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Effects of Hormone Therapy and Flavonoids Capable on Reversal of Menopausal Immune Senescence.
Vrachnis, N, Zygouris, D, Vrachnis, D, Antonakopoulos, N, Fotiou, A, Panagopoulos, P, Kolialexi, A, Pappa, K, Mastorakos, G, Iliodromiti, Z
Nutrients. 2021;13(7)
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One characteristic of menopause is immune senescence, the gradual decline of the immune system associated with age and hormone changes. This leads to a reduced immune response and increased inflammatory state. Current options to support the immune system during menopause include hormone replacement therapy (HRT) and flavonoid-rich supplementation. While evidence shows these options may influence immune senescence during menopause, specific inflammatory markers and molecular pathways need to be clarified. The aim of this review is to present the latest findings on these therapies and suggest possible directions for future research and treatment. The current literature suggests HRT can modulate the overall inflammatory state. There is not sufficient evidence to show flavonoids enhance the immune response in menopausal women. Based on the discrepancies in the available studies, the authors conclude future studies are needed to better understand the pathways and mediators connecting HRT and the immune system. This understanding will lead to more targeted therapies for menopausal women and the authors point to flavonoid-rich products as a basis for developing future treatment directions.
Abstract
Menopause, probably the most important natural change in a woman's life and a major component of female senescence, is characterized, inter alia, by cessation of ovarian estrogen and progesterone production, resulting in a gradual deterioration of the female immune system. Hormone replacement therapy (HRT) is used in postmenopausal women to relieve some of the peri- and postmenopausal symptoms, while there is also evidence that the therapy may additionally partially reverse menopausal immune senescence. Flavonoids, and especially isoflavones, are widely used for the treatment of menopausal symptoms, although it is not at present clear whether they can reverse or alleviate other menopausal changes. HRT reverses the menopausal CD4/CD8 ratio and also limits the general peri- and postmenopausal inflammatory state. Moreover, the increased levels of interleukins (IL)-1β, IL-6, and IL-8, as well as of tumor necrosis factor-α (TNF-α) are decreased after the initiation of HRT. However, some reports show no effect of HRT on IL-4, IL-10, and IL-12. It is thus evident that the molecular pathways connecting HRT and female immune senescence need to be clarified. Interestingly, recent studies have suggested that the anti-inflammatory properties of isoflavones possibly interact with inflammatory cytokines when applied in menopause treatments, thereby potentially reversing immune senescence. This narrative review presents the latest data on the effect of menopausal therapies, including administration of flavonoid-rich products, on age-associated immune senescence reversal with the aim of revealing possible directions for future research and treatment development.
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Creatine Supplementation in Women's Health: A Lifespan Perspective.
Smith-Ryan, AE, Cabre, HE, Eckerson, JM, Candow, DG
Nutrients. 2021;13(3)
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Creatine supplementation in females has been largely understudied. Changes in creatine homeostasis naturally occur across the lifecycle, and recent findings suggest supplementation may be important during different phases of a woman's lifespan. The aim of this review was to highlight the current findings around creatine metabolism in females from young adulthood to old age. The literature indicates creatine supplementation in females may improve exercise performance, pregnancy outcomes, cognitive performance, and reduce mental fatigue. Based on these findings, the authors conclude creatine supplementation has a potentially positive implication for numerous metabolic, hormonal, and neurological outcomes for females. They suggest future studies should evaluate creatine supplementation and metabolism with respect to the menstrual and reproductive cycle.
Abstract
undefined: Despite extensive research on creatine, evidence for use among females is understudied. Creatine characteristics vary between males and females, with females exhibiting 70-80% lower endogenous creatine stores compared to males. Understanding creatine metabolism pre- and post-menopause yields important implications for creatine supplementation for performance and health among females. Due to the hormone-related changes to creatine kinetics and phosphocreatine resynthesis, supplementation may be particularly important during menses, pregnancy, post-partum, during and post-menopause. Creatine supplementation among pre-menopausal females appears to be effective for improving strength and exercise performance. Post-menopausal females may also experience benefits in skeletal muscle size and function when consuming high doses of creatine (0.3 g·kg ·d ); and favorable effects on bone when combined with resistance training. Pre-clinical and clinical evidence indicates positive effects from creatine supplementation on mood and cognition, possibly by restoring brain energy levels and homeostasis. Creatine supplementation may be even more effective for females by supporting a pro-energetic environment in the brain. The purpose of this review was to highlight the use of creatine in females across the lifespan with particular emphasis on performance, body composition, mood, and dosing strategies.
