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1.
Effect of an intensive intervention on the increase of physical activity and the decrease of sedentary lifestyle in inactive postmenopausal.
Alonso-Domínguez, R, Sánchez-Aguadero, N, Llamas-Ramos, I, Lugones-Sánchez, C, González-Sánchez, S, Gómez-Marcos, MA, García-Ortiz, L, ,
Journal of advanced nursing. 2021;(4):2064-2072
Abstract
BACKGROUND During the transition to menopause, women experience different psychological, hormonal, and physical alterations that can affect their health. Physical activity is considered an important strategy in the prevention and control of such changes. AIM: To evaluate the short-term effect of an intensive intervention, based on a combined exercise programme using a Smartband, on the increase of physical activity and the decrease of sedentary lifestyle in postmenopausal and inactive women. DESIGN Randomized clinical trial with two parallel groups. METHODS In total, 100 postmenopausal and inactive women aged 45-70 years will be randomized to a control group or an intervention group. Both groups will be given a standardized advice about physical activity. The intervention group will carry out a supervised 12-week programme of aerobic and muscle strengthening exercise; moreover, the women in this group will receive a Smartband to assist them in the intervention. The main result will be the increase of physical activity and the decrease of sedentary lifestyle, measured with an accelerometer for 1 week. This programme will be conducted by a nurse and a physiotherapist of the health centre. The study was approved by the Drug Research Ethics Committee of the Salamanca Health Service on 15 February 2019. The project was funded by the Autonomous Government of Castile and Leon and by the Carlos III Health Institute. DISCUSSION Physical activity is an important strategy to consider when addressing the changes caused by menopause, although the current evidence shows that further studies should be carried out with longer intervention periods and new technologies. IMPACT This study will allow determining the effectiveness of the intensive intervention based on a combined programme of physical activity using a Smartband in postmenopausal and inactive women. TRIALS REGISTRATION ClinicalTrials.gov with identifying code NCT03872258.
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A 16-week concurrent exercise program improves emotional well-being and emotional distress in middle-aged women: the FLAMENCO project randomized controlled trial.
Aparicio, VA, Flor-Alemany, M, Marín-Jiménez, N, Coll-Risco, I, Aranda, P
Menopause (New York, N.Y.). 2021;(7):764-771
Abstract
OBJECTIVE To analyze the influence of a supervised concurrent exercise program on emotional well-being and emotional distress in middle-aged women. METHODS This randomized controlled trial included 150 middle-aged women recruited for the FLAMENCO project. Participants were allocated into counseling (n = 75) or exercise (n = 75) groups. The counseling group attended conferences on healthy lifestyle (including diet and physical activity topics). The exercise group followed a 60-min concurrent (aerobic + resistance) exercise training 3 days/wk for 16 weeks. Emotional health was assessed with the Positive and Negative Affect Schedule (PANAS) in two diverse timeframes, state (PANAS-S) and trait (PANAS-T) ranging from 10 to 50, where higher scores reflect greater affective emotional health/experience (positive affect subscale) and greater emotional distress (negative affect subscale). The differences between the counseling and exercise groups in PANAS were analyzed by linear regression. RESULTS The total number of women for the per-protocol analyses was 111 divided into the counseling (n = 53) and exercise (n = 58) groups. After adjusting for body mass index and Mediterranean diet adherence, PANAS-S and PANAS-T-positive affect scores increased by 3.81 and 3.02, respectively, in the exercise group whereas they decreased by 0.15 and increased by 0.51 in the counseling group (both, P < 0.05). PANAS-T negative affect decreased by 4.10 in the exercise group whereas only decreased by 0.9 in the counseling group (P < 0.05). CONCLUSION A 16-week concurrent exercise program improved emotional experience in middle-aged women. Specifically, women in the exercise group significantly improved their emotional well-being and emotional distress through greater changes in positive affect and negative affect compared with the counseling group.
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Randomized, double-blind, placebo-controlled trial to examine the safety, pharmacokinetics and effects of Epimedium prenylflavonoids, on bone specific alkaline phosphatase and the osteoclast adaptor protein TRAF6 in post-menopausal women.
