Menopause Weight Gain Series Day 6 - Estrogen and Progesterone
Hot Flashes Wane with Diet, Weight Loss
Women who lost 10 percent or more of their body weight had the greatest improvement in hot flashes and night sweats, study shows.
By Charles Bankhead, MedPage Today
Medically Reviewed by Robert Jasmer, MD
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WEDNESDAY, July 11, 2012 (MedPage Today) —Menopausal vasomotor symptoms decreased significantly in women who lost weight during a year-long low-fat dietary intervention, an analysis of the Women's Health Initiative (WHI) showed.
Weight loss increased the odds of symptom resolution among women who reported vasomotor symptoms at baseline: women who lost at least 10 pounds were 23 percent more likely to see their symptoms resolve, and women who lost 10 percent or more of their baseline body weight were 56 percent more likely to see a resolution of their symptoms, according to Candyce H. Kroenke, ScD, of Kaiser Permanente in Oakland, Calif., and colleagues.
Overall, women in the trial who were randomized to the dietary intervention had a 14 percent greater likelihood of symptom resolution than did women in the control arm, the authors reported online inMenopause.
Women in the intervention arm who lost 10 percent or more of their body weight had the greatest improvement in hot flashes and night sweats, they noted.
"It seems like this would be a reasonable alternative for women who don't want to take hormone therapy as a way of reducing hot flashes and night sweats," Kroenke toldMedPage Today.
Higher body weight has been associated with greater vasomotor symptomatology among menopausal women, but the effect of changes in weight — loss or gain — on menopausal symptoms has received little attention in the literature.
Two studies suggested that weight gain or increased adiposity was associated with greater symptomatology (Breast Cancer Res Treat2010; 124: 205-211,Am J Epidemiol2009; 170: 766-774). Results of a single randomized trial showed a reduction in hot flash frequency and severity in women assigned to a weight-loss intervention (Arch Intern Med2011; 170: 1161-1167).
Some evidence has suggested that dietary habits might also influence menopausal vasomotor symptoms, Kroenke and colleagues wrote in their introduction. In particular, some studies have indicated that high fiber intake and low fat consumption might improve symptoms.
The WHI included a dietary modification trial that randomized participants either to a dietary intervention that emphasized reduced fat consumption and increased consumption of fruits, vegetables, and whole-grain products, or to a control group. Women in the intervention arm also participated in a behavior modification program that included group sessions and consultations with nutritionists.
Although weight loss was not a goal of the dietary intervention trial, participants in the intervention arm lost 4 to 5 pounds during the first year. Overall, 21 percent of women in the intervention arm lost weight, as did 7 percent of those in the control group.
Kroenke and colleagues analyzed data on 17,473 WHI participants ages 50 to 79 who were included in the dietary intervention trial. The primary objective of the analysis was to identify factors associated with changes in vasomotor symptoms.
At baseline, 73 percent to 74 percent of participants reported no night sweats or hot flashes. Of those women who did report symptoms, 6 percent rated the symptoms as moderately severe, and 1 percent said they had severe symptoms. The authors found that 56 percent of the women had no vasomotor symptoms at baseline or 1 year.
An age-adjusted analysis showed that women in the intervention arm were 19 percent more likely to have resolution of vasomotor symptoms. The difference declined to 14 percent in a multivariate analysis. However, the dietary intervention had no effect in women who rated their symptoms as moderate or severe at baseline.
Among all women with vasomotor symptoms at baseline, weight loss ≥10 pounds and ≥10 percent of body weight significantly increased the likelihood of symptom resolution at 1 year.
Weight loss ≥10 percent among women in the intervention arm boosted the odds of symptom resolution by 89 percent compared with women in the control group who maintained baseline body weight.
Women in the intervention arm also were 25 percent less likely to report any vasomotor symptoms after 1 year, as compared with the control group.
Weight loss ≥10 percent of baseline body weight was associated with a 30 percent reduction in the odds for vasomotor symptoms at one year.
Among women who reported vasomotor symptoms at baseline, weight loss increased the likelihood that the symptoms would resolve during the study.
The impact of baseline weight or body mass index on outcomes at 1 year was not specifically evaluated. Similar to the general population, most of the women in the study were overweight.
"I think that this study would be fairly generalizable to the population, which is two-thirds overweight," said Kroenke.
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