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Nutrition Challenges for Middle-Aged and Older Women

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition in Women".

Deadline for manuscript submissions: closed (30 April 2021) | Viewed by 52832

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Special Issue Editor

Prof. Masakazu Terauchi

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Guest Editor

Department of Women's Health, Tokyo Medical and Dental University, Tokyo, Japan
Interests: women’s health; menopause; osteoporosis

Special Issue Information

Dear Colleagues,

During the menopausal transition and postmenopausal periods, women are affected by a variety of symptoms, such as hot flashes, night sweats, vaginal dryness, depression, anxiety, and insomnia. Non-specific somatic symptoms are also common, including muscle and joint pain, tiredness, and dizziness. Some of these effects (particularly vasomotor symptoms and vaginal atrophy) are closely associated with estrogen deficiency, but the exact mechanisms underlying the other symptoms are not fully understood.

Postmenopausal women are also at increased risk of cardiovascular morbidity as a net effect of central obesity, dyslipidemia, hypertension, and diabetes, as well as for osteoporosis, cognitive decline, and genitourinary syndrome of menopause.

Hormone replacement therapy (HRT) has played a central role in improving menopausal symptoms and reducing the disease risks associated with estrogen deficiency. However, due to growing concern for the side effects of HRT, especially in patients with hormone-sensitive cancer such as breast and uterus cancer, research has turned to the effects of nutraceutical approaches to these symptoms and diseases.

In this Special Issue of Nutrients, we would like to bring together manuscripts dealing with the topic of “Nutrition Challenges for Middle-Aged and Older Women”. Topics may include dietary interventions with foods, altered nutrient intake or food supplements, and specific dietary pattern interventions, such as the Mediterranean Diet or calorie restriction, in humans.

Different types of manuscripts, including original clinical research articles and up-to-date reviews (systematic reviews and meta-analyses) are welcome.

Prof. Masakazu Terauchi
Guest Editor

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

climacteric
menopause
perimenopause
postmenopause
diet
food
nutrition

Published Papers (11 papers)

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Research

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10 pages, 764 KiB

Open AccessArticle

The Inverse Correlation of Isoflavone Dietary Intake and Headache in Peri- and Post-Menopausal Women

by Mayuko Kazama, Masakazu Terauchi, Tamami Odai, Kiyoko Kato and Naoyuki Miyasaka

Nutrients 2022, 14(6), 1226; https://doi.org/10.3390/nu14061226 - 14 Mar 2022

Cited by 2 | Viewed by 3115

Abstract

This study investigated the relationship between headache and dietary consumption of a variety of nutrients in middle-aged women. This cross-sectional analysis used first-visit records of 405 women aged 40–59 years. The frequency of headaches was assessed using the Menopausal Health-Related Quality of Life Questionnaire. Of the 43 major nutrient intakes surveyed using the brief-type self-administered diet history questionnaire, those that were not shared between women with and without frequent headaches were selected. Multiple logistic regression analysis was used to identify nutrients independently associated with frequent headaches. After adjusting for background factors related to frequent headache (vasomotor, insomnia, anxiety, and depression symptoms), the estimated dietary intake of isoflavones (daidzein + genistein) (mg/1000 kcal/day) was negatively associated with frequent headaches (adjusted odds, 0.974; 95% confidence interval, 0.950–0.999). Moreover, the estimated isoflavone intake was not significantly associated with headache frequency in the premenopausal group, whereas it significantly correlated with that in the peri- and post-menopausal groups. Headache in peri- and post-menopausal women was inversely correlated with the dietary intake of isoflavones. Diets rich in isoflavones may improve headaches in middle-aged women. Full article

(This article belongs to the Special Issue Nutrition Challenges for Middle-Aged and Older Women)

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12 pages, 298 KiB

Open AccessArticle

Deficiency in the Essential Amino Acids l-Isoleucine, l-Leucine and l-Histidine and Clinical Measures as Predictors of Moderate Depression in Elderly Women: A Discriminant Analysis Study

by Silvia Solís-Ortiz, Virginia Arriaga-Avila, Aurora Trejo-Bahena and Rosalinda Guevara-Guzmán

