More and more young women are overweight
(Vienna, 6th March 2015) More and more young women are markedly overweight - due to their lifestyle and as a result of environmental factors, but also because they tend towards insulin resistance and weight gain in certain stages of their lives due to hormones, for example during puberty, but also during pregnancy and during the menopause. This is also associated with secondary conditions such as diabetes, altered blood lipid levels and also the increased risk of cardiovascular disease. These are the words of the Head of the Gender Medicine Unit at the MedUni Vienna, Alexandra Kautzky-Willer, on the occasion of International Women's Day next Sunday (8th March 2015).
Visceral and liver fat remain under-estimated as a risk factor in women - unlike in the treatment of overweight men, says the expert in endocrinology and metabolic medicine. Abdominal circumference actually has greater predictive merit for complications such as diabetes in women than it does in men. So it is important to think about glucose tolerance testing very early in overweight women, especially before or during pregnancy, in order to stratify the risk of diabetes, since women who are pregnant and overweight are increasingly becoming insulin resistant.
But also to detect any deficiencies of key vitamins or trace elements: "Many women who are overweight still lack certain vitamins such as vitamin D, but also folic acid or iodine, which can impair foetal brain development during pregnancy," says Kautzky-Willer, who carries out research through her EU project "DALI" (Vitamin D and Lifestyle Intervention for Gestational Diabetes Mellitus Prevention), which is led by the MedUni Vienna, into effective preventative measures for gestational diabetes.
Breaking the negative cycle
Every preventative measure can help, stresses Kautzky-Willer: "It's always worth changing your lifestyle and switching to healthy nutrition and more exercise - the earlier the better - but even when people are massively overweight or at the start of pregnancy." Lifestyle and environmental factors have a major role to play in obesity. It was discovered in recent studies, for example, that the environment in which we live, as well as lack of sleep, stress and shift work, represent a high risk for weight gain, especially for women.
Says Kautzky-Willer: "Chronic stress causes complex changes in the hormone balance and in women especially can often lead to stress-induced hunger and eating episodes that ultimately cause excess weight gain. Overweight women also suffer more frequently from anxiety and depression and also often have to battle secondary conditions such as diabetes, which then impair their quality of life further. These negative cycles need to be broken." This is because the risk of cardiovascular disease such as a heart attack or stroke is also strongly associated with being overweight and depression, especially in women.
Gender-separate prevention programmes are particularly effective
Prevention programmes are therefore very important. Says Kautzky-Willer: "Recent international studies have illustrated that gender-separate programmes yield better results in terms of motivating overweight men to lose weight and exercise together in a football club, for example."
The same also applies to overweight women, who tend to stick together in similar groups - as was the case, for example, in the cooperation project between the MedUni Vienna, led by Kautzky-Willer, and the "la Pura - women's health resort kamptal" and the international healthcare services provider VAMED. At this health resort designed exclusively for women, the emphasis lies on prevention, individual risk analysis with integrated glucose tolerance test, relaxation, healthy nutrition including healthy fasting programmes, exercise, sport and personalised therapy under medical supervision and with gender-specific aspects taken into account.
A recent international study involving input from the MedUni Vienna's Clinical Department of Endocrinology and Metabolic Medicine (University Department of Internal Medicine III) discovered, for example, that there are gender-specific differences in blood glucose control in relation to hypoglycaemia - especially during insulin treatment. "This means that particular care needs to be taken, especially in women, to ensure that the dose of insulin is adjusted according to their weight, and that the balance between blood glucose control and the risk of hypoglycaemia is optimised."
Service: Diabetes, Obesity & Metabolism
„Gender-based differences in glycaemic control and hypoglycaemia prevalence in patients with type 2 diabetes: results from patient-level pooled data of six randomised controlled trials.“ A. Kautzky-Willer, L. Kosi, J. Lin, R. Mihajlevic. Diabetes Obes Metab. 2015 Feb 12. doi: 10.1111/dom.12449.