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Vitamin D Boosts Alendronate Tail Effect on Bone Mineral Density in Postmenopausal Women with Osteoporosis.
Catalano, A, Bellone, F, Santoro, D, Schwarz, P, Gaudio, A, Basile, G, Sottile, MC, Stoian, SA, Corica, F, Morabito, N
Nutrients. 2021;13(6)
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Post-menopausal women are at an increased risk for bone associated disorders such as osteoporosis. Treatments with drugs known as bisphosphonates aim to increase bone density, bone strength, and reduce bone fractures. However long-term treatment may be associated with poor outcomes and short treatment breaks where use is discontinued, may be of benefit. Vitamin D, which has shown to be of benefit during treatment with bisphosphonates, may be of increased importance during these treatment breaks. This retrospective study of postmenopausal women aimed to determine if vitamin D status influenced bone density after osteoporosis treatment had ceased in 1686 patients. The results showed that in those who discontinued osteoporosis treatment, individuals with the highest levels of vitamin D had a greater increase in bone mineral density. Bone density was also associated with a change in vitamin D level. It was concluded that in those who have discontinued osteoporosis treatment improving vitamin D status may be of benefit to bone density. This study could be used by healthcare professionals to understand how vitamin D supplementation may be of benefit in osteoporotic, post-menopausal women who have stopped treatment due to worries of long-term side effects.
Abstract
undefined: Vitamin D modulates bisphosphonate (BP) efficacy, but its contribution to bone mineral density (BMD) after BP discontinuation is not known. To address this topic, we performed a retrospective analysis of postmenopausal women exposed to alendronate (ALN) to treat osteoporosis who regularly continued the supplementation of cholecalciferol or calcifediol at recommended doses. In the ninety-six recruited women (age 61.1 ± 6.9 years), ALN was administered for 31.2 ± 20.6 months and then discontinued for 33.3 ± 18.9 months. The modification of 25(OH)D serum levels over time was associated with a change of alkaline phosphatase (r = -0.22, = 0.018) and C-terminal collagen type 1 telopeptide (r = -0.3, = 0.06). Women in the tertile of the highest increase in 25(OH)D level showed a 5.7% BMD gain at lumbar spine, that was twice as great in comparison with participants with a lower 25(OH)D variation. At a multiple regression analysis, BMD change was associated with time since menopause (ß = 2.28, SE 0.44, < 0.0001), FRAX score for major fracture (ß = -0.65, SE 0.29, = 0.03), drug holiday duration (ß = -2.17, SE 0.27, < 0.0001) and change of 25(OH)D levels (ß = 0.15, SE 0.03, = 0.0007). After ALN discontinuation, improving the vitamin D status boosts the ALN tail effect on BMD.
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Associations between Diet Quality and Anthropometric Measures in White Postmenopausal Women.
Arikawa, AY, Kurzer, MS
Nutrients. 2021;13(6)
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Menopause is associated with hormonal fluctuations, which may cause biological and behavioural changes such as sleep disturbances, obesity, and bone loss. Dietary modifications may reduce the impact of weight gain and bone loss. The aim of this cross-sectional study was to determine the association between diet quality and body measurements in 937 post-menopausal women. The results showed that the average waist circumference was 83cm, which is associated with an increased risk of developing chronic diseases. A healthier diet was associated with lower waist circumference. Intakes of whole grains, dairy, protein, sodium, and saturated fat were not at recommended levels. Only 12.5% consumed the recommended daily intake of calcium and even in those taking calcium supplements, intakes were still inadequate. There were no associations between bone mass density and calcium or vitamin D intake, however there was a trend towards increased bone density with physical activity. It was concluded that a healthier diet was associated with a lower occurrence of obesity. Although no associations between calcium intake and BMD were seen, further studies are warranted. Healthcare professionals could use this study to understand the importance of recommending a healthier diet in postmenopausal women to prevent obesity and chronic diseases.
