Menopause, physical activity, and body composition/fat distribution in midlife women.

PURPOSE: Hormonal changes associated with menopause, chronological aging, and lifestyle, specifically physical activity, may all influence the changes in body composition and fat distribution experienced by midlife women. This cross-sectional study examined those relations in a representative sample of 248 white and Chinese women, ages 47-57, participating in an ancillary study to the Study of Women's Health Across the Nation (SWAN), a multi-center, longitudinal investigation of the natural history of the menopause in a racially/ethnically diverse cohort. METHODS: Body composition (lean mass, percent body fat) was assessed with dual energy x-ray absorptiometry, and central adiposity was determined by waist circumference. Physical activity was assessed from 7 d of accelerometer recordings. Menopausal status was based on self-reported bleeding patterns. RESULTS: Higher levels of physical activity, particularly vigorous-intensity activity, were generally independently associated with decreased percent body fat and smaller waist circumference, although these findings were not statistically significant in the Chinese women. Among the white women, every half a standard deviation increase in total activity was associated with a 1.6-point decrease in percent body fat (P = 0.002). Waist circumference decreased from 96.2 cm (SE = 1.04) in those doing no vigorous-intensity activity to 81.4 cm (SE = 1.05) in those doing 10 min or more a day (P for trend = 0.05). For both the whites and the Chinese, late peri- and postmenopausal status was associated with lower lean mass, and among the Chinese, tended to be associated with higher percent body fat. CONCLUSION: These findings suggest that regular physical activity may help to mitigate the tendency for weight gain and adverse changes in body composition and fat distribution that accompany aging and the menopausal transition.

Treatment with stimulants among youths in a large California health plan.

OBJECTIVE: The aim of this study was to examine the use of stimulants among youths in a large and diverse health plan in California from 1996-2000. METHODS: Computerized pharmacy, outpatient visit, and membership files were used to conduct a population-based analysis of stimulant use among over 500,000 enrollees aged 2-18 years. Annual prevalence rates of stimulant use were estimated by calendar year, age, gender, and geographic area. RESULTS: The annual percentage of continuously enrolled 2- through 18-year-olds receiving at least one prescription for a stimulant rose from 1.86% (95% confidence interval (CI) 1.82-1.90) in 1996 to 1.93% (95% CI, 1.90-1.96) in 2000. An increase was observed only among girls 8 years of age or older and among boys 12 years or older. Use of methylphenidate decreased, whereas use of extended-release amphetamine products increased. Stimulant use was lower and use of other psychotropic drugs was higher among children with visits for attention-deficit/hyperactivity disorder (ADHD) and a coexisting psychiatric disorder than among those seen for ADHD alone. Of the 11,698 children receiving at least one stimulant in 2000, 24% of these children received a single prescription. Approximately 55% of stimulant prescriptions were written by physicians in pediatrics and 45% by physicians in psychiatry. CONCLUSIONS: The prevalence of treatment with stimulants was lower than what generally has been reported in other parts of the United States; it increased by approximately 4% between 1996 and 2000, and was frequently short term or intermittent.