Introduction: Cardiovascular disease affects a greater proportion of females than it does males, and is responsible for an estimated 52 percent of female deaths per annum, globally. Due to the loss of oestrogen associated with the menopause, post-menopausal females are at elevated risk for hypercholesterolaemia which is a primary risk factor for cardiovascular disease. It has not yet been conclusively established whether resistance training can be used to ameliorate hypercholesterolaemia. Aim: This randomized controlled trial investigated what effect 12 weeks of progressive resistance training would have on plasma lipoproteins in a sample of post-menopausal females. Methods: Caucasian women (n=30 intervention and n=18 control) between the ages of 55 and 65 years who were not taking hormone replacement therapy were recruited. Participants did not smoke, were sedentary, were not taking any form of cholesterol-lowering medication, had at least one cholesterol abnormality at baseline but were otherwise healthy and able to participate in a strength training programme. Following extensive medical pre-screening, information dissemination and voluntary consent, the sample was divided into two groups. The exercise sample undertook 12 weeks of resistance training on five days of the week. The control group received no intervention. Measurements were obtained at baseline and every four weeks thereafter and included measures of strength, biochemistry (oestradiol, testosterone, full blood lipid profile, glycated haemoglobin and sex hormone binding globulin), anthropometry, morphology and self-reports (dietary intake, energy expenditure and the profile of mood states questionnaire). Results: There was no change to low density lipoprotein cholesterol, high density lipoprotein cholesterol, triglyceride content or total cholesterol as a result of the intervention. Back, chest and leg strength increased significantly (p<0.01) (increases of 51 percent, 35 percent and 43 percent respectively from baseline); waist circumference dropped (p<0.01) by 5 percent overall and diastolic blood pressure decreased significantly (-9 percent, p<0.01) in the exercise cohort but no change was noted in the matched control. Dietary intake, energy expenditure and body mass remained unchanged in both samples. Morphology (sum of skinfolds, estimated body fat content and girth measures) did not change and nor did other biochemical measures (HbA1c and sex hormone binding globulin) or hormone levels (oestradiol and testosterone). Despite the lack of overall change, an important finding was noted in individual results where a clear indication of ‘responders’ and ‘non-responders’ emerged. Conclusion: Overall mean results suggest that 12 weeks resistance training undertaken five days of the week was ineffective in reducing hypercholesterolaemia in this sample. Despite there being no identifying characteristics determined in this sample, evidence of responders and non-responders to the intervention indicates that reliance on mean data may not be sufficient when analysing data from exercise interventions. Therefore, while progressive resistance training had a positive effect on strength, waist circumference and diastolic blood pressure, it did not positively influence the plasma lipoproteins in this cohort of post-menopausal women. / Maiden name: Kelly, Janet Erica

