Every year, 2 million women reach menopause in the United States, and they may spend 40% or more of their life in a postmenopausal state. In the years immediately preceding menopause—known as the menopause transition (or perimenopause)—changes in hormones and body composition increase a woman’s overall cardiometabolic risk. In this narrative review, we summarize the changes in weight, body composition, and body fat distribution, as well as the changes in energy intake, energy expenditure, and other cardiometabolic risk factors (lipid profile, glucose metabolism, sleep health, and vascular function), that occur during the menopause transition. We also discuss the benefits of lifestyle interventions in women in the earlier stages of menopause before these detrimental changes occur. Finally, we discuss how to include perimenopausal women in research studies so that women across the life‐span are adequately represented. image

Skipping breakfast and consuming fast food are related to the risk of obesity and are common adolescent behaviors. The relationship between these behaviors and biomarkers related to diabetes and CVD is understudied in this population. Data are from a study of the etiologic factors related to obesity risk in adolescents. Breakfast and fast food consumption were assessed using a self-report survey. Anthropometrics, fasting lipids, glucose, insulin, and homeostatic model assessment for insulin resistance (HOMA-IR) were assessed. Multivariate analyses were used to examine the relationship between dietary behaviors and selected biomarkers, controlling for calories consumed, body mass index (BMI), and demographic covariates. 367 adolescents (11 to 18-years; mean 14.7 ± 1.8 years) were assessed at the University of Minnesota-Twin Cities from 2006-2008. Breakfast consumption was significantly associated with lower BMI, body fat, insulin, HOMA-IR, and metabolic syndrome (MetS) cluster score, while fast food consumption was associated with higher BMI, body fat, low-density lipoprotein cholesterol, triglycerides, glucose, insulin, HOMA-IR, and MetS cluster score. Some gender differences were observed. Breakfast and fast food consumption appear to be related to important metabolic syndrome biomarkers for chronic disease in a sample of healthy adolescents. The importance of this finding needs to be validated by examining the stability of this pattern over time and to assess the pattern in other populations.

Background: Calorie restriction (CR) influences aging processes and extends average and maximal life spans. The CALERIE 2 (Comprehensive Assessment o

A metabolic adaptation, defined as an increase in energy expenditure (EE) beyond what is expected with weight gain during overfeeding (OF), has been reported but also refuted. Much of the inconsistency stems from the difficulty in conducting large, well-controlled OF studies in humans. The primary aim of this study was to determine whether a metabolic adaptation to OF exists and if so, attenuates weight gain. Thirty-five young adults consumed 40% above their baseline energy requirements for 8 wk, and sleeping metabolic rate (SMR) and 24-h sedentary energy expenditure (24h-EE) were measured before and after OF. Subjects were asked to return for a 6-mo post-OF follow-up visit to measure body weight, body composition, and physical activity. After adjusting for gains in fat-free mass and fat mass, SMR increased by 43 ± 123 kcal/d more than expected (P = 0.05) and 24h-EE by 23 ± 139 kcal/d (P = 0.34), indicating an overall lack of metabolic adaptation during OF despite a wide variability in the response. Among the 30 subjects who returned for the 6-mo follow-up visit, those who had a lower-than-predicted SMR (basal EE) retained more of the fat gained during OF. Likewise, subjects displaying a higher-than-predicted sedentary 24h-EE lost significantly more fat during the 6-mo follow-up. Metabolic adaptation to OF was on average very small but variable between subjects, revealing "thrifty" or "spendthrift" metabolic phenotypes related to body weight loss 6 mo later. This trial was registered at clinicaltrials.gov as NCT01672632.