopausal symptoms and may offer a benefit to the cardiovascular system OBJECTIVE To investigate the effect of soy protein supplementation with known levels of phytoestrogens on cardiovascular disease risk factors and menopausal symptoms in perimenopausal women . METHODS A r and omized , double-blind crossover trial was conducted in 51 women consuming isocaloric supplements containing 20 g of complex carbohydrates ( comparison diet ) , 20 g of soy protein containing 34 mg of phytoestrogens given in a single dose , and 20 g of soy protein containing 34 mg of phytoestrogens split into two doses .  Women were r and omly assigned to one of the three diets for 6-week periods and subsequently were r and omized to the remaining two interventions to determine whether differences existed between the treatment diets for cardiovascular disease risk factors , menopausal symptoms , adherence , and potential adverse effects . RESULTS Significant declines in total cholesterol ( 6 % lower ) and low density lipoprotein cholesterol ( 7 % lower ) were observed in both soy diets compared with the carbohydrate placebo diet . A significant decline in diastolic blood pressure ( 5 mm Hg lower ) was noted in the twice-daily soy diet , compared with the placebo diet . Although nonsignificant effects were noted for a number of measures of quality of life , a significant improvement was observed for the severity of vasomotor symptoms and for hypoestrogenic symptoms in the twice-daily group compared with the placebo group . No significant effects were noted for triglycerides , high density lipoprotein cholesterol or frequency of menopausal symptoms . Adherence was excellent in all groups . CONCLUSIONS Soy supplementation in the diet of nonhypercholesterolemic , nonhypertensive , perimenopausal women result ed in significant improvements in lipid and lipoprotein levels , blood pressure , and perceived severity of vasomotor symptoms . These data corroborate the potential importance of soy supplementation in reducing chronic disease risk in Western population Abstract Orsatti , FL , Nahas , EAP , Orsatti , CL , de Oliveira , EP , Nahas-Neto , J , da Mota , GR , and Burini , RC . Muscle mass gain after resistance training is inversely correlated with trunk adiposity gain in postmenopausal women . J Strength Cond Res 26(8 ) : 2130–2139 , 2012—The aim of this study was to evaluate alterations in trunk adiposity ( TA ) over 9 months of resistance training ( RT ) and associate these changes with the hypertrophy of muscle mass ( MM ) in postmenopausal women ( PW ) . The investigation used a sample that consisted of 22 PW ( 44–69 years old ) . The group was subjected to RT ( 60–80 % of 1 repetition maximum ) for the total body 3 d·wk−1 . Body composition  ( dual-energy x-ray absorptiometry )  and plasma levels of insulin-like growth factor-1 ( IGF-1 ) , follicle-stimulating hormone , E2 ( Immulite system )  , and interleukin-6 ( IL-6  ; enzyme-linked immunosorbent assay ) were assessed at the beginning and end of the experiment . After RT , only women who acquired up to 5 % TA gained MM , whereas women who acquired > 5 % TA exhibited increased IL-6 and no MM gain ( p < 0.05 ) . The & Dgr;MM was negatively associated with time of menopause ( r = −0.45 , p < 0.05 ) and positively associated with baseline IGF-1 ( r = 0.47 , p < 0.05 ) . Only & Dgr;LE ( leg extension ) was negatively associated with baseline IL-6 ( p < 0.05 ) . Trunk adiposity growth ( & Dgr;TF , kilograms ) was positively correlated with changes in IL-6 ( r = 0.68 , p < 0.05 ) . The MM gain was negatively correlated with & Dgr;TF ( r = −0.63 , p < 0.05 ) and changes in IL-6 ( r = −0.73 , p < 0.05 ) . After adjusting all of the confounding variables , only baseline IGF-1 ( positively ) and changes in IL-6 ( negatively ) influenced MM , and only the increase in TA influenced IL-6 . Our study suggests that increased levels of TA during RT increase IL-6 concentrations , which is a significant negative predictor of MM gain in PW The Women 's Healthy Lifestyle Project is a 5-year r and omized clinical testing whether a behavioral intervention aim ed at lifestyle changes in diet and physical activity