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An intensive behavioral weight loss intervention and hot flushes in women |
Huang AJ, Subak LL, Wing R, West DS, Hernandez AL, Macer J, Grady D, Program to Reduce Incontinence by Diet Exercise Investigators |
Archives of Internal Medicine 2010 Jul 12;170(13):1161-1167 |
clinical trial |
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
BACKGROUND: Higher body mass index is associated with worse hot flushes during menopause but the effect of weight loss on flushing is unclear. METHODS: Self-administered questionnaires were used to assess bothersome hot flushes in a 6-month randomized controlled trial of an intensive behavioral weight loss program (intervention) versus a structured health education program (control) in 338 women who were overweight or obese and had urinary incontinence. Weight, body mass index, abdominal circumference, physical activity, calorie intake, blood pressure, and physical and mental functioning were assessed at baseline and at 6 months. Repeated-measures proportional odds models examined intervention effects on bothersome hot flushes and potential mediating factors. RESULTS: Approximately half of participants (n = 154) were at least slightly bothered by hot flushes at baseline. Among these women, the intervention was associated with greater improvement in bothersome flushes versus control (odds ratio (OR) for improvement by 1 Likert category 2.25; 95% confidence interval (CI) 1.20 to 4.21). Reductions in weight (OR 1.32; 95% CI 1.08 to 1.61; per 5-kg decrease), body mass index (1.17; 1.05 to 1.30; per 1-point decrease), and abdominal circumference (1.32; 1.07 to 1.64; per 5-cm decrease) were each associated with improvement in flushing, but changes in physical activity, calorie intake, blood pressure, and physical and mental functioning were not related. The effect of the intervention on flushing was modestly diminished after adjustment for multiple potential mediators (OR 1.92; 95% CI 0.95 to 3.89). CONCLUSION: Among women who were overweight or obese and had bothersome hot flushes, an intensive behavioral weight loss intervention resulted in improvement in flushing relative to control. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT00091988.
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