WEIGHT CONTROL IN PERI AND EARLY POSTMENOPAUSAL WOMEN

肥胖是一种可预防的疾病，但它对发病率和死亡率的影响很大。由于正常和生活方式的改变，女性患肥胖症、心血管疾病和骨质疏松症的风险随着更年期急剧增加。此外，许多围绝经期妇女由于目前超重或肥胖、曾经肥胖或有肥胖家族史，已经有肥胖的危险。鉴于许多证据表明，肥胖的逆转通常是困难的和不成功的长期，一个预防性的方法，强调适度的生活方式的改变可能更有利于促进长期的行为改变和体重控制随着年龄的增长。因此，本研究的主要目的是评估适度生活方式干预计划的有效性，或预防围绝经期和绝经后早期有肥胖风险的妇女在2年内体重、全身质量和腹部脂肪组织的增加。第二个目标是确定干预对日常身体活动的影响，这将根据每日总消耗和静息代谢率计算，分别由双标记水法和间接量热法确定。一项随机对照试验将用于评估对中西部一家大型医疗中心女性员工的干预。干预是一个适度的生活方式改变项目，重点是教参与者如何改变他们的饮食习惯，并结合额外的体育活动，作为改变每日能量平衡的一种手段，以防止在两年的干预期间体重增加。干预的4个组成部分包括：1)减少膳食脂肪摄入量；2)增加日常身体活动；3)每月连续两天在综合临床研究中心的代谢厨房或由参与者准备的低脂肪、低热量的食物；4)“学习伙伴”制度，每个参与者都与一个伙伴配对，与她保持经常联系，讨论目标和进展，以及动机。该项目的结果旨在提供有关生活方式计划的有价值的信息，这些信息可以帮助女性在体重增加普遍的时候控制体重。

Obesity is a preventable condition that contributes significantly to morbidity and mortality. A women's risk for obesity, as well as cardiovascular disease and osteoporosis, increases dramatically with menopause due to normal and lifestyle changes. Furthermore, many perimenopausal women are already at risk for obesity based upon current overweight or obesity, former obesity, or a family history of obesity. In light of much evidence that reversal of obesity generally is difficult and unsuccessful long-term, a preventive approach that emphasizes modest lifestyle modifications may be superior in promoting long-term behavioral changes and weight control with advancing age. Therefore, the primary aim of this study is to assess the effectiveness of a modest lifestyle intervention program or preventing gains in body weight, whole body bat mass, and abdominal adipose tissue during a 2-year period in perimenopausal and early postmenopausal women who are at risk for obesity. A second aim is to determine the effects of the intervention on daily physical activity, which will be calculated from total daily expenditure and resting metabolic rate, as determined by the doubly labeled water method and indirect calorimetry, respectively. A randomized, controlled trial will be used to evaluate the intervention in female employees of a large Midwestern medical center. The intervention is a modest lifestyle modification program that will focus on teaching participants ways to modify their dietary habits and incorporate additional physical activity, as a means of altering daily energy balance to prevent weight gain during the 2-year intervention period. The 4 components of the intervention include: 1) reducing dietary fat intake; 2) increasing daily physical activity; 3) two consecutive days per month of low-fat, low-calorie meals prepared either in the metabolic kitchen of the General Clinical Research Center or by the participant; and 4) a "study- buddy" system, in which each participant is paired with a buddy with whom she is to keep in the frequent contact, discuss goals and progress, and motive. The results of this project are intended to provide valuable information regarding lifestyle programs that may assist women in controlling body weight at a time when weight gain is common.