can prevent the rise in weight and low-density lipoprotein cholesterol ( LDL-c ) observed during menopause . Cardiovascular risk factor and behavioral data from 489 participants ( intervention group n = 236 ; control group n = 253 ) who attended baseline , 6-month , and 18-month clinical assessment s were analyzed to determine how well initial improvements achieved at 6 months were maintained over the subsequent year of follow-up . Results indicated that the treatment effect persisted at 18 months for weight , body mass index , total cholesterol , LDL-c , systolic blood pressure ( SBP ) , and glucose levels . Intervention participants maintained improvements in physical activity , caloric intake , dietary cholesterol , SBP , and glucose levels between 6 and 18 months , although weight , total cholesterol , and LDL-c began to rise during this period . Eighty percent of intervention participants compared to 45 % of controls were at or under baseline weight at 18 months , suggesting that promoting modest weight loss may be an effective approach to preventing weight gain in these women We compared the effects of one vs two daily bouts of walking on aerobic fitness and body composition in postmenopausal women . One hundred and thirty-four subjects were r and omized into exercise groups or a control group and 130 completed the study . The subjects walked 5 d/week for 15 weeks at 65 % of their maximal aerobic power expending 300 kcal ( 1255 kJ ) in exercise in one ( Group S1 ) or two daily sessions ( Group S2 ) . VO(2max ) was measured in a direct maximal treadmill test . Body mass index ( BMI ) was calculated and the percentage of body fat ( fat% ) estimated using skinfold measurements . The net change in the VO(2max ) was 2.5 mL min/kg ( 95 % CI 1.5 , 3.5 ) ( 8.7 % ) in Group S1 and 2.5 mL min/kg ( 95 % CI 1.5 , 3.5 ) ( 8.8 % ) in Group S2 . The net change in body mass was -1.2 kg ( 95 % CI-1.9 , -0.5 ) in Group S1 and -1.1 kg ( 95 % CI -1.8 , -0.4 ) in Group S2 . The net fat% change was -2.1 % ( 95 % CI-2.7 , -1.4 ) in Group S1 and -1.7 % ( 95 % CI-2.3 , -1.0 ) in Group S2 . Exercise improved the maximal aerobic power and body composition equally when walking was performed in one or two daily bouts Objective Menopause-induced estrogen deficiency increases the risk of cardiovascular disease , which is related to a shift in regional fat distribution . We tested the hypothesis that estrogen-like isoflavones in soy protein isolate ( SPI+ ) would lessen both regional fat gain and lean loss compared with isoflavone-poor soy ( SPI− ) . Design Perimenopausal participants ( N = 69 ) were r and omly assigned ( double-blind ) to 24 weeks of treatment ( 40 g soy or whey protein per day ) : SPI+ ( n = 24 ) , SPI− ( n = 24 ) , or whey control ( n = 21 ) ; each participant had blood drawn in the fasted ( 12 hours ) state , had physical activity assessed , and kept a 5-day food diary . Dual-energy x-ray absorptiometry was used to examine the effects of SPI+ on regional fat and lean tissue distribution changes in the waist , hip , and thigh regions . Results Mean body mass increased ( P < 0.01 ) in each group , but treatment had no effect on gain in overall body mass , fat mass , or lean mass using analysis of variance . In all treatment groups combined , lean mass increased in each region ; fat mass increased only in the waist region . Treatment had an effect ( P = 0.039 ) on hip lean mass and a marginal effect ( P = 0.077 ) on thigh fat . Regression analyses revealed that SPI+ diminished the increase in thigh fat ( P = 0.018 ) and heightened the increase in hip lean ( P = 0.035 ) mass . Carbohydrate intake ( P = 0.006 ) and cohort ( reflective of season ; P = 0.011 ) contributed to the gain in thigh fat . Total protein intake ( P = 0.0012 ) , plasma insulin ( P = 0.0034 ) , and physical activity ( P = 0.047 ) contributed to the gain in hip lean mass . Conclusions Gain in hip lean mass was greater ( P = 0.014 ) in SPI+ than other groups , but SPI+ did not reduce the disease-promoting menopausal shift in regional fat mass BACKGROUND Exercise intensity may affect the selective loss of abdominal adipose tissue . OBJECTIVE This study showed