Nutrition Education and Art- and Dance/Movement Therapy for Postmenopausal Women with Weight Concerns

Rebekka Magdalena Dieterich-Hartwell; Deeptha Sukumar; Girija Kaimal

Objective: Although menopause is an inevitable stage of life for all women and by 2030, 47 million worldwide will be menopausal, this transition is not given sufficient attention and particularly overweight postmenopausal women are a largely ignored group. Meanwhile, postmenopausal women with an elevated BMI are at risk for cardiovascular disease. Moreover, hormonally driven changes may cause higher levels of anxiety, depression, and exhaustion, and the loss of reproduction and self-identity, along with other life stressors, can have negative impacts on quality of life. In order to address both the physical and psychosocial health needs of this population, we developed an integrative and innovative approach named I2CAN (Integrative Intervention with Creative Arts and Nutrition), consisting of nutrition education (NE) and creative arts therapy sessions (CAT) (art therapy, dance/movement therapy, and therapeutic writing). The aims are to determine how and to what extent this combined approach will 1. significantly reduce cortisol, sPTH (serum parathyroid hormone), and inflammatory cytokines and 2. significantly enhance psychosocial Design: In this 16-week mixed methods randomized controlled trial, participants are being assigned to either a control group or an intervention group (8 weeks of NE and 8 weeks of CAT, alternating weekly). Both groups take place on a virtual platform with sessions lasting between 45 minutes (NE) and 60 minutes (CAT). On average each group has between four and six participants. The NE portion includes goal setting and 15 separate topics that focus on caloric restriction and health and wellness The 8 CAT sessions address four psychosocial areas, quality of life, emotional regulation, body image, and stress management and include an introduction to the theme, a movement warm-up relating to the theme, an art therapy directive relating to the theme, a movement cool-down, and a time of verbal processing and takeaways. Prior to the first session, participants in the intervention group are receiving art materials as well as a box with both art, journaling, and movement prompts, separated by the four different themes. These prompts are reiterated at the end of the CAT sessions to encourage participants to engage in new and positive daily habits. Quantitative outcome measures are being collected from all participants at baseline and at the completion of the study and include biochemical markers and a battery of psychosocial assessments. Qualitative data in form of clinical notes, narrative responses, observations, and photographed artwork are gathered throughout the study and individual semi-structured interviews are scheduled with the participants in the intervention group at the end of the study to learn about their overall experiences. All quantitative analyses are being conducted through SPSS. The qualitative data is analyzed using a thematic analysis method. The data is then merged through cross tabulation and a joint display. Results: While this randomized controlled trial is currently underway, we do have preliminary results from a pilot that took place in 2022 and only included a small intervention group that received 8 sessions of NE and 8 sessions of CAT over the course of 16 weeks. Due to regulatory limitations during the COVID-19 pandemic, the physiological measures (DXA and blood draws) could also not be collected. Nevertheless, based on the survey responses, the participants improved in the areas of quality of life, affect, self-efficacy, stress, anxiety, and body image, and also reported physical improvements (decreases in BMI and blood pressure) by the end of the study. Through the interviews, we learned that the participants appreciated having a special time set aside that permitted mindful art, writing, and movement experiences. They were able to connect with one another and share personal experiences in a small intimate setting (3 participants, 2 therapists). Conclusion: These preliminary findings are promising and suggest that this integrative and innovative approach is beneficial for psychosocial wellbeing and weight management for overweight postmenopausal women. More research is necessary to substantiate these results and with the current study in progress, new findings will be forthcoming.

Nutrition Education and Art- and Dance/Movement Therapy for Postmenopausal Women with Weight Concerns

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Nutrition Education and Art- and Dance/Movement Therapy for Postmenopausal Women with Weight Concerns

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