Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Author:
Karagkouni Iliana
Dissertation committee:
Πανουλής Κωνσταντίνος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Λαμπρινουδάκη Ειρήνη, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Σταματελόπουλος Κίμων, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γιαννακούλια Μαρία, Καθηγήτρια, Τμήμα Επιστήμης Διαιτολογίας – Διατροφής, Χαροκόπειο Πανεπιστήμιο
Καϊτελίδου Δάφνη, Καθηγήτρια, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Ελευθεριάδης Μακάριος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γαλάνης Πέτρος, Επίκουρος Καθηγητής, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Original Title:
Γευματικές συνήθειες, δείκτες καρδιαγγειακού κινδύνου και ποιότητα ζωής στις περι- και μετα- εμμηνοπαυσιακές γυναίκες
Translated title:
Eating habits, cardiovascular risk indicators and quality of life in peri- and post-menopausal women
Summary:
Introduction: Menopausal women are characterized by increased risk of developing chronic diseases, such as obesity and cardiovascular diseases. The increase in cardiovascular risk after the menopausal transition remains partly explained until today. The menopausal transition and its complications, such as physical or psychological symptoms, affect negatively women’s well-being and health-related quality of life (HRQoL). Life-style patterns as the nutritional status and dietary habits are highly associated with several quality-of-life parameters during menopause. Despite the progressive increase of scientific interest about the impact of meal and dietary patterns on developing obesity and cardiovascular risk, relative studies in peri-menopausal and post-menopausal women are limited. Equally few are the studies that investigate the potential role of diet in HRQoL during menopause.
Aim: This cross-sectional study aimed to identify the existing relation between meal and dietary patterns with cardiovascular risk indices and HRQoL parameters among healthy peri- and postmenopausal women. Anthropometric indices including body weight, waist circumference, waist/hip ratio, mid-upper arm circumference and triceps skin fold, as well as, indices of vascular structure and function were evaluated as indicators of cardiovascular risk during menopause.
Methods: Study sample was consisted of 453 postmenopausal women without clinically overt cardiovascular disease recruited from Menopause Clinic of Aretaieio Hospital of Athens between September 2017 and July 2022. Eligible were women, who had FSH >25 mIU/mL and estradiol <50 pg/mL, after 12 consecutive months without menses. Basic demographic characteristics, medical and menstrual history were recorded from all study participants. Physical activity was assessed by International Physical Activity Questionnaire, dietary intake was assessed by a validated semi-quantitative food frequency and 24-hr dietary recall. The adherence to Mediterranean diet was evaluated through Mediterranean Dietary Score. Finally, anthropometric, biochemical and hormone characteristics were assessed and a standardized physical examination was conducted for each participant. The vascular assessment included carotid-femoral pulse wave velocity (PWV), carotid and femoral-artery intima-media thickness (IMT), FMD and atheromatous plaques presence. Self-reported HRQoL was assessed by using the 12-Item Short-Form Health Survey (SF-12). In addition, the intensity of psychological, physical and vasomotor menopausal symptoms was assessed through the Greene Climacteric Scale (GCS).
Results: Mean age of participants was 63±7 years and BMI was 27 ± 4.7 kg/m2. According to MedDiet Score, mean adherence to Mediterranean diet was 36.4 ± 5.1. Linear regression models showed a significant negative correlation between daily nuts consumption and body weight (b-coefficient= -5.499; p<0.001), as well as waist circumference (b-coefficient= -2.138; p=0.031) of the study participants. The breakfast energy was positively related to the body weight of women (b-coefficient= 0.011; p=0.002). Daily fruits consumption was negatively associated with the MUAC (b-coefficient= -1.407; p=0.009), while a relative correlation was observed between the daily non-refined cereals consumption with the TSF (b-coefficient= -3.084; p=0.01). The negative association between nuts consumption and body weight remained statistically significant after Bonferroni adjustment for statistical significance. Pulse wave velocity was negatively related to the daily consumption of coffee/tea drinks (b-coefficient= -0.547; p=0.045) and positively related to the daily fish/seafood consumption (b-coefficient= 3.563; p=0.014) and daily meals’ number (b-coefficient= 0.346; p=0.003). The daily potatoes consumption was associated with higher values of common carotid artery thickness (b-coefficient= 0.976; p<0.001) and total carotid thickness (b-coefficient= 0.446; p=0.008). Daily consumption of refined cereals (b-coefficient= 0.157; p=0.009) and alcohol (b-coefficient= 0.176; p=0.049) were positively associated with common carotid artery thickness. Daily nuts consumption was negatively associated with internal carotid atherosclerotic plaque (b-coefficient= -0.482; p=0.043). The positive association between the potato consumption and the common carotid artery thickness remained statistically significant after Bonferroni adjustment for statistical significance. The PCS-SF12 was positively related to the daily consumption of coffee/tea drinks (b-coefficient= 3.450; p=0.002) and negatively related to the breakfast meal fat (b-coefficient= - 0.146; p=0.011). The MCS-SF12 was positively related to lunch energy (b-coefficient= 0.004; p=0.008), lunch carbohydrates (b-coefficient= 0.034; p=0.009) and lunch protein (b-coefficient = 0.065; p= 0.008). The physical symptoms severity was negatively related to the daily consumption of non-starchy cooked vegetables as meals basis (b-coefficient= -3.513; p=0.042) and low/medium fat meat (b-coefficient=-1.587; p= 0.036), as well as with the lunch fat (b-coefficient= -0.009; p=0.028). Daily consumption of full-fat dairy products (b-coefficient= -0.776; p=0.019) and lunch carbohydrates (b-coefficient=-0.006; p=0.012) were associated with lower intensity of vasomotor menopausal symptoms. The above regression models did not remained statistically significant after adjusting to the Bonferroni correction parameter (p<0.001). Adherence to the Mediterranean diet was negatively related to the MUAC (b-coef= -0.074; p=0.014) and TSF (b-coef= -0.166; p=0.013), but there was of any statistical significance after Bonferroni adjustment (p<0.001). No statistical significance was observed between adherence to the Mediterranean diet and other parameters of vascular function and quality of life among menopausal women.
Conclusions: Dietary patterns that include daily consumption of nuts, fruits, whole grains, coffee/tea and lower frequency of potato consumption may be associated with better weight control, improved body composition indices and reduced progression of subclinical atherosclerosis among postmenopausal women, regardless of the traditional cardiovascular risk factors, total daily energy intake or physical activity. Components of meal patterns were not strongly statistically significantly related to the included indicators of cardiovascular risk and quality of life. Moreover, dietary patterns that include daily consumption of coffee/tea, non-starchy vegetables, lean meat products and full-fat dairy products may be associated with better parameters of menopausal women's quality of life. It would be beneficial to identify a specific dietary pattern to manage cardiovascular risk and enhance quality of life during menopause in terms of physical and mental well-being.
Main subject category:
Health Sciences
Keywords:
Menopause, Meal patterns, Dietary pattern, Cardiovascular diseases, Health-related quality of life
Number of references:
284
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Karagkouni_Iliana_PhD.pdf
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