whether aerobic exercise intensity affects the loss of abdominal fat and improvement in cardiovascular disease risk factors under conditions of equal energy deficit in women with abdominal obesity . DESIGN This was a r and omized trial in 112 overweight and obese [ body mass index ( in kg/m(2 ) ) : 25 - 40 ; waist circumference > 88 cm ] , postmenopausal women assigned to one of three 20-wk interventions of equal energy deficit  : calorie restriction ( CR only ) , CR plus moderate-intensity aerobic exercise ( CR + moderate-intensity ) , or CR plus vigorous-intensity exercise ( CR + vigorous-intensity ) . The diet was a controlled program of underfeeding during which meals were provided at individual calorie levels ( approximately 400 kcal/d ) . Exercise ( 3 d/wk ) involved treadmill walking at an intensity of 45 - 50 % ( moderate-intensity ) or 70 - 75 % ( vigorous-intensity ) of heart rate reserve . The primary outcome was abdominal visceral fat volume . RESULTS Average weight loss for the 95 women who completed the study was 12.1 kg ( + /-4.5 kg ) and was not significantly different across groups . Maximal oxygen uptake ( O(2)max ) increased more in the CR + vigorous-intensity group than in either of the other groups ( P < 0.05 ) . The CR-only group lost relatively more lean mass than did either exercise group ( P < 0.05 ) . All groups showed similar decreases in abdominal visceral fat ( approximately 25 % ; P < 0.001 for all ) . However , changes in visceral fat were inversely related to increases in O(2)max ( P < 0.01 ) . Changes in lipids , fasting glucose or insulin , and 2-h glucose and insulin areas during the oral-glucose-tolerance test were similar across treatment groups . CONCLUSION With a similar amount of total weight loss , lean mass is preserved , but there is not a preferential loss of abdominal fat when either moderate- or vigorous-intensity aerobic exercise is performed during caloric restriction . This trial was registered at ( Clinical Trials.gov ) as : NCT00664729 OBJECTIVE To examine whether dietary changes and the consumption of dairy products fortified with calcium and vitamin D3 versus the use of a calcium supplement alone could have any effect on anthropometric and body composition indices of postmenopausal women over a 12-month period . METHODS 101 healthy postmenopausal women were r and omized to a dietary intervention group ( DG : n=39 ) , receiving approximately 1200 mg of calcium and 7.5 microg of vitamin D3 per day via fortified dairy products and attending biweekly dietary and lifestyle intervention sessions ; a calcium supplemented group ( CaG : n=26 ) receiving a total of 1200 mg calcium per day ; and a control group who continued with their usual diet ( CG : n=36 ) . Dietary , physical activity , anthropometric , body composition and distribution ( based on DXA ) data were collected at baseline and after 12 months of intervention . RESULTS No significant differences were observed in the mean 12-month changes in certain anthropometric ( i.e. weight , BMI ) and DXA ( i.e. total body fat and lean mass ) indices between groups . However , the DG was found to have a lower decrease in mid-arm muscle circumference ( P<0.001 ) and a lower increase in the sum of skinfolds ' thickness ( P=0.042 ) compared with the CaG and the CG . Furthermore , the DG was also found to have a greater decrease in the percentage of legs ' fat mass ( P=0.025 ) and a higher increase in the percentage of legs ' lean mass ( P=0.012 ) compared with the two other groups . CONCLUSION The application of a holistic intervention approach combining nutrition and lifestyle counseling with consumption of fortified dairy products for 12 months was found to have favourable changes in certain anthropometric and body composition indices compared to calcium supplementation alone Calcium from dairy sources is beneficial to weight loss ; however , no studies have compared the effects of dairy to nondairy sources of calcium on weight loss . This pilot study explored differences between soy and skim milk on changes in anthropometric values in premenopausal women . In a prospect i ve r and omized controlled trial , 14 women with