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Effective and sustainable lifestyle-interventions to reduce the risk of cardiovascular diseases for women from the menopause: a literature review.

Leemrijse, C., Vervloet, M., Dijk, L. van, Korevaar, J. Effective and sustainable lifestyle-interventions to reduce the risk of cardiovascular diseases for women from the menopause: a literature review. Archives of Women Health and Care: 2020, 3(2), p. 2-19.
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Background
Each year 2.2 million women in Europe die from cardiovascular diseases. The risk of cardiovascular diseases increases from the onset of the menopause and may be reduced by a healthy lifestyle. However, insight in sustainable, effective lifestyle interventions targeted at women around the menopause is lacking. The aim of this study is to find sustainable, effective lifestyle interventions to reduce cardiovascular risk for women (starting) from the menopause, and to investigate effective strategies to enhance adherence.

Methods
Literature search for controlled studies on lifestyle-interventions for women around the menopause, that reported positive effects on cardiovascular risks.

Results
Two dietary interventions, eight exercise programs, three combined programs and one health coaching intervention reported a reduction of cardiovascular risk. The type of diets varies, but common features are reduction of fat and calories and application of behavioral change techniques. The exercise programs apply different types of movement, but are in general supervised group programs. All dietary and exercise interventions are characterized by many contacts and professional guidance. Several strategies to improve treatment adherence are applied such as peer support, telephone calls for missed sessions, self-monitoring and incentives. In general, a high effort to keep women in the program seems to results in relatively good adherence.

Conclusion
Interventions that sustainably reduce cardiovascular risk factors for women starting from the menopause are characterized by intensive strategies such as strict diets, exercise programs with many weekly sessions, guidance by professionals and high efforts to increase adherence. It is the question whether these interventions, tested in a research setting, are applicable and attractive for a large population in daily practice. The challenge is to develop less intensive but sustainable effective interventions that require less strategies to guarantee adhere. Such interventions should be tailored to the specific needs and health problems of women from the menopause.