Nutrients 2021, 13(11), 3875; https://doi.org/10.3390/nu13113875 - 29 Oct 2021

Cited by 13 | Viewed by 4266

Abstract

Increases in depression are common in some elderly women. Elderly women often show moderate depressive symptoms, while others display minimal depressive symptoms. These discrepancies have produced contradictory and inconclusive outcomes, which have not been explained entirely by deficits in neurotransmitter precursors. Deficiency in some amino acids have been implicated in major depression, but its role in non-clinical elderly women is not well known. An analysis of essential amino acids, depression and the use of discriminant analysis can help to clarify the variation in depressive symptoms exhibited by some elderly women. The aim was to investigate the relationship of essential amino acids with affective, cognitive and comorbidity measures in elderly women without major depression nor severe mood disorders or psychosis, specifically thirty-six with moderate depressive symptoms and seventy-one with minimal depressive symptoms. The plasma concentrations of nineteen amino acids, Beck Depression Inventory (BDI) scores, Geriatric Depression Scale (GDS) scores, global cognitive scores and comorbidities were submitted to stepwise discriminant analysis to identify predictor variables. Seven predictors arose as important for belong to the group based on amino acid concentrations, with the moderate depressive symptoms group characterized by higher BDI, GDS and cognitive scores; fewer comorbidities; and lower levels of l-histidine, l-isoleucine and l-leucine. These findings suggest that elderly women classified as having moderate depressive symptoms displayed a deficiency in essential amino acids involved in metabolism, protein synthesis, inflammation and neurotransmission. Full article

(This article belongs to the Special Issue Nutrition Challenges for Middle-Aged and Older Women)

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Graphical abstract

11 pages, 570 KiB

Open AccessArticle

Associations between Diet Quality and Anthropometric Measures in White Postmenopausal Women

by Andrea Y. Arikawa and Mindy S. Kurzer

Nutrients 2021, 13(6), 1947; https://doi.org/10.3390/nu13061947 - 6 Jun 2021

Cited by 4 | Viewed by 2926

Abstract

The purpose of this cross-sectional study was to examine the relationship between diet and anthropometric measures in postmenopausal women. Data collected from 937 women enrolled in the Minnesota Green Tea Trial (NTC00917735) were used for this analysis. Dietary intake and health-related data were collected via questionnaires. Body weight, height, and waist circumference (WC) were measured by the study staff. The mean age of participants was 59.8 years and mean WC was 83 cm. Approximately 30% of the participants had WC greater than 88 cm. Healthy Eating Index-2015 score was 72.6 and the Dietary Inflammatory Index score was 0. Intakes of whole grains, dairy, protein, sodium, and saturated fat did not meet the dietary guidelines. Only 12.5% consumed the recommended daily amount of calcium (mean intake = 765 mg/day). When calcium supplements were considered, only 35.2% of the participants had adequate intakes, even though 68.9% reported taking a calcium supplement. We found that age and number of medications taken were significantly associated with waist circumference (p = 0.005). Women who reported taking two or more medications had greater WC (85 cm) compared to women who reported not taking any medications (82.2 cm), p = 0.002. Our findings suggest that achieving adequate calcium and vitamin D intake may be challenging to postmenopausal women. Full article

(This article belongs to the Special Issue Nutrition Challenges for Middle-Aged and Older Women)

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12 pages, 976 KiB

Open AccessArticle

Effects of Chlorogenic Acids on Menopausal Symptoms in Healthy Women: A Randomized, Placebo-Controlled, Double-Blind, Parallel-Group Trial

by Yuka Enokuchi, Atsushi Suzuki, Tohru Yamaguchi, Ryuji Ochiai, Masakazu Terauchi and Kiyoshi Kataoka

Nutrients 2020, 12(12), 3757; https://doi.org/10.3390/nu12123757 - 7 Dec 2020

Cited by 6 | Viewed by 4035

Abstract

A reduction in estrogen levels in the perimenopausal and postmenopausal periods causes various symptoms in women, such as hot flushes, sweats, depression, anxiety, and insomnia. Chlorogenic acids (CGAs), which are phenolic compounds widely present in plants such as coffee beans, have various physiological functions. However, the effects of CGAs on menopausal symptoms are unknown. To examine the effects of CGAs on menopausal symptoms, especially hot flushes, a randomized, placebo-controlled, double-blind, parallel-group trial was conducted in healthy women. Eighty-two subjects were randomized and assigned to receive CGAs (270 mg) tablets or the placebo for 4 weeks. After 4 weeks of intake, the number of hot flushes, the severity of hot flushes during sleep, and the severity of daytime sweats decreased significantly in the CGA group compared to the placebo group. The modified Kupperman index for menopausal symptoms decreased significantly after 2 weeks in the CGA group compared to the placebo group. Adverse effects caused by CGAs were not observed. The results show that continuous intake of CGAs resulted in improvements in menopausal symptoms, especially hot flushes, in healthy women. Full article

(This article belongs to the Special Issue Nutrition Challenges for Middle-Aged and Older Women)

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12 pages, 266 KiB

Open AccessArticle

Depressive Symptoms in Middle-Aged and Elderly Women Are Associated with a Low Intake of Vitamin B6: A Cross-Sectional Study

by Tamami Odai, Masakazu Terauchi, Risa Suzuki, Kiyoko Kato, Asuka Hirose and Naoyuki Miyasaka

