Menopause: The Journal of The North American Menopause Society Vol. 19, No. 9, pp. 1022/1028 DOI: 10.1097/gme.0b013e3182503834 * 2012 by The North American Menopause Society Reproductive characteristics and obesity in middle-aged women seen at an outpatient clinic in southern Brazil Heloı ´sa Theodoro, MS, 1 Alice Dalpicolli Rodrigues, MS, 1 Karina Giane Mendes, PhD, 2,3 Ruth Henn Liane, PhD, 1 Vera Maria Vieira Paniz, PhD, 1 and Maria Teresa Anselmo Olinto, PhD 1,4 Abstract Objective: The objective of this study was to investigate the association between reproductive events and abdominal obesity (waist circumference, Q88 cm) and general obesity (body mass index, Q30.0 kg/m 2 ) in a sample of women between the ages of 40 and 65 years treated at an outpatient clinic in southern Brazil. Methods: This was a cross-sectional study of a sample of 617 women from southern Brazil. Menopause status was classified as premenopausal, women who had regular menstrual cycles; perimenopausal, women who had irregular menstrual cycles whether in periodicity or flow; or postmenopausal, women whose last menstrual period occurred more than 12 months before the time of interview. Poisson regression was used to calculate crude and adjusted prevalence ratios and their respective 95% CIs. Results: The prevalence rates of abdominal and general obesity were 66.6% (95% CI, 62.8%-70.3%) and 45.5% (95% CI, 41.5%-9.4%), respectively. After adjustment for demographic, socioeconomic, and behavioral variables, early menarche (e11 y) and parity were strong predictors of abdominal and general obesity, presenting a dose- response relationship. Women with a history of three or more pregnancies and menarche at age 11 years or earlier had a 25% higher prevalence of abdominal obesity (95% CI, 1.07-1.46) and a 75% increase in obesity (95% CI, 1.37-2.24) compared with nulliparous or primiparous women with menarche at 14 years or older. Women with a postmenopause status showed an increase of 52% in general obesity, compared with those with a premenopause status. Conclusions: Characteristics of reproductive life may have a strong influence on body fat buildup in women during the menopausal transition. Key Words: Menopausal transition Y Obesity Y Abdominal obesity Y Menarche Y Parity. W orldwide life expectancy at birth is increasing, having reached 68 years in 2009 1 ; nevertheless, sex differences in life expectancy remain within each country and in the world population. In Brazil, for instance, life expectancy at birth was 76 years for women and 69 years for men, with women outliving men by 5 to 8 years. 2 These life expectancy gaps mean that a growing proportion of women are experiencing the entire perimenopausal period and are therefore more susceptible to metabolic disorders. 3 The perimenopausal period includes the menopausal tran- sition and postmenopausal stages and may begin around age 40 years and extend to the approximate age of 65 years. It rep- resents the transition between the reproductive and nonrepro- ductive periods of the female life cycle and involves a series of physiological, hormonal, and psychological changes. 4 Hormo- nal and metabolic changes usually entail a decrease in energy needs, leading to weight gain and a gradual replacement of muscle by adipose tissue. 5,6 Therefore, body fat buildup is heightened in this stage of life. 7,8 In addition, body fat distri- bution seems to change during the menopausal transition, with a tendency to accumulate adipose tissue in the abdominal region. 9<12 Knowledge of the determinants of obesity is relevant because of the negative impact of this condition on the health status of perimenopausal women. Obesity increases the risk of cardiovascular disease and all-cause mortality in middle-aged women. 13,14 Abdominal fat has been considered a potential predictor of insulin resistance, diabetes mellitus, hypercholes- terolemia, hypertension, and the metabolic syndrome. 11,15,16 Some studies have shown a history of reproductive events, such as early menarche, multiparity, and early motherhood, as potential factors that may encourage the development of Received September 13, 2011; revised and accepted February 2, 2012. From the 1 Post-graduate Programme in Collective Health, University of Vale do Rios dos Sinos, RS, Brasil; 2 Post-graduate Programme of Endocrinology, Federal University of Rio Grande do Sul, RS, Brasil; 3 University of Caxias do Sul, RS, Brasil; and 4 Department of Nutrition, Federal University of Health Sciences, Porto Alegre, RS, Brasil. Funding/support: This study was supported by the Brazilian National Research Council (CNPqYprocess n.304793/2010-8) and Research Sup- port Foundation of Rio Grande do Sul State, Brasil (Edital FAPERGS 01/2010YARD). Financial disclosure/conflicts of interest: None reported. Address correspondence to: Maria Teresa Anselmo Olinto, PhD, Post- graduate Programme in Collective Health, University of Vale do Rios dos Sinos, Ave. Unisinos 950, Sa ˜o Leopoldo, RS, CEP 93022-000, Brasil. E-mail: mtolinto@gmail.com 1022 Menopause, Vol. 19, No. 9, 2012 Copyright © 2012 The North American Menopause Society. Unauthorized reproduction of this article is prohibited.