overweight/obesity were r and omly assigned to 720 mL soy milk ( n=7 ) or an equivalent volume of skim milk ( n=7 ) daily for 8 weeks . Subjects followed a 500-kcal deficit diet based on metabolic rate data . There were no anthropometric differences between soy and skim milk groups at baseline . Subjects followed an energy-restricted diet ; both groups experienced reductions in kilogram weight ( 4.27+/-2.05 vs 3.76+/-2.25 ; P=0.668 ) , body fat percent ( 1.30+/-1.37 vs 1.87+/-1.45 ; P=0.464 ) , and abdominal circumference ( 11.28+/-5.23 vs 8.66+/-2.51 ; P=0.259 ) while attenuating losses of fat-free mass ( 1.12+/-1.29 vs 0.43+/-1.12 ; P=0.299 ) during the 8-week study . There were no significant differences in weight , fat percent , abdominal circumference , and fat-free mass between groups . To optimize the weight loss effects of calcium , one can consume 720 mL of either soy milk or skim milk daily Objective . To examine if healthy borderline overweight postmenopausal women with osteoporosis can improve their waist circumference and lipid profile with a moderate physical training program . Design . R and omized controlled trial . Setting . One hundred and twelve postmenopausal women were r and omized to normal sedentary life or one year of physical training consisting of three brisk walks and 1–2 aerobic exercises/week . Main Outcome Measures . Waist circumference reduction , waist circumference reduction in relation to observed level of participation in physical intervention and changes in cholesterol , triglycerides , apolipoproteins B and A1 and high‐sensitivity C‐reactive protein ( hs‐CRP ) . Results . At start the mean ( SD ) waist circumference was 83.6 ( 7.7 ) and 81.8 ( 7.5 ) cm in the control and training groups , respectively . In relation to baseline , the 12 months intervention led to a waist reduction of 0.3 cm ( 2.7 ) ( p = 0.36 ) and 1.6 cm ( 4.7 ) ( p = 0.02 ) in the respective groups but the inter‐group comparison was not significant in an intention‐to‐treat analysis ( p = 0.09 ) . The ninety‐two women completing the study intervention were analyzed per protocol . A tendency for better waist reduction in relation to the women 's observed physical intensity level was observed ( p = 0.07 , ANOVA for linear trend across training intensity levels ) . Training women improved their waist circumference 1.7 cm ( p = 0.01 ) compared to baseline and was borderline significantly better than controls ( p = 0.059 ) . No significant changes in response to the intervention were observed for blood pressure , cholesterol , triglycerides , apolipoproteins and hs‐CRP . Conclusions . A moderate physical exercise program for healthy postmenopausal women during one year reduced the waist circumference in a training intensity dependent manner Phytoestrogens and training could be effective to reduce cardiovascular and type 2 diabetes mellitus risk factors in postmenopausal women . Nevertheless , the impact of their combination on adipokines and systemic inflammation was never investigated . The objective was to verify if 6 months of mixed training combined with phytoestrogens could have an additional effect on adipokine levels and systemic inflammation in obese postmenopausal women . Fifty-two obese women aged between 50 and 70 years were r and omly assigned to ( 1 ) exercise with placebo ( EX + PL ; n = 25 ) or ( 2 ) exercise with phytoestrogens ( EX + PHY ; n = 27 ) . Body weight , waist circumference , fat mass , and lean body mass ( dual-energy x-ray absorptiometry ) were assessed . Fasting plasma glucose and insulin , adiponectin , leptin , and C-reactive protein ( CRP ) levels were obtained after a 12-hour overnight fast . Total energy intake was measured with a 3-day dietary record . All measurements were performed before and after the 6-month intervention . Although energy intake remained unchanged , body composition was improved in all women ( all Ps < .02 ) . Plasma CRP and leptin levels decreased in both groups similarly ( all Ps < .03 ) , whereas plasma adiponectin and insulin did not change with exercise combined with placebo or phytoestrogens . Correlation analyses showed that homeostasis model assessment of