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Submitted on July 3, 2006
Accepted on December 18, 2006
Department of Epidemiology; University of Michigan School of Public Health; Ann Arbor, MI 48104
* To whom correspondence should be addressed. E-mail: mfsowers{at}umich.edu.
Context: Understanding the menopause association with body weight is important because excess weight increases risk for stroke, incident cardiovascular disease, cardiovascular mortality, and all-cause mortality among the middle-aged.
Objective: To examine chronological age and ovarian age and consider how these could influence body size and composition in mid-life women.
Design and Setting: The Study of Women's Health Across the Nation is a longitudinal, community-based study. This report uses data from the Michigan SWAN site.
Participants: 543 pre- or early perimenopausal African-American and Caucasian women aged 42-52 years at baseline examination.
Main Outcome Measures: Waist circumference, fat mass and skeletal muscle mass, from bioelectrical impedance, was assessed in 7 annual serial measures. Annual follicle-stimulating hormone (FSH) values were assayed by ELISA. The final menstrual period (FMP) was defined retrospectively following 12 months of amenorrhea.
Results: There was an absolute cumulative six-year increase in fat mass of 3.4 kg and a six-year decrease in skeletal muscle mass of 
0.23 kg. There was an absolute cumulative six-year increase of 5.7 cm in waist circumference. The logFSH change was positively correlated with log(fat mass) change. Waist circumference increased over the time period, but one year following FMP, the rate of increase slowed. Fat mass continued to increase with no change in rate.
Conclusions: Both time (chronological aging) and ovarian aging contributed to substantial changes in body composition (fat and skeletal muscle mass) and waist circumference. These changes have important ramifications for establishing a metabolic environment that can be healthy or unhealthy.
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