Perimenopausal obesity.

Obesity is recognized as one of the most important underlying risk factors for a wide variety of diseases, including heart disease and diabetes. Women are particularly prone to obesity, and approaches that address life transitions across the life span suggest that a number of factors may converge at passage points, such as menopause, that contribute to weight accumulation in the aging woman. The menopausal phase of a woman's life brings a number of changes that may trigger and maintain weight gain. Although the prevalence of overweight and obesity is attributable to each of these factors, it is most likely the interaction among multiple factors that determines an individual's propensity for excess energy intake, sedentary behavior, patterns of fat distribution, and risk of developing obesity. The problem of weight change and obesity in perimenopausal women is best understood from an ecological perspective that can integrate the analysis of factors across levels, from the culture and built environment of the community to family-related factors to individual factors, such as subjective norms, values, attitudes, and beliefs, and biological/genetic predispositions. This review describes the literature relevant to weight change during perimenopause using a multilevel perspective and recommends future directions for the development of translational weight management research to meet the unique needs of women.

Ecodevelopmental contexts for preventing type 2 diabetes in Latino and other racial/ethnic minority populations.

Diabetes is the sixth leading cause of death in the United States and it is now cited along with obesity as a global epidemic. Significant racial/ethnic disparities exist in the prevalence of diabetes within the US, with racial and ethnic minorities disproportionately affected by type 2 diabetes and its complications. Racial/ethnic and socioeconomic factors influence the development and course of diabetes at multiple levels, including genetic, individual, familial, community and national. From an ecodevelopmental perspective, cultural variables assessed at one level (e.g., family level dietary practices) may interact with other types of variables examined at other levels (e.g., the availability of healthy foods within a low-income neighborhood), thus prompting the need for a clear analysis of these systemic relationships as they may increase risks for disease. Therefore, the need exists for models that aid in "mapping out" these relationships. A more explicit conceptualization of such multi-level relationships would aid in the design of culturally relevant interventions that aim to maximize effectiveness when applied with Latinos and other racial/ethnic minority groups. This paper presents an expanded ecodevelopmental model intended to serve as a tool to aid in the design of multi-level diabetes prevention interventions for application with racial/ethnic minority populations. This discussion focuses primarily on risk factors and prevention intervention in Latino populations, although with implications for other racial/ethnic minority populations that are also at high risk for type 2 diabetes.