Yong, EL, Cheong, WF, Huang, Z, Thu, WPP, Cazenave-Gassiot, A, Seng, KY, Logan, S
Phytomedicine : international journal of phytotherapy and phytopharmacology. 2021;:153680
Abstract
BACKGROUND Fragility fractures due to menopausal osteoporosis are a major cause of morbidity and mortality. Osteoporotic medications have substantial side effects that limit long term use. HYPOTHESES Ingestion of a purified extract of Epimedium spp. (EP) is safe, can increase serum levels of prenylflavonoid metabolites, exert positive changes in bone specific alkaline phosphatase (BSAP), suppress of tumor necrosis factor receptor associated factor 6 (TRAF6) protein in osteoclast-precursor monocytes in peripheral blood and therefore have the potential to reduce post-menopausal bone loss. STUDY DESIGN & METHODS Healthy postmenopausal women were randomized in a double-blind fashion to consume either EP prenylflavonoid extract (740 mg daily) or placebo daily for 6 weeks. The main outcome measures were safety and pharmacokinetics of EP flavonoids. Fasting blood was collected at 3- and 6-weeks, and two weeks after stopping medication for safety evaluations and measurement of BSAP. Peripheral blood monocytes were harvested for measurement of TRAF6 levels. Serum levels of the EP metabolites icariin, icariside I & II, icaritin and desmethylicaritin were measured using tandem mass spectrometry, and non-compartmental pharmacokinetic analyses performed using WinNonlin software. RESULTS Between October 2018 and Jun 2020, 58 postmenopausal women, aged 57.9 ± 8.9 years, were randomized and completed the study. Consumption of EP prenylflavonoids was not associated with any significant adverse symptoms, with no changes in hepatic, hematological, and renal parameters observed. The main metabolites detected in sera after ingestion of EP prenylflavonoid capsules were desmethylicaritin, icaritin and icariside II. Icariin and icariside I were below detection levels. Ingestion of EP prenylflavonoids induced a median Cmax and AUC0→∞ for desmethylicaritin of 60.9 nM, and 157.9 nM ×day, respectively; and were associated with higher levels of BSAP (p < 0.05) and a trend (p = 0.068) towards lower levels of TRAF6 in peripheral blood monocytes eight weeks after commencing prenylflavonoid ingestion. Prenylflavonoid metabolites were not detected in the sera of placebo participants. CONCLUSIONS Despite the widespread consumption of EP extracts, the safety, mechanisms of action of their bioactive compounds, and therapeutic indications in humans are unknown. Daily consumption of EP prenylflavonoids for six weeks was safe. The predominant metabolite in sera was desmethylicaritin. Rise in prenylflavonoid metabolites was associated with higher levels of the bone anabolic marker BSAP, suggesting potential therapeutic value for post-menopausal osteoporosis.
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Four-weeks daily intake of oral collagen hydrolysate results in improved skin elasticity, especially in sun-exposed areas: a randomized, double-blind, placebo-controlled trial.
Sangsuwan, W, Asawanonda, P
The Journal of dermatological treatment. 2021;(8):991-996
Abstract
BACKGROUND Topical as well as oral 'collagen' is widely popularized and claimed to possess anti-aging properties for the past several years. Few placebo-controlled trials exist. OBJECTIVES Primary: To evaluate the effect of collagen hydrolysate (CH) ingestion for 4 weeks on skin elasticity. Secondary: To compare the effects of CH ingestion on skin elasticity between sun-exposed and sun-protected areas. MATERIALS AND METHODS This study was a prospective, randomized, double-blind placebo-controlled trial comparing the effects of daily intake of 5-g oral CH and placebo in post-menopausal women. Participants were evaluated for skin elasticity, using cutometer at baseline, 2 and 4 weeks after randomization and 4 weeks after discontinuation of study agents. RESULTS A total of 36 participants were enrolled. Skin elasticity measured from left and right cheeks in participants receiving CH increased compared to placebo (p=.006, .03, respectively). After 4 weeks of discontinuation of study agents (week 8), skin elasticity measured from both left and right cheeks remained different between CH and placebo group (p=.01, .004, respectively). CONCLUSIONS We demonstrated significant improvement of skin elasticity in sun-exposed areas after 4 weeks ingestion of marine CH. The improvement of elasticity remained 4 weeks after discontinuation of study agents. There were no severe adverse effects during the study.
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A novel approach to increasing community capacity for weight management a volunteer-delivered programme (ActWELL) initiated within breast screening clinics: a randomised controlled trial.
