Intensive exercise improves insulin sensitivity after menopause

By Lorraine L. Janeczko

NEW YORK (Reuters Health) - Postmenopausal women who regularly engage in high-intensity exercise may mitigate the declines in insulin sensitivity and other metabolic parameters that are associated with menopause, according to research from Denmark.

"Postmenopausal women increased peripheral insulin sensitivity, skeletal muscle insulin-stimulated glucose uptake, and skeletal muscle mass to the same extent as premenopausal women after 3 months of high-intensity exercise training," the authors reported online September 25 in Menopause.

"Insulin sensitivity, especially involving skeletal muscle glucose uptake, is as responsive to high-intensity exercise in postmenopausal women as in premenopausal women. The lesson from this study is that many risk factors that can reduce lifespan and healthspan following menopause can be substantially ameliorated by regular exercise training," Dr. K. Sreekumaran Nair of Mayo Clinic in Rochester, Minnesota, told Reuters Health by email.

"The benefits in postmenopausal women are not different from those that have been reported in older men," said Dr. Nair, who was not involved in the study.

Through Danish newspaper ads in the Copenhagen area, lead author Dr. Camilla M. Mandrup of the University of Copenhagen and her colleagues recruited 21 late premenopausal women (mean age, 48.5) and 20 early postmenopausal women (mean age, 53) for a 3-month high-intensity aerobic exercise training program. The exercise involved supervised indoor cycling three times a week for one hour.

The premenopausal women had regular menses and plasma estradiol (E2) in the normal fertile range; the postmenopausal women had not experienced menses for at least 1 year. The two groups had a similar mean body-mass index and body-composition profile.

All participants were healthy and of normal body weight, but they reported exercising for less than 2 hours per week during the past 2 years. Women who smoked, used hormonal contraceptives, consumed alcohol excessively, had chronic disease, took daily medication, or had abnormal blood-test results for liver, kidney, or bone-marrow function were excluded.

Computed estimates showed that the training program increased the participants’ lean body mass by an average of 0.5 kg and thigh-muscle mass by 0.2 kg, and it reduced fat percentage by 1.0%. These changes were statistically similar between the premenopausal and postmenopausal groups.

Although the postmenopausal women had a lower estimated metabolic rate in the vastus lateralis muscle and the femoral muscles than the premenopausal women, as well as a lower glucose disposal rate, exercise training improved these parameters significantly – and to a similar extent - in both groups.

"It is well known that, following menopause in women, many changes in fat distribution and insulin sensitivity occur. These changes lead to increased cardiometabolic risks in these women similar to those that occur in men. How much these changes are related to alterations in lifestyle, especially physical activities, is not fully known," Dr. Nair said.

Dr. Rebecca Starck of Cleveland Clinic in Ohio, who was not involved in the study, advised providers to "continue to encourage regular exercise and maintenance of a healthy weight. This is exceedingly important during perimenopause and early menopause because our ability to metabolize sugar and carbohydrates may be further affected by our hormonal changes."

"Menopause is a stage of life; it is not a disease state,” she told Reuters Health by email. “Women will generally experience a change in hormonal effects that requires an adjustment in exercise and/or diet in order to maintain the same state of health, but the ability to reduce the risk of diabetes and cardiovascular disease continues to remain in large part a lifestyle choice."

Dr. Mandrup did not reply to requests for comment.

SOURCE: http://bit.ly/2xCqLU0

Menopause 2017.

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