May 20, 2014 - (BRONX, NY) - For otherwise healthy middle-aged women who are overweight or obese, physical activity may be their best option for avoiding heart disease, according to a study that followed nearly 900 women for seven years. These findings were reported in a paper led by authors at Albert Einstein College of Medicine of Yeshiva University and Montefiore Medical Center, the University Hospital for Einstein, and published today in the Journal of Clinical Endocrinology & Metabolism.
"Being overweight or obese increases a person's risk for developing conditions such as hypertension, elevated triglyceride levels and elevated fasting glucose levels--all of them risk factors for heart disease, the leading cause of death in the U.S.," said lead author Unab Khan, M.B.B.S.,M.S. ), assistant professor of pediatrics and of family and social medicine at Einstein and attending physician, pediatrics at Montefiore. "With about two out of every three American women overweight or obese, we need to find practical ways to keep them healthier, longer."
The authors identified 866 overweight and obese women, aged 42 to 52 who were enrolled in the Study of Women's Health Across the Nation/, or SWAN, a multicenter, multiethnic study designed to examine the health of women during their middle years. The women studied were categorized as "metabolically benign overweight/obese." That means they had at most one risk factor for heart disease and therefore were at a lower risk for developing the disease. The study's main goal was to identify factors that may influence these women to fall into the "at-risk overweight/obese" category, i.e., at high risk of developing heart disease--as well as factors that would help women avoid the high-risk category.
Throughout the seven-year study, the women were tested annually for heart disease risk factors. They also completed an annual survey describing their physical activity for the prior 12 months, which ranged from active living, caregiving and doing household chores to exercise and sports.
During the seven years, 373 of the participants--43 percent of the total--had progressed from having at most a single risk factor for heart disease (i.e., metabolically benign overweight/obese) to at-risk overweight/obese, meaning they had developed two or more of the following five heart-disease risk factors: hypertension; low blood level of HDL ("good") cholesterol; elevated blood levels of triglycerides, elevated fasting glucose level (indicating pre-diabetes or diabetes); and elevated levels of C-reactive protein ( indicating inflammation).
Low-to-moderate physical activity--at the start of the study and during it--was the only lifestyle factor found to protect overweight/obese women from becoming at-risk for heart disease. More specifically, women who participated in physical activity during the study were 16 percent less likely to become at-risk for heart disease compared with women who were not physically active.
The researchers also identified several "triggers" that predisposed women to become at-risk for heart disease:
- Women who had elevated fasting glucose levels or took antidiabetic drugs at the start of the study were more than three times as likely to become at-risk for heart disease compared with women who had normal fasting glucose levels when the study began.
- Women who had hypertension at the start of the study were three times more likely to fall into the at-risk group compared with women who were not hypertensive at the start of the study.
- Women who gained weight during the study were 16 percent more likely to become at-risk for heart disease compared with women who did not gain weight.
"A large number of women who began the study-- more than 40 percent of them-- were no longer heart-healthy by the end of it," said Dr. Khan. "But our study does demonstrate the important role that physical activity can play in protecting overweight or obese women from becoming at-risk for heart disease. Our findings suggest that physical activity may be able to prevent overweight women from developing heart disease even if they have risk factors for the disease."
The study is titled "Progression from Metabolically Benign to At-risk Obesity in Perimenopausal Women: A Longitudinal Analysis of Study of Women Across the Nation (SWAN)." Dan Wang, M.S., of Einstein was also an author of the study. Other authors were Carrie A. Karvonen-Gutierrez, M.P.H., Ph.D., and Kelly R. Ylitalo of the University of Michigan School of Public Health; Naila Khalil, M.B.B.S., M.P.H., Ph.D., of Wright State University; and senior author Nanette Santoro, M.D., of the University of Colorado-Denver School of Medicine.
The Study of Women's Health Across the Nation (SWAN) has grant support from the National Institutes of Health, the National Institute on Aging, the National Institute of Nursing Research, and the Office of Research on Women's Health (Grants U01NR004061, U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, U01AG012495, and K23HL105790, to U.I.K.)
About Albert Einstein College of Medicine of Yeshiva University
Albert Einstein College of Medicine of Yeshiva University is one of the nation's premier centers for research, medical education and clinical investigation. During the 2013-2014 academic year, Einstein is home to 734 M.D. students, 236 Ph.D. students, 106 students in the combined M.D./Ph.D. program, and 353 postdoctoral research fellows. The College of Medicine has more than 2,000 full-time faculty members located on the main campus and at its clinical affiliates. In 2013, Einstein received more than $155 million in awards from the NIH. This includes the funding of major research centers at Einstein in diabetes, cancer, liver disease, and AIDS. Other areas where the College of Medicine is concentrating its efforts include developmental brain research, neuroscience, cardiac disease, and initiatives to reduce and eliminate ethnic and racial health disparities. Its partnership with Montefiore Medical Center, the University Hospital and academic medical center for Einstein, advances clinical and translational research to accelerate the pace at which new discoveries become the treatments and therapies that benefit patients. Through its extensive affiliation network involving Montefiore, Jacobi Medical Center -Einstein's founding hospital, and five other hospital systems in the Bronx, Manhattan, Long Island and Brooklyn, Einstein runs one of the largest residency and fellowship training programs in the medical and dental professions in the United States. For more information, please visit www.einstein.yu.edu, read our blog, follow us on Twitter, like us on Facebook, and view us on YouTube.
About Montefiore Medical Center
About Montefiore Medical Center
As the University Hospital for Albert Einstein College of Medicine, Montefiore is a premier academic medical center nationally renowned for its clinical excellence, scientific discovery and commitment to its community. Recognized among the top hospitals nationally and regionally by U.S. News & World Report, Montefiore provides compassionate, patient- and family-centered care and educates the healthcare professionals of tomorrow. The Children's Hospital at Montefiore is consistently named in U.S. News' "America's Best Children's Hospitals." With four hospitals, 1,491 beds and 90,000 annual admissions, Montefiore is an integrated health system seamlessly linked by advanced technology. State-of-the-art primary and specialty care is provided through a network of more than 130 locations across the region, including the largest school health program in the nation and a home health program. Montefiore's partnership with Einstein advances clinical and translational research to accelerate the pace at which new discoveries become the treatments and therapies that benefit patients. The medical center derives its inspiration for excellence from its patients and community, and continues to be on the frontlines of developing innovative approaches to care. For more information please visit http://www.