In the national initiative, Healthy People 2000, a coordinated effort for the prevention of disease through the improvement of the health of all Americans is underway. An important aspect of the initiative is the role of exercise in the prevention of many diseases, especially osteoporosis and cardiovascular disease (CVD). A recent NIH supported workshop, """"""""Physical Activity and Cardiovascular Health: Special Emphasis on Women and Youth,"""""""" recommended that additional research is needed, especially in women, concerning the effects of both aerobic and weightlifting exercise on the musculoskeletal and cardiovascular systems. The workshop also emphasized the importance of investigating estrogen replacement therapy (ERT) which has been shown to modify risk factors related to both diseases in postmenopausal women. The investigators propose to conduct a randomized clinical trial employing a 2x2 factorial design to examine the effects of exercise, ERT and their interaction on bone mineral density (BMD) and CVD risk factors in postmenopausal women of age 50 to 65 years. Subjects (n=400) will be randomized to one of four groups: ERT and exercise (n=100); ERT and no exercise (n=100); no ERT and exercise (n=100); no ERT and no exercise (n=100). The exercise program will emphasize aerobic weight-bearing exercises and resistance exercise using free weights and weight resistance machines. The investigators propose to monitor changes in axial and appendicular BMD and total and regional body composition using dual-energy X-ray absorptiometry (DEXA), selected measures of muscle strength, aerobic capacity and indicators of quality of life, along with changes in serum triglycerides, total cholesterol, total HDL and HDL2 and HDL3 subfractions, LDL after 6 and 12 months of training as well as after a one year follow-up in which all subjects will be encouraged to continue the intervention without supervision. Biochemical markers of bone formation and resorption as well as serum levels of calcitropic hormones, sex steroids, sex hormone binding globulin and fasting insulin will also be measured at 6 month intervals during and 12 months after the 1 year intervention to assess hormonal correlates of BMD, serum lipids and lipoproteins. Duplicate blood collections made approximately one week apart will be used to minimize within subject variability in baseline and 12 month lipid and endocrine data. The investigators propose to extend yearly follow-up to 5 years by applying for a continuation. The proposed study uses an integrative approach to examine the effects of ERT, exercise and their interaction on risk factors for two of the major diseases affecting postmenopausal women. Although ERT may reduce the risk for osteoporosis and CVD by maintaining BMD and altering serum lipoprotein profiles, its prescription may not be indicated for all postmenopausal women. Whether exercise is an efficacious alternative or adjunct intervention for risk factor reduction is not presently known. Similarly, it is not known whether the combination of ERT and exercise has synergistic effects on BMD and serum lipids and lipoproteins. The investigators state that the proposed study will increase understanding of the effects of exercise and ERT on bone and lipid metabolism and will provide much needed information for prescriptions of exercise and ERT aimed at the prevention of osteoporosis and CVD in postmenopausal women.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Project (R01)
Project #
5R01AR039559-07
Application #
2653902
Study Section
Epidemiology and Disease Control Subcommittee 2 (EDC)
Project Start
1989-08-05
Project End
1998-11-30
Budget Start
1998-02-01
Budget End
1998-11-30
Support Year
7
Fiscal Year
1998
Total Cost
Indirect Cost
Name
University of Arizona
Department
Miscellaneous
Type
Schools of Arts and Sciences
DUNS #
City
Tucson
State
AZ
Country
United States
Zip Code
85721
Bea, J W; Blew, R M; Going, S B et al. (2016) Dual energy X-ray absorptiometry spine scans to determine abdominal fat in postmenopausal women. Am J Hum Biol 28:918-926
Klimentidis, Y C; Bea, J W; Lohman, T et al. (2015) High genetic risk individuals benefit less from resistance exercise intervention. Int J Obes (Lond) 39:1371-5
Bea, Jennifer W; Lohman, Timothy G; Cussler, Ellen C et al. (2010) Lifestyle modifies the relationship between body composition and adrenergic receptor genetic polymorphisms, ADRB2, ADRB3 and ADRA2B: a secondary analysis of a randomized controlled trial of physical activity among postmenopausal women. Behav Genet 40:649-59
Bea, Jennifer W; Cussler, Ellen C; Going, Scott B et al. (2010) Resistance training predicts 6-yr body composition change in postmenopausal women. Med Sci Sports Exerc 42:1286-95
Farrell, Vanessa A; Harris, Margaret; Lohman, Timothy G et al. (2009) Comparison between dietary assessment methods for determining associations between nutrient intakes and bone mineral density in postmenopausal women. J Am Diet Assoc 109:899-904
Milliken, L A; Cussler, E; Zeller, R A et al. (2009) Changes in soft tissue composition are the primary predictors of 4-year bone mineral density changes in postmenopausal women. Osteoporos Int 20:347-54
Milliken, Laura A; Wilhelmy, Jennifer; Martin, Catherine J et al. (2006) Depressive symptoms and changes in body weight exert independent and site-specific effects on bone in postmenopausal women exercising for 1 year. J Gerontol A Biol Sci Med Sci 61:488-94
Maurer, Jaclyn; Harris, Margaret M; Stanford, Vanessa A et al. (2005) Dietary iron positively influences bone mineral density in postmenopausal women on hormone replacement therapy. J Nutr 135:863-9
Milliken, L A; Going, S B; Houtkooper, L B et al. (2003) Effects of exercise training on bone remodeling, insulin-like growth factors, and bone mineral density in postmenopausal women with and without hormone replacement therapy. Calcif Tissue Int 72:478-84
Teixeira, Pedro J; Going, Scott B; Houtkooper, Linda B et al. (2003) Resistance training in postmenopausal women with and without hormone therapy. Med Sci Sports Exerc 35:555-62

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