Nutrients 2020, 12(11), 3437; https://doi.org/10.3390/nu12113437 - 9 Nov 2020

Cited by 11 | Viewed by 6998

Abstract

This study investigated the nutritional factors that are associated with anxiety and depressive symptoms in Japanese middle-aged and elderly women. We conducted a cross-sectional study with 289 study participants aged ≥40 years (mean age = 52.0 ± 6.9 years). Their dietary habits, menopausal status and symptoms, and varied background factors, such as body composition, lifestyle factors, and cardiovascular parameters, were assessed. Their anxiety and depressive symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS), where scores of 0–7 points, 8–10 points, and 11–21 points on either the anxiety or depression subscales were categorized as mild, moderate, and severe, respectively. The dietary consumption of nutrients was assessed using a brief self-administered diet history questionnaire. The relationships between the moderate-to-severe anxiety/depressive symptoms and the dietary intake of 43 major nutrients were investigated using multivariate logistic regression analyses. After adjusting for age, menopausal status, and the background factors that were significantly related to depressive symptoms, moderate and severe depression was significantly inversely associated with only vitamin B6 (adjusted odds ratio per 10 μg/MJ in vitamin B6 intake = 0.89, 95% confidence interval = 0.80–0.99). A higher intake of vitamin B6 could help relieve depressive symptoms for this population. Full article

(This article belongs to the Special Issue Nutrition Challenges for Middle-Aged and Older Women)

13 pages, 1437 KiB

Open AccessArticle

Efficacy and Safety of Kudzu Flower–Mandarin Peel on Hot Flashes and Bone Markers in Women during the Menopausal Transition: A Randomized Controlled Trial

by Ji Eon Kim, Hyeyun Jeong, Soohee Hur, Junho Lee and Oran Kwon

Nutrients 2020, 12(11), 3237; https://doi.org/10.3390/nu12113237 - 22 Oct 2020

Cited by 6 | Viewed by 3295

Abstract

This randomized controlled study aimed to assess the efficacy and safety of an extract mixture of kudzu flower and mandarin peel (KM) on hot flashes (HFs) and markers of bone turnover in women during the menopausal transition. Healthy women aged 45–60 years with the menopausal HFs were randomly assigned in a 1:1 ratio to either KM (1150 mg/day) or placebo arms for 12 weeks (n = 84). The intent-to-treat analysis found that compared with the placebo, the KM significantly attenuated HF scores (p = 0.041) and HF severities (p < 0.001), with a mean difference from baseline to week 12. The KM also improved bone turnover markers, showing a significant reduction in bone resorption CTx (p = 0.027) and a tendency of increasing bone formation OC relative to the placebo. No serious adverse events and hormonal changes were observed in both groups. These findings suggest that KM consumption may improve the quality of life in ways that are important to symptomatic menopausal women. Full article

(This article belongs to the Special Issue Nutrition Challenges for Middle-Aged and Older Women)

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22 pages, 771 KiB

Open AccessArticle

The Change in the Content of Nutrients in Diets Eliminating Products of Animal Origin in Comparison to a Regular Diet from the Area of Middle-Eastern Europe

by Kamila Kowalska, Jacek Brodowski, Kamila Pokorska-Niewiada and Małgorzata Szczuko

Nutrients 2020, 12(10), 2986; https://doi.org/10.3390/nu12102986 - 29 Sep 2020

Cited by 15 | Viewed by 4292

Abstract

Introduction: The diet of Poles became similar to the western style of nutrition. It is rich in saturated fats, it contains significant quantities of salt, and has very low fruit and vegetable content. On the other hand, introducing an incorrectly planned diet that eliminates animal products may be associated with the risk of deficiencies of certain vitamins and minerals. Taking into account the regular diet of Poles, a properly balanced vegetarian menu may be a better and safer choice for the proper functioning of the organism. Aim: The analysis of the content of individual types of vegetarian diets and a comparison with the menus of the regular diet of the Polish population. Materials and methods: 70 menus were subjected to a quantitative analysis, 10 menus for each 7 type of diet eliminating products of animal origin and regular diets without elimination. The caloricity of the designed diets was ±2000 kcal. The quantitative evaluation of the menus was performed using the Dieta 6d dietary program. Statistical significance was established at p ≤ 0.05. Results: It was observed that the regular diet of Poles (RD) featured the highest content of total fats, as well as saturated acids and cholesterol. The VEGAN diet was characterized by the lowest total protein content and the lack of wholesome protein and cholesterol. RD was characterized by the lowest average content of dietary fiber. The highest content of saccharose was observed in RD. Sodium content in RD significantly exceeded the recommended daily norm. RD featured insufficient content of the following minerals and vitamins: potassium, calcium, magnesium, iodine, Vitamin E, Vitamin C, folates, and Vitamin D. The norm for calcium has not been fulfilled also in milk-free and vegan diets. All of the analyzed diets lacked proper amounts of iodine and Vitamin D. The highest content of polyunsaturated fatty acids was observed in the VEGAN diet. The periodic elimination of meat and fatty dairy products should be included in the treatment of the metabolic syndrome, hypertensions, hyperlipidemia, obesity, and type 2 diabetes. Conclusions: The regular diet of Poles turned out to be more dangerous for health in terms of deficiencies than properly balanced diets eliminating products of animal origin. Full article

