Lifestyle intervention can prevent weight gain during menopause: results from a 5-year randomized clinical trial

Ann Behav Med. 2003 Dec;26(3):212-20. doi: 10.1207/S15324796ABM2603_06.


Context: Menopausal-related weight gain and increased waist circumference have major cardiovascular health implications for older women. The efficacy of a dietary and physical activity lifestyle intervention to prevent weight gain and elevations in cardiovascular disease (CVD) risk factors from the peri- to postmenopause is unknown.

Objective: To report the 54-month results of a lifestyle dietary and physical activity program on weight, body composition, physical activity, diet, and other CVD risk factors.

Design: Data are from a 5-year randomized clinical trial known as the Women's Healthy Lifestyle Project, conducted from 1992 to 1999.

Participants: 535 healthy, premenopausal women ages 44 to 50 at study entry enrolled into the trial.

Intervention: Participants were randomly assigned to either a lifestyle intervention group receiving a 5-year behavioral dietary and physical activity program or to an assessment-only control group. The lifestyle intervention group was given modest weight loss goals (5-15 lb, or approximately 2.3-6.8 kg) to prevent subsequent gain above baseline weight by the end of the trial. To achieve weight loss and lower low-density lipoprotein cholesterol levels, intervention participants followed an eating pattern consisting of 1,300 kcal/day (25% total fat, 7% saturated fat, 100 mg of dietary cholesterol) and increased their physical activity expenditure (1,000-1,500 kcal/week).

Main outcome measures: Regarding weight gain prevention, 55% (136/246) of intervention participants were at or below baseline weight compared with 26% (68/261) of controls after 4.5 years, chi2(2, N = 507) =45.0, p <.001. The mean weight change in the intervention group was 0.1 kg below baseline (SD = 5.2 kg) compared with an average gain of 2.4 kg (SD = 4.9 kg) observed in the control group. Waist circumference also significantly decreased more in the intervention group compared with controls (M = -2.9 cm, SD = 5.3 vs. M = -0.5 cm, SD = 5.6, p <.001). Moreover, participants in the lifestyle intervention group were consistently more physically active and reported eating fewer calories and less fat than controls. Long-term adherence to physical activity and a low-fat eating pattern was associated with better weight maintenance.

Conclusions: In healthy women, weight gain and increased waist circumference during the peri- to postmenopause can be prevented with a long-term lifestyle dietary and physical activity intervention.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Anthropometry
  • Body Composition
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control
  • Diet
  • Exercise
  • Female
  • Health Behavior
  • Humans
  • Life Style*
  • Menopause*
  • Middle Aged
  • Obesity / complications*
  • Obesity / prevention & control*
  • Risk Factors
  • Treatment Outcome
  • Weight Gain*