insulin resistance ( r = -0.58 , P = .02 ) and fasting insulin levels ( r = -0.42 , P = .02 ) at baseline were both correlated with changes in leptin levels . Baseline fasting glucose ( r = -0.36 , P = .03 ) and adiponectin ( r = 0.45 , P = .005 ) levels were associated with changes in CRP concentrations . Although mixed exercise program combined with phytoestrogens does not seem to provide any additional effect , mixed training improves systemic inflammation and leptin concentrations in obese postmenopausal women OBJECTIVES To compare the effects of daily ingestion of dietary soy supplementation , low-dose hormone therapy ( HT ) and placebo on psychological , somatic and urogenital symptoms in postmenopausal women . STUDY DESIGN A double-blind , r and omized , controlled trial . Sixty healthy , symptomatic , postmenopausal women of 40 - 60 years of age were allocated to use dietary soy supplementation ( containing 90 mg of isoflavone ) or HT ( 1 mg estradiol and 0.5 mg norethisterone acetate ) or placebo . MAIN OUTCOME MEASURES the Menopause Rating Scale ( MRS ) was used to assess menopausal symptoms at baseline and after 16 weeks of treatment . Intention-to-treat analyses were performed using the chi-square test , Fisher 's exact test , the Kruskal-Wallis non-parametric test and analysis of variance ( ANOVA ) . RESULTS No statistically significant differences were found between the groups with respect to baseline clinical and sociodemographic characteristics . The psychological , somatic and urogenital symptoms analyzed in the MRS improved during treatment in all the groups , except for urogenital symptoms in the placebo group in which no significant changes were detected . Comparison between groups revealed a statistically significant improvement in somatic symptoms ( hot flashes and muscle pain ) in the users of HT ( -45.6 % ) and dietary soy supplementation ( -49.8 % ) . Urogenital symptoms ( vaginal dryness ) improved significantly in HT users ( -38.6 % ) and in users of the dietary soy supplementation ( -31.2 % ) . There was no statistically significant difference between the groups with respect to overall MRS score or to scores obtained in the psychological symptoms subscale . CONCLUSION Dietary soy supplementation may constitute an effective alternative therapy for somatic and urogenital symptoms of the menopause PURPOSE The main purpose of this study was to analyze the impact of a 1-yr resistance-training program on body composition and muscle strength in postmenopausal women , and to describe the impact of hormone replacement therapy ( HRT ) on body composition changes , with and without exercise . Secondarily , we wanted to study dose-response relationships between measures of program compliance and changes in primary outcomes . METHODS Subjects were postmenopausal women ( 40 - 66 yr ) r and omly assigned to an exercise ( EX ) group ( N = 117 ) and a nonexercise group ( N = 116 ) . The EX group participated in a 1 yr trainer-supervised resistance-training program , 60 - 75 min.d-1 , 3 d.wk-1 . Lean soft tissue ( LST ) and fat tissue ( FT ) changes were measured by dual-energy x-ray absorptiometry and strength by one-repetition maximum testing . RESULTS Significant ( P < 0.001 ) gains in LST were observed for women who exercised , regardless of HRT status , whereas women who did not exercise lost LST ( P < 0.05 ) if they were not taking HRT , and gained LST ( P = 0.08 ) if they were on HRT . The only significant FT losses were observed for women who exercised while on HRT ( P < 0.05 ) . Strength increases were observed at all sites ( P < 0.001 ) . Total weight lifted by subjects in their training sessions was a significant predictor of changes in LST ( P < 0.001 ) and strength ( P < 0.01 ) . CONCLUSIONS Resistance and weight-bearing exercise significantly changed total and regional body composition in postmenopausal women by increasing LST in all women and decreasing FT in women on HRT . Hormone therapy showed no independent effects on body composition , but it protected nonexercising women from losses in LST . The lean and muscle strength changes observed were partially dependent on the volume of training , as expressed by attendance and total weight lifted in 1 yr of training OBJECTIVE To assess beneficial effects of a soy rich diet on the main biomarkers of cardiovascular health in menopause , compared with the effects of the hormone replacement therapy ( HRT ) . METHODS 187 healthy asymptomatic postmenopausal women , aged 39 - 60 , were recruited and r and omized into three groups : a soy rich diet group , a HRT group , and a control group .  