Anderson, AS, Chong, HY, Craigie, AM, Donnan, PT, Gallant, S, Hickman, A, McAdam, C, McKell, J, McNamee, P, Macaskill, EJ, et al
The international journal of behavioral nutrition and physical activity. 2021;(1):34
Abstract
BACKGROUND It is estimated that around 30% of breast cancers in post-menopausal women are related to lifestyle. The breast cancer-pooling project demonstrated that sustained weight loss of 2 to 4.5 kg is associated with an 18% lower risk of breast cancer, highlighting the importance of small changes in body weight. Our study aimed to assess the effectiveness a volunteer-delivered, community based, weight management programme (ActWELL) for women with a BMI > 25 kg/m2 attending NHS Scotland Breast Screening clinics. METHODS A multicentre, 1:1 parallel group, randomised controlled trial was undertaken in 560 women aged 50 to 70 years with BMI > 25 kg/m2. On completion of baseline measures, all participants received a breast cancer prevention leaflet. Intervention group participants received the ActWELL intervention which focussed on personalised diet advice and pedometer walking plans. The programme was delivered in leisure centres by (the charity) Breast Cancer Now volunteer coaches. Primary outcomes were changes between groups at 12 months in body weight (kg) and physical activity (accelerometer measured step count). RESULTS Two hundred seventy-nine women were allocated to the intervention group and 281 to the comparison group. Twelve-month data were available from 240 (81%) intervention and 227 (85%) comparison group participants. Coaches delivered 523 coaching sessions and 1915 support calls to 279 intervention participants. Mean weight change was - 2.5 kg (95% CI - 3.1 to - 1.9) in the intervention group and - 1.2 kg (- 1.8 to 0.6) in the comparison group. The adjusted mean difference was - 1.3 kg (95% CI - 2.2 to - 0.4, P = 0.003). The odds ratio for losing 5% weight was 2.20 (95% CI 1.4 to 3.4, p = 0.0005) in favour of the intervention. The adjusted mean difference in step counts between groups was 483 steps/day (95% CI - 635 to 1602) (NS). CONCLUSIONS A community weight management intervention initiated at breast screening clinics and delivered by volunteer coaches doubled the likelihood of clinically significant weight loss at 12 months (compared with usual care) offering significant potential to decrease breast cancer risk. TRIAL REGISTRATION Database of registration: ISCRTN. Registration number: 11057518 . Date trial registered:21.07.2017. Date of enrolment of first participant: 01.09.2017.
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Effect of a Remotely Delivered Weight Loss Intervention in Early-Stage Breast Cancer: Randomized Controlled Trial.
Reeves, MM, Terranova, CO, Winkler, EAH, McCarthy, N, Hickman, IJ, Ware, RS, Lawler, SP, Eakin, EG, Demark-Wahnefried, W
Nutrients. 2021;(11)
Abstract
Limited evidence exists on the effects of weight loss on chronic disease risk and patient-reported outcomes in breast cancer survivors. Breast cancer survivors (stage I-III; body mass index 25-45 kg/m2) were randomized to a 12-month, remotely delivered (22 telephone calls, mailed material, optional text messages) weight loss (diet and physical activity) intervention (n = 79) or usual care (n = 80). Weight loss (primary outcome), body composition, metabolic syndrome risk score and components, quality of life, fatigue, musculoskeletal pain, menopausal symptoms, fear of recurrence, and body image were assessed at baseline, 6 months, 12 months (primary endpoint), and 18 months. Participants were 55 ± 9 years and 10.7 ± 5.0 months post-diagnosis; retention was 81.8% (12 months) and 80.5% (18 months). At 12-months, intervention participants had significantly greater improvements in weight (-4.5% [95%CI: -6.5, -2.5]; p < 0.001), fat mass (-3.3 kg [-4.8, -1.9]; p < 0.001), metabolic syndrome risk score (-0.19 [-0.32, -0.05]; p = 0.006), waist circumference (-3.2 cm [-5.5, -0.9]; p = 0.007), fasting plasma glucose (-0.23 mmol/L [-0.44, -0.02]; p = 0.032), physical quality of life (2.7 [0.7, 4.6]; p = 0.007; Cohen's effect size (d) = 0.40), musculoskeletal pain (-0.5 [-0.8, -0.2]; p = 0.003; d = 0.49), and body image (-0.2 [-0.4, -0.0]; p = 0.030; d = 0.31) than usual care. At 18 months, effects on weight, adiposity, and metabolic syndrome risk scores were sustained; however, significant reductions in lean mass were observed (-1.1 kg [-1.7, -0.4]; p < 0.001). This intervention led to sustained improvements in adiposity and metabolic syndrome risk.
