UPCOMING

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PHOENIX, ARIZONA:

THURSDAY, SEPTEMBER 20 @ 6:30 PM

The Natural Science of Women

A Hot Fash Havoc Event

ARIZONA SCIENCE CENTER

www.azscience.org

 

 

PORT TOWNSEND, WASHINGTON: 

WEDNESDAY, OCTOBER 3, 2012

Hot Flash Events

"Back by Popular Demand"

Northwest Maritime Center

 834 Sheridan St., Port Townsend, WA

 

Dates to be announced for 2013:

Santa Monica, California

Morristown, New Jersey

Ottawa, Ontario 

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Press Release: International Menopause Society

Ten years after the WHI, the IMS calls for NIH to revise recommendations on hormone replacement therapy (HRT)
Embargo: 00.01 (Central European Summer Time), 9th July, 2012

July 9th marks 10 years since the first press conference from the Women's Health Initiative (WHI) study, a large randomized controlled trial on HRT, funded by the National Institutes of Health (NIH) in the USA. The presentation of these initial results caused a dramatic drop in the use of HRT throughout the world.

The presentation and interpretation of the WHI data was heavily criticized by many in the menopause community. Over the last 10 years, this data has continued to be re-evaluated, and the negative interpretations of several of the initial conclusions are now open to question. The International Menopause Society (IMS) believes that the NIH has been guilty of unbalanced reporting in failing to inform women about the latest information. The IMS calls on the WHI and the NIH to revise its advice to reflect current consensus - not just the initial WHI results.
 

The IMS points out that all drugs have risks and benefits. The NIH and WHI were very prominent in calling attention to the risks of HRT when the first results came out. However, as the WHI has continued to re-evaluate the results, some of their interpretations of the data have changed.
 
* For example, in 2002 the initial WHI findings failed to point out that HRT initiated near menopause or before the age of 60 years, pose very little risk compared to HRT initiated later in life. This is very relevant as the majority of women initiating HRT will do so in this window of opportunity before the age of 60 years. Many WHI researchers now accept that there are age-related effects.
 

* The WHI has also failed to emphasize the later findings that estrogen alone therapy, as given to women who have had a hysterectomy, actually decreases the risk of breast cancer.
 
These are just two examples of the how opinions have changed over the last 10 years.

IMS President Dr Tobie de Villiers (Cape Town, SA) said:

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Small Sustainable Habits: 

"Having a hard time losing weight after menopause?  CBS News has been giving some good health tips lately and ... for some reason ... this one caught my eye and I thought I'd share it with you." H.H.
 
(CBS News) Post-menopausal women often have a hard time losing weight. But, promising new research shows that there may be simple dietary considerations that may help shed pounds - and keep them off for good.What's on the list of foods to avoid and items to chow down on? It's relatively simple: Eating less sugar, meats and cheeses and consuming more fruits and vegetables were shown to help long-term weight loss.  

Why calories count: 10 common myths busted
"With more than one-third of all Americans considered obese, it's clear that standard behavioral obesity treatment is producing poor long-term results," lead investigator Bethany Barone Gibbs, assistant professor at the University of Pittsburgh's department of health and physical activity, said in the university press release.

"We found that some important behaviors differ for long-term versus short-term weight control among women in their 50s and 60s, who are already at higher risk for weight gain."
Traditionally, women are told to watch their calorie intake to lose weight, which may not be sustainable for long periods of time. Because post-menopausal women have a natural energy expenditure decline, it's even harder for them to lose and maintain weight.

"Not only does motivation decrease after you start losing weight, there are physiological changes, including a decreased resting metabolic rate," Gibbs said in the news release. "Appetite-related hormones increase. Researchers studying the brain are now finding that you have enhanced rewards and increased motivation to eat when you've lost weight." 

Investigators looked at 481 obese and overweight post-menopausal women who had a waist size of more than 31.5 inches. Some of the group was instructed to join a lifestyle change group, which met regularly with nutritionists, exercise physiologists and psychologists. They were instructed to reduce total, saturated and trans fat along with cholesterol from meat, dairy, fats, oils, baked goods, and snacks; reduce energy intake and increase foods high in soluble fiber.

Eating fruits, vegetables, whole grains and items high in plant stanols/sterols known to lower cholesterol and omega-3 fatty acids like fish were also encouraged. Exercise toward the minimum goal of 150 minutes of moderate-intensity physical exercise a week was slowly introduced. If the participant wanted to, they were given tips on how to increase their exercise to up to 240 minutes per week. 

The others were given the option of attending a health education group in which healthcare professionals educated the subjects on women's health, with no specific attention towards weight loss. 

Weight was recorded at six months and 48 months. On average, the women in the lifestyle change group lost 8 pounds over the four years. In comparison, the women in the health education group lost only half a pound. However, 57 percent of the intervention participants and 29 percent of controls had maintained at least a five-pound weight loss.  

In both groups, short-term weight loss during the first six months was attributed the most to eating less sugar and fried foods, as well as eating more fish. After four years, continued decreases in eating deserts, sugary drinks, meats and cheeses with increases in eating more fruits and vegetables helped increase weight loss, showing these practices were more appropriate for long-term effects. 