The main purpose of this study was to assess the effect of progressive resistance training on the blood lipid profile in post-menopausal women. Thirty-four female subjects aged 50 to 75 years were selected from the population of Grahamstown, South Africa. All participants were previously sedentary and possessed at least one lipid profile abnormality but were otherwise healthy. Pre-tests included a sub-maximal stress Electrocardiogram, measures of stature, mass, central and limb girths as well as an oral glucose tolerance test (OGTT) and a total blood lipid profile. Participants took part in a 24-week progressive resistance training programme, consisting of three supervised sessions per week, each lasting 45 minutes and were not permitted to lose more than 10% of initial body mass during the 24-week study. All pre-test measures, excluding the stress ECG and the OGTT, were repeated every four weeks for the duration of the study. Results were that body mass, body mass index and waist-to-hip ratio did not change. Girth measures at mid-humerus, chest, waist, hip, mid-quadricep and mid-gastrocnemius all decreased significantly (p=0.05). LDL-cholesterol increased significantly over the course of 24 weeks (3.61mmol.L-1 to 4.07mmol.L-1) as did total cholesterol (5.81mmol.L-1 to 6.24mmol.L-1). Triglyceride concentration remained unchanged and HDL-cholesterol decreased significantly between the pre-test measure (1.55mmol.L-1) and the measure after six months (1.42mmol.L-1). It can be concluded that the blood lipid profile in a sample of post-menopausal women was not positively affected by a progressive resistance training programme over a 24 week period. / Maiden name: Kelly, Janet Erica

Pau King-man. / Thesis submitted in: October 2001. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2002. / Includes bibliographical references (leaves 173-181). / Abstracts in English and Chinese. / Acknowledgements --- p.i / Abstract --- p.ii / Abstract (Chinese version) --- p.iii / Table of Contents --- p.iv / List of Figures --- p.xii / List of Tables --- p.xiii / List of Abbreviations --- p.xxiv / Chapter CHAPTER ONE: --- INTRODUCTION / Chapter 1.1 --- Women's Overweight and Obesity Prevalence and Trends --- p.1 / Chapter 1.2 --- Etiology of Overweight and Obesity --- p.2 / Chapter 1.3 --- Health Consequences of Obesity in Women --- p.4 / Chapter 1.4 --- Dietary and Physical Activity Recommendations for Good Health for Adults --- p.6 / Chapter 1.5 --- Health Behavior Change Theories --- p.8 / Chapter 1.6 --- Weight Control/Loss Interventions for Women --- p.10 / Chapter 1.7 --- Weight Loss Risks --- p.11 / Chapter 1.8 --- Health Promotion Programs for Women --- p.12 / Chapter 1.9 --- General Situation and Population Trends Among Hong Kong Middle- aged Women --- p.15 / Chapter 1.10 --- Nutrition-related Morbidity and Mortality Among Hong Kong Women --- p.16 / Chapter 1.11 --- Diet Composition of Hong Kong Middle-aged Women --- p.20 / Chapter 1.12 --- Physical Activity Patterns of Hong Kong Middle-aged Women --- p.21 / Chapter 1.13 --- Education and Health in Hong Kong Middle-aged Women --- p.23 / Chapter 1.14 --- Attitudes Toward and Beliefs About Diet and Health of Hong Kong Middle-aged Women --- p.24 / Chapter 1.15 --- Common Weight Loss Methods Among Hong Kong Middle-aged Women --- p.25 / Chapter 1.16 --- Sources of Health Information Among Hong Kong Middle-aged Women --- p.25 / Chapter 1.17 --- Summary --- p.26 / Chapter 1.18 --- Study Purpose and Objectives --- p.26 / Chapter CHAPTER TWO: --- METHODOLOGY / Chapter 2.1 --- Recruitment of Participants --- p.29 / Chapter 2.2 --- Focus Groups --- p.29 / Chapter 2.3 --- Survey Instrument --- p.30 / Chapter 2.3.1 --- Questionnaire --- p.30 / Chapter 2.3.2 --- Three-day Dietary Record --- p.35 / Chapter 2.3.3 --- Anthropometric and Cholesterol Measurements --- p.35 / Chapter 2.4 --- Intervention --- p.37 / Chapter 2.5 --- Evaluation --- p.39 / Chapter 2.5.1 --- Process Evaluation --- p.39 / Chapter 2.5.2 --- Outcome Evaluation --- p.40 / Chapter 2.6 --- Data Management --- p.40 / Chapter 2.7 --- Statistics --- p.40 / Chapter 2.8 --- Data Analysis --- p.41 / Chapter 2.8.1 --- Physical Activity Patterns --- p.41 / Chapter 2.8.2 --- Dietary Patterns --- p.44 / Chapter 2.8.3 --- Nutrition Knowledge Score --- p.45 / Chapter 2.8.4 --- Physical Activity Knowledge Score --- p.46 / Chapter 2.8.5 --- Blood Total Cholesterol --- p.46 / Chapter 2.8.6 --- Body Mass Index --- p.47 / Chapter 2.8.7 --- Percent Body Fat --- p.47 / Chapter 2.9 --- Ethics --- p.47 / Chapter CHAPTER THREE: --- RESULTS / Chapter 3.1 --- Focus Group Results --- p.43 / Chapter 3.1.1 --- General Description of Participants --- p.48 / Chapter 3.1.2 --- Perceived Values and Views on 'Health' --- p.50 / Chapter 3.1.3 --- Perceived Values and Views on 'Healthy Lifestyle' --- p.51 / Chapter 3.1.4 --- Perceived Values and Views on 'Healthy Eating' --- p.52 / Chapter 3.1.5 --- Perceived Values and Views on 'Physical Activity' --- p.53 / Chapter 3.1.6 --- The Factors Motivating the Women to Adopt a Healthy Lifestyle --- p.53 / Chapter 3.1.7 --- Sources of Information About Healthy Eating and Physical Activity --- p.55 / Chapter 3.1.8 --- Suggestions for the Type and Content of Activities in a Health Promotion Program --- p.55 / Chapter 3.2 --- Participation Rate in the Study --- p.56 / Chapter 3.3 --- Pretest --- p.57 / Chapter 3.3.1 --- General Participant Sociodemographic Description --- p.57 / Chapter 3.3.2 --- Anthropometry --- p.59 / Chapter 3.3.3 --- Health Conditions Reported --- p.60 / Chapter 3.3.4 --- Meal Patterns --- p.61 / Chapter 3.3.5 --- Nutrient Supplements Practices --- p.62 / Chapter 3.3.6 --- Cooking Practices --- p.63 / Chapter 3.3.7 --- Food Removal Behavior --- p.65 / Chapter 3.3.8 --- Food Label Reading --- p.65 / Chapter 3.3.9 --- Dietary Intake --- p.66 / Chapter a. --- From the Three-day Dietary Records --- p.66 / Chapter b. --- From the Food Frequency Questionnaire --- p.68 / Chapter 3.3.10 --- Nutrition Knowledge --- p.69 / Chapter 3.3.11 --- Physical Activity Habits --- p.72 / Chapter 3.3.12 --- Physical Activity Knowledge --- p.73 / Chapter 3.3.13 --- Intention and Confidence in Changing Behavior --- p.76 / Chapter 3.3.14 --- Perceived Difficulties in Changing Behavior --- p.77 / Chapter 3.3.15 --- Perceived Methods Facilitating Behavior Change --- p.79 / Chapter 3.3.16 --- Health Information Desired --- p.80 / Chapter 3.3.17 --- Areas of Health the Women Would Like to Improve --- p.81 / Chapter 3.3.18 --- Summary Profile of the Women at Pretest --- p.82 / Chapter 3.4 --- Outcome Evaluation --- p.85 / Chapter 3.5 --- Posttest --- p.85 / Chapter 3.5.1 --- General Participant Sociodemographic Description --- p.85 / Chapter 3.5.2 --- Anthropometry --- p.86 / Chapter 3.5.3 --- Health Conditions Reported --- p.87 / Chapter 3.5.4 --- Meal Patterns --- p.88 / Chapter 3.5.5 --- Nutrient Supplements Practices --- p.89 / Chapter 3.5.6 --- Cooking Practices --- p.90 / Chapter 3.5.7 --- Food Removal Behavior --- p.91 / Chapter 3.5.8 --- Food Label Reading --- p.91 / Chapter 3.5.9 --- Dietary Intake --- p.93 / Chapter a. --- From the Three-day Dietary Records --- p.93 / Chapter b. --- From the Food Frequency Questionnaire --- p.94 / Chapter 3.5.10 --- Nutrition Knowledge --- p.95 / Chapter 3.5.11 --- Physical Activity Habits --- p.98 / Chapter 3.5.12 --- Physical Activity Knowledge --- p.99 / Chapter 3.5.13 --- Analysis the Changes by Education Level --- p.102 / Chapter 3.5.14 --- Analysis the Changes by Age Group --- p.104 / Chapter 3.5.15 --- Intention and Confidence in Changing Behavior --- p.105 / Chapter 3.5.16 --- Perceived Difficulties in Changing Behavior --- p.107 / Chapter 3.5.17 --- Perceived Methods Facilitating Behavior Change --- p.109 / Chapter 3.5.18 --- Health Information Desired --- p.110 / Chapter 3.5.19 --- Areas of Health the Women Would Like to Improve --- p.111 / Chapter 3.5.20 --- Summary Profile of the Women at Posttest --- p.112 / Chapter 3.6 --- Participants' Evaluation of the Intervention Program --- p.113 / Chapter 3.7 --- Follow-up --- p.118 / Chapter 3.7.1 --- General Participant Sociodemographic Description --- p.118 / Chapter 3.7.2 --- Anthropometry --- p.118 / Chapter 3.7.3 --- Health Conditions Reported --- p.121 / Chapter 3.7.4 --- Meal Patterns --- p.121 / Chapter 3.7.5 --- Nutrient Supplements Practices --- p.122 / Chapter 3.7.6 --- Cooking Practices --- p.123 / Chapter 3.7.7 --- Food Removal Behavior --- p.125 / Chapter 3.7.8 --- Food Label Reading --- p.126 / Chapter 3.7.9 --- Dietary Intake --- p.127 / Chapter a. --- From the Three-day Dietary Records --- p.127 / Chapter b. --- From the Food Frequency Questionnaire --- p.129 / Chapter 3.7.10 --- Nutrition Knowledge --- p.131 / Chapter 3.7.11 --- Physical Activity Habits --- p.135 / Chapter 3.7.12 --- Physical Activity Knowledge --- p.136 / Chapter 3.7.13 --- Intention and Confidence in Changing Behavior --- p.140 / Chapter 3.7.14 --- Analysis the Changes by Education Level --- p.142 / Chapter 3.7.15 --- Analysis the Changes by Age Group --- p.143 / Chapter 3.7.16 --- Perceived Difficulties in Changing Behavior --- p.144 / Chapter 3.7.17 --- Perceived Methods Facilitating Behavior Change --- p.145 / Chapter 3.7.18 --- Health Information Desired --- p.148 / Chapter 3.7.19 --- Areas of Health the Women Would Like to Improve --- p.149 / Chapter 3.7.20 --- Summary Profile of the Women at Follow-up --- p.150 / Chapter CHAPTER FOUR: --- DISCUSSION / Chapter 4.1 --- Implications of Findings --- p.154 / Chapter 4.1.1 --- Current Situations in Diet and Physical Activity of Hong Kong Middle-aged Women --- p.154 / Chapter 4.1.2 --- Overall Effects of the Program --- p.161 / Chapter a. --- Changes in Knowledge --- p.161 / Chapter b. --- Changes in Awareness and Intention --- p.163 / Chapter c. --- Changes in Behavior --- p.164 / Chapter d. --- Changes in Anthropometery --- p.166 / Chapter 4.2 --- Strengths and Limitations of the Study --- p.167 / Chapter 4.3 --- Implications and Recommendations for Meeting the Challenges of Improving Hong Kong Middle-aged Women's Nutrition and Physical Activity Habits --- p.169 / Chapter 4.4 --- Suggestions for Future Research --- p.170 / Chapter CHAPTER FIVE: --- CONCLUSIONS --- p.172 / References --- p.173 / Appendices / Chapter A --- Consent form (Chinese version) --- p.182 / Chapter B --- Consent form (English version) --- p.183 / Chapter C --- Questionnaire (Chinese version) --- p.184 / Chapter D --- Questionnaire (English version) --- p.196 / Chapter E --- Photos for food amount quantities and household measures (Chinese version) --- p.210 / Chapter F --- Photos for food amount quantities and household measures (English version) --- p.213 / Chapter G --- Sample of dietary record (Chinese version) --- p.216 / Chapter H --- Sample of dietary record (English version) --- p.217 / Chapter I --- Three-day dietary record (Chinese version) --- p.218 / Chapter J --- Three-day dietary record (English version) --- p.221 / Chapter K --- Pamphlets for health talks (Chinese version) --- p.224 / Chapter L --- Pamphlets for health talks (English version) --- p.236 / Chapter M --- Pamphlets for physical activity demonstration (Chinese version) --- p.248 / Chapter N --- Pamphlets for physical activity demonstration (English version) --- p.253 / Chapter O --- Process evaluation questionnaire (Chinese version) --- p.258 / Chapter P --- Process evaluation questionnaire (English version) --- p.260 / Chapter Q --- Overall evaluation questionnaire (Chinese version) --- p.262 / Chapter R --- Overall evaluation questionnaire (English version) --- p.263 / Chapter S --- Focus group questionnaire (Chinese version) --- p.264 / Chapter T --- Focus group questionnaire (English version) --- p.265 / Chapter U --- Focus group question guides (Chinese version) --- p.266 / Chapter V --- Focus group question guides (English version) --- p.268 / Chapter W --- The food consumption patterns of women in the Education and Control Groups --- p.270