WISHFIT: women’s research takes a village.
I was heartened to read that the folks at Rush University Medical Center in Chicago have partnered with a community of local women to fight obesity and promote a healthier menopausal transition. What’s especially novel about this program, which is called WISHFIT (Women in Southside Health FIT), is that during the first year of the five-year study, it will be relying on “pioneers” for guidance in designing and testing the program and subsequently spreading the word. One of the program’s primary researchers, Dr. Sheila Dugan, who is an Associate Professor in the Department of Physical Medicine and Rehabilitation at Rush University Medical School, characterizes the approach as “community-based participatory medicine,” with a critical grassroots component. I would go one step further and call it a health 2.0, social media approach to medical research.
The goals of WISHFIT are to ultimately change the behavior of women who are sedentary or engage in physical activity only occasionally in order to help reduce the fat rolls around the midsection (called visceral fat). If you’ve been reading Flashfree for awhile, you will recall that visceral fat is a common problem in menopausal women that is likely related to fluctuating hormone levels as we age. Not only is it unattractive, but the development of fat around the midsection is dangerous because it has been linked with metabolic syndrome, a variety of symptoms that in concordance, increase the risk for heart disease.
Importantly, the National Institutes of Health, National Cancer Institute, National Institute of Diabetes, Digestion and Kidney Diseases are joining forces with Rush to take the study out of the laboratory setting and into the community. In fact, Dr. Dugan explains that research has shown that “there are millions of studies out there that show if we bring women into the University and have them exercise, they will lose weight and improve their fat composition. But when they are left to their own devices, they go back to themselves.” She says that by having a community of postmenopausal women involved in developing a ‘tool kit’ of physical and stress-reducing activities or activities that help them to embrace healthier eating habits, the researchers are hoping that they can help their premenopausal peers incorporate new ways of thinking and acting so that they can get through menopause in healthier ways. She also points to data showing that change is better maintained not only by motivating the individual but also through the support of friends and social networks, which are needed for change to last.
Dr. Dugan notes that two Southside Chicago communities- Beverly and Morgan Park – have been the subject of prior research (Study of Women’s Health Across the Nation or SWAN) that identified the link between hormonal changes and visceral fat. In fact, some of the data also firmly established the link between markers of chronic disease and stress and sedentary lifestyles. The 30 Pioneers selected to lead the project will be women who participated in SWAN.
The five-year program also includes two studies examining 1) how social networks play a role in influencing health behaviors, and 2) if positive reinforcement works as well as financial incentives in getting women to change their lifestyle and become more physically active. An additional component entails before and after ‘person on the street’ interviews to educate and engage the community about what happens during menopause, heart disease and other risks and steps that can be taken to combat it.
“Midlife women already have all sorts of concerns on their minds. They need to have support around allowing themselves to take care of themselves and give themselves the freedom to actually step out of all their roles to do so. Our goal,” she emphasizes,”is to bring energy — spiritual and financial — to the community because we truly believe that the only way that these women will have a chance to take care of themselves is by everyone around them buying into how important it is.”
Noting that they are taking a three-pronged attack that entails community, social and individual level interventions, Dr. Dugan adds that community and social support are the links that have been missing in obesity research in particular. I’d like to believe that these links have also been missing in gender research that focuses on women; in fact, perhaps this model isthe breakthrough that is needed to change some gender inequities in our healthcare.
It really does take a village, doesn’t it? Only time will tell.
Read MoreWhen it comes to physical fitness, forget the hormones
[youtube=http://www.youtube.com/watch?v=pnVT0HGVNwY&feature=related]
Hey. We’re all going to get there one day – slowing down, lower coordination, challenged balance, right? Hmm, maybe not. At least I’d like to think that it’s possible to delay or stave off the natural physical decline of aging. So what’s the deal anyhow?
Estrogen strikes again!
Declining levels of estrogen as a women ages are linked to changes within the body that directly affect physical function. And like many other age-related changes that occur, hormone therapy has been overpromised as a panacea for physical functioning. In fact, for years, women have been advised the hormone therapy might benefit and even improve overall functioning. Yet, reports supporting this particular benefit of hormone therapy have been inconsistent, with some showing improvements and other, actually showing detriment.
The latest evidence to emerge against hormone therapy comes from a comprehensive analysis of 2,400 older postmenopausal women who had taken HRT or placebo tablet. The women had all been part of the the Women’s Health Initiative Study, which, as you may recall, was halted when HRT was found to increase the risk for heart attack, stroke, blood clots and breast cancer.
