Sedentary Lifestyle and High-Carbohydrate Intake are Associated with Low-Grade Chronic Inflammation in Post-Menopause: A Cross-sectional Study

Alves, Bruna Cherubini; Silva, Thaís Rasia da; Spritzer, Poli Mara

doi:10.1055/s-0036-1584582

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Revista Brasileira de Ginecologia e Obstetrícia

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Sumário

Original Article • Rev. Bras. Ginecol. Obstet. 38 (07) • July 2016 • https://doi.org/10.1055/s-0036-1584582 copy

Sedentary Lifestyle and High-Carbohydrate Intake are Associated with Low-Grade Chronic Inflammation in Post-Menopause: A Cross-sectional Study

Sedentarismo e alto consumo de carboidratos associados à inflamação crônica de baixo grau na pós-menopausa: um estudo transversal

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction

Cardiovascular disease (CVD) is the leading cause of death in post menopausal women, and inflammation is involved in the atherosclerosis process.

Purpose

to assess whether dietary pattern, metabolic profile, body composition and physical activity are associated with low-grade chronic inflammation according to highsensitivity C-reactive protein (hs-CRP) levels in postmenopausal women.

Methods

ninety-five postmenopausal participants, with no evidence of clinical disease, underwent anthropometric, metabolic and hormonal assessments. Usual dietary intake was assessed with a validated food frequency questionnaire, habitual physical activity was measured with a digital pedometer, and body composition was estimated by bioelectrical impedance analysis. Patients with hs-CRP ≥ 10 mg/L or using hormone therapy in the last three months before the study were excluded from the analysis. Participants were stratified according to hs-CRP lower or ≥3 mg/L. Sedentary lifestyle was defined as walking fewer than 6 thousand steps a day. Two-tailed Student's t-test, Wilcoxon-Mann-Whitney U or Chi-square (x ²⁾ test were used to compare differences between groups. A logistic regression model was used to estimate the odds ratio of variables for high hs-CRP.

Results

participants with hs-CRP ≥ 3 mg/L had higher body mass index (BMI), body fat percentage, waist circumference (WC), triglycerides, glucose, and homeostasis model assessment of insulin resistance (HOMA-IR) (p = 0.01 for all variables) than women with hs-CRP <3 mg/L. Also, women with hs-CRP ≥3 mg/L had a higher glycemic load diet and lower protein intake. Prevalence of sedentary lifestyle (p < 0.01) and metabolic syndrome (p < 0.01) was higher in women with hs-CRP ≥3 mg/L. After adjustment for age and time since menopause, the odds ratio for hs- CRP ≥3 mg/L was higher for sedentary lifestyle (4.7, 95% confidence interval [95%CI] 1.4-15.5) and carbohydrate intake (2.9, 95%CI 1.1-7.7).

Conclusions

sedentary lifestyle and high-carbohydrate intake were associated with low-grade chronic inflammation and cardiovascular risk in postmenopause.

Keywords:
inflammation; cardiovascular disease; menopause; dietary pattern; physical activity

	Overall	<3 mg/dL	≥3 mg/dL	p-value
	n = 95	n = 72	n = 23
Age (years)^a	54.7 ± 4.8	54.7 ± 5.0	55.3 ± 4.1	0.58
Time since menopause (years)^b	5.0(2.0–10.0)	5.0(3.0–10.0)	4.5(2.9–8.0)	0.46
Years at school^b	8.0(5.0–11.0)	8.0(5.0–11.0)	8.0(5.0–11.0)	0.79
White, n (%)^c	83(87.4)	61(84.7)	22(95.6)	0.28
BMI (kg/m²)^b	26.2(23.8–29.1)	25.3(23.1–28.0)	29.9(25.0–32.0)	< 0.01
WC (cm)^b	84.5(78.0–91.0)	83.0(76.2–87.4)	94.0(89.0–101.5)	< 0.01
Lean mass (kg)^b	23.4(8.5–33.1)	22.6(21.1–25.4)	23.9(21.3–26.8)	0.31
Fat mass (kg)^b	23.9(36.0–120.0)	21.3(17.0–26.5)	30.3(24.0–34.4)	< 0.01
% Fat mass^a	35.4 ± 7.0	33.6 ± 6.6	40.9 ± 5.0	< 0.01
TC (mg/dL)^a	217.7 ± 35.5	216.9 ± 36.8	220.4 ± 31.7	0.38
HDL-c (mg/dL)^b	53.0(45.0–63.0)	53.0(46.2–64.7)	48.0(41.0–52.0)	0.02
LDL-c (mg/dL)^b	137.4(117.3–159.0)	135.9(116.8–156.7)	143.6(122.9–161.2)	0.45
TG (mg/dL)^b	98.0(73.0–146.0)	88.5(72.0–138.5)	134.0(98.0–208.0)	0.01
Glucose (mg/dL)^a	92.8 ± 8.4	91.5 ± 7.5	97.1 ± 9.6	< 0.01
Insulin (µUI/mL)^b	8.8(5.9–13.9)	7.9(5.7–12.1)	14.7(8.1–19.5)	< 0.01
HOMA-IR^b	2.0(1.3–3.3)	1.8(1.3–2.8)	3.2(1.7–4.5)	0.01
LAP^b	30.8(17.8–45.9)	25.2(17.3–38.1)	45.9(32.7–65.3)	< 0.01
Hypertension (%)^c	37 (39%)	27 (37%)	10 (43%)	0.67
Metabolic syndrome^c	18 (19%)	8 (11%)	10 (43%)	< 0.01
Mean steps a day^b	5,258(3,662–8,227)	6,069(4,315–8,394)	3,961(2,310–5,962)	< 0.01

