Rush University Medical Center develops WISHFIT program to help pre-menopausal women reduce visceral fat

Rush University Medical Center collaborates with Southside Chicago community for a sustained increase in physical activity and decrease in stress in pre-menopausal women

Under a $7.1 million grant from the National Institutes of Health, Rush University Medical Center is developing a novel program, called WISHFIT, to help pre-menopausal women reduce visceral fat through a sustained increase in physical activity and reduction in stress.

The program itself will be designed by both Rush researchers and women in two Southside Chicago communities, Beverly and Morgan Park. These communities were the subjects of studies over the past 15 years that found a link between the changing hormonal balance in the peri-menopausal years to the accumulation of visceral fat. Visceral fat has been shown to raise the risk of diabetes and cardiovascular disease.

"This is not a program that will be imposed on the community. It's not even a program that we are doing for the community. Rather, we will be involved with Southside women in a fully collaborative partnership," said Lynda Powell, PhD, chair of preventive medicine at Rush University Medical Center.

In designing the program, the collaboration will draw on research in behavioral and social sciences demonstrating important requirements for changing human behavior. Such studies have shown that for sustained change to occur, people need to be intrinsically motivated, which can be achieved by learning how to enjoy being physically active and managing stress. Research also shows that sustained change comes about when the individual's social networks, particularly same-sex friends, hold similar values and norms and when the community supports the need for change and supplies the resources that facilitate it.

The program will aim to change the behavior of women who exercise sporadically or not at all and will be led by "mavens" or "pioneers," women leaders in the community. The pioneers will help discover what does and does not work, design and test the program, and transmit its value to other community members. The aim is to create a "buzz" around the cardiovascular risks following menopause, particularly for the development of visceral fat, and the role of physical activity and stress management in preventing them.

"Visceral fat develops in women during the menopausal transition with the shift from an estrogen- to a testosterone-dominated hormonal milieu," Powell said. "We can't change the hormonal balance that comes with menopause, but we can change other factors, like physical activity and stress management, both of which have been shown to be very effective in reducing visceral fat.

"Other programs have sought to increase physical activity by focusing primarily on motivating the individual. But to effect lasting change, a person's social networks and community need to be involved."