Abstract P061: Associations Between Body Composition, Diet, And CVD Risk Markers Among Women During The Menopausal Transition: Findings From The AHA Research Goes Red Women's Health Registry
Authors: Aggarwal Brooke , Scaccia Samantha , Davis Ellen , Kodoth Varna , Liu Sally , Wummer Brianna , Sun Yifei 
Published: April 2022

Introduction:
The menopausal transition has been identified as a key period of detrimental changes in women’s adiposity levels and overall CVD risk, yet the specific mechanisms underlying changes in body composition during this period have not been fully elucidated.

Hypothesis:
We hypothesized that in this national sample of women ages 45-55y, greater body fat percentage would be associated with multiple clinical indicators of CVD risk and behavioral factors, and would vary by stage of menopause (i.e., pre-, peri-, and post).

Methods:
The Research Goes Red (RGR) Weight Study, a prospective observational study and collaboration between AHA and Verily’s Project Baseline, was used to evaluate cross-sectional associations between body fat, dietary intake, and CVD risk markers by menopausal status. Women (N=257, mean age=50 ± 2.8y) completed a 1-wk food record using the NIH ASA 24-Hour Dietary Assessment Tool at baseline. Fasting blood samples including leptin, lipids, and C-reactive protein (CRP) were drawn and analyzed at LabCorp Inc. facilities across the US. Participants logged body fat percentage using an OMRON BCM-500 scale for 7 days out of each month, and percentages were averaged. Multivariable linear regression models, adjusted for age, race/ethnicity, education, and menopausal status, were used to evaluate the relation of body composition with clinical CVD risk factors, leptin, and dietary intake.

Results:
Mean (SD) body fat percentage overall was 40.9% (9.07%) and did not differ by menopausal status at baseline (n=63 pre-, n=101 peri-, and n=93 post-). Mean (SD) serum leptin and HDL-C values were highest in post-menopausal women compared to peri- and pre-menopausal women [55 (29.5) mg/mL vs. 41 (29.5) vs 39 (25.6), p=.047, and 64 (17.8) mg/dL vs. 63 (18.8) vs. 53 (10.5), p<.001, respectively]. In linear regression models, after adjustment for confounders, greater body fat percentage was associated with higher leptin levels (B=2.26, p<.001), CRP (B=.16, p<.001), triglycerides (B=1.34, p<.001), VLDL cholesterol (B=.23, p=.001), and lower HDL-C (B=-.048, p<.001). Lower protein intake was associated with higher leptin levels (B=-.46, p=.006), and lower carbohydrate intake was associated with higher LDL-C (B=-.08, p=.03). In stratified analyses, body fat percentage was associated with triglycerides and VLDL-cholesterol in peri-menopausal women (B=2.5, p<.001; B=.43, p<.001), but not pre- or post-menopausal. Similarly, higher carbohydrate intake was associated with higher leptin levels in peri-menopausal women only (B=.13, p=.02).

Conclusions:
Findings from the RGR Weight Study baseline exam identify several factors that may be associated with adverse weight changes and increased CVD risk during the menopausal transition. Future longitudinal studies in this cohort may provide necessary insights to inform strategies aimed at weight management during this key life period.