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The impact of preoperative vitamin administration on skeletal status following sleeve gastrectomy in young and middle-aged women: a randomized controlled trial.
Ben-Porat, T, Weiss, R, Khalaileh, A, Abu Gazala, M, Kaluti, D, Mintz, Y, Sherf-Dagan, S, Yackobovitch-Gavan, M, Rottenstreich, A, Brodie, R, et al
International journal of obesity (2005). 2021;(9):1925-1936
Abstract
BACKGROUND The appropriate strategies to minimize skeletal deterioration following bariatric surgeries are inconclusive. This randomized controlled trial evaluated the effect of preoperative vitamin supplementation on bone mineral density (BMD) and biochemical parameters in females post-sleeve gastrectomy (SG). METHODS Participants were randomized to a 2-month preoperative treatment with a multivitamin and vitamin D 4000 IU/d (intervention arm) or 1200 IU/d (control arm). Preoperative and 12-month postoperative follow-up evaluations included anthropometrics, biochemical parameters, and dual energy X-ray absorptiometry (DEXA). RESULTS Sixty-two females (median age 29.7 years and median BMI 43.4 kg/m2) were recruited, 87% completed the 12-month follow-up. For the intervention and control arms, significant and similar reductions at 12-months post-surgery were observed in BMD of the hip (-6.8 ± 3.7% vs. -6.0 ± 3.6%; P = 0.646) and of the femoral neck (-7.1 ± 5.8% vs. -7.2 ± 5.5%; P = 0.973). For the intervention compared to the control arm, the 25 hydroxyvitamin D (25(OH)D) increment was greater after 2 months treatment, and vitamin D deficiency rates were lower at 3 and 6-months follow-up (P < 0.016). However, at 12-months postoperative, 25(OH)D values and vitamin D deficiency were comparable between the arms (P > 0.339). Predictors for BMD decline in the total hip were the percentage of excess weight-loss, age>50 years, and lower initial BMI (P ≤ 0.003). CONCLUSIONS SG was associated with a significant decline in BMD of the hip and femoral neck in young and middle-aged women, and was unaffected by preoperative vitamin D supplementation. Females who are peri-menopausal or with greater postoperative weight-loss should be particularly followed for BMD decline.
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Long-term effects of resveratrol on cognition, cerebrovascular function and cardio-metabolic markers in postmenopausal women: A 24-month randomised, double-blind, placebo-controlled, crossover study.
Thaung Zaw, JJ, Howe, PR, Wong, RH
Clinical nutrition (Edinburgh, Scotland). 2021;(3):820-829
Abstract
Ageing and menopause contribute to endothelial dysfunction, causing impaired cerebral perfusion, which is in turn associated with accelerated cognitive decline. In a 14-week pilot study, we showed that supplementation with low-dose resveratrol, a phytoestrogen that can enhance endothelial function, improved cerebrovascular and cognitive functions in postmenopausal women. We sought to confirm these benefits in a larger, longer-term trial. A 24-month randomized, placebo-controlled crossover trial was undertaken in 125 postmenopausal women, aged 45-85 years, who took 75 mg trans-resveratrol or placebo twice-daily for 12 months and then crossover to the alternative treatment for another 12 months. We evaluated within individual differences between each treatment period in measures of cognition (primary outcome), cerebrovascular function in the middle cerebral artery (cerebral blood flow velocity: CBFV, cerebrovascular responsiveness: CVR) and cardio-metabolic markers as secondary outcomes. Subgroup analyses examined effects of resveratrol by life stages. Compared to placebo, resveratrol supplementation resulted a significant 33% improvement in overall cognitive performance (Cohen's d = 0.170, P = 0.005). Women ≥65 years of age showed a relative improvement in verbal memory with resveratrol compared to those younger than 65 years. Furthermore, resveratrol improved secondary outcomes including resting mean CBFV (d = 0.275, P = 0.001), CVR to hypercapnia (d = 0.307, P = 0.027), CVR to cognitive stimuli (d = 0.259, P = 0.032), fasting insulin (d = 0.174, P = 0.025) and insulin resistance index (d = 0.102, P = 0.034). Regular supplementation with low-dose resveratrol can enhance cognition, cerebrovascular function and insulin sensitivity in postmenopausal women. This may translate into a slowing of the accelerated cognitive decline due to ageing and menopause, especially in late-life women. Further studies are warranted to observe whether these cognitive benefits of resveratrol can reduce the risk of dementia.
