Wednesday, August 15, 2012

Can A wider waist in middle-aged women be prevented?

Research by University of Canberra expert in nutrition and dietetics Lauren Williams shows that although this weight gain is due to a normal series of changes in the metabolism of women at this age, it could be easily prevented.

While menopause has been identified as a high risk time for weight gain, Professor Williams, who recently joined the University as Head of Nutrition and Dietetics, said there are few obesity prevention interventions targeted to this age group.

UC Professor Lauren Williams (right) is conducting research on intervention to prevent weight gain in "40 something" women. Photo: Michelle McAulay

“It’s amazing that in Australia we don’t have any evidence about effective interventions to prevent the weight gain that happens around menopause. It’s such an important time to prevent weight gain,” Professor Williams said.

She explained that the weight you gain at menopause comes at a very critical time because it builds up abdominally, which is a dangerous place for it to go because it surrounds the body’s internal organs and increases the risk of obesity-associated diseases.

“The deficiency in oestrogen during menopause results in multiple changes, one of them being a redistribution of where fat likes to be stored in your body, away from the buttocks and thighs and more up to your middle, and with that redistribution comes the increased health risks.

“When you are younger and you gain weight, it goes to your thighs; you might not like it but it’s not going to harm you,” she said. “If you look at the prevalence of heart disease in women there are vastly different rates before and after menopause.”

Building on a longer research project with colleagues at the University of Newcastle, Professor Williams is conducting a randomised controlled trial aimed at testing an intervention that specifically prevents the weight gain that happens around the time of menopause in women.

In the first stage of her 40-Something Intervention research, which started in May 2010, Professor Williams recruited 54 women between 45-50 years old, who were still pre-menopausal and not obese.
After going through an assessment process and completing a series of measurements, the women were split into two groups to be monitored for two years. The first group included 28 women who received structured intervention (which meant consultations with a dietitian and a physiologist, who used motivational enhancement therapy).

The second group included 26 women who only received written information about exercising and dietary intakes. Half of the women in both groups had a healthy weight and half were overweight.
After 12 months, Professor Williams and her team found that the structured intervention group had a significantly better weight profile than the one that had only received the written information, which didn’t register significant change.

Preliminary results show that the average weight of the group that received health professional intervention went from 66.6 kilos to 63.2 kilos. Their body mass also decreased and their waist circumference also went down.

A woman’s healthy waist should be of 80 cm or less. The structured intervention group’s waist went from a mean of 82.3 cm to 77.4 cm, moving from a moderate risk to normal.
The study is reaching the end of its second phase in which they are monitoring the women to assess if the improvements were maintained.

“This is a relatively low intensity intervention –only five hours of contact with health professionals over the course of a year – so it would not be an expensive program for the government to implement,” Professor Williams said.

“The intervention is based on an existing model under chronic disease management in the Medicare system.

“Menopausal women are not currently covered under this scheme unless they have a chronic disease but if the scheme were to be extended to improve the health of women after menopause, the government would ultimately be saving on health costs.

“If we can prove that this model works, it would ideally be applied with women attending their health assessment with their General Practitioner at 45 years of age. They would be assessed on eligibility for this treatment and referred to appropriate practitioners,” Professor Williams said.

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