Prevention of cardiovascular risk factor elevations in healthy premenopausal women.
BACKGROUND
A number of factors contribute to increased risk of coronary heart disease (CHD) among postmenopausal women, including atherogenic changes in serum cholesterol profiles, weight gain, and decreases in physical activity during the menopause. To date, no study has attempted to prevent elevations in primary CHD risk factors as women experience menopause.


METHODS
A sample of 535 healthy premenopausal women, ages 44-50, were recruited for an ongoing 5-year randomized prevention trial testing whether increases in low-density lipoprotein cholesterol (LDL-C) and body weight can be prevented during the menopause with a dietary and behavioral intervention. The aim was to reduce total dietary and saturated fat and cholesterol, prevent weight gain, and increase physical activity levels. Changes in CHD risk factors after the first 6 months of treatment were analyzed comparing 253 intervention and 267 assessment-only control participants.


RESULTS
The intervention group showed significant reductions in total cholesterol (-0.34 mmol/liter), LDL-C (-0.28 mmol/liter), triglycerides (-0.04 mmol/liter), weight (-4.8 kg), waist-hip ratio (-0.008), systolic blood pressure (-3.5 mm Hg), diastolic blood pressure (-2.2 mm Hg), serum glucose levels (-0.06 mmol/liter), and HDL-C (-0.06 mmol/liter) and significant increases in physical activity (+383 kcal). No significant changes were observed in the control group.


CONCLUSIONS
Six-month results suggested that participants were receptive to the preventive approach to CHD risk reduction and were successful in making initial positive lifestyle changes. Follow-up data will evaluate long-term adherence to the intervention and the interaction between adherence and physiological changes during menopause.
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania 15261, USA.
L
L
Simkin-Silverman
R R
RR
Wing
D H
DH
Hansen
M L
ML
Klem
A P
AP
Pasagian-Macaulay
E N
EN
Meilahn
L H
LH
Kuller
D000704:Analysis of Variance; D000886:Anthropometry; D001786:Blood Glucose; D001794:Blood Pressure; D001835:Body Weight; D016009:Chi-Square Distribution; D003327:Coronary Disease / Q000517:prevention & control*; D018752:Diet, Fat-Restricted; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006266:Health Education / Q000379:methods*; D006801:Humans; D008055:Lipids / Q000097:blood; D008875:Middle Aged; D010349:Patient Compliance; D017697:Premenopause / Q000097:blood; D012307:Risk Factors; D012657:Self-Help Groups; D015431:Weight Loss
D001786:Blood Glucose; D008055:Lipids