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Effects of branched-chain amino acid supplementation and resistance training in postmenopausal women.
Bagheri, R, Forbes, SC, Candow, DG, Wong, A
Experimental gerontology. 2021;:111185
Abstract
BACKGROUND The age-related loss in muscular function is typically accelerated after menopause. Resistance training (RT) has been shown to increase muscle mass and strength in postmenopausal women. Branched-chain amino acid (BCAA) supplementation acutely increases myofibrillar protein synthesis (MPS) and decreases muscle soreness following RT. However, the combined effects of BCAA supplementation and RT on muscle mass, strength, and regulatory factors on postmenopausal cohorts are currently unknown. The purpose of this study was to explore the combined effects of BCAA supplementation and RT on muscle mass, strength, and regulatory factors in postmenopausal women. METHODS Thirty postmenopausal women were randomly assigned to one of three conditions: RT and placebo (PLA; n = 10), RT and BCAA (BCAA; 9 g/day; n = 10), or control (CON; n = 10). Muscle mass, strength, and serum concentrations of muscle regulatory factors (myostatin, follistatin, and insulin-like growth factor-1 [IGF-1]) were assessed before and following 8 weeks of whole-body supervised RT (3×/week, 3-4 sets using 60-75% 1-repetition maximum [1-RM]). RESULTS There were significant increases (P < 0.05) in muscle mass and strength in both the PLA and BCAA conditions. Additionally, myostatin significantly (P < 0.05) decreased, while IGF-1 (P < 0.05) increased following PLA and BCAA. However, follistatin significantly increased in the BCAA condition. There were no differences between RT conditions over time. Furthermore, there were no changes in any variable after CON. CONCLUSIONS Short-term (8 weeks) RT is an effective intervention for improving muscle mass, strength, and muscle regulatory factors in postmenopausal women. The addition of BCAA supplementation to RT failed to augment these physiological changes.
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Resistance training-induced improvement in exercise tolerance is not dependent on muscle mass gain in post-menopausal women.
de Oliveira Júnior, GN, de Sousa, JFR, Carneiro, MADS, Martins, FM, Santagnello, SB, Orsatti, FL
European journal of sport science. 2021;(7):958-966
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Abstract
Menopause transition may impair muscle function, decreasing exercise tolerance. The torque-duration relationship (hyperbolic curve) forms a practical framework within which exercise tolerance may be explored. In this regard, resistance training (RT) increases the curvature constant of this relationship (W'). Muscle hypertrophy and strength gains have been suggested as possible mediators of RT-induced improvement in W', however, it is unclear what the main mediator is. Higher-volume RT (HV-RT), beyond that recommended by RT-guidelines (i.e. three sets per exercise), may promote greater hypertrophy, but not higher strength gains. Hence, this study aimed to investigate whether greater hypertrophy in HV-RT maximises W' gain when compared to LVRT in postmenopausal women (PW). Fifty-eight PW were randomised to the control group (CTRL), HV-RT (six sets per exercise) or LV-RT (three sets per exercise). They underwent a 12-week RT program and were assessed for W', thigh lean body mass (TLBM) and maximal isometric voluntary contraction (MIVC). The TLBM gain was higher (P < 0.001) in the HV-RT (9.4%) than LV-RT (3.7%). However, both HV-RT and LV-RT similarly increased MIVC (9.7% vs. 16.5%, P = 0.063) and W' (26.4% vs. 34.6% P = 0.163). Additionally, the changes in W' were associated with the changes in TLBM (31%, P = 0.003) and MIVC (52%, P= <0.001). However, when the changes in TLBM and MIVC were inserted into the predictive model, only the MIVC (33%, P = 0.002) was a predictor of W'. Thus, although HV-RT promoted greater hypertrophy than LV-RT, HV-RT does not seem to maximise W' in PW.