Résumé
L’augmentation de la prévalence de l’obésité, chez les femmes, joue un rôle prépondérant dans l’apparition du syndrome métabolique et des comorbidités associées. De plus, la ménopause s’accompagne de nombreux changements physiologiques dont une augmentation du poids et de la masse grasse abdominoviscérale reflétée par un accroissement de la circonférence de la taille, un des critères du syndrome métabolique selon le NCEP/ATP III. Ces changements relatifs à la distribution régionale de la graisse sont généralement associés à une détérioration du bilan lipidique-lipoprotéique, une élévation de la tension artérielle de repos, une résistance à l’insuline et/ou une intolérance au glucose, ainsi qu’à un profil pro-inflammatoire et thrombotique exacerbé. Dans les sociétés industrialisées où l’alimentation hyperlipidique et la sédentarité sont ancrées dans les habitudes de vie, l’activité physique semble être un facteur clé pour minimiser le gain de poids à la ménopause et ainsi diminuer l’incidence des maladies cardiovasculaires et du diabète de type 2 associés au syndrome métabolique. Dans ce contexte, l’entraînement en endurance et notamment la marche pratiquée à une intensité modérée (60–70 % de la \( \dot VO_2 \)max) à raison de 45 minutes par séance, trois à cinq fois par semaine, pendant une durée minimale de 12 semaines, associée ou non à une restriction calorique, diminue non seulement la masse grasse, la glycémie à jeun et l’hypertension artérielle, réduit l’inflammation chronique et le risque de thromboses, mais améliore également le profil lipidique-lipoprotéique et la sensibilité à l’insuline chez les femmes ménopausées. Un entraînement quotidien de durée et d’intensité modérées, comme la marche, semble donc être une stratégie pertinente visant à améliorer la santé cardiométabolique des femmes, à la ménopause.
Abstract
The increased prevalence of obesity is a key factor in the emergence of metabolic syndrome and its associated comorbidities in women. In addition, menopause is often accompanied by a number of physiological changes including increased body weight and increased visceral fat mass, which are reflected by an increase in waist circumference, one of the criteria for metabolic syndrome according to NCEP/ATP III. Moreover, changes in regional fat distribution observed at menopause are generally related to a deteriorated lipid-lipoprotein profile, elevated resting blood pressure, insulin resistance and/or glucose intolerance, as well as enhanced pro-inflammatory and thrombotic states. In industrialized societies characterized by hyperlipidic food and sedentary lifestyle, physical activity seems to be a key factor in minimizing weight gain associated with menopause and thereby decreasing the risk of developing cardiovascular diseases and type 2 diabetes, both associated with metabolic syndrome. Indeed, endurance training, and more particularly, walking for 45 minutes at a moderate intensity (60–70% of the \( \dot VO_2 \)max), 3–5 times/week, for a minimum of 12 weeks, combined or not with a diet, not only decreases fat mass, fasting glycaemia and hypertension, chronic inflammation state and thrombotic risk, but it also improves lipidlipoprotein indices and insulin sensitivity, in postmenopausal women. In conclusion, daily training, of moderate duration and intensity, such as active walking, seems to be a valuable strategy for improving the cardiometabolic risk profile of menopausal women.
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Riesco, E., Vallée, K., Tessier, S. et al. Impact de l’activité physique seule ou combinée à une diète sur le syndrome métabolique chez les femmes ménopausées. Obes 3, 177–183 (2008). https://doi.org/10.1007/s11690-008-0135-3
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DOI: https://doi.org/10.1007/s11690-008-0135-3