Association of objectively measured physical fitness with health-related quality of life of mid-life women: the FLAMENCO project.

OBJECTIVES: This study aimed to explore the association of physical fitness with health-related quality of life (HRQoL) in mid-life women and to examine the potential independent association of physical fitness components with the physical and mental components from the 36-Item Short-Form Health Survey (SF-36) in this population. METHODS: This cross-sectional study comprised 183 mid-life women from southern Spain who participated in the FLAMENCO project. Body composition was measured through an impedanciometer, a stadiometer, and dual-energy X-ray absorptiometry. Physical fitness was objectively measured with the Senior Fitness Test battery (cardiorespiratory fitness, flexibility, and dynamic balance/agility) plus handgrip strength (muscle strength). The SF-36 questionnaire was used to assess HRQoL of the participants. RESULTS: All the physical fitness components were associated with the SF-36 physical function (all p < 0.05) except for lower-body flexibility. The rest of the physical fitness components showed associations with most of the SF-36 dimensions (all p < 0.05). Dynamic balance/agility and upper-body flexibility were independently associated with the SF-36 physical component scale, explaining 15% and 17% of the SF-36 physical component scale, respectively. Any physical fitness component showed independent associations with the SF-36 mental component scale. CONCLUSIONS: Greater physical fitness levels are associated with better HRQoL of mid-life women. Dynamic balance/agility and upper-body flexibility were the strongest independent physical fitness components associated with the SF-36 physical component scale.

Mediterranean diet, tobacco consumption and body composition during perimenopause. The FLAMENCO project.

OBJECTIVE: To study the association of the adherence to the Mediterranean diet (MD) and tobacco consumption with body composition during perimenopause. STUDY DESIGN AND METHODS: A cross-sectional study in 176 perimenopausal women from the FLAMENCO project. A food frequency questionnaire and the Mediterranean Diet Score were assessed. Body composition was measured using dual-energy X-ray absorptiometry. MAIN OUTCOMES MEASURES: Body mass index (BMI), fat mass (FM), ratio of gynecoid to total fat mass (G/T), ratio of android to gynecoid fat mass (A/G), visceral adipose tissue (VAT) and waist circumference (WC). RESULTS: Intake of whole-grain cereals was associated with lower WC, FM percentage, android FM, VAT and higher G/T (all p < 0.05). Intake of nuts was associated with lower BMI and FM percentage and intake of fruits with lower BMI, WC, total and android FM, FM percentage, A/G, VAT and higher G/T (all p < 0.05). Intake of pulses was associated with lower weight, BMI and android FM. Intake of whole dairy products was associated with lower weight, BMI, WC, total and android FM and VAT (all p < 0.05). Intake of olive oil was associated with lower WC and FM percentage (all p < 0.05). Intake of sweetened beverages was associated with higher weight, BMI, WC, FM percentage, android FM, VAT and total FM (all, p < 0.05). Smokers had a lower MD adherence (p < 0.05). Finally, a greater MD adherence was associated with higher G/T (p < 0.01) and lower A/G (p < 0.05). CONCLUSIONS: A higher MD adherence, avoiding tobacco, an increased consumption of whole-grain cereals, nuts, fruits, pulses, whole dairy products and olive oil, and a lower consumption of sweetened beverages might contribute to a healthier body composition during perimenopause.

Effects of concurrent exercise on cardiometabolic status during perimenopause: the FLAMENCO Project.

OBJECTIVES: The aim of this study was to evaluate the influence of a 4-month concurrent exercise training program on cardiometabolic status in perimenopausal women. METHODS: The participants (n = 150) were randomized into counseling (n = 75) and exercise (n = 75) groups. The exercise group followed 4-month (3 days/week, 60 min/session) concurrent training. The counseling group attended conferences on a healthy lifestyle. We determined plasma glucose, total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides, and C-reactive protein, and measured blood pressure and the resting heart rate. RESULTS: In the per-protocol analyses, the exercise group showed lower LDL-C concentrations than the counseling group when the model was further adjusted for the baseline values and diet (10.2 mg/dl; 95% confidence interval -19.4, -0.96; p = 0.031). Borderline significant total cholesterol and diastolic blood pressure were reduced in both groups with better results in exercise group (p = 0.068 and p = 0.090, respectively). CONCLUSION: The present findings suggest that the concurrent exercise training program could improve plasma glucose, lipid profile, CRP, and systolic and diastolic blood pressures in the exercise group. These results also suggest the importance of a healthy diet and active behavior during menopause, as improvements in both the exercise and the counseling group were observed. Future analysis should combine both interventions in search of better results.

Association of objectively measured physical activity and physical fitness with menopause symptoms. The Flamenco Project.

