We examined the effects of the menopause transition on plasma lipids, insulin-like growth factor I (IGF-I) and blood pressure. An initial cohort of 38, non-smoking, healthy premenopausal women (44-48 years) were examined at baseline and after a 6-year follow-up period. At follow-up, 18 women had spontaneously stopped menstruating, whereas 17 women remained premenopausal. Women who experienced natural menopause showed a greater decline in high-density lipoproteins (-5 +/- 4 mg dL-1 vs. -1 +/- 3 mg dL-1; P < 0.01) and a greater increase in low-density lipoproteins (13 +/- 12 vs. 5 +/- 10 mg dL-1; P < 0.05) and fasting triglycerides (14 +/- 15 vs. 5 +/- 11 mg dL-1; P < 0.05) than women who remained premenopausal. No menopause effect was noted for total cholesterol. We noted a greater decline in IGF-I levels in women who experienced a natural menopause (-21 +/- 11 ng mL-1) than women who remained postmenopausal (-4 +/- 10 ng mL-1). Systolic blood pressure increased in postmenopausal (13 +/- 10 mmHg) compared with premenopausal women (5 +/- 4 mmHg: P < 0.01), whereas no menopause effect was noted for diastolic blood pressure. The increase in the waist-to-hip ratio was related to a decrease in high-density lipoprotein (r = -0.49; P < 0.05) and increase in low-density lipoprotein (r = 0.48; P < 0.05). The decline in IGF-I was related to the decline in reported leisure time physical activity (0.44: P < 0.05). We conclude that the natural menopause transition is associated with a worsening of the lipid profile and decline in IGF-I, which might be mitigated by deleterious changes in body fat distribution and physical activity.

Our results suggest that the previously reported relationship between low SHBG levels and increased metabolic disease risk in women is mediated, to a large extent, by concomitant variation in body fatness and intra-abdominal adipose tissue accumulation.

OBJECTIVE: To examine the accuracy, precision and bias of body fat estimates using traditional research based techniques, relative to those derived from a 4-compartment model in healthy, older men and women. DESIGN AND SUBJECTS: Cross-sectional comparison of various body composition techniques in 41 healthy women (68.2 AE 6.6 y) and 41 healthy men (70.2 AE 7.0 y) with an age range of 57±90 y. METHODS: Fat mass (FM) by the 4-compartment (4C) model was compared to that derived by dual energy X-ray absorptiometry (DXA), underwater weight (UWW) and total body water (TBW). RESULTS: On a group mean basis, FM by the 4C model (24.4 AE 7.4 kg in women, 18.2 AE 7.6 kg in men) was similar to other techniques. The regression between FM by 4C and DXA signi®cantly deviated from the line of identity (FM by 4C 0.76*FM by DXA 5.9 kg for women; 0.81*FM by DXA 3.4 kg for men). FM by UWW was similar to FM by 4C model in men but not women (FM by 4C 0.87*FM by UWW 4.3 kg). FM by TBW was similar to FM by 4C model in women, but not men (FM by 4C 0.80*FM by TBW 4.7 kg). For DXA, there was no signi®cant bias in estimates of FM in men or women. For UWW, there was signi®cant bias in men with an over-estimate of FM among leaner subjects and under-estimates in fatter subjects. For TBW data, there was a signi®cant bias in men with an under-estimate of FM among leaner subjects and over-estimate in fatter subjects. CONCLUSIONS: Individual estimates of FM by DXA can be improved by correction factors that calibrate experimental data to standards such as the 4-C model. The assumptions of the Siri 2 compartment model are appropriate in healthy elderly men but not women, where a new equation is suggested. Inaccuracies in FM from TBW data are likely to be explained by age-related changes in the hydration of fat free mass (FFM).

OBJECTIVES: (1) To examine misreporting of total energy intake in older African-American men and women using the double-labeled water procedure; and (2) to identify signi®cant physiological and demographic determinants of total energy intake misreporting in older African Americans. DESIGN: Cross-sectional study examining gender differences and determinants of misreporting of total energy intake in older African-American men and women. SUBJECTS: Sixty-four, older African-American men (n 28) and women (n 36); 52 ± 84 y old; body mass index of 20.5 ± 45.1 kgam 2 . MEASUREMENTS: Misreporting of total energy intake (difference between reported intakes and measured energy expenditure by doubly labeled water procedure), peak VO 2 , resting metabolic rate (by indirect calorimetry), indices of body fat and fat distribution (by dual-energy X-ray absorptiometry and anthropometry), income, living arrangement and education (by interview). RESULTS: Older African-American men and women under-reported total energy intake to a modest degree and there were no gender differences in the magnitude of the misreporting. Peak VO 2 (a determinant of daily energy requirements) and percentage intakes of fat and protein were signi®cant correlates of misreporting of total energy intake in older African Americans. When these correlates were entered in a multiple regression model, only percentage dietary fat and protein intakes independently predicted misreporting of total energy intake. CONCLUSIONS: Cultural differences in attitudes regarding food and weight have signi®cant effects on misreporting of total energy intake in older African Americans. In addition, individuals who misreported their total energy intake to a greater extent reported consuming less fat and more protein. Misreporting of total energy intake may occur less frequently in older African Americans as compared to other racial groups, since they may be less preoccupied with body size and image.

OBJECTIVE: In the postmenopausal years, women develop a central pattern of fat distribution and an increased risk of developing cardiovascular disease (CVD). The possibility that these events are related has not been extensively investigated. The object of the present study was to test the hypotheses that, 1) menopause-related differences in lipids are associated with greater estimated intra-abdominal adiposity, and 2) the relationship between individual adipose depots and plasma lipids differs with menopausal status. DESIGN: Cross-sectional. SUBJECTS: 141 healthy pre-and postmenopausal women aged 35 ± 65 y. MEASUREMENTS: Total body fat by hydrodensitometry was used as an index of whole-body adiposity, the sum of ®ve central skinfold measurements as an index of subcutaneous upper-body adiposity, and estimated intra-abdominal adipose tissue (IAF) as an index of visceral adiposity. Fasting plasma concentrations of total cholesterol (total-C), highand low-density-lipoprotein cholesterol (HDL-C, LDL-C), and triglycerides were used as indices of CVD risk. RESULTS: Postmenopausal women had greater total body fat (P`0.001), summed central skinfolds (P`0.01), estimated IAF (P`0.001), higher plasma concentrations of total-C (P`0.001), LDL-C (P`0.001) and triglycerides (P`0.001), than premenopausal women. The relationship between central skinfolds and LDL-C differed with menopausal status, being signi®cant in pre-but not postmenopausal women. Adjustment for estimated IAF with analysis of covariance decreased menopause-related differences in levels of total-C, LDL-C and triglycerides by approx 40 ± 70%. CONCLUSION: These observations suggest that, 1) menopause-related changes in IAF may adversely affect the plasma lipid pro®le, and 2) menopausal status affects the relationship between central subcutaneous fat and LDL-C. Studies with measured IAF are needed to con®rm present results.