title: Weight gain among women in the late reproductive years.
abstract: BACKGROUND
  Given the impact of obesity on mortality and morbidity in women, we evaluated correlates of weight gain in women ages 35-47 years.
  
  
  METHODS
  Three hundred and thirty-six African American and Caucasian American women, randomly selected from among urban residents aged 35-47 years and pre-menopausal at baseline, were included in the prospective cohort study. Participants were followed over a 4-year period. Baseline measures included anthropometric variables, socio-demographic factors, measures of anxiety, depressed mood, quality of life, and self-reported measures of diet, vigorous physical activity, alcohol consumption and cigarette smoking. Hormone measurements were obtained during the follicular phase of the menstrual cycle. Weight gain was assessed by comparing the baseline weight with weight measured at the end of the 4-year period.
  
  
  RESULTS
  Over 25% of the cohort gained > or =10 lb during follow-up. Five of the 14 women (36%) who were considered menopausal gained weight. Women aged 45-47 were 61% less likely to gain > or =10 lb compared with women aged 35-39 [odds ratio (OR) = 0.39, 95% confidence interval (CI) 0.18-0.87]. Depressed mood was a major correlate of weight gain (OR = 1.9, 95% CI 1.09-3.31). Other psychological measures, including anxiety and quality of life, were similarly correlated with weight gain. No association was detected for levels of sex hormones or self-reported measures of physical activity. Most recalled dietary factors were not predictive of subsequent weight gain in our population.
  
  
  CONCLUSIONS
  In this population-based sample of women aged 35-47 years, psychological factors were the major predictors of gaining > or =10 lb during a 4-year follow-up period. Few of the other measures, including baseline hormone values, were correlated with subsequent weight gain. These findings suggest that screening for depression and anxiety may be important clinical assessments to identify women at increased risk of substantial weight gain.
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, 423 Guardian Drive, 605 Blockly Hall, Philadelphia, PA 19104, USA. msammel@cceb.upenn.edu
authors.forename: Mary D
authors.initials: MD
authors.lastname: Sammel
authors.forename: Jeane Ann
authors.initials: JA
authors.lastname: Grisso
authors.forename: Ellen W
authors.initials: EW
authors.lastname: Freeman
authors.forename: Lori
authors.initials: L
authors.lastname: Hollander
authors.forename: Li
authors.initials: L
authors.lastname: Liu
authors.forename: Shinlan
authors.initials: S
authors.lastname: Liu
authors.forename: Deborah B
authors.initials: DB
authors.lastname: Nelson
authors.forename: Michelle
authors.initials: M
authors.lastname: Battistini
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D005518:Food Preferences; D015438:Health Behavior / Q000208:ethnology; D006728:Hormones / Q000097:blood; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D015143:Philadelphia; D017697:Premenopause / Q000208:ethnology / Q000502:physiology* / Q000523:psychology; D012307:Risk Factors; D011795:Surveys and Questionnaires; D015430:Weight Gain / Q000502:physiology*; D044465:White People / Q000706:statistics & numerical data
chemical_list: D006728:Hormones