Longitudinal changes in weight in perimenopausal and early postmenopausal women: effects of dietary energy intake, energy expenditure, dietary calcium intake and hormone replacement therapy

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Abstract
OBJECTIVE: To investigate whether energy intake or energy expenditure affects 5–7 y weight gain in perimenopausal and early postmenopausal women, and whether hormone replacement therapy (HRT) use or dietary calcium (Ca) intake are contributory factors. DESIGN: Longitudinal, observational study of healthy women around the menopause. SUBJECTS: A total of 1064 initially premenopausal women, selected from a random population of 5119 women aged 45–54 y at baseline. In all, 907 women (85.2%) returned 6.30.6 y later for repeat measurements. Of these, 36% were postmenopausal (no HRT) and 45% had taken HRT, and 898 women completed the questionnaires. MEASUREMENTS: Weight, height, estimation of energy intake by food frequency questionnaire and physical activity level (PAL) by questionnaire. RESULTS: Change in PAL influenced weight change explaining 4.4% (P=0.001) of the variation. Alterations in dietary energy intake also had a small but significant effect (0.6% P=0.013). Dietary Ca intake had no effect on weight or weight change. CONCLUSION: Mean weight had increased and was influenced more by reduced energy expenditure rather than increased energy intake. HRT and dietary Ca intake did not influence weight gain.