oa SA Pharmaceutical Journal - Weight gain after the menopause -is it inevitable? : clinical



There is an age-related increase in obesity between the ages of 45 and 65 years. <BR>The metabolic syndrome is a multifaceted clinical disorder that is closely linked to obesity and its diagnositic criteria are constantly being reassessed. <BR>Hormonal changes and changes in body composition are of specific relevance to the menopause. <BR>The main decrease in energy expenditure in a patient aged 70 years compared with a person aged 25 years would be in the capacity for intense exercise, occupational energy expenditure, dietary-induced thermogenesis and a drop in basal metabolic rate. <BR>Postmenopausal BMI will be strongly related to:<UL> &lt;LI&gt; pre-menopausal BMI (a positive correlation)</LI> &lt;LI&gt; pre-menopausal level of physical activity (a negative correlation)</LI> &lt;LI&gt; ethnicity (Afro-American, Caucasian and Hispanic women appear more susceptible to postmenopausal weight gain, while Chinese and Japanese women appear relatively protected)&lt;/LI&gt; &lt;LI&gt; surgical induction of menopause (positive correlation)&lt;/LI&gt; &lt;LI&gt; hormonal use (affords a relative protection with a 1-1.5 index less rise in BMI).</LI></UL> With age, and in the absence of GH and HRT, muscle protein will be replaced by adipose tissue leading to reduced physical ability and obesity, notably in the subcutaneous, abdominal and visceral areas. <BR>In addition to having a favourable effect on lean body mass and bone mineral density, HRT with oestradiol with or without progesterone or norethisterone will also decrease percentage body fat with a favourable increase in the ratio of subcutaneous to visceral fat ratio in the abdominal ratio. <BR>Weight gain is not inevitable in the menopause.


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