Full text of DOI:10.1093/gerona/55.10.M607

Journal of Gerontology: MEDICAL SCIENCES
Copyright 2000 by The Gerontological Society of America
2000, Vol. 55A, No. 10, M607–M612
Determinants of Body Composition in
Postmenopausal Women
James M. Hagberg,1,2 Joseph M. Zmuda,1 Steve D. McCole,1,3 Kathleen S. Rodgers,2
Kenneth R. Wilund,2 and Geoffrey E. Moore1
1Division of Cardiology, University of Pittsburgh Medical Center, Pennsylvania.
2Department of Kinesiology, University of Maryland, College Park.
3Department of Human Kinetics, University of Wisconsin–Milwaukee.
Background. Little is known about the effects of different levels of long-term physical activity on total body and re-
gional fat and whether hormone replacement therapy interacts with physical activity level to affect body composition in
postmenopausal women.
Methods. We determined the associations between different levels of habitual physical activity, hormone replace-
ment therapy (HRT), and total and regional body composition in postmenopausal women. Twenty sedentary, 20 active
nonathletic, and 23 endurance-trained women (approximately half on HRT) had total and regional body composition as-
sessed by dual-energy x-ray absorptiometry. The athletes and active nonathletic women had been active for the same
number of years and the same number of hours per week.
Results. The athletes and sedentary women weighed the same, but the active nonathletic groups on and not on HRT
weighed 3–12 kg more (p Ͻ .05). Athletes had less trunk, arm, leg, and total body fat than sedentary and active nonathletic
women ( p Ͻ .05). Women on HRT tended to have lower total body ( p ϭ .07), but not regional, fat values. Linear regression
.
analyses indicated that VO2max in ml/kg/min was the major independent determinant of total and regional body fat accounting
for 52% to 70% of their variances. Athletes had greater caloric and carbohydrate intake than their less active peers, but
all groups had similar protein, fat, saturated fat, monounsaturated fat, and polyunsaturated fat intakes.
Conclusions. Intense training, but not low- to moderate-intensity physical activity, is associated with markedly
lower levels of total and regional body fat in postmenopausal women. HRT has less of an effect on body composition
than intense exercise training in postmenopausal women.
UMEROUS systems are affected by the hormonal al-
terations that occur with menopause in women. One of
and the American College of Sports Medicine concluded
that 30 minutes of low- to moderate-intensity exercise on
most, if not all, days of the week provides substantial health
benefits and results in reduced CV disease mortality (15).
Clearly, many more postmenopausal women would choose
to initiate and maintain this type of a physical activity pro-
gram compared to the intense and prolonged training of an
endurance athlete. However, to our knowledge, no studies
have assessed whether prolonged participation in a low- to
moderate-intensity physical activity program is associated
with lower levels of total body and trunk fat.
We hypothesized that total body and trunk fat levels
would be lower in active nonathletes compared with sedentary
postmenopausal women, in endurance-trained compared with
active nonathletic postmenopausal women, and in postmeno-
pausal women on HRT compared with those not on HRT.
Habitual dietary intake was also measured to assess the po-
tential impact on body composition in these women.
N
the more important changes that occurs with menopause is
the change in body composition, evident as an increase in
total body and trunk fat (1,2). Body fat, especially that located
on the trunk, is associated with an increased cardiovascular
(CV) disease risk as a result of the direct association between
total body and regional fatness and CV disease risk (3,4).
Increased total body and regional fatness also have indirect
effects on other CV disease risk factors including plasma li-
poprotein-lipid profiles, blood pressure, and insulin resistance
(1). Some evidence indicates that hormone replacement
therapy (HRT) might ameliorate or reverse the increases in
body fat that occur following menopause, which might be one
mechanism for the cardioprotection afforded by HRT (5).
