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Longitudinal changes in weight in perimenopausal and early postmenopausal women: effects of dietary energy intake, energy expenditure, dietary calcium intake and hormone replacement therapy


OBJECTIVE: To investigate whether energy intake or energy expenditure affects 5–7 y weight gain in perimenopausal and early postmenopausal women, and whether hormone replacement therapy (HRT) use or dietary calcium (Ca) intake are contributory factors.

DESIGN: Longitudinal, observational study of healthy women around the menopause.

SUBJECTS: A total of 1064 initially premenopausal women, selected from a random population of 5119 women aged 45–54 y at baseline. In all, 907 women (85.2%) returned 6.3±0.6 y later for repeat measurements. Of these, 36% were postmenopausal (no HRT) and 45% had taken HRT, and 898 women completed the questionnaires.

MEASUREMENTS: Weight, height, estimation of energy intake by food frequency questionnaire and physical activity level (PAL) by questionnaire.

RESULTS: Change in PAL influenced weight change explaining 4.4% (P=0.001) of the variation. Alterations in dietary energy intake also had a small but significant effect (0.6% P=0.013). Dietary Ca intake had no effect on weight or weight change.

CONCLUSION: Mean weight had increased and was influenced more by reduced energy expenditure rather than increased energy intake. HRT and dietary Ca intake did not influence weight gain.

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  1. Shaw A, McMann A, Field J . Scottish health survey 1998. Scottish Executive Department of Health: Edinburgh; 2000.

    Google Scholar 

  2. Reilly JJ, Lord A, Bunker VW, Prentice AM, Coward WA, Thomas AJ, Briggs RS . Energy balance in healthy elderly women. Br J Nutr 1993; 69: 21–27.

    Article  CAS  Google Scholar 

  3. Manson JE, Colditz GA, Stampfer MJ, Willett WC, Rosner B, Monson RR, Speizer FE, Hennekens CH . A prospective study of obesity and risk of coronary heart disease in women. N Engl J Med 1990; 322: 882–889.

    Article  CAS  Google Scholar 

  4. Matthews KA, Meilahn E, Kuller LH, Kelsey SF, Caggiula AW, Wing RR . Menopause and risk factors for coronary heart disease. N Engl J Med 1989; 321: 641–646.

    Article  CAS  Google Scholar 

  5. Wing RR, Matthews KA, Kuller LH, Meilahn EN, Platinga PL . Weight gain at the time of menopause. Arch Intern Med 1991; 51: 97–102.

    Article  Google Scholar 

  6. Poehlman ET, Toth MJ, Gardner AW . Changes in energy balance and body composition at menopause: a controlled longitudinal study. Ann Intern Med 1995; 123: 673–675.

    Article  CAS  Google Scholar 

  7. Ryan PJ, Harrison R, Blake GM, Fogelman I . Compliance with hormone replacement therapy (HRT) after screening for postmenopausal osteoporosis. Br J Obstet Gynaecol 1992; 99: 325–328.

    Article  CAS  Google Scholar 

  8. Zemel MB, Shi H, Greer B, Dirienzo D, Zemel PC . Regulation of adiposity by dietary calcium. FASEB J 2000; 14: 1132–1138.

    Article  CAS  Google Scholar 

  9. Lovejoy JC, Champagne CM, Smith SR, de Jonge L, Xie H . Ethnic differences in dietary intakes, physical activity, and energy expenditure in middle-aged, premenopausal women: the Healthy Transitions Study. Am J Clin Nutr 2001; 74: 90–95.

    Article  CAS  Google Scholar 

  10. Heaney RP, Davies KM, Barger-Lux MJ . Calcium and weight: clinical studies. J Am Coll Nutr 2002; 21: 152S–155S.

    Article  CAS  Google Scholar 

  11. Davies KM, Heaney RP, Recker RR, Barger-Lux MJ, Lappe JM . Calcium intake and body weight. J Clin Endocrinol Metab 2000; 85: 4635–4638.

    CAS  PubMed  Google Scholar 

  12. Garton MJ, Torgerson DJ, Donaldson C, Russell IT, Reid DM . Recruitment methods of screening programmes: trial of a new method within a regional osteoporosis study. BMJ 1992; 305: 82–84.

