title: The effect of menopause on the relation between weight gain and mortality among women.
abstract: OBJECTIVE
  To examine the effect of menopause on the relation between weight gain and all-cause mortality.
  
  
  METHODS
  Prospective cohort study of 6,030 adults (ages 25-82 years) who never smoked cigarettes, had no history of coronary heart disease, cancer, or stroke, and were enrolled in a 29-year follow-up in which anthropometric data were given at baseline and at 17 years after baseline.
  
  
  RESULTS
  Weight gain that occurred over a 17-year interval (baseline to 17 years after baseline) increased the mortality risk of men and middle-aged women, but decreased the mortality risk of older women. Further study of the women revealed that a strong protective effect of weight gains was only evident among the leanest (<or=25 kg/m2) postmenopausal women. Specifically, weight gains of 10 kg or more (median = 13 kg) produced an almost threefold decrease in mortality risk among the leanest (<or=25 kg/m2) postmenopausal women [hazard ratio (HR) (95% confidence interval; CI) = 0.35 (0.13, 0.96)], but did not confer strong protection for heavier (>25 kg/m2) postmenopausal women [HR (95% CI) = 0.81 (0.41, 1.58)] or for premenopausal women [HR (95% CI) = 1.05 (0.49, 2.25) for <or=25 kg/m2, 0.95 (0.38, 2.37) for >25 kg/m2]. We found that the protective effect of weight gain among the leanest postmenopausal women was primarily due to a more than threefold decrease in cardiovascular disease mortality risk. One possible explanation for these findings is that weight gain increases the level of adipose-tissue-derived estrogen among lean postmenopausal women.
  
  
  CONCLUSIONS
  Moderate menopausal weight gain may be well tolerated in lean women.
authors.affiliation: Department of Epidemiology & Biostatistics, School of Public Health, Loma Linda University, Loma Linda, California 92350, USA.
authors.forename: P N
authors.initials: PN
authors.lastname: Singh
authors.forename: E
authors.initials: E
authors.lastname: Haddad
authors.forename: S F
authors.initials: SF
authors.lastname: Knutsen
authors.forename: G E
authors.initials: GE
authors.lastname: Fraser
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D003327:Coronary Disease / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D012044:Regression Analysis; D012307:Risk Factors; D016019:Survival Analysis