Abdominal fat distribution in pre- and postmenopausal women: The impact of physical activity, age, and menopausal status

doi:10.1053/meta.2001.24931

Metabolism

Volume 50, Issue 8, August 2001, Pages 976-982

https://doi.org/10.1053/meta.2001.24931 Get rights and content

Abstract

Age-related increases in total body fat have been reported, but the impact of menopause on abdominal fat distribution is still unclear. The purpose of this study was to determine the impact of menopausal status on abdominal fat distribution using magnetic resonance imaging (MRI). In addition, we investigated the influence of abdominal fat distribution on blood lipid profiles and leptin concentrations. Twenty-three premenopausal (PRE), 27 postmenopausal (POST), and 28 postmenopausal women on estrogen replacement therapy (ERT) had measurements of regional abdominal fat, blood lipids, and serum leptin concentrations. The women were matched for body mass index (BMI) and total body fat mass. Age and menopausal status were not found to be significant predictors of total abdominal fat, visceral fat, or subcutaneous fat, while physical activity was a significant predictor (P [lt ] .01) for total abdominal fat (R² = .16), visceral fat (R² = .32) and percent visceral fat (R² = .25). There was a trend for a greater visceral fat content in the POST women compared with the PRE women (2,495.0 [plusmn] 228.4 v 1,770.4 [plusmn] 240.8 cm², respectively, P = .06). The percent visceral abdominal fat was significantly lower (P [lt ] .05) in the premenopausal women than in either postmenopausal group (PRE, 23.2% [plusmn] 1.7%; POST, 28.9% [plusmn] 1.8%; ERT, 28.9% [plusmn] 1.6%). Menopausal status and age did not influence any of the blood lipid values. Abdominal fat distribution was a significant predictor of cholesterol concentrations and the cholesterol/high-density lipoprotein-cholesterol (HDL-C) ratio, but only accounted for approximately 15% of the variability in these levels. Total body fat and physical activity accounted for 47% of the variability in leptin concentrations, while abdominal fat distribution, age, and menopausal status were not significant predictors. In conclusion, in early postmenopausal women, the level of physical activity accounts for the variability in abdominal fat distribution observed, while menopausal status and age do not play a significant role. ERT was not associated with additional benefits in abdominal fat distribution compared with postmenopausal women not on ERT or in the blood lipid profile in these women.

References (0)

Cited by (126)

