In a longitudinal retrospective analysis published in the journal Menopause, researchers investigated if variations in the frequency of vasomotor symptoms (VMS) precede weight changes in women.
For this study, researchers utilized data from the Study of Women’s Health Across the Nation (SWAN) study—an ongoing, multisite, longitudinal, epidemiologic cohort study capturing biopsychosocial information from women in the United States in midlife and beyond.
The primary objective was to measure the correlation between VMS frequency and weight gain utilizing a lagged approach with first-difference regression models. The secondary objectives were to statistically measure mediation by sleep problems and moderation by menopause status and investigate the association between cumulative, 10-year VMS exposure and long-term weight gain.
The authors wrote, “We examined whether changes in VMS frequency were associated with weight gain in midlife women, taking into consideration the impact of concomitant sleep problems and menopause status. We also explored the extent to which cumulative exposure to VMS is associated with long-term weight gain. Characterizing the temporal association between VMS frequency and weight changes may help improve health outcomes in and after the menopause transition.”
Women in premenopause or perimenopause aged 42 to 52 years at baseline self-reported VMS frequency (hot flashes/night sweats) and sleep problems at up to 10 annual visits. Menopause status, weight, BMI, and waist circumference were compared across visits.
Data were collected in annual surveys of enrolled women at baseline (n = 3,302) and for up to 10 annual follow-up visits between 1995 and 2008. The questionnaires evaluated participants’ medical history, use of medical services and medications, menstrual status, quality of life, psychosocial environment, work and lifestyle behaviors, and symptoms of menopause, including self-reported severity and frequency of VMS and sleep quality.
The authors indicated that the primary analysis sample included 2,361 participants (12,030 visits). The average (SD) age at the baseline visit for the 2,361 participants in the primary analysis sample was 51 (3.7) years. Approximately one-half (47.5%) of participants in the analytic sample self-reported as white/non-Hispanic, and one-half (52.5%) self-reported as black/African American, Japanese/Japanese American, Chinese/Chinese American, or Hispanic.
The results revealed that augmented VMS frequency across visits was associated with subsequently increased weight (0.24 kg), BMI (0.08 kg/m2), and waist circumference (0.20 cm).
The authors wrote, “Cumulative exposure to a high frequency of VMS (≥6 days/2 weeks) over 10 consecutive annual visits was associated with increases in weight measures, including a 3.0-cm increase in waist circumference. Contemporaneous sleep problems mediated no more than 27% of waist circumference increases. Menopause status was not a consistent moderator.”
The authors noted that their findings suggest that sleep is not the only mediator of VMS-associated weight gain and that other factors also contribute.
Based on their findings, the authors wrote, “This is the first known study demonstrating that increases in VMS, the onset of high-frequency VMS, and cumulative exposure to VMS over time may be independently associated with weight gain among midlife women. Sustained accrual of VMS was associated with a significant increase in waist circumference over 10 years. These novel findings build on previous study findings linking weight to VMS.”
Lastly, the authors noted that their findings highlight the necessity for future studies that provide more insight into the mechanisms that trigger this association which may provide pertinent data that may aid in advancing counseling and potential interventions for women with VMS.
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