Daily intake	< 3 mg/dL	≥3 mg/dL	p-value	Reference range
	n = 72	n = 23	p-value	Reference range
Total Kcal^b	1,716.8 (1,418.8–2,217.3)	2,053.3 (1,415.0–2,584.7)	0.18	−
% Carbohydrate Kcal^b	55.4 (50.4–58.4)	61.3 (55.9–65.1)	< 0.01	45–65^*
Carbohydrate (g)^b	244.5 (186.6–309.0)	295.4 (202.3–397.3)	0.06	130^*
Glycemic load (g)^b	128.4 (95.4–153.3)	152.0 (111.5–197.3)	0.04	< 120^#
Glycemic index (%)^b	55.5 (51.8–58.4)	55.9 (52.7–58.3)	0.72	ND
Fiber (g)^b	25.3 (19.3–34.1)	28.6 (20.8–43.3)	0.14	25^*
% Protein Kcal^a	16.9 ± 2.7	15.1 ± 3.5	0.03	10–35^*
Protein (g)^b	79.1 (57.5–90.8)	70.4 (64.6–94.5)	0.65	46^*
% Fat Kcal^a	24.1 ± 5.6	21.6 ± 5.3	0.06	20–35^*
Fat (g)^b	48.3 (32.0–61.5)	48.4 (37.3–54.2)	0.91	ND
SFA (%)^a	7.1 ± 2.1	6.0 ± 1.6	0.03	< 10%^d
PUFA (%)^a	3.3 ± 1.0	3.3 ± 1.0	0.74	ND
MUFA (%)^b	7.0 (5.8–8.8)	6.6 (5.1–7.4)	0.10	ND
Cholesterol (mg)^b	183.2 (132.1–254.6)	210.1 (108.1–255.9)	0.98	< 300^b
Calcium (mg)^b	721.1 (509.9–999.2)	794.1 (462.8–944.8)	0.73	1,200^*
Magnesium (mg)^b	238.9 (190.0–315.4)	289.0 (195.8–387.5)	0.19	320^*
Iron (mg)^b	8.2 (6.4–11.4)	10.6 (6.7–14.1)	0.12	8^*
Zinc (mg)^b	7.9 (5.9–9.7)	8.0 (6.3–9.8)	0.72	8^*
Sodium (mg) ^a	1,785.8 (1,415.8–2,204.6)	1,839.2 (1,564.1–2,448.7)	0.22	< 1,500^*
Selenium (µg)^b	88.9 (64.5–111.9)	91.3 (71.6–106.8)	0.82	55^*
Folate (µg)^b	490.1 (361.1–645.4)	480.7 (406.1–947.6)	0.47	400^*
Vitamin D (µg)^b	4.6 (2.4–10.6)	2.7 (1.9–7.1)	0.13	10–15^*
Vitamin B12 (µg)^b	4.4 (3.1–5.7)	3.2 (2.2–4.2)	0.07	2.4^*
Vitamin E (mg)^b	3.5 (2.5–4.7)	4.8 (2.9–6.0)	0.04	15^*
Vitamin C (mg)^b	157.1 (106.7–272.0)	207.6 (114.7–478.4)	0.33	75^*
Vitamin A (µg)^b	699.7 (451.3–1,170.8)	859.2 (364.6–1,747.1)	0.47	700^*

Variable	OR	95% CI	p-value^a
% Carbohydrate Kcal (>55)	2.9	1.1–7.7	0.03
Glycemic load (>120 g)^b	1.8	0.6–5.0	0.30
Sedentary lifestyle (<6,000 steps/day)	4.7	1.4–15.5	0.01
Waist Circumference (≥88 cm)^c	13.6	3.9–47.0	< 0.01
% Body fat^d	18.7	2.2–155.9	0.01

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[1] Address for correspondence Poli Mara Spritzer, MD, PhD, Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, 90035-003, Porto Alegre, RS., Brazil (e-mail: spritzer@ufrgs.br).