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Effects of a dietary intervention and weight change on vasomotor symptoms in the Women’s Health Initiative

Kroenke, Candyce H. ScD, MPH1; Caan, Bette J. DrPH1; Stefanick, Marcia L. PhD2; Anderson, Garnet PhD3; Brzyski, Robert MD, PhD4; Johnson, Karen C. MD, MPH5; LeBlanc, Erin MD, MPH6; Lee, Cathy MD7; La Croix, Andrea Z. PhD3; Park, Hannah Lui PhD8; Sims, Stacy T. PhD2; Vitolins, Mara DrPH9; Wallace, Robert MD, MS10

Menopause: The Journal of The North American Menopause Society: September 2012 - Volume 19 - Issue 9 - p 980–988
doi: 10.1097/gme.0b013e31824f606e
Original Articles

Objective The aim of this study was to determine whether a dietary intervention designed to reduce fat intake and increase intake of fruit, vegetables, and whole grains, and weight loss, reduces vasomotor symptoms (VMS; ie, hot flashes or night sweats) in postmenopausal women.

Methods We included 17,473 postmenopausal US women, ages 50 to 79 years, at baseline who participated in the Women’s Health Initiative Dietary Modification trial and were not taking menopausal hormone therapy. Logistic regression was used to evaluate associations.

Results In multivariate-adjusted analyses, with simultaneous adjustment for the intervention and weight change, assignment to the dietary intervention versus the control arm was significantly (odds ratio [OR], 1.14; 95% CI, 1.01-1.28) related to a higher likelihood of symptom elimination among women with VMS at baseline. In addition, women with symptoms at baseline who lost 10 lb or more (OR, 1.23; 95% CI, 1.05-1.46) or lost 10% or more of their baseline body weight (OR, 1.56; 95% CI, 1.21-2.02) between baseline and year 1 were significantly more likely to eliminate VMS compared with those who maintained weight. Upon examining the joint effect of the dietary modification and weight loss, compared with women in the control arm who maintained weight, women who lost substantial weight (≥10%) as a part of the intervention (OR, 1.89; 95% CI, 1.39-2.57) but not as part of the control arm (OR, 1.40; 95% CI, 0.92-2.13) were significantly more likely to end VMS, although these two groups did not differ significantly from each other. Large weight loss (>22 lb), but not dietary changes, was related to the elimination of moderate/severe VMS.

Conclusions Weight loss as part of a healthy dietary modification may help eliminate VMS among postmenopausal women.

From the 1Division of Research, Kaiser Permanente, Oakland, CA; 2Stanford Prevention Research Center, Stanford University, Stanford, CA; 3Fred Hutchinson Cancer Research Center, Seattle, WA; 4University of Texas, San Antonio, TX; 5University of Tennessee Health Science Center, Memphis, TN; 6Center for Health Research, Kaiser Permanente Northwest, Portland, OR; 7University of California–Los Angeles, Los Angeles, CA; 8Department of Epidemiology, University of California–Irvine, Irvine, CA; 9Wake Forest University, Winston-Salem, NC; and 10University of Iowa College of Public Health, Iowa City, IA.

Received November 29, 2011; revised and accepted January 26, 2012.

Funding/support: The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services through contracts HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, and HHSN271201100004C.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Candyce H. Kroenke, ScD, MPH, Division of Research, Kaiser Permanente, Oakland, CA. E-mail:

©2012The North American Menopause Society