Can weight gain and an increase in abdominal adiposity throughout menopause be managed through diet and exercise interventions? A systematised review of current evidence
By Gail Brady - Online MSc - Advanced Nutrition
Abstract
Background
Increases in body weight and abdominal adiposity in women during midlife have been linked to both chronological ageing and the hormonal changes of menopause. Abdominal adiposity and visceral adipose tissue (VAT) are associated with a number of health issues and chronic diseases, including type 2 diabetes, cardiovascular disease and certain cancers, and are therefore detrimental to health. Diet and exercise may be effective in managing these changes in body composition and improving health outcomes.
Aims and Objectives
To assess current evidence on the effectiveness of dietary and exercise interventions for managing weight gain and abdominal adiposity throughout the stages of menopause in women aged 40–70 years. The pathogenesis of these changes in body composition was also considered.
Methods
A systematic search strategy was carried out to identify English-language studies published between 01 Jan 2014 and 31 Jul 2019 using four databases: PubMed, ScienceDirect, the Cochrane library and AMED. Randomised controlled trials and experimental study designs researching dietary and exercise interventions and recording quantitative data to measure body weight (BW) and abdominal fat were included. Animal studies and studies including hormone replacement therapies were excluded. A narrative synthesis and thematic approach were used to synthesise the findings. Quality appraisal was assessed using Cochrane’s risk-of-bias tools for non-randomised and randomised trials.
Results
Of 1,841 citations screened, 12 studies met the inclusion criteria. The studies including energy-restricted dietary interventions produced significant reductions in BW and waist circumference (WC). Exercise at higher frequencies and intensities reduced body fat (BF) and BW. However, an energy-restricted diet combined with regular moderate-to high-intensity exercise resulted in reductions in BW, BF, subcutaneous adipose tissue, VAT, and WC. Dietary supplementation with green tea extract and isoflavones alone were not shown to be effective. Isoflavones combined with exercise and golden flaxseed, along with an energy-restricted diet, reduced WC and BF.
Conclusions
Combined dietary, exercise, and supplement interventions were most effective at reducing BW and abdominal adiposity, exceeding the effects of diet, exercise, and supplements alone. Adherence to interventions is key for sustained and long-term effects. Motivational counselling is recommended. Changes to BW and BF should be addressed in early peri-menopause. Further research is needed.
