Influence of Menopausal Status on Lipids and Lipoproteins and Fat Mass Distribution: The Pioneer Project

Following menopause, fat redistribution and increased risk for dyslipidemia are common. The influence of menopause; however, on the associations between total and regional fat mass with lipids and lipoproteins remains unclear. PURPOSE: The purpose of this investigation was to determine the influence of menopausal status on associations between total and regional fat mass and lipids and lipoproteins. METHODS: Sedentary, non-smoking women (n=209) were grouped based on current menstrual status: premenopausal (n=143, mean±SD; age=42.7±7.7 yr, BMI=24.5±4.0 kg•m -2, WC=77.4±9.9 cm) or postmenopausal (n=66, mean±SD; age=52.9±5.3 yr, BMI= 24.9±4.2 kg•m -2, WC=78.8±9.9 cm). Fasting (12 hr) serum samples were analyzed for total cholesterol (TC), triglyceride (Tg), LDL-C, HDL-C, HDL2-C, and HDL3-C concentrations. Total (TF), abdominal (AF), hip (HF) and mid-thigh (MTF) fat mass were quantified by DXA. A MANCOVA was used to determine differences between groups for total and regional fat mass and lipids and lipoproteins controlling for HRT status. Stepwise multiple regression analysis was used to determine if menopausal status influenced the association of total and regional fat mass with lipids and lipoproteins. The criterion reference for statistical significance was set at a P \u3c 0.05. RESULTS: Postmenopausal women had significantly greater TC, HDL-C, LDL-C and HDL3-C concentrations than premenopausal women. No significant differences were observed between groups for total and regional fat mass. In premenopausal women, AF predicted TC, but no associations were observed in postmenopausal women. In premenopausal women, AF+HF and AF+TF were significant predictors of Tg and LDL-C, respectively. In contrast, only AF predicted Tg and LDL-C in postmenopausal women. AF+MTF best predicted HDL-C in premenopausal women; however, TF+MTF best predicted HDL-C in postmenopausal women. In premenopausal women, no associations were observed with HDL2-C or HDL3-C. TF and TF+MTF were best predictors of HDL2-C and HDL3-C, respectively in postmenopausal women. CONCLUSION: Menopausal status has an effect on lipid and lipoprotein-cholesterol concentrations, but not on total and regional fat mass. In addition, menopausal status had an influence on the associations of total and regional fat mass with lipids and lipoproteins

Nursing with Eating, Activity, and Supportive Environment (EASE) : Effects of an Eight-week Mentoring Program

Each year, approximately 2.8 million adults die from complications related to obesity (World Health Organization, 2011). One in three adults aged 20 years or older is obese, and 6% are morbidly obese. This problem is increasing at an alarming rate in young adults, and 20.5% of college students are classified as being overweight based upon their body mass index (BMI) (Adderley-Kelly, 2007). The purpose of this study was to increase knowledge about evidence-based, effective interventions that will enable college-aged, pre-nursing students to attain physical and mental well-being. The participants (N=24) were freshman and sophomore pre-nursing majors who were randomized into two groups (control and intervention). The intervention group met once a week for an eight-week nutrition and physical activity mentoring program at Texas Woman’s University. The participants were educated about proper diet and exercise recommendations and kept physical activity, nutrition, and stress management logs. Measured outcomes, mean changes and standard deviations over the eight week period included body weight (-0.3 kg + 1.7), BMI (-0.12 kg/m2 + 0.68), waist circumference (-2.5 cm + 1.9), and perceived stress scale (0.0 + 3.6). One-way ANOVAs with a p value of 0.05 were used for statistical analysis. There were no significant differences in weight, BMI, waist circumference or stress between the groups. Body composition and mental stress are difficult to change in an eight-week mentoring program, although improved knowledge may set the stage for future behavior change. A longer term program may need to be used to observe changes in weight, BMI, waist circumference, and stress

Influence of Race on the Female Athlete Triad

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Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

Background Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain. Methods RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov , NCT00541047 . Findings Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths. Interpretation Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy. Funding Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society

Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial

Background Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear. Methods RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047. Findings Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths. Interpretation Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population

Daytime and nighttime casein supplements similarly increase muscle size and strength in response to resistance training earlier in the day: a preliminary investigation

BACKGROUND: Casein protein consumed before sleep has been suggested to offer an overnight supply of exogenous amino acids for anabolic processes. The purpose of this study was to compare supplemental casein consumed earlier in the day (DayTime, DT) versus shortly before bed (NightTime, NT) on body composition, strength, and muscle hypertrophy in response to supervised resistance training. METHODS: Thirteen males participated in a 10-week exercise and dietary intervention while receiving 35 g casein daily. Isocaloric diets provided 1.8 g protein/kg body weight. RESULTS: Both groups increased (p < 0.05) in lean soft tissue (DT Pre: 58.3 ± 10.3 kg; DT Post: 61.1 ± 11.1 kg; NT Pre: 58.3 ± 8.6 kg; NT Post: 60.3 ± 8.2 kg), cross-sectional area (CSA, DT Pre: 3.4 ± 1.5 cm2; DT Post: 4.1 ± 1.7 cm2; NT Pre: 3.3 ± 1.6 cm2; NT Post: 3.7 ± 1.6 cm2) and strength in the leg press (DT Pre: 341 ± 87.3 kg; DT Post: 421.1 ± 94.0 kg; NT Pre: 450.0 ± 180.3 kg; NT Post: 533.9 ± 155.4 kg) and bench press (DT Pre: 89.0 ± 27.0 kg; DT Post: 101.0 ± 24.0 kg; NT Pre 100.8 ± 32.4 kg; NT Post: 109.1 ± 30.4 kg) with no difference between groups in any variable (p > 0.05). CONCLUSIONS: Both NT and DT protein consumption as part of a 24-h nutrition approach are effective for increasing strength and hypertrophy. The results support the strategy of achieving specific daily protein levels versus specific timing of protein ingestion for increasing muscle mass and performance. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03352583