    Article  CAS  Google Scholar 

  13. Torgerson DJ, Garton MJ, Donaldson C, Russell IT, Reid DM . Recruitment methods for screening programmes: trial of an improved method within a regional osteoporosis study. BMJ 1993; 307: 99.

    Article  CAS  Google Scholar 

  14. New SA, Bolton-Smith C, Grubb DA, Reid DM . Nutritional influences on bone mineral density: a cross-sectional study in menopausal women. Am J Clin Nutr 1997; 65: 1831–1839.

    Article  CAS  Google Scholar 

  15. New SA, Robins SP, Campbell MK, Martin JC, Garton MJ, Bolton Smith C, Grubb DA, Lee SJ, Reid DM . Dietary influences on bone metabolism—further evidence of a positive link between fruit and vegetable consumption and bone health? Am J Clin Nutr 2000; 71: 142–151.

    Article  CAS  Google Scholar 

  16. New SA, Bolton-Smith C . Development of a food frequency questionnaire. Proc Nutr Soc 1993; 52: 330A.

    Google Scholar 

  17. Bodner CH, Soutar A, New SA, Scaife AR, Byres M, Henderson GD, Brown K, Godden DJ . Validation of a food frequency questionnaire for use in a Scottish population: correlation of antioxidant vitamin intakes with biochemical measures. J Hum Nutr Diet 1998; 11: 373–380.

    Article  Google Scholar 

  18. Yarnell JWG, Fehily AM, Milbank JE, Sweetnam PM, Walker CL . A short dietary questionnaire for use in an epidemiological study: comparison with weighed dietary records. Hum Nutr Appl Nutr 1983; 37: A 103–112.

    PubMed  Google Scholar 

  19. Bolton-Smith C, Woodward M, Tunstall-Pedoe H . The Scottish Heart Health study. Dietary intake by food frequency questionnaire and odds ratios for coronary heart disease risk. I The macronutrients. Eur J Clin Nutr 1992; 46: 75–84.

    CAS  PubMed  Google Scholar 

  20. Bolton-Smith C, Woodward M, Tunstall-Pedoe H . The Scottish Heart Health study. Dietary intake by food frequency questionnaire and odds ratios for coronary heart disease risk. II The antioxidant vitamins and fibre. Eur J Clin Nutr 1992; 46: 85–93.

    CAS  PubMed  Google Scholar 

  21. Tunstall-Pedoe H, Smith WCS, Crombie IK, Tavendale R . Coronary risk factor and lifestyle variation across Scotland: results from the Scottish Heart Health Study. Scot Med J 1989; 34: 556–560.

    Article  CAS  Google Scholar 

  22. Department of Health. Dietary reference values for food energy and nutrients for the United Kingdom. HMSO: London; 1991.

  23. Willett WC, Howe GR, Kushi LH . Adjustment for total energy intake in epidemiologic studies. Am J Clin Nutr 1997; 65: 1220S–1228S.

    Article  CAS  Google Scholar 

  24. WHO Scientific Group. Research on the menopause in the 1990s. World Health Organization: Geneva; 1996.

  25. Crawford SL, Casey VA, Avis NE, McKinlay SM . A longitudinal study of weight and the menopause transition: results from the Massachusetts Women's Health Study. Menopause 2000; 7: 96–104.

    Article  CAS  Google Scholar 

  26. Davies KM, Heaney RP, Recker RR, Barger-Lux MJ, Lappe JM . Hormones, weight change and menopause. Int J Obes Relat Metab Disord 2001; 25: 874–879.

    Article  CAS  Google Scholar 

  27. Guthrie JR, Dennerstein L, Dudley EC . Weight gain and the menopause: a 5-year prospective study. Climacteric 1999; 2: 205–211.

    Article  CAS  Google Scholar 

  28. Dong W, Erin B . Scotand's Health: Scottish Health Survey 1995. Scottish Office Department of Health: Edinburgh; 1997.

    Google Scholar 

  29. Scottish Intercollegiate Guidelines Network (SIGN). Obesity in Scotland. Implementing prevention with weight management. SIGN: Edinburgh; 1996.