In the analysis, women were assessed for physical function (i.e., grip strength, chair stand – the number of times a woman could stand up from a chair without using her arms and timed walk – the time it took to walk a 6-meter course) at the study’s start, and at 1, 3 and 6 years.
What they found.
Over the study’s course:
- Grip strength declined by 12%
- Chair stands declined by 3.5%
- Walk pace slowed by 11.4%
- No differences in physical function were seen in women taking HRT compared to those who had taken placebo
The overall conclusion? Hormones will not slow or benefit physical declines that occur as we age.
So, are we all doomed?
Studies suggest that to stave off physical declines as we age, we need to keep moving! Walking for 30 minutes a day can help to maintain bone strength. Yoga and bo su can help build and maintain balance. Tai Chi or Chi Gung can assist with focus and keep those muscles suppple. Whatever you do, it’s a use it or lose it proposition.
What’s your strategy?
Want to read more? Reuter’s Health has an excellent write-up on this study. (Special thanks to Executive Editor Ivan Oransky for pointing me to these data.)
Read MoreDem bones were made for dancing!
Get on your dancing shoes!
I was inspired to read that professional dancer Erin Boag from Strictly Come Dancing (the UK’s version of Dancing with the Stars), has teamed up with the International Osteoporosis Foundation to inspire all those armchair dancers to get off their butts and work their bones a bit. In fact, many bone experts agree that dancing may be an excellent (and non-boring) way to strengthen bones and muscle, prevent or at least slow osteoporosis.
Mind you, this program is being funded by DAIICHI SANKYO, a pharma company that manufactures drugs that treat osteoporosis. Nevertheless, it’s an important first step towards taking a cheesy premise that attracts millions of television viewers and repackaging some of its basic elements to help people who don’t normally like to exercise to change their habits. Currently available only in Europe and through doctors’ practices, the ‘Improvement through Movement’ DVD offers some easy waltz, rumba and quick step moves.
Osteoporosis is a tremendous problem as we age. In the US, it affects approximately 10 million people, 8 million of whom are women. Worldwide, more than 200 million women suffer from osteoporosis.
I’ve long been a proponent of more natural approaches to solving what ails. And bone health is one of those things that can be easily preserved through weight-bearing physical activity and a healthy diet that incorporates vitamin D and calcium-rich foods and isoflavones. You can read more about bone health in these posts.
In the meantime, this program sounds like a terrific idea that could be easily reproduced in this country as well. What say you ‘Dancing with the Stars?‘ Can we take a page from our European friends on behalf of our US bones?
Read MoreWednesday Bubble: breast cancer during menopause- move your body
[Credit: Stephen diFilipo, Fountain at the Gaylord Hotel, National Harbor ©2009. With permission]
October is National Breast Cancer month. In honor of family and friends who have survived breast cancer, I am dedicating this month’s Bubbles to posting choice bits of information about the topic this month. I admire these women greatly – for their strength, their tenacity and their hope. Rock on ladies!
Nothing like a bit of good news to kick off the month!
Early this year, I wrote about a study showing that exercise could help reduce breast cancer risk. Today’s post provides evidence that the timing and intensity of that activity makes a huge difference.
In this study, which appears in BioMed Central Cancer, researchers examined and compared the relationship of light physical activity to moderate to vigorous activity and its association to breast cancer risk in 118,699 women in menopause. Activity levels were studied during four periods of life: ages 15 to 18, ages 19 to 29, ages 35 to 39 and the past 10 years. Light activities included bowling, golf (riding in a cart), table tennis, slow walking/slow dancing, light calesthenics, light gardening, fishing, horseshoes/croquet and light housework. Moderate-to-vigorous activities included tennis, golf (walking), biking, swimming, heavy gardening, weight lifting, basketball/baseball, football/soccer, cheerleading/drill team, handball/raquetball, hiking/mountain climbing, fast walking/fast dancing, rowing, aeroboics, jogging/running and heavy housework.
The researchers found no association between activity intensity and breast cancer risk in the time periods leading up to menopause. However, Women engaging in more than 7 hours per week of moderate to vigorous activity during the past 10 years had a significant, 16% lower risk of developing breast cancer compared to women who were inactive or only engaged in light activity. This benefit remained even when the researchers took factors such as age, body mass index, family history, or hormone use into consideration. The type of tumour cancer stage also had no effect.
Although researchers have been aware that a high versus low level of physical activity may protect against developing breast cancer during menopause, this is the first study to actually examine activity during other time periods and then compare them to more recent time periods.
