Impact of Promoting a Healthy Lifestyle on Anthropometric Characteristics, Climacteric Symptoms, Sleep Quality and Quality of Life in Women During Menopausal Transition

Article ID: e060723218461 Pages: 10

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Abstract

Objective: The purpose of the study was to assess the effects of a lifestyle promotion based on the principles of the Mediterranean diet (MD) combined with regular physical exercise on climacteric symptoms, sleep quality, and quality of life in women in the menopausal transition.

Methods: Among 100 perimenopausal women recruited, 80 (48 ± 2 years) with climacteric symptoms were eligible for the study and were randomized into two groups: an intervention group (n=40) that received nutritional counselling based on the principles of MD with the practice of regular activity during 8 weeks, and a control group (n=40). At baseline and 8 weeks after the initiation of nutritional intervention, we assessed daily energy expenditure and food intake, anthropometric characteristics, climacteric symptoms, sleep quality, and quality of life.

Results: Results showed that in the intervention group, compared to the control group, after 8 weeks of nutritional counselling, a significant decrease was noted in somatic and psychologic (p<0.01) symptoms. No significant difference was noted in urogenital symptoms. The quality of life was improved by the decrease of the Menopause Rating Score (-25%, p<0.001). A decrease was observed in subjective sleep quality (-27%, p<0.05), sleep duration (-39%, p<0.05), habitual sleep efficiency (-43%, p<0.05), and daytime dysfunction (-43%, p<0.01). The score of PSQI was decreased by (-31%, p<0.01), which meant that the quality of sleep improved.

Conclusion: Anthropometric characteristics, climacteric symptoms, sleep quality and quality of life were improved in women on menopausal transition adopting a healthy lifestyle based on the principles of Mediterranean eating pattern combined with regular physical activity.