Increased habitual levels of physical activity can mark-
edly affect a person’s daily energy expenditure, energy bal-
ance, and, consequently, their body composition. The long-
term vigorous exercise training of older endurance-trained
men is associated with low levels of body fat (6–8). How-
ever, very little data exist on the body composition of endur-
ance-trained postmenopausal women (9–14). Furthermore,
only one study has addressed the potential role of HRT in
determining body composition in these women (13).
METHODS
Postmenopausal women were recruited based on their
physical activity habits (sedentary, active nonathlete, or en-
durance-trained athlete) and HRT status. All subjects pro-
vided their written consent to participate in the study. The
study was approved by the Institutional Review Board of the
In 1995, the Centers for Disease Control and Prevention
M607

M608
HAGBERG ET AL.
University of Pittsburgh Medical Center. Postmenopausal
status was initially identified by self-report as the lack of
menses for more than 2 years and later confirmed by elevated
luteinizing and follicle-stimulating hormone levels. Seden-
tary women had not participated in regular physical activity
for more than 2 years. Active nonathletic women were taking
part in low- to moderate-intensity physical activity (walking,
aerobics, swimming, etc.) more than 90 minutes per week
and more than 3 days per week, but not training for endur-
ance-based competitive events. Subjects for these two groups
were recruited from the Pittsburgh metropolitan area. Women
athletes were distance runners from across the United States
who were training intensely for competitive endurance-based
events. The final study population consisted of 20 sedentary
women (9 on HRT, 11 not on HRT), 20 active nonathletic
women (9 on HRT, 11 not on HRT), and 23 endurance-
trained athletes (11 on HRT, 12 not on HRT). Approxi-
mately one third of the women on HRT were taking only es-
trogen. Two thirds of the women on HRT were taking com-
bined estrogen and progestin with roughly half of them on
continuous and half on cyclic progestin programs. Each sub-
ject’s physical activity and HRT program had been constant
for 2 years or more preceding this study. Three (27%) of the
active nonathletic women not on HRT and 4 (44%) of the ac-
tive nonathletic women on HRT included some resistive or
upper body exercise in their physical activity program. Four
(33%) of the women athletes not on HRT and 5 (45%) of the
women athletes on HRT included some resistive or upper
body exercise in their training.
rior tissue thickness so that all scans were performed at me-
dium speed. Fat and fat-free soft tissue masses and percent
fat were measured for the total body, arms, legs, and trunk
using the default Lunar definitions. Software version 1.3z
was used to obtain and analyze all scans. All scans were
performed and analyzed by one investigator, thus eliminat-
ing interobservor error. Details of the DEXA procedure and
analysis have been published elsewhere (17). The total body
composition data (percent of fat, lean body mass) from
these women have been published previously (16).
Dietary Assessments
We also sought to assess whether dietary habits might
confound our interpretation of the associations between ha-
bitual physical activity levels, HRT status, and body com-
position. Subjects completed a 3-day food record that con-
sisted of 2 weekdays and 1 weekend day. The food records
were analyzed for daily kcal, protein, fat, carbohydrate, and
saturated, monounsaturated, and polyunsaturated fat intake
as factors that could affect overall energy intake and body
composition. All records were analyzed by a registered dieti-
tian using Computrition, Inc., software (Chatsworth, CA).
Statistics
All data are reported as mean Ϯ standard deviation. Multi-
variate analyses of variance (ANOVAs) were performed as an
initial step to assess the differences in overall body composition
profiles and dietary habits among the different subject groups.
ANOVA and analysis of covariance (ANCOVA) with post hoc
analyses were then used to compare groups in terms of body
composition at specific anatomical sites. Bivariate correlations
and multiple linear regressions were used to assess the inde-
pendent determinants of total and regional body composition.
P Ͻ .05 was accepted as statistically significant.
Sedentary and active nonathletic women completed a
Bruce exercise test to screen for CV disease; women with
no evidence of CV disease underwent a second maximal ex-
.
ercise treadmill test to measure VO2max (16). Women ath-
letes underwent a single test to screen for CV disease and to
.
.
assess VO2max (16). The VO2max data from these women
have been published previously (16).