Abstract
undefined: The purpose of this cross-sectional study was to examine the relationship between diet and anthropometric measures in postmenopausal women. Data collected from 937 women enrolled in the Minnesota Green Tea Trial (NTC00917735) were used for this analysis. Dietary intake and health-related data were collected via questionnaires. Body weight, height, and waist circumference (WC) were measured by the study staff. The mean age of participants was 59.8 years and mean WC was 83 cm. Approximately 30% of the participants had WC greater than 88 cm. Healthy Eating Index-2015 score was 72.6 and the Dietary Inflammatory Index score was 0. Intakes of whole grains, dairy, protein, sodium, and saturated fat did not meet the dietary guidelines. Only 12.5% consumed the recommended daily amount of calcium (mean intake = 765 mg/day). When calcium supplements were considered, only 35.2% of the participants had adequate intakes, even though 68.9% reported taking a calcium supplement. We found that age and number of medications taken were significantly associated with waist circumference ( = 0.005). Women who reported taking two or more medications had greater WC (85 cm) compared to women who reported not taking any medications (82.2 cm), = 0.002. Our findings suggest that achieving adequate calcium and vitamin D intake may be challenging to postmenopausal women.
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Botanicals in Postmenopausal Osteoporosis.
Słupski, W, Jawień, P, Nowak, B
Nutrients. 2021;13(5)
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One of the main age-associated hormonal imbalances women experience during peri- and post-menopause is osteoporosis. Oestrogen plays a protective role in maintaining bone mineral density, so a decrease in this hormone that naturally occurs with menopause leads to an increased risk of osteoporosis. Due to the various side effects associated with pharmaceutical drugs, many women seek complementary or alternative treatments during menopause. The aim of this review is to present the current information on the efficacy and mechanism of plant-derived compounds in modulating menopause-associated bone metabolism. The main plant compounds that have been studied in detail are phytoestrogens, specifically isoflavones. The literature shows these compounds not only prevent bone resorption, but also promote bone formation. This review also highlights the many biologically plausible mechanisms by which these compounds influence bone metabolism. According to these findings, the authors conclude there are many bioactive, plant-based compounds that may be useful alternative therapies for peri- and post-menopausal women experiencing osteoporosis. While there is promising potential therapeutic use for these botanicals, further clinical research is needed.
Abstract
Osteoporosis is a systemic bone disease characterized by reduced bone mass and the deterioration of bone microarchitecture leading to bone fragility and an increased risk of fractures. Conventional anti-osteoporotic pharmaceutics are effective in the treatment and prophylaxis of osteoporosis, however they are associated with various side effects that push many women into seeking botanicals as an alternative therapy. Traditional folk medicine is a rich source of bioactive compounds waiting for discovery and investigation that might be used in those patients, and therefore botanicals have recently received increasing attention. The aim of this review of literature is to present the comprehensive information about plant-derived compounds that might be used to maintain bone health in perimenopausal and postmenopausal females.
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Moderate Consumption of Beer (with and without Ethanol) and Menopausal Symptoms: Results from a Parallel Clinical Trial in Postmenopausal Women.
Trius-Soler, M, Marhuenda-Muñoz, M, Laveriano-Santos, EP, Martínez-Huélamo, M, Sasot, G, Storniolo, CE, Estruch, R, Lamuela-Raventós, RM, Tresserra-Rimbau, A
Nutrients. 2021;13(7)
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During the menopause, hormonal changes can trigger uncomfortable symptoms such as hot flashes, night sweats, sleep disturbances, and vaginal dryness. Hormone replacement therapy does reduce some of the symptoms, however there has been an increased interest in alternative therapies such as phytoestrogens to relieve these symptoms. Phytoestrogens are compounds with oestrogen-like properties naturally found in plants. Beer is the main food source of the strongest phytoestrogen identified to date. The aim of this six-month parallel, controlled clinical intervention trial was to evaluate if a moderate daily intake of beer, with or without alcohol, could reduce menopausal symptoms in women. Female sex hormone profile and cardiovascular risk factors (CVRF) were also monitored. 34 postmenopausal women took part. One group included alcoholic beer (AB), and a second group added non-alcoholic beer (NAB) for 6 months. The control group took no alcohol in this time. After a 6-month follow-up both groups (AB and NAB) significantly reduced the severity of the menopause-related symptoms. These results must be considered as preliminary and will require confirmation with larger sample sizes.
