Background: Weight gain in perimenopausal women results in increased visceral adipose

Background: Weight gain in perimenopausal women results in increased visceral adipose tissue, leading to metabolic syndrome and associated comorbidities. or a self-directed intervention (SDI) (print materials only) (n=26). The primary outcome, body weight (kg) and secondary outcomes (blood lipids, glucose, body fat %, lean mass % and waist circumference) were measured at baseline and postintervention (12 months), and intention-to-treat analysis was conducted. Results: Forty women completed all measures and IWP-3 supplier adhered to all protocols. The weight at 12 months for the MI group of 65.6?kg (95% CI: 64.5; 66.8) was significantly different (P=0.034) from the SDI group of 67.4?kg (95% CI: 66.2; 68.6). When stratified by baseline BMI category, the MI group lost IL8 significantly more weight (?2.6?kg; 95% CI: ?3.9; ?1.2) than the SDI group (?0.1?kg; 95% CI: ?1.2; 1.0, P=0.002) for the healthy weight women. The overweight women lost weight regardless of the intervention group, with no between-group difference (?3.5?kg; 95% CI: ?6.1, ?1.0 and ?2.3; 95% CI: ?4.1, ?0.5, P=0.467). Conclusion: This relatively low-intensity intervention, incorporating MI into health professional counselling, not only effectively prevented weight gain but also achieved significant weight loss and decreased diastolic blood pressure. Further refinements are required to optimise outcomes for overweight women. Introduction Obesity is a key public health challenge of the postindustrialised world. Physiological and psychological factors make obesity resistant to treatment, highlighting the distinct need for prevention.1 The high incidence of obesity means preventive efforts need to be directed to whole IWP-3 supplier populations, or population subgroups at high risk.2 Prevention of weight gain is particularly important during the menopause transition, which is associated with oestrogen deficiency-induced visceral fat deposition,3, 4 and IWP-3 supplier decreased total energy requirements secondary to loss of lean body mass,5 creating a metabolic environment in mid-age women conducive to metabolic syndrome and weight gain.3 Metabolic syndrome, characterised by insulin resistance,6, 7 accounts for an estimated 48% of coronary events in postmenopausal women.4 Observational studies provide evidence for increasing body fatness8, 9, 10 and deterioration of the lipid profile with the menopause;11 however, evidence of effective interventions designed to prevent menopausal weight gain is lacking. To the authors’ knowledge, only one intervention, the Women’s Healthy Lifestyle Project (WHLP),12, 13 has been published. The WHLP randomised 535 premenopausal women into a lifestyle intervention group (15-session diet and exercise education program followed by a maintenance program for 5 years) or an assessment-only control group. IWP-3 supplier The lifestyle group lost a mean (s.d.) of 0.1 (5.2)?kg and only raised low-density lipoprotein (LDL)-cholesterol by 0.09?mmol?l?1 after 54 months compared with the control group, which gained 2.4 (4.9)?kg and had a rise in LDL-cholesterol of 0.23?mmol?l?1.13 These results, while impressive, required intensive resources for the intervention, making population-wide application problematic. Lower intensity interventions that are feasible and sustainable are needed. The Australian primary health-care setting provides a model to test an intervention for women about to enter menopause. The National Health Service, Medicare Australia, IWP-3 supplier funds up to five consultations per year with an allied health practitioner (including Dietitians and Exercise Physiologists) for patients with chronic and complex medical problems referred by their general practitioners.14 Extension of this service-delivery model to prevent obesity in women in late premenopause would provide a relatively low-intensity, sustainable, national intervention aimed at preventing obesity in a high-risk group. The aim of the current study was to test the feasibility and effectiveness of a 12-month health professional intervention (the 40-Something study) in preventing obesity in non-obese premenopausal women, in comparison with women self-directing their intervention after receiving written information. Materials and methods Study design and participants A parallel-group randomised controlled trial (RCT) design was used to compare the health professional-led intervention (motivational interviewing (MI) intervention), with a written information self-directed intervention (SDI). The study consisted of a 12-month intervention phase followed by 12 months of monitoring only, and conformed to CONSORT guidelines.15 The study received ethical approval from the University of Newcastle Human Research Ethics Committee (H2010-0030), and was registered with the Australian New Zealand Clinical Trials Registry (reference number ACTRN12611000064909). The detailed methods of the study have been published.16 Participants.

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