RESULTS
Body Composition Assessments
Body composition was measured by dual-energy x-ray
absorptiometry (DEXA; DPX-L, Lunar Corp., Madison,
WI) in the morning while the subjects maintained an over-
night fast. All women were of the appropriate anteroposte-
Subject Characteristics
As shown in Table 1, all six subject groups were of similar
age and had been postmenopausal the same number of years.
The three groups of subjects on HRT had been taking hormones
Table 1. Physical Characteristics of the Subjects
Sedentary
Active Nonathletes
Endurance Athletes
No HRT
HRT
No HRT
HRT
No HRT
HRT
(n ϭ 11)
(n ϭ 9)
(n ϭ 11)
(n ϭ 9)
(n ϭ 12)
(n ϭ 11)
Age, years
Years PM
HRT history, years
PA history, years
PA, hours/week
66 Ϯ 6
16 Ϯ 8
—
62 Ϯ 5
11 Ϯ 4
8 Ϯ 4
—
64 Ϯ 6
15 Ϯ 9
—
12 Ϯ 6
5.1 Ϯ 2.5
—
61 Ϯ 4
12 Ϯ 6
10 Ϯ 7
12 Ϯ 8
6.0 Ϯ 2.8
—
65 Ϯ 4
16 Ϯ 5
—
16 Ϯ 5
5.5 Ϯ 1.9
29 Ϯ 9
65 Ϯ 4
22 Ϯ 13
11 Ϯ 10
14 Ϯ 4
5.5 Ϯ 1.3
32 Ϯ 10
—
—
—
—
—
Running mileage, miles/week
.
VO2max
L/min
1.4 Ϯ 0.2†
23 Ϯ 2†
1.4 Ϯ 0.3†
24 Ϯ 5†
1.7 Ϯ 0.2*
26 Ϯ 2†
1.6 Ϯ 0.2†
26 Ϯ 3†
2.1 Ϯ 0.2*
38 Ϯ 6*
2.2 Ϯ 0.4*
39 Ϯ 5*
ml/kg/min
Notes: HRT ϭ hormone replacement therapy; PM ϭ postmenopausal; PA ϭ physical activity. Values are expressed as mean Ϯ SD. Years PM is the number of
years the women had been postmenopausal. HRT history is the number of continuous years those women on HRT had been taking HRT. PA history is the number of
continuous years at the current level of physical activity. PA hours/week is the number of hours of physical activity per week. * and † indicate values within the same
variable significantly different at p Ͻ .05.

BODY COMPOSITION IN POSTMENOPAUSAL WOMEN
M609
for the same length of time. In addition, the athletic and active
nonathletic women had been undergoing their physical activity
programs for the same number of years and hours per week.
groups had the same body weight. HRT status did not have
an effect on lean mass. There also were no significant inter-
action effects of physical activity and HRT status on total
body composition variables.
The athletes on and not on HRT were running the same
.
number of miles per week in training. VO2max was higher
Regional Body Composition
in the athletes than in the sedentary and active nonathletic
.
As shown in Tables 2 and 3, when trunk, arm, and leg
percent fat values were included in multivariate ANOVAs,
the athletic women had significantly lower overall regional
body fat percentages compared with both the sedentary and
active nonathletic women. Furthermore, ANOVAs on each
individual region also indicated that the women athletes had
lower trunk, arm, and leg percent body fat than both the sed-
entary and active nonathletic women. Multivariate and indi-
vidual ANOVAs both indicated that sedentary and active
nonathletic women did not differ in terms of percent fat
overall or at individual regions. Although most regional fat
percentages were lower in women on HRT compared with
those of the same physical activity status not on HRT, these
differences were not significant.
groups, whether expressed as l/min or ml/kg/min. VO2max in
l/min was higher in the active nonathlete than in the sedentary
.
women, but VO2max in ml/kg/min did not differ between
.
these two groups. VO2max was not affected by HRT status.