"People are so motivated when they start a weight loss program," Gibbs said in the news release. "You can say, 'I'm never going to eat another piece of pie,' and you see the pounds coming off. Eating fruits and vegetables may not make as big a difference in your caloric intake. But that small change can build up and give you a better long-term result, because it's not as hard to do as giving up French fries forever." 

Just how little of an change did people have to make? Adding two servings a day of fruits and vegetables from what they previously ate was shown to result in a three-pound weight loss four years later. Cutting down 16 ounces daily of sugary beverages also was linked a three-pound deduction in the same period of time. 

Eating at restaurants less was also shown to have some impact on weight loss, but since dining out decreased regardless of weight loss at the 48 month mark, researchers hypothesized that it may have also had to do with economic factors.
The study appears in the September 2012 issue of the Journal of the Academy of Nutrition and Dietetics. 

"This study provides a glimpse at why changes in eating patterns must be maintainable for weight loss to be sustainable," Connie Diekman, director of university nutrition at Washington University in St. Louis, said to HealthDay. She was not involved in the study.  

Karen Giblin, president of the menopause support organization Red Hot Mamas North America, Inc. told NBC News that the study displays what so many menopausal women in America struggle with: the ability to shed pounds. She was not involved with the study either, but co-authored a book with Dr. Mache Seibel on the subject called "Eat to Defeat Menopause."
"I recall at age 25 if I wanted to lose five pounds I could do it in a week. Now, it takes far longer to lose weight," she admitted. 

But simple things similar to what the study showed like making exercise an active part of her life, not skipping meals and snacking on healthier items like fruit or almonds helped her lose weight.
"It's so hard counting calories and keeping food diaries for years and years and years," Gibbs said. "We have a population-sized problem here."

Press Release: 

PRESS RELEASE - Climacteric (journal of the International Menopause Society)
Embargoed until 00.01 Thursday 5th July, 2012 (EDT - New York time)
BILLION DOLLAR NIH STUDY MAY HAVE HARMED WOMEN'S HEALTH - CALL FOR AN INDEPENDENT COMMISSION OF ENQUIRY
 
A one-billion dollar publicly-funded study into women's health may have harmed rather than helped the health of menopausal women. Founder and Executive Director Emeritus of the North American Menopause Society Professor Wulf Utian, writing in the peer-reviewed journal Climacteric, says that the analysis of the WHI study has been so compromised that an independent commission of enquiry is needed to establish whether the conclusions of the study can be justified by the data which the study produced. This call is supported by the International Menopause Society.  

The results of the Women's Health Initiative (WHI) study in July 2002 caused a dramatic drop in Menopausal Hormone Therapy use following a controversial press announcement in July 2002 and subsequent WHI announcements. However, the WHI has come in for criticism over the way the results have been interpreted. Now, 10 years down the line, Professor Utian, calls for an independent review of the conclusions, to attempt to resolve the controversy.  

Professor Utian says:
"The WHI is a valuable study, but the way the results have been interpreted has caused real problems for most menopausal women, as well as giving US taxpayers poor value for their billion dollars.  

To take just one example, the WHI developed its own methods of evaluating the relative importance of benefits and risks of MHT. But this method was never validated. In fact, the WHI ignored an entire science of ranking clinical outcomes using proven and validated tools.
This means that a project designed to be of benefit to women's health has boomeranged and instead may have resulted in significant impairment to both quality of life and physical health of women  

If menopausal hormone therapy is given to women below the age of 60 or within 10 years of menopause, the risks are rare. Unfortunately, the way in which the WHI reported the halting of part of their investigation in July 2002 led millions of women to abruptly drop the therapy. Now it is estimated that this discontinuation may have resulted in over 43000 additional bone fractures per year in the USA, and most likely an even greater number of cardiovascular events, the leading cause of death in women in the USA. The negative impact on quality of life, through recurrence of hot flashes and impaired sleep is immeasurable".  

Professor Utian, recognizing that this is a harsh indictment, calls for an urgent independent evaluation of the key WHI publications to determine whether the data reported justified the conclusions drawn, and the subsequent message delivered to women. If not, it is crucial that a clear updated message be delivered to women progressing currently through and beyond menopause so that further potential harm can be avoided.
He says:
"We are 10 years on from the biggest study on post- menopausal women ever conducted, and in many ways we are back where we started. Women in the next 10 years need to be given the chances which mistakes over the WHI denied to women over the last 10 years".  

Dr Tobie de Villiers, President of the International Menopause Society said:
"The International Menopause Society supports Dr Utian's call for an independent commission of enquiry; this call mirrors our own views. This is an important topic, and needs to be open to the widest possible scrutiny".  

ENDS  

The full article: A decade post WHI, menopausal hormone therapy comes full circle - need for independent commission, by W. H. Utian, Consultant in Women's Health, Executive Director Emeritus, The North American Menopause Society; Professor Emeritus, Reproductive Biology, Case Medical School, Cleveland, Ohio, USA, appears in the peer reviewed journal CLIMACTERIC 2012;15:320-325.
Wulf Utian can be contacted via email at wulf@utianllc.com, or call USA 216-378-1840.
Tobie de Villiers can be contacted via:
Climacteric is the official (peer-reviewed) journal of the International Menopause Society. The International Menopause Society is the global body representing clinicians and scientists working with the menopause. Website: www.imsociety.org
For more information on this story, or for comment or background on the menopause, please contact the IMS Press Officer, Tom Parkhill