Graphical Abstract

[1]
Delamater, L.; Santoro, N. Management of the perimenopause. Clin. Obstet. Gynecol., 2018, 61(3), 419-432.
[http://dx.doi.org/10.1097/GRF.0000000000000389] [PMID: 29952797]
[2]
Wu, L.; Chen, R.; Ma, D.; Zhang, S.; Walton-Moss, B.; He, Z. Effects of lifestyle intervention improve cardiovascular disease risk factors in community-based menopausal transition and early postmenopausal women in China. Menopause, 2014, 21(12), 1263-1268.
[http://dx.doi.org/10.1097/GME.0000000000000248] [PMID: 24781851]
[3]
Proietto, J. Obesity and weight management at menopause. Aust. Fam. Physician, 2017, 46(6), 368-370.
[PMID: 28609591]
[4]
Senouci, A.; Benharrat, L.I.; Zemmour, A.; Benhabib, W.; Mekki, K. Sleep quality and its relationship with climacteric symptoms and quality of life in women on menopausal transition. Nor. Afr. J. Food Nutr. Res., 2021, 5(12), 93-99.
[http://dx.doi.org/10.51745/najfnr.5.12.93-99]
[5]
Nateri, N.S.; Beigi, M.; Kazemi, A.; Shirinkam, F. Women coping strategies towards menopause and its relationship with sexual dysfunction. Iran. J. Nurs. Midwifery Res., 2017, 22(5), 343-347.
[PMID: 29033986]
[6]
Kline, C.E.; Irish, L.A.; Krafty, R.T.; Sternfeld, B.; Kravitz, H.M.; Buysse, D.J.; Bromberger, J.T.; Dugan, S.A.; Hall, M.H. Consistently high sports/exercise activity is associated with better sleep quality, continuity and depth in midlife women: The SWAN sleep study. Sleep, 2013, 36(9), 1279-1288.
[http://dx.doi.org/10.5665/sleep.2946] [PMID: 23997360]
[7]
Bahri, N.; Yoshany, N.; Morowatisharifabad, M.A.; Noghabi, A.D.; Sajjadi, M. The effects of menopausal health training for spouses on women’s quality of life during menopause transitional period. Menopause, 2016, 23(2), 183-188.
[http://dx.doi.org/10.1097/GME.0000000000000588] [PMID: 26783984]
[8]
Greenblum, C.A.; Rowe, M.A.; Neff, D.F.; Greenblum, J.S. Midlife women. Menopause, 2013, 20(1), 22-27.
[http://dx.doi.org/10.1097/gme.0b013e31825a2a91] [PMID: 22929034]
[9]
Davis, S.R.; Castelo-Branco, C.; Chedraui, P.; Lumsden, M.A.; Nappi, R.E.; Shah, D.; Villaseca, P. Understanding weight gain at menopause. Climacteric, 2012, 15(5), 419-429.
[http://dx.doi.org/10.3109/13697137.2012.707385] [PMID: 22978257]
[10]
El Khoudary, S.R.; Aggarwal, B.; Beckie, T.M.; Hodis, H.N.; Johnson, A.E.; Langer, R.D.; Limacher, M.C.; Manson, J.E.; Stefanick, M.L.; Allison, M.A. Menopause transition and cardiovascular disease risk: Implications for timing of early prevention: A scientific statement from the American heart association. Circulation, 2020, 142(25), e506-e532.
[http://dx.doi.org/10.1161/CIR.0000000000000912] [PMID: 33251828]
[11]
Aparicio, V.A.; Borges-Cosic, M.; Ruiz-Cabello, P.; Coll-Risco, I.; Acosta-Manzano, P.; Špacírová, Z.; Soriano-Maldonado, A. Association of objectively measured physical activity and physical fitness with menopause symptoms. The Flamenco Project. Climacteric, 2017, 20(5), 456-461.
[http://dx.doi.org/10.1080/13697137.2017.1329289] [PMID: 28580794]
[12]
Moratalla-Cecilia, N.; Soriano-Maldonado, A.; Ruiz-Cabello, P.; Fernández, M.M.; Gregorio-Arenas, E.; Aranda, P.; Aparicio, V.A. Association of physical fitness with health-related quality of life in early postmenopause. Qual. Life Res., 2016, 25(10), 2675-2681.
[http://dx.doi.org/10.1007/s11136-016-1294-6] [PMID: 27085340]
[13]
Barrea, L.; Pugliese, G.; Laudisio, D.; Colao, A.; Savastano, S.; Muscogiuri, G. Mediterranean diet as medical prescription in menopausal women with obesity: a practical guide for nutritionists. Crit. Rev. Food Sci. Nutr., 2021, 61(7), 1201-1211.