Overall Body Composition
As shown in Table 2, height did not differ among the six
groups of women. The athletic and sedentary women were
of similar body weight; however, the active nonathletic
women were 3–12 kg heavier than the sedentary and athletic
groups. Physical activity status significantly affected total
body percent fat, which was significantly and markedly
lower in the athletes compared with the sedentary and active
nonathletic women, who both had similar percent body fat
values. Fat mass was also significantly and markedly lower
in the athletes, with the sedentary and active nonathletic
women again having similar fat mass values. The effect of
HRT status on total body percent fat approached significance
(p ϭ .07) as women on HRT tended to have lower total
body percent fat values. HRT status had less of an effect on fat
mass with women on HRT who tended to have slightly lower
total body fat mass (p ϭ .12).
There was a significant effect of physical activity status
on total body lean mass (p ϭ .01); the active nonathletic
and athletic women had higher lean mass than the sedentary
women. However, the active nonathletic women had higher
lean mass than the sedentary women as a result of their in-
creased body weight, because the percent of total body weight
that was lean mass was the same in these two groups. On the
other hand, the higher lean mass in the athletes compared
with the sedentary women was the result of a greater per-
centage of their total body weight being lean mass as both
Determinants of total and regional body composition:
.
VO2max, in ml/kg/min, was significantly and inversely corre-
lated with all measures of body fat including percent total body
fat, fat mass, and regional fat percentages ( r ϭ Ϫ.74 to Ϫ.84,
all p Ͻ .0001), and was significantly and positively correlated
with lean body mass (r ϭ .32, p ϭ .01). Years of physical
activity also correlated significantly and inversely with all
measures of total and regional body fat (r ϭ Ϫ.24 to Ϫ.36,
p ϭ .01 to .07), but not lean mass (r ϭ .21, p ϭ .11). HRT
duration also correlated significantly and inversely with all
measures of total and regional body fat (r ϭ Ϫ.25 to Ϫ.29,
p ϭ .02 to .05), except leg percent fat (r ϭ Ϫ.18, p ϭ .18);
HRT duration did not correlate with lean mass (r ϭ Ϫ.05, p ϭ
.68). Age, years postmenopausal, and HRT status did not corre-
late significantly with any of the body composition variables.
.
In multiple linear regressions, VO2max, years of activity,
and HRT duration were independent determinants of total
body percent fat, accounting for 70%, 3%, and 2% of the to-
Table 2. Body Composition of the Subjects
Sedentary
Active Nonathletes
Endurance Athletes
No HRT
No HRT
HRT
No HRT
HRT
HRT
(n ϭ 11)
(n ϭ 9)
(n ϭ 11)
(n ϭ 9)
(n ϭ 12)
(n ϭ 11)
Height, cm
Weight, kg
Total body
Percent fat
Fat mass
Percent lean
Lean mass
Trunk
Percent fat
Percent lean
Arms
Percent fat
Percent lean
Legs
158 Ϯ 6
59 Ϯ 5†
158 Ϯ 5
59 Ϯ 8†
160 Ϯ 6
66 Ϯ 8*
159 Ϯ 6
62 Ϯ 10*
161 Ϯ 6
57 Ϯ 8†
159 Ϯ 8
54 Ϯ 8†
37 Ϯ 3†
22 Ϯ 4†
63 Ϯ 3†
37 Ϯ 2†
36 Ϯ 7†
22 Ϯ 7†
64 Ϯ 6†
38 Ϯ 4†
38 Ϯ 3†
25 Ϯ 5†
62 Ϯ 4†
41 Ϯ 4
37 Ϯ 6†
23 Ϯ 7†
63 Ϯ 5†
39 Ϯ 4†
28 Ϯ 8*
16 Ϯ 7*
72 Ϯ 7*
41 Ϯ 4*
22 Ϯ 5*
12 Ϯ 3*
78 Ϯ 6*
42 Ϯ 7*
37 Ϯ 4†
63 Ϯ 5†
35 Ϯ 8†
65 Ϯ 7†
39 Ϯ 4†
61 Ϯ 4†
37 Ϯ 5†
63 Ϯ 5†
27 Ϯ 9*
73 Ϯ 8*
21 Ϯ 6*
79 Ϯ 5*
36 Ϯ 4†
64 Ϯ 5†
30 Ϯ 9†
70 Ϯ 8†
34 Ϯ 4†
66 Ϯ 5†
32 Ϯ 7†
68 Ϯ 8†
24 Ϯ 7*
76 Ϯ 6*
21 Ϯ 5*
79 Ϯ 4*
Percent fat
Percent lean
41 Ϯ 3†
59 Ϯ 4†
41 Ϯ 8†
59 Ϯ 5†
39 Ϯ 5†
61 Ϯ 4†
41 Ϯ 7†
59 Ϯ 6†
31 Ϯ 8*
69 Ϯ 7*
24 Ϯ 5*
76 Ϯ 4*
Notes: HRT ϭ hormone replacement therapy. Values are expressed as mean Ϯ SD. * and † indicate values within the same variable significantly different at p Ͻ .05.