Abstract
undefined: The menopausal transition can be a challenging period for women's health and a trigger of uncomfortable symptoms. Beer is the main food source of isoxanthohumol, a precursor of 8-prenylnaringenin, the strongest phytoestrogen identified to date. As phytoestrogens are reported to reduce perimenopausal symptoms, we evaluated if a daily moderate consumption of beer with (AB) and without alcohol (NAB) could improve menopausal symptoms and modify cardiovascular risk factors. A total of 37 postmenopausal women were enrolled in a parallel controlled intervention trial and assigned to three study groups: 16 were administered AB (330 mL/day), 7 NAB (660 mL/day), and 14 were in the control group. After a 6-month follow-up of the 34 participants who finished the trial, both interventions (AB and NAB) significantly reduced the severity of the menopause-related symptoms ( -value AB vs. Control: 0.009; -value NAB vs. Control: 0.033). Moreover, AB had a beneficial net effect on psychological menopausal discomforts compared to the control group. As the sex hormone profile did not differ significantly between the study groups, the effects of both types of beers (AB and NAB) are attributed to the non-alcoholic fraction of beer. Furthermore, moderate NAB consumption improved the lipid profile and decreased blood pressure in postmenopausal women.
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Nutrition in Menopausal Women: A Narrative Review.
Silva, TR, Oppermann, K, Reis, FM, Spritzer, PM
Nutrients. 2021;13(7)
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Menopause is the permanent cessation of menstrual cycles following the loss of ovarian follicular activity. It is associated with increased prevalence of obesity, metabolic syndrome, cardiovascular disease, and osteoporosis. The aim of this narrative review was to discuss the current evidence on the association between dietary patterns and clinical endpoints in postmenopausal women (body composition, bone mass, and risk markers for cardiovascular disease), and thereby providing novel insight into the establishment of optimal dietary guidelines for healthy postmenopausal period. Research shows that: - the changes in weight and fat distribution in women are associated with aging and mainly with the decrease in oestradiol levels during peri- and post-menopause. - calcium, vitamin D, vitamin K, selenium, magnesium, and beta-carotene adequate intake could be linked with better BMD in postmenopausal women. - diet is a major modifiable risk factor for cardiovascular disease and could be a powerful intervention to reduce cardiovascular risks in postmenopausal women. - the Mediterranean diet is composed of healthy foods that have anti-inflammatory and antioxidant properties. Authors indicate that future studies evaluating the effects of low-fat, plant-based diets on fat mass in post-menopausal women are needed.
Abstract
Among the various aspects of health promotion and lifestyle adaptation to the postmenopausal period, nutritional habits are essential because they concern all women, can be modified, and impact both longevity and quality of life. In this narrative review, we discuss the current evidence on the association between dietary patterns and clinical endpoints in postmenopausal women, such as body composition, bone mass, and risk markers for cardiovascular disease. Current evidence suggests that low-fat, plant-based diets are associated with beneficial effects on body composition, but further studies are needed to confirm these results in postmenopausal women. The Mediterranean diet pattern along with other healthy habits may help the primary prevention of bone, metabolic, and cardiovascular diseases in the postmenopausal period. It consists on the use of healthy foods that have anti-inflammatory and antioxidant properties, and is associated with a small but significant decrease in blood pressure, reduction of fat mass, and improvement in cholesterol levels. These effects remain to be evaluated over a longer period of time, with the assessment of hard outcomes such as bone fractures, diabetes, and coronary ischemia.
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Vegan Diet Health Benefits in Metabolic Syndrome.