[http://dx.doi.org/10.1080/10408398.2020.1755220] [PMID: 32329636]
[14]
Álvarez-Pérez, J.; Sánchez-Villegas, A.; Díaz-Benítez, E.M.; Ruano-Rodríguez, C.; Corella, D.; Martínez-González, M.Á.; Estruch, R.; Salas-Salvadó, J.; Serra-Majem, L. Influence of a mediterranean dietary pattern on body fat distribution: Results of the PREDIMED–canarias intervention randomized trial. J. Am. Coll. Nutr., 2016, 35(6), 568-580.
[http://dx.doi.org/10.1080/07315724.2015.1102102] [PMID: 27314172]
[15]
Eguaras, S.; Toledo, E.; Buil-Cosiales, P.; Salas-Salvadó, J.; Corella, D.; Gutierrez-Bedmar, M.; Santos-Lozano, J.M.; Arós, F.; Fiol, M.; Fitó, M.; Ros, E.; Serra-Majem, L.; Pintó, X.; Martínez, J.A.; Sorlí, J.V.; Muñoz, M.A.; Basora, J.; Estruch, R.; Martínez-González, M.Á. Does the Mediterranean diet counteract the adverse effects of abdominal adiposity? Nutr. Metab. Cardiovasc. Dis., 2015, 25(6), 569-574.
[http://dx.doi.org/10.1016/j.numecd.2015.03.001] [PMID: 25921850]
[16]
Cespedes Feliciano, E.M.; Tinker, L.; Manson, J.E.; Allison, M.; Rohan, T.; Zaslavsky, O.; Waring, M.E.; Asao, K.; Garcia, L.; Rosal, M.; Neuhouser, M.L. Change in dietary patterns and change in waist circumference and DXA trunk fat among postmenopausal women. Obesity, 2016, 24(10), 2176-2184.
[http://dx.doi.org/10.1002/oby.21589] [PMID: 27548405]
[17]
Vetrani, C.; Barrea, L.; Rispoli, R.; Verde, L.; De Alteriis, G.; Docimo, A.; Auriemma, R.S.; Colao, A.; Savastano, S.; Muscogiuri, G. Mediterranean diet: What are the consequences for menopause. Front. Endocrinol., 2022, 13, 886824.
[http://dx.doi.org/10.3389/fendo.2022.886824] [PMID: 35546996]
[18]
Widmer, R.J.; Flammer, A.J.; Lerman, L.O.; Lerman, A. The mediterranean diet, its components, and cardiovascular disease. Am. J. Med., 2015, 128(3), 229-238.
[http://dx.doi.org/10.1016/j.amjmed.2014.10.014] [PMID: 25447615]
[19]
Herber-Gast, G.C.M.; Mishra, G.D. Fruit, Mediterranean-style, and high-fat and -sugar diets are associated with the risk of night sweats and hot flushes in midlife: Results from a prospective cohort study. Am. J. Clin. Nutr., 2013, 97(5), 1092-1099.
[http://dx.doi.org/10.3945/ajcn.112.049965] [PMID: 23553160]
[20]
Warwick, P.M.; Edmundson, H.M.; Thomson, E.S. Prediction of energy expenditure: Simplified FAO/WHO/UNU factorial method vs continuous respirometry and habitual energy intake. Am. J. Clin. Nutr., 1988, 48(5), 1188-1196.
[http://dx.doi.org/10.1093/ajcn/48.5.1188] [PMID: 3189205]
[21]
Black, A.E.; Coward, W.A.; Cole, T.J.; Prentice, A.M. Human energy expenditure in affluent societies: An analysis of 574 doubly-labelled water measurements. Eur. J. Clin. Nutr., 1996, 50(2), 72-92.
[PMID: 8641250]
[22]
ANSES French food composition table; French Agency for Food, Environment and Occupational health and safety, 2016.
[23]
Heinemann, L.A.J.; Potthoff, P.; Schneider, H.P.G. International versions of the menopause rating scale (MRS). Health Qual. Life Outcomes, 2003, 1(1), 28.
[http://dx.doi.org/10.1186/1477-7525-1-28] [PMID: 12914663]
[24]
Buysse, D.J.; Reynolds, C.F., III; Monk, T.H.; Berman, S.R.; Kupfer, D.J. The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry Res., 1989, 28(2), 193-213.
[http://dx.doi.org/10.1016/0165-1781(89)90047-4] [PMID: 2748771]
[25]
Waist Circumference and Waist-Hip Ratio; World Health Organization: Geneva, Switzerland, 2011.
[26]