M610
HAGBERG ET AL.
Table 3. Probability Values for the Differences Between Groups
Within a Multivariate ANOVA Framework Comparing Trunk,
Arm, and Leg Fat Percentages
by the active nonathletic women was not associated with lower
total body or regional percent fat values compared with seden-
tary women. In the present study, HRT had minimal effects on
body composition.
Active
Nonathletes
Endurance
Athletes
The present data clearly indicate that the intense endurance
training programs of the postmenopausal women athletes
were associated with significantly and markedly lower total
body and regional percent fat values. Six previous studies—
two that used underwater weighing, two that used skinfold
measures, and two that used DEXA—reported that 50–70-
year-old endurance-trained women athletes had lower total
body percent fat than, or that would be expected in, sedentary
women of the same age (9–14). Five of these investigations
studied women athletes with average ages between 53 and 57
years (9,11–14). The study in the oldest athletes (mean age,
62 years) included only 7 women (10). Thus, our results ex-
tend the findings of these previous studies indicating that pro-
longed high-intensity endurance training in 60ϩ-year-old
women athletes, as in older men (6–8), is associated with
lower levels of total body percent fat.
Sedentary
No HRT HRT No HRT HRT No HRT HRT
Sedentary
No HRT
HRT
—
0.17
—
0.19
0.23
0.25
0.85
0.00
0.08
0.00
0.00
Active nonathletes
No HRT
HRT
—
0.52
—
0.01
0.00
0.00
0.00
Endurance athletes
No HRT
HRT
—
0.20
—
Note: HRT ϭ hormone replacement therapy.
.
tal variation, respectively. VO2max, years of activity, and
HRT duration were also independent determinants of trunk
The present data also extend the results of these previous
studies of overall body composition in postmenopausal
women, because they provide strong evidence that older en-
durance-trained women have lower levels of trunk fat. In one
previous study, endurance-trained women averaging 57 years
of age had lower umbilicus subcutaneous skinfolds than
sedentary women of the same age (12). In a second study,
women runners averaging 55 years of age had a lower waist
circumference than their sedentary peers (9). The same
general findings also were evident in two recent studies of
women athletes with average ages of 56 to 58 years; how-
ever, in one study, sedentary women of the same age were not
studied as a comparison group, and in the other, the sedentary
women weighed over 25% more than the women athletes
(13,14). In the present study, the postmenopausal women ath-
letes had significantly and markedly lower trunk percent fat
values than sedentary and active nonathletic women of the
same age. This finding is especially important as trunk fat is
an independent CV disease risk factor (1,4).
percent fat, accounting for 64%, 5%, and 3% of the total
variation, respectively. VO2max and years of activity were
the only independent determinants of total body fat mass
.
and accounted for 52% and 5% of the total variation, re-
.
spectively. VO2max was the only independent determinant
of both leg and arm percent fat and accounted for 62% and
.
