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Metabolic syndrome, menopause and ethnicity

Metabolic syndrome is on the rise and affecting greater numbers of menopausal women. Disturbingly, this condition prevails in some ethnic groups. Distinguished by obesity, high blood sugar levels, high blood pressure, and high cholesterol, metabolic syndrome contributes to increased risk of developing a number of health risks including type 2 diabetes, hypertension, and cardiovascular disease.

The risks for metabolic syndrome fluctuate over the course of a lifetime, based on changes in weight and waist circumference measurements. Shifting hormone levels during menopause that may or may not receive hormone replacement therapy treatment are further affected by lifestyle choices and healthcare habits.

Consider that the average woman will gain about .55 kilograms or just over one pound per year after age 40 as well as increased fat stores and loss of muscle mass without adopting healthier lifestyle choices. But not all women are so fortunate, depending on geographic location and racial background.

What role does ethnicity play? What can be done?
No one is immune from the devastating effects of metabolic syndrome; indeed rates are increasing and show no indications of discrimination based on culture, race, or income. Approximately 20-40% of Caucasian women will receive a diagnosis during or after menopause; postmenopausal rates tend to rise with age.

But that does not let other groups off the hook. In fact, Hispanic, and African American women are at greater risk. Some theories point to genetic makeup while others blame lifestyle factors. Many women belonging to these groups fall into lower income categories, leading to limited dietary choices, and little or no access to medical awareness and/or regular physical activity. Both groups are more susceptible to cardiovascular disease and adult onset or type 2 diabetes during and after menopause.

While poverty and poor health easily correlate, doctors notice greater numbers of metabolic syndrome in additional ethnic groups. More Asian women are showing signs of greater waist measurements, increased obesity, and high cholesterol levels. The exportation of the so-called ‘North American or Western’ sedentary lifestyle fueled by diets high in fat, salt and sugar while low in fiber and nutrients is spreading metabolic syndrome around the world.

For many women, income levels do play a part in accessing quality healthcare.
With a substantial number of people around the world living on as little as $1 a day, dietary choices are extremely limited, as are medical clinics and educational programs. In South Asia, more women must survive with little or no adequate healthcare. This means many of the metabolic syndrome factors easily controlled with diet and exercise are difficult to overcome. Limited access to timely and relevant information only adds to the mix.

Researchers point to the need for greater inclusion of traditionally overlooked ethnic groups in studies. The goal is to provide the necessary healthcare management information to help women deal with, prevent, or reverse the effects of metabolic syndrome. With type 2 diabetes and cardiovascular disease rates reaching epidemic proportions, the time is now to work on reversing these negative trends and ensuring women everywhere have access to the health information they need.

Lumsden, Mary Ann (GB) Dept. Obstetrics/Gynecology, Queen Elizabeth Building, University of Glasgow. Presented at the 13th Congress on Menopause Rome 2011.

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