  30. Black AE, Coward WA, Cole CJ, Prentice AM . Human energy expenditure in affluent societies: an analysis of 574 doubly-labelled water measurements. Eur J Clin Nutr 1996; 50: 72–92.

    CAS  Google Scholar 

  31. Prentice AM, Black AE, Coward WA, Cole TJ . Energy expenditure in overweight and obese adults in affluent societies: an analysis of 319 doubly-labelled water measurements. Eur J Clin Nutr 1996; 50: 93–97.

    CAS  PubMed  Google Scholar 

  32. Panotopoulos G, Raison J, Ruiz JC, Guy-Grand B, Basdevant A . Weight gain at the time of the menopause. Hum Reprod 1997; 12: 126–133.

    Article  Google Scholar 

  33. Sowers M, Crutchfield M, Bandekar R, Randolph JF, Shapiro B, Schork MA, Jannausch M . Bone mineral density and its change in pre- and perimenopausal white women: the Michigan Bone Health Study. J Bone Miner Res 1998; 13: 1134–1140.

    Article  CAS  Google Scholar 

  34. Maheshwari H, Sharma L, Baumann G . Decline of plasma growth hormone binding protein in old age. J Clin Endocrinol Metab 1996; 81: 995–997.

    CAS  PubMed  Google Scholar 

  35. de Castro JM . Heritability of diurnal changes in food intake in free-living humans. Nutrition 2001; 17: 713–720.

    Article  CAS  Google Scholar 

  36. Barker DJ . Intrauterine programming of coronary heart disease and stroke. Acta Paediatr Suppl 1997; 423: 178–182.

    Article  CAS  Google Scholar 

  37. Espeland MA, Stefanick ML, Kritz-Silverstein D, Fineberg SE, Waclawiw MA, James MK, Greendale GA . Effect of postmenopausal hormone therapy on body weight and waist and hip girths. J Clin Endocrinol Metab 1997; 82: 1549–1556.

    CAS  PubMed  Google Scholar 

  38. Norman RJ, Flight IH, Rees MC . Oestrogen and progestogen hormone replacement therapy for peri- menopausal and post-menopausal women: weight and body fat distribution. Cochrane Database System Rev 2003; AB001018.

  39. Kritz-Silverstein D, Barrett-Connor E . Long-term menopausal hormone use, obesity, and fat distribution in older women. JAMA 1996; 275: 46–49.

    Article  CAS  Google Scholar 

  40. Burnette MM, Meilahn E, Wing RR, Kuller LH . Smoking cessation, weight gain, and changes in cardiovascular risk factors during menopause: the Healthy Women Study. Am J Public Health 1998; 88: 93–96.

    Article  CAS  Google Scholar 

  41. Newmark HL, Wargovich MJ, Bruce WR . Colon cancer and dietary fat, phosphate, and calcium: a hypothesis. J Natl Cancer Inst 84; 72: 1323–1325.

    CAS  Google Scholar 

  42. Suzuki K, Suzuki K, Mitsuoka T . Effect of low-fat, high-fat, and fiber-supplemented high-fat diets on colon cancer risk factors in feces of healthy subjects. Nutr Cancer 92; 18: 63–71.

    Article  CAS  Google Scholar 

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We are grateful to David Grubb of the Rowett Research Unit for running the ORACLE programme to analyse our food frequency and physical activity questionnaire. We are also very grateful for the hard work of the radiographers and research nurses at the Osteoporosis Research Unit, and to all the women who kindly participated in the study.

We gratefully acknowledge the UK Department of Health and the Medical Research Council for project grant support for HMM and to the Arthritis Research Campaign (ARC) for continuing infrastructure support for DMR. The Health Services Research Unit is funded by the Chief Scientist Office of the Scottish Executive Health Department. Any views expressed are ours.

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Correspondence to H M Macdonald.

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Macdonald, H., New, S., Campbell, M. et al. Longitudinal changes in weight in perimenopausal and early postmenopausal women: effects of dietary energy intake, energy expenditure, dietary calcium intake and hormone replacement therapy. Int J Obes 27, 669–676 (2003).

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  • weight gain
  • menopause
  • physical activity level
  • dietary energy intake
  • HRT
  • calcium

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