News: Another reason to battle the bulge

Body fat may not be as helpful at protecting against hot flashes as we once thought. In fact, increased abdominal girth may increase the number of those scorching annoyances in midlife women.

The Study of Women's Health Across the Nation Heart Study, an ancillary study to the community-based cohort Study of Women's Health Across the Nation (SWAN), included 461 women aged 45 to 58 years with an intact uterus and at least one ovary.

The authors of the study found that every 1-SD increase in total and subcutaneous abdominal adiposity increased the odds of hot flashes by about 28% and 30%, respectively (OR=1.28; 95% CI, 1.06–1.55 and OR=1.30; 95% CI, 1.07–1.58, respectively). Visceral adiposity, on the other hand, was not associated with hot flashes.

Commentary by Nanette F. Santoro, MD, Professor and Director, Division of Reproductive Endocrinology, Albert Einstein College of Medicine, Bronx, NY.

Dr. Thurston's research, from the SWAN Study, challenges the accepted dogma that adiposity protects women from vasomotor symptoms. The fact that obese women in the early menopause transition experience more hot flashes implies that the insulating action of body fatness increases retention of body heat and thereby increases symptoms. It may still hold that after menopause, when estrogen levels are consistently low, body fatness poses an advantage, but this remains to be seen as the women in SWAN are studied over time.