The impact of exercise training on inflammatory markers in postmenopausal women: A systemic review and meta-analysis
2021, Experimental Gerontology
Citation Excerpt :
Adipose tissue, especially visceral adipose tissue (VAT) is the important source of pro-inflammatory cytokines such as IL-6 and TNF-α, and CRP (Tilg and Moschen, 2006; Berg and Scherer, 2005; Gustafson et al., 2007; Forouhi et al., 2001; Park et al., 2010). Deposition of VAT increases in menopause, and can lead to the production and release of these inflammatory markers (Kershaw and Flier, 2004; Kanaley et al., 2001; Tchernof et al., 2004; Carr, 2003; Lee et al., 2009). Thus, a reduction in adipose tissue, especially VAT following exercise training, may play an important role in the reduced production of IL-6 and TNF-α, and consequently the circulating levels of these markers of inflammation.
The postmenopausal stage of life is associated with increased systemic inflammation that may be mitigated through exercise training. The effects of exercise training on inflammatory markers in postmenopausal women, however, require further elucidation. We therefore performed a systematic review and meta-analysis to investigate the available high-quality research on the effects of exercise training on inflammatory markers in postmenopausal women.
Electronic searches in PubMed, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and Google Scholar were conducted to identify articles published through April 2021, for studies comparing exercise training to a control condition, on inflammatory markers including CRP, IL-6, TNF-α and adiponectin in postmenopausal women. Randomized or non-randomized controlled trials of exercise training were included according to the following criteria: (A) English language articles; (B) involving women participants who were post-menopausal; (C) providing measures of inflammatory markers including IL-6, TNF-α, CRP or adiponectin at baseline and after completion of the intervention; (D) an exercise training intervention duration of ≥4 weeks.
Results were extracted from the included studies and standardized mean differences (SMD) and 95% confidence intervals (95% CIs) were calculated. Thirty-two studies (representing 38 intervention groups) involving 1510 postmenopausal women were retrieved from the databases for analyses. Overall, exercise training significantly reduced IL-6 [−0.75 (95% CI: −1.07 to −0.42), p < 0.001; 20 interventions], TNF-α [−0.64 (95% CI: −0.91 to −0.37), p < 0.001; 24 interventions] and CRP [−0.64 (95%CI: −0.91 to −0.38), p < 0.001; 21 interventions] and increase adiponectin [0.98 (95% CI: 0.10 to 1.86), p = 0.02; 6 interventions], when compared with control. Furthermore, subgroup analyses suggested that aerobic, resistance, and combined training significantly reduced IL-6, TNF-α and CRP (p < 0.05). Exercise training improved IL-6, TNF-α and CRP in both younger (age < 64 years) and older (age ≥ 64 years) participants (p < 0.05).
These results suggest that exercise training may be an effective intervention for reducing pro-inflammatory markers and increasing adiponectin in postmenopausal women.
Effect of aging, menopause, and age at natural menopause on the trend in body mass index: a 15-year population-based cohort
2019, Fertility and Sterility
Citation Excerpt :
Results of a longitudinal study showed that both energy intake and expenditure are declined during menopausal transition (36). Menopause and related depressive disorders may also influence physical activity, which can further increase fat mass and alter its distribution (37, 38). To the best of our knowledge, this is the first population-based cohort study with more than 15 years of short-interval follow-ups that evaluates ANM and its relation to the trend of BMI.
To observe the effects of menopause, age at natural menopause (ANM), and aging on the trend in body mass index (BMI).
Prospective cohort with a 15-year follow-up of 929 women. Data obtained from the Tehran Lipid and Glucose Study.
Not applicable.
none.
Of women participating in the Tehran Lipid and Glucose Study, 929 who were reproductive during the study and menopaused at the last follow-up were included. Anthropometric data were measured repeatedly every 3 years, and the trend in BMI, associated with menopause and ANM, was tested using the generalized estimating equation.
Body mass index in each follow-up session.
The adjusted model of the generalized estimating equation illustrates that BMI increases by age (β = 0.16) and menopausal status (β = 1.11). It also shows that women with higher ANM experienced a decreasing BMI (β = −0.03) compared with women with lower ANM. The interaction term of menopause and time (menopause × time) has a negative effect on BMI; that is, the usual increase in BMI after menopause is attenuated by time. (β = −0.4, 95% confidence interval −0.6, −0.3).
Menopause and aging are independently correlated with increasing BMI. The trend in BMI, however, depends on the ANM of study participants: women with higher ANM than mean ANM of our population (i.e., 49 years) face a decreasing BMI compared with those with lower ANM.
Efecto del envejecimiento, la menopausia y la edad de la menopausia natural sobre la tendencia en el índice de masa corporal: una cohorte poblacional de 15 años.
Observar los efectos de la menopausia, la edad de la menopausia natural (EMN) y el envejecimiento sobre la tendencia del índice de masa corporal (IMC).
Cohorte prospectiva de 929 mujeres seguidas durante 15 años. Datos obtenidos del Estudio de Lípidos y Glucosa de Teherán.
No aplica.
Ninguna.
De las mujeres participantes en el Estudio de Lípidos y Glucosa de Teherán, se incluyó a 929 que estaban en edad reproductiva en el momento del estudio y menopáusicas en la última sesión de seguimiento. Se midieron datos antropométricos repetidamente cada 3 años y la tendencia en el IMC, asociada a la menopausia y la EMN, se evaluó mediante la ecuación de estimación generalizada.
Índice de masa corporal en cada sesión de seguimiento.
