ZOE Study Finds Novel Link Between Menopause and Metabolic Health

Researchers from personalized nutrition company ZOE and world-leading scientists from King’s College London, Harvard T.H. Chan School of Public Health, and Massachusetts General Hospital, have revealed that diet can be the key to reducing unfavorable health changes associated with menopause. This is according to the largest study of its kind, published as a pre-print in The Lancet, which explores how menopause affects day-to-day metabolism.

Menopause is defined as the point in time when a woman hasn’t had a period in 12 months, usually occurring naturally, most often after age 45. Spending more than one-third of their lives in a post-menopausal state, women going through this transition often find they are more susceptible to changes in body composition, mood, sleep, inflammation, glycemic control, and cholesterol levels, contributing to an increased risk of heart disease and many other metabolic health problems.

Dr. Sarah Berry, senior author of the study, Lead Nutritional Scientist at ZOE and Associate Professor in Nutritional Sciences in the Department of Nutritional Sciences at King’s College London, said, “Menopause has historically been vastly understudied and women have been under-represented in health research, especially in relation to diet and health. Our research shows that menopause is a time of major metabolic upheaval, which can have significant impact on long-term health. These findings will help us deliver simple yet more personalized nutrition and health advice with greater efficacy to reduce the health burden of menopause.”

The transition into menopause can add many layers of complication to the way women eat, sleep and feel. ZOE’s researchers found key differences in inflammation and blood sugar levels after eating in post-menopausal versus pre-menopausal women. The unfavorable effect of menopause on blood sugar control, which is a key risk factor for cardiovascular disease and type 2 diabetes, was found even in age-matched (i.e., women of a similar age) pre- and post-menopusal women, showing, for the first time, that this decline in blood sugar control was not just an inevitable part of aging. Another novel finding of this research was that the association between menopause with higher body fat and inflammation was partly mediated by poor diet and the microbiome. Given that diet and microbiome composition are intricately linked,* this shows the potential role of diet in modulating some of the unfavorable health effects of menopause.

The research team also found that post-menopausal women consumed higher intakes of dietary sugars and reported poorer sleep compared with pre-menopausal women, which are both associated with increased risk for type 1 and type 2 diabetes, obesity, and cardiovascular disease. These changes in diet and sleep, alongside the decrease in physical activity reported in previous studies, are linked to declining estrogen and may act in concert to increase the risk for weight gain over time.

Further, the study also observed differences in the abundance of bacterial species between pre- and post-menopausal women, including pro-inflammatory and obesogenic bacteria. The team’s previous research associated these species with unfavorable cardiometabolic health, diet and inflammatory outcomes.

“ZOE’s PREDICT study gives us an opportunity to study nutrition and health in thousands of people at an unprecedented scale, breadth and depth,” noted Kate Bermingham, first author on the paper from King’s College London. “Our insights are helping to unravel the complex connections between lifestyle, hormones, metabolism and health in a way that simply wasn’t possible before. Small diet and lifestyle changes have the potential to make a big difference to how women manage their symptoms and improve this transition.”

“The good news is that what you eat may partially reduce the unfavorable health impacts of menopause, either directly by reducing inflammation and blood sugar spikes or indirectly by altering the microbiome to a more favourable composition,” said Dr. Berry. “ZOE’s personalized nutrition program promotes a healthy gut microbiome and targets diet-induced inflammation, postprandial responses and body weight. We’re committed to continuing to incorporate our scientific learnings on menopause into our program to better support women through menopause.”

These latest findings point toward the need to develop more tailored nutrition and lifestyle advice for women at different stages in life, taking into account their personal metabolic responses, evolving microbiome and hormonal status. As more women go through menopause, it is vital that clinicians, researchers, the general public and policymakers encourage open, supportive discussions on this topic, pointing to research like ZOE’s, to enable science-backed dietary and lifestyle advice that will effectively reduce the unfavorable effects of menopause on cardiometabolic risk.