57% of their total variances, respectively. VO2max was the
only independent determinant of lean mass, accounting for
9% of the total population variance in total body lean mass.
Dietary Composition
As seen in Table 4, the women athletes had greater daily
caloric and carbohydrate intake than both the sedentary and
active nonathlete women. The sedentary and active nonath-
letic women had similar daily intake of total calories and
carbohydrates. The six groups of women did not differ in
overall intake of protein, fat, saturated fat, monounsaturated
fat, and polyunsaturated fat.
DISCUSSION
Although the intense training of the athletes in the present
study was associated with lower levels of total and regional
percent fat values, women who had undergone the same
number of years and hours per week of low- to moderate-
intensity physical activity had the same total and regional
body composition as sedentary women. These differential
The results of this study indicate that the years of intense
training that postmenopausal women athletes had undergone
was associated with lower total body and regional percent fat
values. However, the same number of hours per week and
years of low- to moderate-intensity physical activity completed
Table 4. Dietary Compositions of the Subjects Related to Body Composition
Sedentary
Active Nonathletes
Endurance Athletes
Dietary Intake
No HRT
HRT
No HRT
HRT
No HRT
HRT
Energy, kcal/day
Protein, g/day
CHO, g/day
1503 Ϯ 227†
9 Ϯ 3
192 Ϯ 49†
54 Ϯ 20
19 Ϯ 9
1426 Ϯ 281†
9 Ϯ 4
208 Ϯ 28†
40 Ϯ 15
13 Ϯ 6
1451 Ϯ 239†
9 Ϯ 4
211 Ϯ 45†
46 Ϯ 15
15 Ϯ 6
1446 Ϯ 348†
8 Ϯ 4
192 Ϯ 68†
45 Ϯ 24
15 Ϯ 10
16 Ϯ 8
1630 Ϯ 412*
10 Ϯ 6
226 Ϯ 71*
50 Ϯ 22
15 Ϯ 8
1697 Ϯ 391*
10 Ϯ 3
319 Ϯ 123*
51 Ϯ 18
15 Ϯ 6
Fat, g/day
Saturated fat, g/day
Monounsaturated fat, g/day
Polyunsaturated fat, g/day
19 Ϯ 8
9 Ϯ 3
14 Ϯ 5
9 Ϯ 4
16 Ϯ 6
9 Ϯ 4
18 Ϯ 9
10 Ϯ 6
17 Ϯ 7
10 Ϯ 3
8 Ϯ 4
Notes: HRT ϭ hormone replacement therapy; CHO ϭ carbohydrates. Values are expressed as mean Ϯ SD. * and † indicate values within the same variable significantly
different at p Ͻ .05.

BODY COMPOSITION IN POSTMENOPAUSAL WOMEN
M611
effects of low- to moderate- compared with higher-intensity en-
durance training on body composition are also evident in
previous longitudinal training studies in older men and
perhaps the most appropriate interpretation of these results
is that the many years of prolonged high-intensity training
the women athletes had completed clearly had a greater effect
on total and regional body fat values than HRT.
women. We previously found that 6 months of approxi-
.
mately 40% of VO2max training in sedentary 60- to 69-
year-old men and women did not alter body weight or com-
Although the weaknesses inherent with food records are
well documented, they still represent the most valid and
least intrusive means of quantifying dietary habits in a free-
living population. Bearing in mind the limitations of food
records, it is clear that the different groups of women had
similar daily intakes of dietary constituents that could influence
body fat and lean body mass stores. Further, the athletes had
higher daily energy and carbohydrate intakes, differences
that clearly would not result in lower total body or regional
fat stores. Thus, our data provide no evidence that habitual
dietary intakes contributed substantially to the body compo-
sition differences evident between these groups of women.