El modelo ajustado de la ecuación de estimación generalizada ilustra que el IMC aumenta con la edad (ß = 0.16) y el estatus menopáusico (ß = 1.11). También muestra que las mujeres con una EMN más tardía experimentaron un descenso del IMC (ß = -0.03) comparado con las mujeres con una EMN más temprana. El término de interacción de menopausia y tiempo (menopausia x tiempo) tiene un efecto negativo sobre el IMC; esto es, el habitual aumento de IMC tras la menopausia se atenúa con el tiempo (ß = -0.4, intervalo de confianza del 95% -0.6, -0-3).
La menopausia y el envejecimiento se correlacionan independientemente con el aumento de IMC. La tendencia del IMC, sin embargo, depende de la EMN de las participantes en el estudio: las mujeres con EMN más tardía que la EMN media de nuestra población (i.e., 49 años) se enfrentan a un descenso del IMC comparadas con aquellas con una EMN más temprana.
Visceral and Intrahepatic Fat Are Associated with Cardiometabolic Risk Factors Above Other Ectopic Fat Depots: The Framingham Heart Study
2018, American Journal of Medicine
Citation Excerpt :
It is well established that risk of cardiometabolic disease increases with both increasing age and fat accumulation, while accumulation of fat also increases with advanced age.10,27-30 In a similar context, demographic and lifestyle factors, such as sex, smoking status, alcohol use, physical activity, postmenopausal status, and hormone replacement therapy, are also considered as traditional risk factors for cardiometabolic disease that are also related to accumulation of fat.31-37 Accordingly, the relationships between fat measures and cardiometabolic risk factors are not uniform across individuals with various demographic and lifestyle factors.
We examined the associations among 8 different fat depots accumulated in various anatomic regions and the relationship between these fat depots and multiple cardiometabolic risk factors.
Participants were from the Framingham Heart Study Offspring and Third Generation who also participated in the multidetector computed tomography substudy in 2002-2005. Exposures were multidetector computed tomography–derived fat depots, including abdominal subcutaneous adipose tissue, abdominal visceral adipose tissue, intramuscular fat, intrathoracic fat, pericardial fat, thoracic periaortic fat, intrahepatic fat, and renal sinus fat. Multivariable-adjusted regression analyses with a forward selection procedure were performed to identify the most predictive fat depots.
Of 2529 participants, 51.9% were women (mean age, 51.1 years). Visceral adipose tissue had the strongest correlations with each of the other fat measures (range, 0.26-0.77) and with various cardiometabolic risk factors (range, −0.34 to 0.39). As determined by the selection models, visceral adipose tissue was the only fat depot that was associated with all cardiometabolic risk factors evaluated in this study (all P<.05). Selection models also showed that subcutaneous adipose tissue and intrahepatic fat were associated with cardiometabolic risk factors related to the traits of dysglycemia, dyslipidemia, and hypertension (all P<.05). However, only associations with visceral adipose tissue and intrahepatic fat persisted after further adjustment for body mass index and waist circumference.
Visceral adipose tissue and intrahepatic fat were consistent correlates of cardiometabolic risk factors, above and beyond standard anthropometric indices. Our data provide important insights for understanding the associations between variations in fat distribution and cardiometabolic abnormalities.
Energy-matched moderate and high intensity exercise training improves nonalcoholic fatty liver disease risk independent of changes in body mass or abdominal adiposity — A randomized trial
2018, Metabolism: Clinical and Experimental
Exercise training is commonly prescribed for individuals diagnosed with nonalcoholic fatty liver disease (NAFLD); however, consensus regarding the volume and intensity of exercise for optimal benefits is lacking. Thus, we determined whether high intensity interval exercise training (HIIT) produced greater reductions in intrahepatic lipid (IHL) content and NAFLD risk factors compared with energy-matched moderate intensity continuous exercise training (MICT) in obese adults with liver steatosis.
Eighteen obese adults were randomized to either 4 weeks of HIIT (4 min 80% VO₂peak/3 min, 50% VO₂peak) or MICT (55% VO₂peak, ~ 60 min), matched for energy expenditure (~ 400 kcal/session) and compared to five non-exercising age-matched control subjects. IHL was measured by ¹H-MRS and frequent blood samples were analyzed for glucose, insulin, c-peptide, and NEFA levels during a liquid meal test (180 min) to characterize metabolic phenotype.
Baseline body weight, visceral abdominal adiposity, and fasting insulin concentrations were greater in the MICT vs HIIT group (P < 0.05), while IHL was tightly matched between MICT and HIIT subjects (P > 0.05), albeit higher than control subjects (P < 0.01). Visceral abdominal adiposity, body mass, liver aminotransferases (ALT, AST), and hepatic apoptotic/inflammatory markers (cytokeratin 18 and fetuin a) were not reduced with either exercise training intervention (P > 0.05). Both HIIT and MICT lowered IHL (HIIT, − 37.0 ± 12.4%; MICT, − 20.1 ± 6.6%, P < 0.05); however, the reduction in IHL was not statistically different between exercise intensities (P = 0.25). Furthermore, exercise training decreased postprandial insulin, c-peptide, and lipid peroxidation levels (iAUC, P < 0.05).
Collectively, these findings indicate that energy-matched high intensity and moderate intensity exercise are effective at decreasing IHL and NAFLD risk that is not contingent upon reductions in abdominal adiposity or body mass.
MRI-based quantification of adipose tissue distribution in healthy adult cats during body weight gain
2023, Frontiers in Veterinary Science
Influence of the different hormonal status changes during their life on fat mass localisation in women: a narrative review
2023, Archives of Physiology and Biochemistry

View all citing articles on Scopus

^☆: Supported in part by a grant from the National Association of Sport and Physical Education (NASPE).

View full text

Abdominal fat distribution in pre- and postmenopausal women: The impact of physical activity, age, and menopausal status☆

Abstract