Clearly, it’s time to move your body if you’ve not been doing so. A 16% reduction in breast cancer risk is significant.
Read MoreExtreme makeover
Great news for women in menopause: it appears that vigorous physical exercise can turn back the clock, at least as far as physical capacity and weight loss ability goes!
Findings from two studies, one published this past July in the Journal of Applied Physiology, and the other this September, in Metabolism – Clinical and Experimental, show for the first time that despite age-related deceases in hormone levels, lean body mass and aerobic capacity, training can achieve the same health benefits that women 16 years younger might experience.
In both studies, researchers looked at the effects of cycling (on a stationary bike) for an hour, five days a week at 65% of maximum lung capacity in 10 sedentary but otherwise healthy postmenopausal women.
(FYI: The term ‘lung capacity’ refers to the maximum amount of air that a person’s lungs can hold after the greatest possible inspiratory effort. When you exhale, the amount of air left in your lungs is known as ‘residual volume.’ This can be affected by age, aerobic capacity and a host of other factors. After the age of 30, the capacity to use and consume oxygen drops by about 1% per year)
In the first, they found that all study participants increased their body’s capacity to consume and use oxygen (known as VO2max) by as much as 16%. At the same time, resting heart rate decreased an average of 4 beats per minute. By the study’s end, blood pressure had also dropped substantially and heart capacity during exercise increased. What’s more, study participants were able to burn fat more efficiently — by about 10%, without relying on carbohydrates. (A primary reason why weight loss can be difficult for women with specific dietary changes is that unlike men, blood sugar (glucose) levels (usually derived from stored carbohydrates) remain stable during exercise and metabolism quickly returns to normal after. So despite vigorous training, weight may remain the same. This is even more true for women going through menopause, as fluctuating hormone levels affect metabolism and the ability to clear glucose from the blood.)
Similar findings were also seen in the second study; not only were women able to consume and use oxygen more significantly, but their ability to metabolize glucose improved by 35%, without any changes in dietary habits.
Overall, these study findings suggest that “older” women can improve and make significant changes in their cardiovascular and metabolic capacities, often to the same extent as women substantially younger, without having to go on extreme diets! The researchers say that these results are also encouraging in terms of increasing overall energy levels and keeping risk for disease in check.
Granted, the training regimens that the study participants undertook were quite strenuous and required a commitment, both in terms of time and exercise frequency. Nevertheless, the researchers believe that even less strenuous exercise could likely produce some degree of benefit.
So, do you need an extreme makeover to realize better health? Not really! Just a bit of inspiration and some kick-ass music to keep you going at the gym. Nice to know that great benefits can be achieved without starving ourselves!
Read MoreWednesday Bubble: What did I forget/hear/see/say…
If you’re anything like me, you are starting to forget things. Things you need to do, why you walk into rooms, shopping lists, things you said, the whole nine yards. For me, it’s become the norm, not the exception and while I spend a lot of time making jokes about it, it also drives me crazy.
Yet, today’s Bubble is not one that I’m likely to forget. I’d like to think of it as one part inspiration and one part WTF? And it leaves me with a whole lot of questions to boot.
Study findings suggest that gaining weight during menopause may increase the risk for loss of gray matter. Gray matter refers to the cortex of the brain, which contains nerve cells. It is involved in muscle control, sensory perception (seeing/hearing), emotions, speech and finally, memory.
In this study, which was published in the online edition of the journal Psychosomatic Medicine, researchers evaluated brain imaging data, demographic information (height, weight) and behavioral measures (perceived psychiatric stress) obtained from 48 healthy postmenopausal women. Data were collected over a 20-year period.
The findings showed a unique association between increase in body weight during the transition from peri- to post-menopause (as measured by body mass index or BMI) and a 22% reduction in grey matter volume. These findings occurred in women who were otherwise healthy, had no history of heart disease or psychiatric illness and did not meet the threshold for obesity (>30 BMI). All women had also undergone natural menopause.
The researchers suggest that weight gain during menopause is a “highly modifiable risk factor” that may help to prevent or slow “potential alterations in brain function that are important to quality of life.”
I’ve written previous posts on cognitive issues during menopause, whether they be linked with life stressors, HRT or aging. Now it seems that researchers are telling us that weight gain may also be a risk factor.
Less clear is how much weight gain and what we should do about it. In general one solution to combating weight gain in midlife is restraint. Coupled with exercise, this may just be the magic formula. In the meantime, I think that we need a few more studies to take a closer look at brain matter changes in midlife.
What do you think?
I just forgot why I’m asking you that…!
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