Lifestyle intervention can prevent weight gain during menopause: results from a 5-year randomized clinical trial.

CONTEXT

Menopausal-related weight gain and increased waist circumference have major cardiovascular health implications 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 randomized 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 randomly 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, chi2(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.