Lipid profile , body mass index , blood pressure , endometrial thickness , uterine artery resistance index ( RI ) , were evaluated in all the participants at the baseline , after 6 months , and at the end of the study . RESULTS After a 6-month intervention period , the lipid profile in the soy rich diet group showed a favourable outcome , similar to that observed in the HRT group , but compliance to the diet was low . CONCLUSION Soy products may be used in the prevention of cardiovascular risk in postmenopausal women because of their efficacy in contrasting the negative effects of menopause on the cardiovascular system , but our findings should be confirmed ; moreover , suitable strategies to improve the compliance have to be considered OBJECTIVE The objective was to assess the effect of a low-fat , vegan diet compared with the National Cholesterol Education Program ( NCEP ) diet on weight loss maintenance at 1 and 2 years . RESEARCH METHODS AND PROCEDURES Sixty-four overweight , postmenopausal women were r and omly assigned to a vegan or NCEP diet for 14 weeks , and 62 women began the study . The study was done in two replications . Participants in the first replication ( N = 28 ) received no follow-up support after the 14 weeks , and those in the second replication ( N = 34 ) were offered group support meetings for 1 year . Weight and diet adherence were measured at 1 and 2 years for all participants . Weight loss is reported as median ( interquartile range ) and is the difference from baseline weight at years 1 and 2 . RESULTS Individuals in the vegan group lost more weight than those in the NCEP group at 1 year [ -4.9 ( -0.5 , -8.0 ) kg vs. -1.8 ( 0.8 , -4.3 ) ; p < 0.05 ] and at 2 years [ -3.1 ( 0.0 , -6.0 ) kg vs. -0.8 ( 3.1 , -4.2 ) kg ; p < 0.05 ] . Those participants offered group support lost more weight at 1 year ( p < 0.01 ) and 2 years ( p < 0.05 ) than those without support . Attendance at meetings was associated with improved weight loss at 1 year ( p < 0.001 ) and 2 years ( p < 0.01 ) . DISCUSSION A vegan diet was associated with significantly greater weight loss than the NCEP diet at 1 and 2 years . Both group support and meeting attendance were associated with significant weight loss at follow-up OBJECTIVE To evaluate the effect of a Mindful Restaurant Eating intervention on weight management . DESIGN R and omized control trial . SETTING Greater metropolitan area of Austin , Texas . PARTICIPANTS Women ( n = 35 ) 40 - 59 years old who eat out at least 3 times per week . INTERVENTION The intervention , using 6 weekly 2-hour , small group sessions , focused on reducing calorie and fat intake when eating out through education , behavior change strategies , and mindful eating meditations . MAIN OUTCOME MEASURES Weight , waist circumference , self-reported daily calorie and fat intake , self-reported calories and fat consumed when eating out , emotional eating , diet related self-efficacy , and barriers to weight management when eating out . ANALYSIS General linear models examined change from baseline to final endpoint to determine differences in outcomes between the intervention and control group . RESULTS Participants in the intervention group lost significantly more weight ( P = .03 ) , had lower average daily caloric ( P = .002 ) and fat intake ( P = .001 ) , had increased diet-related self-efficacy ( P = .02 ) , and had fewer barriers to weight management when eating out ( P = .001 ) . CONCLUSIONS AND IMPLICATION S Mindful Restaurant Eating intervention was effective in promoting weight management in perimenopausal women
To determine the effectiveness of exercise and /or nutrition interventions and to address body weight changes  during the menopause transition .