Please select the eligibility criteria that correspond to the clinical trial below.
Title: Program to Reduce Incontinence by Diet and Exercise
Brief Summary: PRIDE will evaluate the impact of weight loss on urinary incontinence in a randomized, controlled trial.


Options:
A: Inclusion Criteria:

* Females aged 40-62 years.
* Menopausal, including:

  * Women who have had a bi-lateral oophorectomy;
  * Women with a uterus who have skipped 2 or more menstrual cycles with an amenorrhea interval of 60 or more days in the past 12 months;
  * Women without a uterus and who still have one or both ovaries, with FSH level greater than 20 mIU/mL and estradiol less than or equal to 50 pg/mL;
  * Women who are using the Mirena IUD or who have had an endometrial ablation and who still have one or both ovaries, with FSH level greater than 20 mIU/mL and estradiol less than or equal to 50 pg/mL.
* Having bothersome hot flashes and/or night sweats.
* In general good health as determined by medical history, blood pressure, and heart rate:

  * Absence of uncontrolled hypertension greater than 160/100;
  * Resting heart rate less than 110 beats per minute;.
  * No history of myocardial infarction, angina, or cerebrovascular events;.
  * No history of liver, renal disease, or uncontrolled seizure disorder.
  * Absence of uncontrolled metabolic disease (such as diabetes) and absence of current infectious disease (such as acute symptoms of mononucleosis) that would put staff and other participants at risk.
* Signed informed consent.

Exclusion Criteria:

* Use of hormone therapy or hormonal contraceptives (with the exception of the Mirena IUD) during the 2 months before enrollment. Vaginal postmenopausal estrogens allowed, with the exception of vaginal creams used more than 3 times a week.
* Use of any other therapy that is taken specifically for hot flashes, including prescription, over-the-counter, or herbal therapies, in the past month.
* Any current severe or unstable medical illness.
* Body mass index (BMI) of 37 or higher, based on measured height and weight.
* Severe uncorrected hearing or vision problems.
* Current, regular use of anti-coagulants 3 or more times per week, e.g. Coumadin, Heparin, Clopidogrel, aspirin at full dose (due to possible omega-3 supplement interaction).
* Drug or alcohol abuse in the past 1 year.
* Major severe depressive episode in the past 3 months.
* Diagnosis of psychosis or psychotic disorder.
* Pregnancy, intending pregnancy, or breastfeeding.
* Current participation in another drug trial or intervention study.
* Inability or unwillingness to complete the study procedures or interventions.
* Physical limitations that limit the ability to participate in yoga or exercise, for example:

  * Limited mobility (paralyzed, cannot walk 2 blocks);
  * Back problems (severe spine abnormality, sciatica, prior back surgery, spine fracture in the past 3 months);
  * musculoskeletal problems that limit the ability to walk on a treadmill or ride a stationary bicycle;
* Presence of any absolute contraindications to exercise testing and training, as defined by the American College of Sports Medicine.
* Practiced or attended any of the following in the prior 3 months:

  * Yoga, tai chi, qi gong, or meditation more than one time per week on average;
  * Aerobic exercise (more than 30 minutes a day on at least 3 days a week);
  * Inability to achieve 85% of heart rate reserve (HRR; the difference between maximum heart rate and resting heart rate) on graded exercise treadmill test.
* Severe allergy to soy (defined as life-threatening reaction to soy that would require medical intervention).
* Allergy or sensitivity to fish.
* Currently eating 4 or more servings of fish per week.
* Currently taking an omega-3 fish oil supplement more than twice per week in the past 4 weeks and unwilling to stop for 12 weeks. Interest women can stop all omega-3 supplements and reevaluate eligibility 4 weeks after stopping the omega-3 supplements.
B: Inclusion Criteria:

* aged ≥ 30 years and not institutionalized
* body mass index 25 to 50 kg/m2
* urinary incontinence symptoms for \> 3 months by self-report and record \> 10 incontinent episodes per week on a 7-day urinary diary
* able to complete a behavioral run-in consisting of self-monitoring of food and activity
* report having a primary health care provider
* able to understand and sign informed consent and complete baseline questionnaires
* agree to not initiate new treatment for incontinence or weight reduction, including behavioral, pharmacological or surgical therapies, for the duration of the study

Exclusion Criteria:

* current use, or use within the previous month of medical therapy for incontinence
* currently pregnant or gave birth in the previous 6 months
* current urinary tract infection (dipstick urinalysis positive for leukocyte esterase, nitrites or blood) or report having \> 4 urinary tract infections in the preceding year
* incontinence of neurologic or functional origin (by history)
* self-report of prior anti-incontinence or urethral surgery, pelvic cancer or pelvic irradiation
* self-report of significant medical conditions of the genitourinary tract (genitourinary fistula, interstitial cystitis, symptomatic pelvic organ prolapse)
* report a medical condition that would affect the safety and/or efficacy of a weight management program involving diet and physical activity, including type 2 diabetes requiring medical therapy that may cause hypoglycemia, chronic steroid use or uncontrolled hypertension (systolic blood pressure \>180 mm Hg or diastolic blood pressure \> 100 mm Hg); women with a history of coronary heart disease may participate with written approval from their primary care physician
* currently engaged in an active weight loss program and/or experienced a 10% or greater weight reduction in the past 3 months
* report being unable to walk 2 blocks (1/4 mile) without stopping
* report conditions that, in the judgment of the Clinical Center Principal Investigator, render potential participants unlikely to follow the protocol for 18 months, including illness likely to be terminal within 2 years, plans to move, substance abuse or other significant psychiatric problems, or dementia
* participating in another research study that involves investigational drugs or can potentially confound the results of PRIDE
C: Inclusion Criteria:

* 50-70 years
* francophone or understanding French
* body mass index \> 27kg/m²
* without physical disability
* without medical treatment influencing metabolism
* non smoker
* light drinker (\<15 g ethanol/day = 1 alcoholic beverage)
* weight stable (\< 2 kg) for 6 mo
* no participation in a supervised exercise program for 6 mo
* without HRT for at least 3 yrs
* and without menses for at least 12 mo

Exclusion Criteria:

* soy allergy
* known hepatic diseases
* asthma
* family history of accident cerebro-vascular
* personal history of a feminine cancer
D: Postmenopausal women aged 45 to 75 years who are overweight or obese (body mass index of 25 to 40 kg/m2) and have normal or mildly elevated BP.

Answer: B