Menopause: The Journal of The North American Menopause Society Vol. 22, No. 3, pp. 304/311 DOI: 10.1097/gme.0000000000000315 * 2014 by The North American Menopause Society
Feelings of energy are associated with physical activity and sleep quality, but not adiposity, in middle-aged postmenopausal women Christie L. Ward-Ritacco, PhD,1 Amanda L. Adrian, PhD,1 Patrick J. O’Connor, PhD,1 Jessica A. Binkowski, MS,1 Laura Q. Rogers, MD, MPH,2 Mary Ann Johnson, PhD,3 and Ellen M. Evans, PhD1 Abstract Objective: Feelings of fatigue and low energy are widespread among middle-aged women and have been shown to negatively affect quality of life. The aim of the present study was to examine the associations among adiposity, physical activity, and feelings of fatigue and energy in postmenopausal women. Methods: Postmenopausal women (N = 74; mean [SD] age, 58.9 [3.8] y) were assessed for adiposity (via dualenergy x-ray absorptiometry), steps per day, minutes of moderate to vigorous physical activity per day (via an accelerometer), prior week intensity of psychological vigor (via the Profile of Mood StatesVShort Form), and prior month frequency of energy feelings (via the vitality scale of the 36-item Medical Outcomes SurveyVShort Form). Sleep quality was measured using the Pittsburgh Sleep Quality Index, depression was measured using the Beck Depression Inventory-II, and perceived stress was measured using the Perceived Stress Scale. Results: Adiposity was negatively related to steps per day (r = j0.55, P G 0.05) and minutes of moderate to vigorous physical activity per day (r = j0.48, P G 0.05). Adiposity was not significantly related to vigor, vitality, or any other psychological measures. Greater vitality was associated with lower total number of medications (r = j0.31, P G 0.01), more steps per day (r = 0.28, P G 0.05), and higher minutes of moderate to vigorous physical activity per day (r = 0.37, P G 0.01). Prior week feelings of vigor were unrelated to any variable of interest. Regression analyses revealed that minutes of moderate to vigorous physical activity per day independently explained 8% of the variance in vitality, whereas sleep quality was also a significant predictor of vitality (both P G 0.05). Conclusions: Engaging in recommended amounts of moderate to vigorous physical activity per day is associated with higher monthly frequency of energy feelings, regardless of adiposity status, in middle-aged postmenopausal women. Key Words: 36-Item Medical Outcomes SurveyVShort Form Y Profile of Mood StatesVShort Form Y Fatigue Y Vitality Y Vigor Y Adiposity Y Physical activity.
F
eelings of low energy and fatigue are a public health concern, as the general population reports fatigue to their primary care physicians in 7% to 45% of visits.1 In adults aged 18 to 45 years who presented with fatigue as a first-time single complaint, 70% were women and only 27% were given an explanatory diagnosis (common diagnoses included anemia, vitamin B12 deficiency, infectious disease, anxiety, and depression).2 Fatigue is also one of the most
Received May 6, 2014; revised and accepted July 1, 2014. From the 1Department of Kinesiology, University of Georgia, Athens, GA; 2Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL; and 3Department of Foods and Nutrition, University of Georgia, Athens, GA. Funding/support: This study was funded, in part, by US Department of Agriculture Hatch grant GEO 00708 to M.A.J. Financial disclosure/conflicts of interest: M.A.J. is currently receiving funding from the US Department of Agriculture. C.L.W.-R., A.L.A., P.J.O’C., J.A.B., E.M.E., and L.Q.R. have no conflicts of interest or financial disclosures to declare. Address correspondence to: Christie L. Ward-Ritacco, PhD, Ramsey Student Center, Department of Kinesiology, University of Georgia, 330 River Rd, Athens, GA 30602. E-mail: [email protected]
304
common symptoms reported by middle-aged postmenopausal women.3,4 Recently, the Centers for Disease Control and Prevention reported that women were more likely than men to report Boften feeling very tired or exhausted on most days or every day over the past 3 months[ and that women aged 45 to 64 years were most likely to report Boften feeling very tired or exhausted.[5 Fatigue and feelings of low energy, along with sleep disturbances and anxiety, have been shown to significantly affect quality of life in postmenopausal women.4 Women in this age group are susceptible to feelings of low energy, as midlife is often a time when women are faced with a number of responsibilities and challenges in a variety of domains, including those related to employment and family.6,7 The physiological and psychological consequences of menopause also coincide with this time of life, and the menopausal transition is associated with decreases in physical activity (PA), increases in body weight and adiposity, and emergence of chronic disease conditions,6 all of which may contribute to feelings of low energy and fatigue. A growing body of literature suggests that increased levels of PA and adoption of regular programs of exercise are
Menopause, Vol. 22, No. 3, 2015
Copyright © 2015 The North American Menopause Society. Unauthorized reproduction of this article is prohibited.