In summary, high-intensity endurance exercise training in
postmenopausal women is associated with lower total body
and regional percent fat values, including the trunk region,
compared with sedentary women of the same age. However,
women taking part in low- to moderate-intensity exercise had
total and regional body compositions no different from those
of sedentary women. HRT use exhibited a nonsignificant ten-
dency to be associated with lower total body and regional
percent fat values, perhaps most importantly indicating that
numerous years of high-intensity endurance training had a
greater effect on total and regional body fat values than
HRT. Dietary constituents known to affect body composi-
tion did not differ among the groups, which suggests that di-
etary habits did not play a substantive role in the body com-
position differences among the groups.
position, whereas an additional 6 months of 70%–85%
.
VO2max training in these same men and women resulted in
significant percent body fat and body weight reductions
(18). In another study in 60- to 69-year-old hypertensive men,
.
9 months of training at 70%–85% VO2max decreased body
.
weight, but 9 months of training at 50% VO2max did not
.
(19). We also found that 6 months of 75%–85% VO2max
training in healthy 70- to 79-year-old men and women re-
sulted in a significant decrease in body fat (20). On the other
.
hand, 6 months of 46% VO2max training followed by an-
.
other 6 months of 57% VO2max training did not change
body weight or composition in 50ϩ-year-old hypertensive
men and women (21). However, these longitudinal inter-
vention studies generally employed exercise programs that
lasted only 6–12 months, and they did not address the possi-
bility that more prolonged periods of low- to moderate-
intensity training might have altered body composition. Our
data extend these findings substantially because they indi-
cate that the much longer (12 years) low- to moderate-inten-
sity physical activity program still was not associated with
lower levels of total body or regional percent fat values.
.
It is also clear from these data that VO2max expressed in
ml/kg/min is the primary determinant of all body composi-
tion variables. For total and regional body fat measures,
.
VO2max independently accounted for 52%–70% of the in-
.
terindividual variability. VO2max was the only independent
determinant of two of the five total and regional body fat
measures. The number of years of physical activity also was an
Acknowledgments
This research was supported by grants to James Hagberg from the Andrus
Foundation of the American Association of Retired Persons and from the
Pennsylvania Affiliate of the American Heart Association. Geoffrey Moore
was supported by the National Institutes of Health (NIH Grant K08
HL03029). This work was also supported by the University of Pittsburgh
General Clinical Research Center (NIH/NCRR/GCRC Grant 5M01
RR00056).
independent determinant of fat mass, but accounted for sub-
stantially less of the variance than VO2max. Years of physical
activity and duration of HRT were also significant independent
.
determinants of percent total body and percent trunk fat;
.
however, again VO2max accounted for, by far, the largest
portion of their variances. These results lend further support to
Address correspondence to James Hagberg, PhD, Department of Kine-
siology, University of Maryland, College Park, MD 20742-2611. E-mail:
jh103@umail.umd.edu
the conclusion that exercise programs that are associated with
.
higher levels of VO2max (only the high-intensity prolonged
training of the athletes in the present study) are associated
with lower levels of total body, trunk, arm, and leg fat.
The estrogen deficiency that is evident following meno-
pause in women is generally associated with an increase in
total body and, more importantly, trunk fat (1,2). A number of
cross-sectional and longitudinal studies indicate that estrogen
replacement in postmenopausal women generally blunts the
total body and trunk fat gains evident after menopause (5).
In the present study, HRT was associated with nonsignificant
trends for lower total body and regional percent fat values.
The lack of statistical significance for the effect of HRT on
body composition in the present study is undoubtedly due to
the relatively small number of subjects in each group; previous
studies reporting significant effects of HRT on body com-
position in postmenopausal women had substantially larger
sample sizes. However, because the same sample sizes were
available to assess the association between different habitual
physical activity levels and total and regional body fat values,
References
1. Stefanick ML. The roles of obesity, regional adiposity, and physical
activity in coronary heart disease in women. In: Wenger NK, Packard
B, eds. Cardiovascular Health and Disease in Women. Greenwich,
CT: Le Jacq Communications; 1993:149–156.
