Exercise and Menopausal Symptoms

Researchers writing in the British Journal of General Practice say that their study “suggest(s) a positive association between somatic and psychological dimensions of health-related quality of life and participation in regular exercise. Women with BMI scores in the normal range reported lower vasomotor symptom scores and better health-related quality of life scores than heavier women.”

Daley A, Macarthur C, Stokes-Lampard H, McManus R, Wilson S, Mutrie N. Exercise participation, body mass index, and health-related quality of life in women of menopausal age. Br J Gen Pract. 2007 Feb;57(535):130-5.

BACKGROUND: Menopausal symptoms can affect women’s health and wellbeing. It is important to develop interventions to alleviate symptoms, especially given recent evidence resulting in many women no longer choosing to take hormone replacement therapy. Exercise may prove useful in alleviating symptoms, although evidence on its effectiveness has been conflicting.
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Exercise, Abdominal Fat, Insulin Resistance

Researchers writing in The Journal of Applied Physiology studied 16 obese men and women, about 63 years old, during a 12 week exercise program. During the program the participants exercised 5 days a week for 60 minutes a day (treadmill/cycle ergometry @ 85% of heart rate max). Among the many things the researchers measured was total abdominal fat, subcutaneous fat (fat under the skin) and visceral fat (the fat that surrounds the organs).

From the study abstract: “Exercise improves glucose metabolism and delays the onset and/or reverses insulin resistance in the elderly by an unknown mechanism. In the present study we examined the effects of exercise training on glucose metabolism, abdominal adiposity and adipocytokines* in obese elderly.”

What the researchers found: “Visceral fat loss after aerobic exercise training improves glucose metabolism and is associated with the reversal of insulin resistance in older obese men and women.”

*Adipocytokines are a collective term for secretions from the fat cells that help regulate energy metabolism and food intake among other functions.

Reference: O’Leary VB, Marchetti CM, Krishnan RK, Stetzer BP, Gonzalez F, Kirwan JP. Exercise-induced reversal of Insulin Resistance in Obese Elderly is associated with reduced Visceral Fat.J Appl Physiol (December 22, 2005) Study abstract

Power Training and Balance in Older Adults

Researchers in Australia and Massachusetts say that low load, high velocity power training can improve balance and reduce fall risks in aging subjects.

From the abstract:
“Age-related decline in muscle power may be an early indicator of balance deficits and fall risk, even in nonfrail adults. This study examined the dose-dependent effect of power training on balance performance in healthy older adults.

One hundred twelve community-dwelling healthy older adults (69 ± 6 years) were randomized to 8–12 weeks of power training at 20% (LOW), 50% (MED), or 80% (HIGH) of maximal strength, or a nontraining control (CON) group…”

The researchers concluded:
“Power training significantly improved balance performance in participants who underwent power training compared to controls. Low intensity power training produced the greatest improvement in balance performance…

Power training improves balance, particularly using a low load, high velocity regimen, in older adults with initial lower muscle power and slower contraction. Further studies are warranted to define the mechanisms underlying this adaptation, as well as the optimum power training intensity for a range of physiological and clinical outcomes in older adults with varying levels of health status and functional independence.”

Orr R, de Vos NJ, Singh NA, Ross DA, Stavrinos TM, Fiatarone-Singh MA. Power Training Improves Balance in Healthy Older Adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 61:78-85 (2006)

Walking off Postmenopausal Decreases in bone mineral density, aerobic fitness, muscle strength, and balance

Researchers writing in the medical journal Physical Therapy say that “Menopause may induce a phase of rapid decreases in bone mineral density, aerobic fitness, muscle strength, and balance, especially in sedentary women.”
Asikainen TM, Suni JH, Pasanen ME, Oja P, Rinne MB, Miilunpalo SI, Nygard CH, Vuori IM.

Effect of brisk walking in 1 or 2 daily bouts and moderate resistance training on lower-extremity muscle strength, balance, and walking performance in women who recently went through menopause: a randomized, controlled trial. Phys Ther. 2006 Jul;86(7):912-23.

From the article abstract:
BACKGROUND AND PURPOSE: Menopause may induce a phase of rapid decreases in bone mineral density, aerobic fitness, muscle strength, and balance, especially in sedentary women. The purpose of this study was to examine the effects and feasibility of an exercise program of 1 or 2 bouts of walking and resistance training on lower-extremity muscle strength (the force-generating capacity of muscle), balance, and walking performance in women who recently went through menopause.