VITALITY, VIGOR, ADIPOSITY, PHYSICAL ACTIVITY
associated with lower feelings of fatigue and greater feelings of energy. It has been reported that physically active adults have a 40% reduced risk of reporting feelings of fatigue and low energy compared with their sedentary peers,8 and that habitual exercise programs increase feelings of energy and decrease feelings of fatigue as effectively as, if not more than, drug treatment and cognitive-behavioral therapy.9 Specifically in middle-aged women, increasing amounts of PA have been associated with increases in feelings of energy, as assessed by the vitality scale of the 36-item Medical Outcomes SurveyV Short Form (SF-36).10 In addition, a 6-month randomized control trial conducted with sedentary overweight and obese postmenopausal women found that feelings of vitality significantly improved from baseline in all exercise groups compared with the control group, independent of changes in weight, and those women who were exposed to the highest dose of exercise experienced the greatest improvement in vitality.11 Although strong evidence for the relationship between PA and feelings of energy continues to accumulate, the independent effects of adiposity and/or the interactive effects of PA and adiposity on feelings of energy and fatigue are less well characterized. Obesity, classified by body mass index (BMI), has been shown to be associated with poorer health-related quality of life in adults,12,13 including lower feelings of energy and vitality.14
Feelings of energy are associated with physical activity and sleep quality, but not adiposity, in middle-aged postmenopausal women Christie L. Ward-Ritacco, PhD,1 Amanda L. Adrian, PhD,1 Patrick J. O’Connor, PhD,1 Jessica A. Binkowski, MS,1 Laura Q. Rogers, MD, MPH,2 Mary Ann Johnson, PhD,3 and Ellen M. Evans, PhD1 Abstract Objective: Feelings of fatigue and low energy are widespread among middle-aged women and have been shown to negatively affect quality of life. The aim of the present study was to examine the associations among adiposity, physical activity, and feelings of fatigue and energy in postmenopausal women. Methods: Postmenopausal women (N = 74; mean [SD] age, 58.9 [3.8] y) were assessed for adiposity (via dualenergy x-ray absorptiometry), steps per day, minutes of moderate to vigorous physical activity per day (via an accelerometer), prior week intensity of psychological vigor (via the Profile of Mood StatesVShort Form), and prior month frequency of energy feelings (via the vitality scale of the 36-item Medical Outcomes SurveyVShort Form). Sleep quality was measured using the Pittsburgh Sleep Quality Index, depression was measured using the Beck Depression Inventory-II, and perceived stress was measured using the Perceived Stress Scale. Results: Adiposity was negatively related to steps per day (r = j0.55, P G 0.05) and minutes of moderate to vigorous physical activity per day (r = j0.48, P G 0.05). Adiposity was not significantly related to vigor, vitality, or any other psychological measures. Greater vitality was associated with lower total number of medications (r = j0.31, P G 0.01), more steps per day (r = 0.28, P G 0.05), and higher minutes of moderate to vigorous physical activity per day (r = 0.37, P G 0.01). Prior week feelings of vigor were unrelated to any variable of interest. Regression analyses revealed that minutes of moderate to vigorous physical activity per day independently explained 8% of the variance in vitality, whereas sleep quality was also a significant predictor of vitality (both P G 0.05). Conclusions: Engaging in recommended amounts of moderate to vigorous physical activity per day is associated with higher monthly frequency of energy feelings, regardless of adiposity status, in middle-aged postmenopausal women. Key Words: 36-Item Medical Outcomes SurveyVShort Form Y Profile of Mood StatesVShort Form Y Fatigue Y Vitality Y Vigor Y Adiposity Y Physical activity.
