Greater fat mass, lower fat-free mass characterize metabolic changes in perimenopause
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Compared with pre- and postmenopausal women, women in perimenopause had increased fat mass, decreased fat-free mass and greater percent body fat, elevating cardiometabolic risks, according to study results.
“Perimenopause may be the most opportune window for lifestyle intervention, as this group experienced the onset of unfavorable body composition and metabolic characteristics,” Abbie E. Smith-Ryan, PhD, CSCS*D, FNSCA, FACSM, FISSN, associate professor in exercise physiology, director of the applied physiology laboratory and co-director of the Human Performance Center at the University of North Carolina at Chapel Hill, and colleagues wrote.
Smith-Ryan and colleagues aimed to determine body composition, fat distribution and metabolism at rest and during exercise among premenopausal, perimenopausal and postmenopausal women.
The cross-sectional study included 72 women aged 35 to 60 years. Researchers assessed body composition via a four-compartment model; fat distribution using DXA-derived android to gynoid ratio; metabolic measures with indirect calorimetry; and lifestyle factors via surveys. They employed one-way analyses of variance and one-way analyses of covariance covaried for age and levels of estrogen and progesterone to compare groups.
Height, weight and BMI were comparable between the three groups.
According to results, despite a similar fat mass and fat-free mass between groups, premenopausal women demonstrated decreased body fat percent compared with perimenopausal women (mean difference, –10.29%; P = .026). Compared with perimenopausal women, premenopausal women had lower android to gynoid ratio (mean difference, –0.16; P = .031). The groups had comparable resting energy expenditure.
In addition, premenopausal women experienced increased fat oxidation during moderate intensity cycle ergometer exercise compared with postmenopausal women (mean difference, 0.09 g per minute; P = .045), whereas change in respiratory exchange ratio between rest and moderate intensity exercise was decreased in premenopausal women compared with perimenopausal (mean difference, –0.05; P = .035) and postmenopausal (mean difference, –0.06; P = .04) women.
In other data, premenopausal women had significantly fewer menopause symptoms than perimenopausal (mean difference, – 6.58; P = .002) and postmenopausal (mean difference, –4.63; P = .044) women. Researchers also reported similarities between groups in lifestyle factors, such as diet and physical activity.
“To prevent unwanted changes in resting metabolism, as well as metabolic flexibility, it is possible that menopausal women should engage in activities that help maintain lean mass (ie, resistance exercise) as well as retain or increase oxidative capacity (ie, moderate to high intensity exercise),” researchers wrote. “Ultimately, future cross-sectional investigations and longitudinal interventions should be designed to target perimenopausal women to determine if menopause-related shifts in body composition and metabolism are preventable with sustainable nutrition and exercise modifications.”
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