Marrone, G, Guerriero, C, Palazzetti, D, Lido, P, Marolla, A, Di Daniele, F, Noce, A
Nutrients. 2021;13(3)
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Plant-based diets (PBD) have grown in popularity in recent years and have been associated with better health outcomes especially with heart disease, however poorly planned PBD’s can result in nutrient deficiencies like vitamin B12. This review aimed to summarise the health benefits of PBD’s, especially vegan diets, compared to omnivorous diets when looking at risk factors associated with heart disease. The authors started by summarising three PBD’s obvious in the literature; vegan diet with no animal products, lacto-ovo-vegetarian (LOV) with dairy products and eggs, and fish-vegetarian including fish and seafoods. The study then highlighted the strengths and weaknesses of the vegan diet, highlighting that although the vegan diet represents a healthy way of eating rich in carbohydrates, omega-6 fats, fibre, vitamin C, vitamin E and magnesium it can be low in protein, omega-3 fats, vitamin B12, vitamin D, calcium, iron, zinc and iodine if not properly planned. Heart disease incidence was reported to be lower in individuals on a PBD, especially vegans, when compared to omnivorous diets possibly due to their improvement on risk factors associated with the disease. Metabolic syndrome, blood pressure, fat production, and blood sugar balance were all shown to be improved and reasons such as their high fibre content reducing energy intake and causing feelings of satiety and their low saturated fat content impacting cholesterol production were listed as possible mechanisms behind the improvements. It was concluded that a nutritionist led, vegan diet can improve risk factors for heart disease resulting in better health outcomes. This study could be used by healthcare practitioners to understand where vegan diets may lack certain nutrients and the Importance of a well-planned vegan diet in the prevention of heart disease in those at an increased risk.
Abstract
Plant-based diets (PBDs) are increasingly consumed by the Italian population and around the world. In particular, among PBDs, the vegan diet is a food pattern characterized by the exclusion of all animal-origin foods. What drives people to adopt this model are mainly ethical, health and environmental reasons. A vegan diet, if well-balanced and varied, can help in achieving and maintaining an optimal state of health. However, this nutritional approach, if not well-balanced, can cause deficiencies in proteins, ω-3 fatty acids, iron, vitamin D and calcium, zinc, iodine and, above all, vitamin B12. Oral food supplements especially fortified foods are recommended in these cases to restore the nutritional deficiencies. A vegan diet generally reduces the risk of developing chronic non-communicable degenerative diseases, such as metabolic syndrome (MetS) and, in addition, requires fewer natural resources for food production than an omnivorous diet. The aim of this review is to analyze the possible impact of the vegan diet on MetS onset and its treatment.
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Effects of DHA-Rich n-3 Fatty Acid Supplementation and/or Resistance Training on Body Composition and Cardiometabolic Biomarkers in Overweight and Obese Post-Menopausal Women.
Félix-Soriano, E, Martínez-Gayo, A, Cobo, MJ, Pérez-Chávez, A, Ibáñez-Santos, J, Palacios Samper, N, Goikoetxea Galarza, I, Cuervo, M, García-Unciti, M, González-Muniesa, P, et al
Nutrients. 2021;13(7)
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Menopause may increase risk for chronic diseases such as obesity, osteoporosis and type 2 diabetes. Interventions to limit menopausal changes such as diet and exercise may improve outcomes. Resistance training and polyunsaturated fats may increase muscle production, however previous studies in postmenopausal women have had mixed outcomes. Therefore this randomised placebo control trial of 124 postmenopausal women aimed to determine if a polyunsaturated fat rich fish oil in combination with resistance training or alone for 16 weeks could affect overweight and obese postmenopausal women. The results showed no combined effect of resistance training and fish oil on body composition, muscle strength, blood pressure, lipids, or blood sugar balance. The resistance training group maintained bone density, increased muscle mass, decreased fat mass and increased blood sugar balance. The fish oil group showed lower blood pressure, lowered triglycerides, and improved muscle quality in lower limbs. It was concluded that resistance training improved body composition, bone density and blood sugar balance and fish oil improved heart health in postmenopausal women. This study could be used by healthcare professionals to recommend fish oil and resistance training to improve all aspects of physiological changes associated with menopause.