F
eelings of low energy and fatigue are a public health concern, as the general population reports fatigue to their primary care physicians in 7% to 45% of visits.1 In adults aged 18 to 45 years who presented with fatigue as a first-time single complaint, 70% were women and only 27% were given an explanatory diagnosis (common diagnoses included anemia, vitamin B12 deficiency, infectious disease, anxiety, and depression).2 Fatigue is also one of the most
Received May 6, 2014; revised and accepted July 1, 2014. From the 1Department of Kinesiology, University of Georgia, Athens, GA; 2Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL; and 3Department of Foods and Nutrition, University of Georgia, Athens, GA. Funding/support: This study was funded, in part, by US Department of Agriculture Hatch grant GEO 00708 to M.A.J. Financial disclosure/conflicts of interest: M.A.J. is currently receiving funding from the US Department of Agriculture. C.L.W.-R., A.L.A., P.J.O’C., J.A.B., E.M.E., and L.Q.R. have no conflicts of interest or financial disclosures to declare. Address correspondence to: Christie L. Ward-Ritacco, PhD, Ramsey Student Center, Department of Kinesiology, University of Georgia, 330 River Rd, Athens, GA 30602. E-mail: [email protected]
304
common symptoms reported by middle-aged postmenopausal women.3,4 Recently, the Centers for Disease Control and Prevention reported that women were more likely than men to report Boften feeling very tired or exhausted on most days or every day over the past 3 months[ and that women aged 45 to 64 years were most likely to report Boften feeling very tired or exhausted.[5 Fatigue and feelings of low energy, along with sleep disturbances and anxiety, have been shown to significantly affect quality of life in postmenopausal women.4 Women in this age group are susceptible to feelings of low energy, as midlife is often a time when women are faced with a number of responsibilities and challenges in a variety of domains, including those related to employment and family.6,7 The physiological and psychological consequences of menopause also coincide with this time of life, and the menopausal transition is associated with decreases in physical activity (PA), increases in body weight and adiposity, and emergence of chronic disease conditions,6 all of which may contribute to feelings of low energy and fatigue. A growing body of literature suggests that increased levels of PA and adoption of regular programs of exercise are
Menopause, Vol. 22, No. 3, 2015
Copyright © 2015 The North American Menopause Society. Unauthorized reproduction of this article is prohibited.
VITALITY, VIGOR, ADIPOSITY, PHYSICAL ACTIVITY
associated with lower feelings of fatigue and greater feelings of energy. It has been reported that physically active adults have a 40% reduced risk of reporting feelings of fatigue and low energy compared with their sedentary peers,8 and that habitual exercise programs increase feelings of energy and decrease feelings of fatigue as effectively as, if not more than, drug treatment and cognitive-behavioral therapy.9 Specifically in middle-aged women, increasing amounts of PA have been associated with increases in feelings of energy, as assessed by the vitality scale of the 36-item Medical Outcomes SurveyV Short Form (SF-36).10 In addition, a 6-month randomized control trial conducted with sedentary overweight and obese postmenopausal women found that feelings of vitality significantly improved from baseline in all exercise groups compared with the control group, independent of changes in weight, and those women who were exposed to the highest dose of exercise experienced the greatest improvement in vitality.11 Although strong evidence for the relationship between PA and feelings of energy continues to accumulate, the independent effects of adiposity and/or the interactive effects of PA and adiposity on feelings of energy and fatigue are less well characterized. Obesity, classified by body mass index (BMI), has been shown to be associated with poorer health-related quality of life in adults,12,13 including lower feelings of energy and vitality.14