OBJECTIVE: The primary aim was to analyze the association of moderate-to-vigorous physical activity (MVPA) with menopause symptomatology and its overall impact. A secondary/exploratory aim was to assess the association of different components of physical fitness with menopause symptomatology. METHODS: This cross-sectional study comprised 191 perimenopausal women from Southern Spain (age range 45-60 years, mean age 52.6 ± 4.5 years). The Blatt-Kupperman Menopausal Index was used to evaluate menopause symptomatology. Objectively measured MVPA was registered with accelerometry. Physical fitness was assessed with the Senior Fitness Test battery plus handgrip strength and sit-and-reach tests. RESULTS: After adjustment for multiple confounders, MVPA was only inversely associated with vertigo (r = -0.185, p < 0.05) and palpitations (r = -0.148, p < 0.05). Upper-body flexibility was inversely associated with the Blatt-Kupperman Menopausal Index global score (r = -0.147, p < 0.05). This test was also inversely associated with vertigo (r = -0.230, p < 0.01) and arthralgia (r = -0.168, p < 0.05). Lower-body muscle strength was associated with lower nervousness (r = -0.171, p < 0.05). Cardiorespiratory fitness was inversely associated with paresthesia (r = -0.158, p < 0.05), vertigo (r = -0.219, p < 0.01), fatigue (r = -0.159, p < 0.05) and arthralgia (r = -0.180, p < 0.05). CONCLUSION: The main findings of the present study indicate a weak association of objectively measured MVPA with menopause symptomatology. Exploratory analyses suggest that upper-body flexibility was associated with slightly lower overall menopause impact whereas neither MVPA nor any physical fitness components studied were associated with vasomotor symptoms.

Influence of the degree of adherence to the Mediterranean diet on the cardiometabolic risk in peri and menopausal women. The Flamenco project.

BACKGROUND AND AIMS: The Mediterranean diet (MD) has been associated with reduced morbidity from cardiovascular diseases in the general population. The aim of this study was to assess whether different degrees of adherence to the MD were associated with the cardiometabolic risk in peri and menopausal women. METHODS AND RESULTS: This cross-sectional study included 198 peri and menopausal women participating in the Flamenco project. Validated questionnaires were used to assess menopause health-related quality of life and degree of adherence to the MD (low, medium and high). The following cardiometabolic risk factors were assessed: fat mass percentage, waist circumference, blood pressure and resting heart rate, plasma markers (total cholesterol, high and low-density lipoprotein cholesterol [HDL-C and LDL-C, respectively], total cholesterol/HDL ratio, triglycerides, C-reactive protein and fasting glucose), Physical activity levels and smoking status. The degree of adherence to the MD among the study sample was 27%, 40% and 30% for low, medium and high adherence, respectively. After controlling for potential confounders, women with a high adherence to the MD showed lower plasma total cholesterol (p = 0.025), resting heart rate (p = 0.005), LDL-C (p = 0.019), triglycerides (p = 0.046) and C-reactive protein (p = 0.009) compared to those with a low adherence. Likewise women with high adherence to the MD showed lower total cholesterol/HDL-C ratio (p = 0.020) compared to those with a medium adherence. The high MD adherence group also showed lower clustered cardiometabolic risk (p = 0.004). Moreover, when analysing specific MD components, whole grain cereals, pulses (both p < 0.05) and red wine (p < 0.01) consumption were inversely associated with the clustered cardiometabolic risk. CONCLUSION: The present findings suggest that a high but not medium adherence to the MD is associated with a cardioprotective effect in peri and menopausal women. As a low percentage of the sample showed a high adherence to the MD, future research aimed at increasing the adherence to this dietary pattern for a better cardiometabolic status during peri and menopause is warranted.

Association of sedentary time and physical activity with pain, fatigue, and impact of fibromyalgia: the al-Ándalus study.

We examined the association of objectively measured sedentary time (ST) and physical activity (PA) levels with pain, fatigue, and the impact of the disease in women with fibromyalgia. Four hundred and nineteen (mean age ± SD = 51.7 ± 7.6 years old) women with fibromyalgia participated. ST and PA levels (light, moderate, and moderate-to-vigorous [MVPA]) were measured with triaxial accelerometry. We assessed experimental pain with algometry and clinical pain, fatigue, and impact of fibromyalgia with a number of questionnaires. The association of ST and light PA with most of the pain- and fatigue-related outcomes and impact of fibromyalgia (all, P ≤ 0.019) was independent of moderate and vigorous PA. Furthermore, the association of vigorous PA with general and physical fatigue was independent of ST and light and moderate PA (all, P < 0.001). In conclusion, lower levels of ST or higher levels of light PA are associated with lower pain, fatigue, and the overall impact of the disease independent of moderate and vigorous PA in women with fibromyalgia. Interestingly, higher vigorous PA is independently associated with lower general and physical fatigue. These results are significant for future ST and PA intervention studies in this population.