SUBJECTS AND METHODS: The subjects were 134 women who recently went through menopause. The study was a 15-week, randomized, controlled trial with continuous and fractionated exercise groups. The outcomes assessed were lower-extremity muscle strength, balance, and walking time over 2 km. Feasibility was assessed by questionnaires, interviews, and training logs.

RESULTS: One hundred twenty-eight women completed the study. Adherence to the study protocol was 92%. Both continuous and fractionated exercise groups improved equally in lower-extremity muscle strength and walking time but not in balance. Almost 70% of the subjects considered the program to be feasible. Two daily walking sessions caused fewer lower-extremity problems than did continuous walking.

DISCUSSION AND CONCLUSION: Brisk walking combined with moderate resistance training is feasible and effective. Fractionating the walking into 2 daily sessions is more feasible than continuous walking.

Muscle Mass and Strength Research

Risk factors for loss of muscle strength in aging men
The researchers concluded that the following were risk factors:
“Multivariate analyses revealed that besides older age, other risk factors also contributed to the loss of muscle strength in older men, including back pain, use of calcium channel blockers, caffeine intake, and height and weight loss.”

Resistance Training Important for Aging Muscles and Tendons
Researchers writing the medical journal Experimental Physiology say that resistance training is not only good for preventing age-related loss of muscle but for tendons as well.

Strength Training and Nutritional Counseling Benefits In Women
Writing in the Canadian Journal of Applied Physiology, researchers noted that long-term strength training and nutritional counseling had positive effects of metabolic health indicators.

Walking off Postmenopausal Decreases in bone mineral density, aerobic fitness, muscle strength, and balance.
Researchers writing in the medical journal Physical Therapy say that “Menopause may induce a phase of rapid decreases in bone mineral density, aerobic fitness, muscle strength, and balance, especially in sedentary women. The purpose of this study was to examine the effects and feasibility of an exercise program of 1 or 2 bouts of walking and resistance training on lower-extremity muscle strength (the force-generating capacity of muscle), balance, and walking performance in women who recently went through menopause.”

What is the Effect of Insulin Resistance and Loss of Lean Muscle (Sarcopenia) As We Age?
Researchers writing in the Journal of The Federation of American Societies for Experimental Biology say: “A reduced response of older skeletal muscle to anabolic stimuli (exercise & diet) may contribute to the development of sarcopenia.

Power Training and Balance in Older Adults
Researchers in Australia and Massachusetts say that low load, high velocity power training can improve balance and reduce fall risks in aging subjects. The researchers concluded: “Power training significantly improved balance performance in participants who underwent power training compared to controls. Low intensity power training produced the greatest improvement in balance performance.

Endurance Training and Age-Related Decline in Immune Function and Endocrine Function

Researchers writing in the medical journal Immunity and Ageing say that long-term endurance training has the potential to decelerate the age-related decline in immune function but not the deterioration in endocrine function.

Arai MH, Duarte AJ, Natale VM. The effects of long-term endurance training on the immune and endocrine systems of elderly men: the role of cytokines and anabolic hormones. Immun Ageing. 2006 Aug 25;3:9

From the article abstract:”highly conditioned elderly men seem to have relatively better preserved immune system than the sedentary elderly men. Long-term endurance training has the potential to decelerate the age-related decline in immune function but not the deterioration in endocrine function.”

Exercise Frequency in Older Women

Researchers writing in the Archives of Gerontology and Geriatrics say “older women who participate in an exercise program three times a week gain greater functional fitness benefits than those who exercise less frequently.”

Nakamura Y, Tanaka K, Yabushita N, Sakai T, Shigematsu R. Effects of exercise frequency on functional fitness in older adult women. Arch Gerontol Geriatr. 2007 Mar-Apr;44(2):163-73.

From the study abstract: This study evaluated the effects of exercise frequency on functional fitness in older women participating in a 12-week exercise program.

Participants (67.8+/-4.6 years) were divided into three different exercise groups (I, II, and III; n=34) and a control group (Group C; n=11). Group I participated in a 90-min exercise program once a week, for 12 weeks, while Group II attended it twice a week, and Group III attended three times a week.

The exercise program consisted of a 10-min warm-up, 20min of walking, 30min of recreational activities, 20min of resistance training, and a 10-min cool-down.

