Simkin-Silverman Laurey R, Wing Rena R, Boraz Miriam A, Kuller Lewis H
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA.
Ann Behav Med. 2003 Dec;26(3):212-20. doi: 10.1207/S15324796ABM2603_06.
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.
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.
Data are from a 5-year randomized clinical trial known as the Women's Healthy Lifestyle Project, conducted from 1992 to 1999.
535 healthy, premenopausal women ages 44 to 50 at study entry enrolled into the trial.
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).
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.
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.
与绝经相关的体重增加和腰围增加对老年女性的心血管健康有重大影响。饮食和体育活动生活方式干预对预防从围绝经期到绝经后期体重增加和心血管疾病（CVD）风险因素升高的效果尚不清楚。
报告一项生活方式饮食和体育活动计划对体重、身体成分、体育活动、饮食及其他CVD风险因素的54个月结果。
数据来自一项为期5年的随机临床试验，即女性健康生活方式项目，该试验于1992年至1999年进行。
535名在研究开始时年龄为44至50岁的健康绝经前女性参加了该试验。
参与者被随机分配到接受为期5年行为饮食和体育活动计划的生活方式干预组或仅接受评估的对照组。生活方式干预组设定了适度的体重减轻目标（5 - 15磅，或约2.3 - 6.8千克），以防止在试验结束时体重超过基线体重。为了实现体重减轻并降低低密度脂蛋白胆固醇水平，干预组参与者遵循每天1300千卡（总脂肪25%，饱和脂肪7%，膳食胆固醇100毫克）的饮食模式，并增加体育活动消耗（每周1000 - 1500千卡）。
关于预防体重增加，4.5年后，55%（136/246）的干预组参与者体重处于或低于基线体重，而对照组为26%（68/261），χ2(2, N = 507)=45.0，p <.001。干预组的平均体重变化比基线低0.1千克（标准差 = 5.2千克），而对照组平均增加2.4千克（标准差 = 4.9千克）。与对照组相比，干预组的腰围也显著下降更多（中位数 = -2.9厘米，标准差 = 5.3；而中位数 = -0.5厘米，标准差 = 5.6，p <.001）。此外，生活方式干预组的参与者始终比对照组更积极地进行体育活动，并且报告摄入的卡路里和脂肪更少。长期坚持体育活动和低脂饮食模式与更好地维持体重有关。
在健康女性中，通过长期的生活方式饮食和体育活动干预，可以预防围绝经期到绝经后期的体重增加和腰围增加。
