Diet and Menopause

Lim et al. (2020) conducted a multi-center, randomised, double-blind, placebo-controlled clinical trial testing the efficacy of Lactobacillus acidophilus YT1 (MENOLACTO) on menopausal symptoms among a female population (aged between 40 and 60) with menopausal symptoms. The women included in the study scored ≥ 20 in the Kupperman index (KMI), which is a measure of menopausal symptom severity. The subjects were assigned to take either 1 × 108 CFU/day MENOLACTO or placebo, and completed a quality of life questionnaire (MENQOL questionnaire) plus were examined on their symptom severity (overall KMI score). Compared to placebo, total and modified KMI scores of the MENOLACTO-taking group were lower (total KMI scores significantly decreased) after 12 weeks. As with KMI scores, the quality of life of the intervention group improved significantly in all 4 of the symptoms examined (physical, psychosocial, vasomotor, and sexual symptoms). No significant differences were found between the groups in levels of blood follicle-stimulating hormone, estradiol, nor endometrial thickness. Without notable side effects, the MENOLACTO alleviated menopausal symptoms and improved the women’s quality of life. The findings suggest its potential role as an alternative supplement to reduce menopausal symptoms in women ineligible for hormonal therapy.

Despite hormonal therapy representing the most effective treatment option for menopause in women, reports of side effects have encouraged Ciappolino et al. (2018) to study alternative medicines such as N-3 long-chain polyunsaturated fatty acids (n-3 LCPUFAs). This review analysed the evidence for the effects of n-3 LCPUFAs on hot flashes and depressive and cognitive disorders in women undergoing menopause. The authors state the reported results are scattered and heterogeneous, and that it was far from conclusive whether n-3 LCPUFAs have a beneficial role in hot flashes and depressive and cognitive symptoms related to menopausal transition.

Schreiber & Dautovich (2017) gathered data from on 815 premenopausal and postmenopausal women [taken from the Midlife in the United States II study (MIDUS II)] and examined stress eating as a mediator between depressive symptoms and weight, in addition to menopausal status as a moderator of the connection between depressive symptoms, stress eating, and weight. The overall purpose was to investigate the association between depressive symptoms and weight in midlife women. The measures used included BMI, a coping questionnaire, and the CIDI-SF (evaluates mental and substance disorders such as major depression). Controlling for covariates, depressive symptoms were not directly associated with weight, b= −0.4, 95% CI [−0.4, 0.1]. Stress eating was found to be a significant mediator between depressive symptoms and weight, b= 0.3, 95% CI [0.06, 0.3], although this mediation was conditional on menopausal stage, with depressive symptoms and stress eating significantly linked in postmenopausal, not premenopausal women. Schreiber & Dautovich (2017) concluded that both stress eating and menopausal status significantly contributed to the depressive symptom-weight association. Since psychosocial factors also play an important role in this relationship, this paper proposed focusing on both behavioral factors and menopausal status when identifying who is at risk of developing poor weight outcomes.

Since the inverse association between dietary fiber intake and depressive symptoms reported in the general population had not been proven in midlife women in particular, Li et al. in 2020 examined a total of 3054 taken from the Study of Women’s Health Across the Nation (SWAN) and searched for correlations between their fiber intake and Center for Epidemiological Studies-Depression (CES-D) score. The sample population was firstly stratified into premenopausal women and early perimenopausal women by their menstrual bleeding patterns. In various linear regression models (unadjusted and adjusted for variables), dietary fiber intake was inversely linked with CES-D scores among premenopausal women, while the crude and fully adjusted models revealed a negative association also between fiber in the diet with depressive symptoms (defined as CES-D scores ≥ 16). Furthermore, the fully adjusted odds ratio (OR) of depressive symptoms was 0.483 when comparing the 4th quartile for fiber intake with the 1st quartile. In early perimenopausal women however, no statistically significant associations could be determined between fiber and signs of depression. The conclusion drawn therefore was that dietary fiber is negatively associated with depressive symptoms only in premenopausal women, and not in early perimenopausal women.

Since oxidative stress has been implicated in the development of mental disorders, and postmenopausal women are at higher risk of these disorders, Abshirini et al. (2019) aimed to assess the association between dietary total antioxidant capacity (DTAC) and depression, stress and anxiety, and also oxidative stress biomarkers, among a group of postmenopausal women. A total of 175 postmenopausal women took part in the study, who were examined on dietary intake [food frequency questionnaire (FFQ)], and mental health [Depression Anxiety Stress Scale (DASS-42)]. The participants’ dietary and serum total antioxidant capacity (TAC), malondialdehyde (MDA), oxidized-LDL, and superoxide dismutase (SOD) concentrations were also taken. The results showed subjects in the highest tertiles of DTAC had significantly lower MDA levels in the blood (p-value<0.001), and also, serum TAC level was significantly higher in those at the second terile of DTAC (p-value = 0.04). In addition, DTAC was discovered to be inversely and independently related to depression and anxiety scores, although no significant correlation was identified with stress score. These findings signify dietary total antioxidant capacity (DTAC) may be used for developing effective dietary measures for reducing depression and anxiety in postmenopausal women.