The possibility that the heightened cardiovascular risk associated with the menopause, which is said to be ameliorated by soybeans, can be reduced with soy isoflavones was tested in 21 women. Although several were perimenopausal, all have been included. A placebo-controlled crossover trial tested the effects of 80-mg daily isoflavones (45 mg genistein) over 5- to 10-week periods. Systemic arterial compliance (arterial elasticity), which declined with age in this group, improved 26% (P < .001) compared with placebo. Arterial pressure and plasma lipids were unaffected. The vasodilatory capacity of the microcirculation was measured in nine women; high acetylcholine-mediated dilation in the forearm vasculature was similar with active and placebo treatments. LDL oxidizability measured in vitro was unchanged. Thus, one important measure of arterial health, systemic arterial compliance, was significantly improved in perimenopausal and menopausal women taking soy isoflavones to about the same extent as is achieved with conventional hormone replacement therapy.

Objective To develop an in-depth picture of both lived experience of obesity and the impact of socio-cultural factors on people living with obesity.Design Qualitative methodology, utilizing in-depth semi-structured interviews with a community sample of obese adults (body mass index ‡30). Community sampling methods were supplemented with purposive sampling techniques to ensure a diverse range of individuals were included.Results Seventy-six individuals (aged 16-72) were interviewed. Most had struggled with their weight for most of their lives (n = 45). Almost all had experienced stigma and discrimination in childhood (n = 36), as adolescents (n = 41) or as adults (n = 72). About half stated that they had been humiliated by health professionals because of their weight. Participants felt an individual responsibility to lose weight, and many tried extreme forms of dieting to do so. Participants described an increasing culture of ÔblameÕ against people living with obesity perpetuated by media and public health messages. Eighty percent said that they hated or disliked the word obesity and would rather be called fat or overweight.Discussion and Conclusion There are four key conclusions: (i) the experiences of obesity are diverse, but there are common themes, (ii) people living with obesity have heard the messages but find it difficult to act upon them, (iii) interventions should be tailored to address both individual and community needs and (iv) we need to rethink how to approach obesity interventions to ensure that avoid recapitulating damaging social stereotypes and exacerbating social inequalities.

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Female sex hormones have been implicated in the cardioprotection of premenopausal women. However, the cardiovascular actions of these hormones and the effects of their natural fluctuations during the menstrual cycle are not fully understood. We studied changes in vascular function during the menstrual cycle in 15 healthy premenopausal women. Four noninvasive procedures were performed during the early follicular (EF), late follicular (LF), early luteal (EL), and late luteal (LL) phases: flow-mediated dilatation (FMD) of the brachial artery during reactive hyperemia, laser Doppler velocimetry (LDV) with direct current iontophoresis of acetylcholine (ACh) and nitroprusside, whole body arterial compliance (WBAC), and pulse wave velocity. Hormone levels were consistent with predicted cycle phase and showed that all subjects ovulated during the cycle studied. FMD, LDV with ACh, and WBAC varied cyclically, with significant increases from the F to LF phase, sharp falls in the EL phase, and significant recoveries in the LL phase. These changes were most marked IT IS WELL established that the incidence of coronary heart disease (CHD) in women at all ages is lower than that in men and increases after menopause, when ovarian secretion of sex hormones is low (1, 2). There is evidence that postmenopausal E-containing hormonal therapy reduces CHD risk (3), suggesting that ovarian hormones may provide protection against CHD in premenopausal women. This is supported by the known actions of female sex hormones on the cardiovascular system, which include effects on plasma lipid levels (4) and direct (5, 6) and indirect (7, 8) actions on vessel wall physiology. In addition, the natural hormonal fluctuations during the menstrual cycle are reflected in cardiovascular changes. For example, total plasma cholesterol, low density lipoprotein cholesterol, and apolipoprotein A1 concentrations decrease and high density lipoprotein cholesterol and apolipoprotein (a) increase during the luteal phase compared with the follicular phase (9 -11), and many circulating factors, such as nitric oxide synthase (12), vascular endothelial growth factor (13), and P-selectin (14), demonstrate cyclical variation. It has also been shown that decreases occur in large vessel endothelial function (15) and radial arterial distensibility (16) in the late luteal phase and in cutaneous vasodilatation in the menstrual compared with the follicular phase (17). However, there have been no studies that have documented in detail the changes occurring simultaneously in large and small vessel endothelial function, nonendothelial smooth muscle function, and arterial elasticity or compliance both within and between follicular and luteal phases of the normal menstrual cycle.A detailed understanding of variations in cardiovascular function during the menstrual cycle is of importance for three reasons: it may assist with the interpretation of vascular parameters in premenopausal women; it may provide insights into the mechanisms underlying sex differences in cardiovascular ri...

Background: To explore the extent to which people living with obesity have attempted to lose weight, their attitudes towards dieting, physical exercise and weight loss solutions, why their weight loss attempts have failed, and their opinions about what would be most beneficial to them in their struggle with their weight.