Maddahi, N.S.; Yarizadeh, H.; Setayesh, L.; Nasir, Y.; Alizadeh, S.; Mirzaei, K. Association between dietary energy density with mental health and sleep quality in women with overweight/obesity. BMC Res. Notes, 2020, 13(1), 189.
[http://dx.doi.org/10.1186/s13104-020-05025-1] [PMID: 32228677]
[27]
Sutton-Tyrrell, K.; Zhao, X.; Santoro, N.; Lasley, B.; Sowers, M.; Johnston, J.; Mackey, R.; Matthews, K. Reproductive hormones and obesity: 9 years of observation from the Study of Women’s Health Across the Nation. Am. J. Epidemiol., 2010, 171(11), 1203-1213.
[http://dx.doi.org/10.1093/aje/kwq049] [PMID: 20427327]
[28]
Blümel, J.E.; Fica, J.; Chedraui, P.; Mezones-Holguín, E.; Zuñiga, M.C.; Witis, S.; Vallejo, M.S.; Tserotas, K.; Sánchez, H.; Onatra, W.; Ojeda, E.; Mostajo, D.; Monterrosa, A.; Lima, S.; Martino, M.; Hernández-Bueno, J.A.; Gómez, G.; Espinoza, M.T.; Flores, D.; Calle, A.; Bravo, L.M.; Benítez, Z.; Bencosme, A.; Barón, G.; Aedo, S. Sedentary lifestyle in middle-aged women is associated with severe menopausal symptoms and obesity. Menopause, 2016, 23(5), 488-493.
[http://dx.doi.org/10.1097/GME.0000000000000575] [PMID: 26818013]
[29]
Sun, D.; Shao, H.; Li, C.; Tao, M. Sleep disturbance and correlates in menopausal women in Shanghai. J. Psychosom. Res., 2014, 76(3), 237-241.
[http://dx.doi.org/10.1016/j.jpsychores.2013.12.002] [PMID: 24529044]
[30]
Cuadros, J.L.; Fernández-Alonso, A.M.; Cuadros-Celorrio, Á.M.; Fernández-Luzón, N.; Guadix-Peinado, M.J.; del Cid-Martín, N.; Chedraui, P.; Pérez-López, F.R. Perceived stress, insomnia and related factors in women around the menopause. Maturitas, 2012, 72(4), 367-372.
[http://dx.doi.org/10.1016/j.maturitas.2012.05.012] [PMID: 22721806]
[31]
Flor-Alemany, M.; Marín-Jiménez, N.; Nestares, T.; Borges-Cosic, M.; Aranda, P.; Aparicio, V.A. Mediterranean diet, tobacco consumption and body composition during perimenopause. The FLAMENCO project. Maturitas, 2020, 137(1), 30-36.
[http://dx.doi.org/10.1016/j.maturitas.2020.04.002] [PMID: 32498934]
[32]
Xi, S.; Mao, L.; Chen, X.; Bai, W. Effect of health education combining diet and exercise supervision in Chinese women with perimenopausal symptoms: A randomized controlled trial. Climacteric, 2017, 20(2), 151-156.
[http://dx.doi.org/10.1080/13697137.2017.1281903] [PMID: 28145818]
[33]
Cano, A.; Marshall, S.; Zolfaroli, I.; Bitzer, J.; Ceausu, I.; Chedraui, P.; Durmusoglu, F.; Erkkola, R.; Goulis, D.G.; Hirschberg, A.L.; Kiesel, L.; Lopes, P.; Pines, A.; van Trotsenburg, M.; Lambrinoudaki, I.; Rees, M. The Mediterranean diet and menopausal health: An EMAS position statement. Maturitas, 2020, 139(1), 90-97.
[http://dx.doi.org/10.1016/j.maturitas.2020.07.001] [PMID: 32682573]
[34]
Stojanovska, L.; Apostolopoulos, V.; Polman, R.; Borkoles, E. To exercise, or, not to exercise, during menopause and beyond. Maturitas, 2014, 77(4), 318-323.
[http://dx.doi.org/10.1016/j.maturitas.2014.01.006] [PMID: 24548848]
[35]
Dabrowska-Galas, M.; Dabrowska, J. Physical activity improves sleep quality in women. Ginekol. Pol., 2021, 92(7), 487-490.
[http://dx.doi.org/10.5603/GP.a2020.0172] [PMID: 33844249]
[36]
Dinu, M.; Pagliai, G.; Casini, A.; Sofi, F. Mediterranean diet and multiple health outcomes: An umbrella review of meta-analyses of observational studies and randomised trials. Eur. J. Clin. Nutr., 2018, 72(1), 30-43.
[http://dx.doi.org/10.1038/ejcn.2017.58] [PMID: 28488692]
[37]
Silva, T.R.; Oppermann, K.; Reis, F.M.; Spritzer, P.M. Nutrition in menopausal women: A narrative review. Nutrients, 2021, 13(7), 2149.
[http://dx.doi.org/10.3390/nu13072149] [PMID: 34201460]