2. Wing RR, Matthews KA, Kuller LH, et al. Waist to hip ratio in mid-
dle-aged women: associations with behavioral and psychological
factors and with changes in cardiovascular risk factors. Arterioscler
Thromb. 1991;11:1250–1257.
3. Schroll M. A longitudinal epidemiologic survey of relative weight at
age 25, 50, and 60 in Glostrup population of men and women born in
1914. Dan Med Bull. 1981;28:106–116.
4. Kannel WB, Cupples LA, Ramaswami R, et al. Regional obesity and
risk of cardiovascular disease: the Framingham Study. J Clin Epide-
miol. 1991;44:183–190.
5. Hassager C, Christiansen C. Estrogen/gestagen therapy changes soft
tissue body composition in postmenopausal women. Metabolism.
1989;38:662–665.
6. Hagberg J, Allen W, Seals D, et al. A hemodynamic comparison of

M612
HAGBERG ET AL.
young and older endurance athletes during exercise. J Appl Physiol.
1985;58:2041–2046.
15. Pate R, Pratt M, Blair S, et al. Physical activity and public health.
JAMA. 1995;273:402–407.
7. Seals D, Hagberg J, Allen W, et al. Glucose tolerance in young and
older athletes and sedentary men. J Appl Physiol. 1984;56:1521–1525.
8. Seals D, Allen W, Hurley B, et al. Elevated high-density lipoprotein
cholesterol levels in older endurance athletes. Am J Cardiol. 1984;54:
390–393.
9. Stevenson E, Davy K, Seals D. Hemostatic, metabolic, and androgenic
risk factors for coronary heart disease in physically active and less ac-
tive postmenopausal women. Arterioscler Thromb. 1995;15:669–677.
10. Wells CL, Boorman MA, Riggs DM. Effect of age and menopausal
status on cardiorespiratory fitness in masters women runners. Med Sci
Sports Exerc. 1992;24:1147–1154.
11. Green JS, Crouse SF, Rohack JJ, et al. Peak exercise hemodynamics in
exercising postmenopausal women taking versus not taking supple-
mental estrogen. Med Sci Sports Exerc. 1998;30:158–164.
12. Kohrt WM, Malley MT, Dalsky GP, et al. Body composition of
healthy sedentary and trained, young and older men and women. Med
Sci Sports Exerc. 1992;24:832–837.
16. McCole SD, Brown MD, Moore GE, et al. Enhanced cardiovascular
hemodynamics in endurance-trained postmenopausal women. J Appl
Physiol. 1999;87:2334–2340.
17. Mazess R, Barden H, Bisek J, et al. Dual energy x-ray absorptiometry
for total body and regional bone mineral and soft tissue composition.
Am J Clin Nutr. 1990;51:1106–1112.
18. Seals D, Hagberg J, Hurley B, et al. Endurance training in older men
and women. I. Cardiovascular responses to exercise. J Appl Physiol.
1984;57:1024–1029.
19. Hagberg J, Montain S, Martin W, et al. Effect of exercise training on
60 to 69 year old persons with essential hypertension. Am J Cardiol.
1989;64:348–353.
20. Hagberg J, Graves J, Limacher M, et al. Cardiovascular responses of
70-79 year old men and women to exercise training. J Appl Physiol.
1989;66:2589–2594.
21. Seals D, Reiling M. Effect of regular exercise on 24-hour arterial pres-
sure in older hypertensive humans. Hypertension. 1991;18:583–592.
13. Van Pelt RE, Davy KP, Stevenson ET, et al. Smaller differences in to-
tal and regional adiposity with age in women who regularly perform
endurance exercise. Am J Physiol. 1998;275:E626–E634.
14. Ryan AS, Nicklas BJ, Elahi D. A cross-sectional study on body com-
position and energy expenditure in women athletes during aging. Am J
Physiol Endocrinol Metab. 1996;34:E916–E921.
Received September 14, 1999
Accepted January 20, 2000
Decision Editor: William B. Ershler, MD