Abstract
Menopause alters body composition by increasing fat mass. Menopausal hormone therapy (MHT) is associated with decreased total and visceral adiposity. It is unclear whether MHT favorably affects energy intake. We aimed to assess in the OsteoLaus cohort whether total energy intake (TEI) and/or diet quality (macro- and micronutrients, dietary patterns, dietary scores, dietary recommendations)—evaluated by a validated food frequency questionnaire—differ in 839 postmenopausal women classified as current, past or never MHT users. There was no difference between groups regarding TEI or consumption of macronutrients. After multivariable adjustment, MHT users were less likely to adhere to the unhealthy pattern ‘fat and sugar: Current vs. never users [OR (95% CI): 0.48 (0.28–0.82)]; past vs. never users [OR (95% CI): 0.47 (0.27–0.78)]. Past users exhibited a better performance in the revised score for Mediterranean diet than never users (5.00 ± 0.12 vs. 4.63 ± 0.08, p < 0.04). Differences regarding compliance with dietary recommendations were no longer significant after adjustment for covariates. Overall, these results argue against a major role of TEI and diet quality as possible mediators of the MHT metabolic benefits. Future research on this relationship should focus on other potential targets of MHT, such as resting energy expenditure and physical activity.
Highlights
Among the most pronounced expressions of sexual dimorphism, menopause or more accurately the menopausal transition (MT) is a phase of progressive gonadal insufficiency occurring selectively in women and evolving towards the permanent cessation of menses at a mean age of 50–52 years [1].Estrogen deficiency is the principal underlying hormonal consequence
The objective of this study was to explore whether relative macronutrient intake, adherence to healthy eating habits and other qualitative elements contribute to the body composition advantages in postmenopausal women of the OsteoLaus cohort taking menopausal hormone therapy (MHT)
These differences were no longer statistically significant after multivariate adjustment. In this cross-sectional analysis of the OsteoLaus cohort, no significant differences regarding dietary intake were found according to MHT status. These results argue against a major role of caloric intake and diet quality as possible mediators of the metabolic benefits of MHT
Summary
Among the most pronounced expressions of sexual dimorphism, menopause or more accurately the menopausal transition (MT) is a phase of progressive gonadal insufficiency occurring selectively in women and evolving towards the permanent cessation of menses at a mean age of 50–52 years [1].Estrogen deficiency is the principal underlying hormonal consequence. In addition to the well-known vasomotor symptoms [2] and accelerated bone loss [3], MT significantly alters body composition with opposite effects on fat and lean body mass [4]. The Study of Women’s Health Across the Nation cohort, which followed longitudinally 1246 women of different ethnic backgrounds, confirmed that both the accelerated fat mass (FM) gain and the decline in lean mass are menopause-related and not merely age-dependent [5]. Nutrients 2019, 11, 1930 with menopausal hormone therapy (MHT) and by what mechanisms [6].
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