Abstract
Resistance training (RT) and n-3 polyunsaturated fatty acids (n-3 PUFA) supplementation have emerged as strategies to improve muscle function in older adults. Overweight/obese postmenopausal women (55-70 years) were randomly allocated to one of four experimental groups, receiving placebo (olive oil) or docosahexaenoic acid (DHA)-rich n-3 PUFA supplementation alone or in combination with a supervised RT-program for 16 weeks. At baseline and at end of the trial, body composition, anthropometrical measures, blood pressure and serum glucose and lipid biomarkers were analyzed. Oral glucose tolerance tests (OGTT) and strength tests were also performed. All groups exhibit a similar moderate reduction in body weight and fat mass, but the RT-groups maintained bone mineral content, increased upper limbs lean mass, decreased lower limbs fat mass, and increased muscle strength and quality compared to untrained-groups. The RT-program also improved glucose tolerance (lowering the OGTT incremental area under the curve). The DHA-rich supplementation lowered diastolic blood pressure and circulating triglycerides and increased muscle quality in lower limbs. In conclusion, 16-week RT-program improved segmented body composition, bone mineral content, and glucose tolerance, while the DHA-rich supplement had beneficial effects on cardiovascular health markers in overweight/obese postmenopausal women. No synergistic effects were observed for DHA supplementation and RT-program combination.
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The Effects of Time-Restricted Eating versus Standard Dietary Advice on Weight, Metabolic Health and the Consumption of Processed Food: A Pragmatic Randomised Controlled Trial in Community-Based Adults.
Phillips, NE, Mareschal, J, Schwab, N, Manoogian, ENC, Borloz, S, Ostinelli, G, Gauthier-Jaques, A, Umwali, S, Gonzalez Rodriguez, E, Aeberli, D, et al
Nutrients. 2021;13(3)
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Metabolic syndrome (MS) is a collection of conditions such as obesity, high blood pressure and impaired ability to balance blood sugars, that increase the sufferers risk of diabetes, stroke, and heart disease. Weight loss and lifestyle modifications are the main recommendations to improve MS. Intermittent fasting is a dietary regime that involves restricting the intake of food to certain times of the day, without restricting calories and has been shown in animal and human studies to result in fat loss and an increased ability to balance blood sugars. This randomised control trial of 218 adults over 6 months aimed to firstly determine relationships between eating duration, unprocessed and processed foods, and lifestyle factors on health and secondly to determine if a 12-hour time restricted eating pattern leads to an improvement in MS. The results showed that higher consumption of processed foods was associated with poorer metabolic health. A 12-hour restricted eating pattern resulted in weight loss, whereas individuals on a standard daily eating pattern did not, however differences between the two groups were not significant. Other measures of metabolic health failed to show any differences between the two groups. It was concluded that a 12-hour restricted eating pattern was feasible over 6 months, however further research is needed to assess if a more restricted time would result in greater weight loss. This study could be used by healthcare professionals to understand that a restricted eating pattern may be of benefit to those with MS, however further research would be needed to determine the optimal timeframe.
Abstract
undefined: Weight loss is key to controlling the increasing prevalence of metabolic syndrome (MS) and its components, i.e., central obesity, hypertension, prediabetes and dyslipidaemia. The goals of our study were two-fold. First, we characterised the relationships between eating duration, unprocessed and processed food consumption and metabolic health. During 4 weeks of observation, 213 adults used a smartphone application to record food and drink consumption, which was annotated for food processing levels following the NOVA classification. Low consumption of unprocessed food and low physical activity showed significant associations with multiple MS components. Second, in a pragmatic randomised controlled trial, we compared the metabolic benefits of 12 h time-restricted eating (TRE) to standard dietary advice (SDA) in 54 adults with an eating duration > 14 h and at least one MS component. After 6 months, those randomised to TRE lost 1.6% of initial body weight (SD 2.9, = 0.01), compared to the absence of weight loss with SDA (-1.1%, SD 3.5, = 0.19). There was no significant difference in weight loss between TRE and SDA (between-group difference -0.88%, 95% confidence interval -3.1 to 1.3, = 0.43). Our results show the potential of smartphone records to predict metabolic health and highlight that further research is needed to improve individual responses to TRE such as a shorter eating window or its actual clock time.
