Work

Menopause is associated with postprandial metabolism, metabolic health and lifestyle: The ZOE PREDICT study

Year: 2022

Type: article

Abstract: Background The menopause transition is associated with unfavourable alterations in health. However, postprandial metabolic changes and their mediating factors are poorly understood. Methods The PREDICT 1 UK cohort ( n =1002; pre- n =366, peri- n =55, and post-menopausal females n =206) assessed phenotypic characteristics, anthropometric, diet and gut microbiome data, and fasting and postprandial (0–6 h) cardiometabolic blood measurements, including continuous glucose monitoring (CGM) data. Differences between menopausal groups were assessed in the cohort and in an age-matched subgroup, adjusting for age, BMI, menopausal hormone therapy (MHT) use, and smoking status. Findings Post-menopausal females had higher fasting blood measures (glucose, HbA1c and inflammation (GlycA), 6%, 5% and 4% respectively), sugar intakes (12%) and poorer sleep (12%) compared with pre-menopausal females ( p <0.05 for all). Postprandial metabolic responses for glucose 2hiauc and insulin 2hiauc were higher (42% and 4% respectively) and CGM measures (glycaemic variability and time in range) were unfavourable post- versus pre-menopause ( p <0.05 for all). In age-matched subgroups ( n =150), postprandial glucose responses remained higher post-menopause (peak 0-2h 4%). MHT was associated with favourable visceral fat, fasting (glucose and insulin) and postprandial (triglyceride 6hiauc ) measures. Mediation analysis showed that associations between menopause and metabolic health indicators (visceral fat, GlycA 360mins and glycaemia (peak 0-2h )) were in part mediated by diet and gut bacterial species. Interpretation Findings from this large scale, in-depth nutrition metabolic study of menopause, support the importance of monitoring risk factors for type-2 diabetes and cardiovascular disease in mid-life to older women to reduce morbidity and mortality associated with oestrogen decline. Funding Zoe Ltd.

Source: EBioMedicine

DOI: 10.1016/j.ebiom.2022.104303