Editorial

JK SCIENCE
EDITORIAL
Postmenopausal Obesity
Sudhaa Sharma, Rupali Bakshi, Vishal. R. Tandon, Annil Mahajan
The prevalence of obesity is increasing world wide Table-1 Health Benefits of Exercise/Weight Reduction (7-10)
and is reaching epidemic proportions. Majority of adults • Fall of 10mm of Hg in systolic BP & diastolic BP are becoming increasingly overweight and one of the sub- in hypertensive patients• Fall upto 50 % in fasting blood glucose in DM patients populations in which this prevalence is growing most rapidly is postmenopausal women. 8.3 million population is forecasted to be obese in age of 50 years or • Fall of 10% of TC,15% LDL,30%TG & 8 % rise in HDL• Postmenopausal women have an increased tendency • 40 % fall in deaths related to obesity for gaining weight. It is as yet unclear whether the • Improve in muscle strength and endurance• Increase in walking endurance menopausal transition itself leads to weight gain, but is known that the physiological withdrawal of estrogen brings • Increase in flexibility and co-ordination about changes in fat distribution (2), together with physical inactivity, are probably the major causes of this • Decrease in incidence of estrogen dependent cancers• Reduction in hot flashes phenomenon. Other contributing factors include ethnicity, • Increase in central endorphin activity reduced lean mass, resting metabolic rate and treatment • Increase in bone mineral content and/or Decrease in with certain drugs, e.g. steroids, insulin, glitazones (3).
bone turnover• Decrease in exercise induced ischemia Moreover, estrogen withdrawal during menopause has a • Decrease in depression and anxiety scores detrimental effect on metabolism and bring changes in body fat distribution from a gynoid to an android pattern, lack of energy (5,6). BMI > 21 in women increases reduced glucose tolerance, abnormal plasma lipids, risk of CVS diseases, DM, Muskloskelton disorders.
increased blood pressure, increased sympathetic tone, WC > 88cm, in women, caries great vascular and endothelial dysfunction and vascular inflammation.As a result postmenopausal obesity compounds the situation A sustained weight loss of 5-10 % in obese patients leading to increased rates of hypertension, diabetes confers marked health benefits (7, 8, 10). The metabolic mellitus, coronary artery disease and mortality. Additional and vascular benefits of even modest reduction of weight consequences of obesity may include hormone-dependent are well described. A reasonably balanced approach to cancer, gallstones, nephrolithiasis, and osteoarthritis with regular exercise can generate similar benefits as HRT and usually without unnecessary risks. There is irrefutable Women with abdominal obesity compared to other evidence of the effectiveness of regular physical activity women have, high vasomotor scores, personal life in the primary and secondary prevention of several chronic dissatisfaction , nervousness, memory loss, depression, diseases (e.g., cardiovascular disease, diabetes, cancer, flatulence, muscle and joint pains, sleeping disorders, hypertension, obesity, depression and osteoporosis) and From the Editorial Team of JK Science, Journal of Medical Education and Research
Correspondence to : Dr Sudhaa Sharma, Editor In General, JK Science, Journal of Medical Education and Research
JK SCIENCE
Table: 2 Lifestyle Interventions to Prevent Weight Gain During Menopause
• Dietary Interventions
Caloric restriction, maintaining a healthy balanced diet, eating pattern consisting of 1,300 kcal/day (25% total fat, 7% saturated fat, 100 mg of dietary cholesterol),eating calcium, flavonoid and antioxidant rich diet. But eating right food withgood intake of fiber, spinach, kale, cabbage, broccoli, tomatoes, beans, lentils and citrus fruits will be of immense value. Onecan avoid of fatty diet, and black coffee. All the excess sugars, salt, even honey should be avoided. Vitamins (B2,B6,B12 andfolic acid) should be suplemented (5,6,7).
• Exercise/Physical Actiity
Major recommendation is to exercise regularly, for at least 30 min on at least 5 days of the week or increased their physicalactivity expenditure (1,000-1,500 kcal/week).Controlled yoga and mindful exercises like meditation under supervision oftrainer.Strength, Resistance & stretching exercise training.Aerobic like walking, jogging, swimming, cycling, dancing, stepups and downs, brisk walking, lawn mowing are recommended by all. High-impact aerobic exercises, ie jumping, skippingshould be avoided by people with osteoporosis and other joint disorders (7-9) .
premature death.Treatment of postmenopausal obesity 2. Dubnov-Raz G, Pines A, Berry EM.Diet and lifestyle in is very simple logically, but incredibly difficult - eat less managing postmenopausal obesity. Climacteric 2007;10(Suppl 2) :38-41.
and exercise more. Pharmacotherapy available for the 3. Samat A, Rahim A, Barnett A. Pharmacotherapy for treatment of obesity are amphetamines, dexamphetamine, obesity in menopausal women.Menopause Int benzphetamine, phendimetrazine, phentermine, diethypropion, mazindol, orlistat, sibutramine and other 4. Rosano GM, Vitale C, Marazzi G, Volterrani M.
Menopause and cardiovascular disease: the evidence.
investigational antiobesity agents are rimonabant, Climacteric 2007; 10 (Suppl 1):19-24.
zonisamide, somatostatin analogs, leptin agonists, gherelin 5. Khajuria V, Chopra VS, Raina AS. Dietary supplement in antagonists etc. Only three drugs, sibutramine, orlistat Menopause. JK Science 2008;10(1):2-4.
and rimonabant are approved by US FDA for long term 6. Dubnov G, Brzezinski A, Berry EM. Weight control and the management of obesity after menopause: the role of use (3). But no convincing data is available recommending physical activity. Maturitas 2003 ;44 (2):89-101 their use in postmenopausal obesity as such.
7. Simkin-Silverman LR, Wing RR, Boraz MA, Kuller Hence, presently life style modification at the transition LH.Lifestyle intervention can prevent weight gain during of menopause will go long way in preventing weight gain menopause: results from a 5-year randomized clinical trial.
Ann Behav Med 2003;26(3):212-20.
during this metabolically vulnerable period which will help 8. Carroll S, Borkoles E, Polman R. Short-term effects of a in primary and secondary prevention of several chronic non-dieting lifestyle intervention program on weight diseases (e.g., cardiovascular disease, diabetes, cancer, management, fitness, metabolic risk, and psychological well- hypertension, obesity, depression and osteoporosis) and being in obese premenopausal females with the metabolic premature death beside keeping women physically and syndrome.Appl Physiol Nutr Metab 2007;32(1):125-42.
9. Kruk J.Physical activity in the prevention of the most frequent chronic diseases: an analysis of the recent evidence.
References
Asian Pac J Cancer Prev 2007;8(3):325-38.
1. Wang YC, Colditz GA, Kuntz KM. Forecasting the 10. Darren E R W,Crytal WN, Shannon SDB. Health benefits obesity epidemic in the aging US. Population.
of physical activity: The evidence. CMAJ 2006 14; Obesity (Silver Spring) 2007;15:2855-65 Editorial Board proudly shares that JK Science,
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