The following items were measured before and after the program: muscular strength, muscular endurance, dynamic balance, coordination, and cardiorespiratory fitness (6-min walking distance).

Comparisons of baseline and post-intervention measures showed significantly greater improvements in body weight, coordination, and cardiorespiratory fitness for Group III compared to the other groups (p<0.05).

In addition, the greatest improvements in body fat, muscular endurance, and dynamic balance were also observed in Group III (p<0.05). However, no significant differences were found in muscular strength.

Older women who participate in an exercise program three times a week gain greater functional fitness benefits than those who exercise less frequently. In order to improve functional fitness in older women, an exercise frequency of at least three times each week should be recommended.

Strength Training and Nutritional Counseling Benefits In Women

Sallinen, J. Fogelholm, M. Pakarinen, A.Juvonen, T. Volek, J.S. Kraemer, W.J. Alen, M. Hakkinen, K. Effects of strength training and nutritional counseling on metabolic health indicators in aging women.J. Appl. Physiol. (2005) 30(6): 690-707.

Writing in the Canadian Journal of Applied Physiology, researchers noted that long-term strength training and nutritional counseling had positive effects of metabolic health indicators.

From the study abstract:
“Effects of strength training (ST) and nutritional counseling (NC) on metabolic health indicators were examined in 50 aging women.

Methods: Subjects performed ST for 21 weeks. NC was given to obtain sufficient energy and protein intake, and recommended intake of fat and fiber.

Results: NC increased intake of protein and polyunsaturated fat by 4.5% and 10.7% and decreased intake of saturated fat by 18.3%. Serum concentrations of total cholesterol (TC), LDL-cholesterol (LDL-C), total and HDL-cholesterol (HDL-C) ratio and triacylglycerols (TAG) decreased, and serum HDL-C increased in all subjects after ST.

Respectively, systolic and diastolic blood pressure and serum insulin concentration decreased in all subjects.

Respectively, changes in serum TC levels were related to protein intake, and changes in serum HDL-C to intake of fat, and inversely to carbohydrate and protein in all subjects.

Conclusions: The long-term ST (strength training) had favorable effects on serum lipids, lipoproteins, insulin concentration, and blood pressure. However, NC further contributed to positive changes in serum lipids and lipoproteins.”

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Exercise, Diabetes, Diabetes Risk

Researchers writing in the Medical Journal Diabetes Care say patients may need more convincing that exercise assists in diabetes management and diabetes risk management.

From the study abstract:
“With increased focus on the obesity and diabetes epidemics, and the clear benefit of exercise in disease prevention and management, this study determined the lifetime prevalence of health professional advice to exercise among individuals with or at risk for diabetes.

A total of 73% of adults with diabetes were told by a health professional to exercise more versus 31% of adults without diabetes. The proportion receiving advice increased as the number of diabetes risk factors increased until reaching similar rates as people with diabetes.

Health professionals advised most patients with or at highest risk for diabetes to exercise, suggesting recognition of its importance for disease management. As risk factors declined, fewer patients were advised to exercise, suggesting missed opportunities for disease prevention. However, exercise has not increased proportional to exercise advice. The challenge remains converting patient awareness into behavior change.”

Morrato EH, Hill JO, Wyatt HR, Ghushchyan V, Sullivan PW. Are Health Care Professionals Advising Patients With Diabetes or At Risk for Developing Diabetes to Exercise More? Diabetes Care 29:543-548, 2006

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You May Need To Exercise More To Avoid Fat Accumulation Associated With Aging

Researchers publishing in the journal Clinical Nutrition say: “Cross-sectional data have shown that sarcopenia (age associated muscle loss) and fat accumulation are associated with aging and can be limited by structured physical training. However, it is often difficult to maintain a long-term compliance to training programs. It is not clear whether leisure-time physical activity is effective in preventing sarcopenia and fat accumulation.

CONCLUSIONS: Mild but significant decline in muscle mass and its TBK (Total Body Potassium) content, and body fat accumulation were observed over a 3-year period in healthy elderly subject: leisure-time physical activity does not seem to prevent them. However, a higher level of physical activity is associated with higher muscle mass and TBK content, and less total and truncal fat.” Read the abstract

Raguso CA, Kyle U, Kossovsky MP, Roynette C, Paoloni-Giacobino A, Hans D, Genton L, Pichard C. A 3-year longitudinal study on body composition changes in the elderly: Role of physical exercise. Clin Nutr. 2005 Dec 2

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