(This article belongs to the Special Issue Nutrition Challenges for Middle-Aged and Older Women)

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9 pages, 240 KiB

Open AccessArticle

Daily Coffee and Green Tea Consumption Is Inversely Associated with Body Mass Index, Body Fat Percentage, and Cardio-Ankle Vascular Index in Middle-Aged Japanese Women: A Cross-Sectional Study

by Yuka Yonekura, Masakazu Terauchi, Asuka Hirose, Tamami Odai, Kiyoko Kato and Naoyuki Miyasaka

Nutrients 2020, 12(5), 1370; https://doi.org/10.3390/nu12051370 - 11 May 2020

Cited by 20 | Viewed by 5561

Abstract

This study aimed to investigate the links between coffee (CF)/green tea (GT) consumption and body composition/cardiovascular parameters in middle-aged Japanese women. We conducted a cross-sectional study of 232 Japanese women aged 40–65 years who had been referred to the menopause clinic of Tokyo Medical and Dental University Hospital between November 2007 and August 2017. Body composition, cardiovascular parameters, and CF/GT consumption frequency were evaluated on their initial visits, using a body composition analyzer, vascular screening system, and brief-type self-administered diet history questionnaire, respectively. We investigated the associations between variables using multivariate logistic regression. After adjustment for age, menopausal status, and other factors, daily CF consumption was inversely associated with high body mass index (BMI) (adjusted odds ratio, 0.14; 95% confidence interval, 0.14–0.96) and body fat percentage (BF%) (0.33; 0.14–0.82), and daily GT consumption with high BF% (0.36; 0.14–0.96). Daily CF + GT consumption was also inversely associated with high BMI (0.15; 0.05–0.50) and BF% (0.30; 0.12–0.74). In pre- and perimenopausal women, daily CF + GT consumption was inversely associated with high cardio-ankle vascular index (CAVI) (0.05; 0.003–0.743). In conclusion, daily CF/GT consumption was inversely associated with high BMI, BF%, and CAVI in middle-aged Japanese women. Full article

(This article belongs to the Special Issue Nutrition Challenges for Middle-Aged and Older Women)

Review

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13 pages, 294 KiB

Open AccessReview

Effects of Hormone Therapy and Flavonoids Capable on Reversal of Menopausal Immune Senescence

by Nikolaos Vrachnis, Dimitrios Zygouris, Dionysios Vrachnis, Nikolaos Antonakopoulos, Alexandros Fotiou, Periklis Panagopoulos, Aggeliki Kolialexi, Kalliopi Pappa, George Mastorakos and Zoi Iliodromiti

Nutrients 2021, 13(7), 2363; https://doi.org/10.3390/nu13072363 - 10 Jul 2021

Cited by 5 | Viewed by 4371

Abstract

Menopause, probably the most important natural change in a woman’s life and a major component of female senescence, is characterized, inter alia, by cessation of ovarian estrogen and progesterone production, resulting in a gradual deterioration of the female immune system. Hormone replacement therapy (HRT) is used in postmenopausal women to relieve some of the peri- and postmenopausal symptoms, while there is also evidence that the therapy may additionally partially reverse menopausal immune senescence. Flavonoids, and especially isoflavones, are widely used for the treatment of menopausal symptoms, although it is not at present clear whether they can reverse or alleviate other menopausal changes. HRT reverses the menopausal CD4/CD8 ratio and also limits the general peri- and postmenopausal inflammatory state. Moreover, the increased levels of interleukins (IL)-1β, IL-6, and IL-8, as well as of tumor necrosis factor-α (TNF-α) are decreased after the initiation of HRT. However, some reports show no effect of HRT on IL-4, IL-10, and IL-12. It is thus evident that the molecular pathways connecting HRT and female immune senescence need to be clarified. Interestingly, recent studies have suggested that the anti-inflammatory properties of isoflavones possibly interact with inflammatory cytokines when applied in menopause treatments, thereby potentially reversing immune senescence. This narrative review presents the latest data on the effect of menopausal therapies, including administration of flavonoid-rich products, on age-associated immune senescence reversal with the aim of revealing possible directions for future research and treatment development. Full article

(This article belongs to the Special Issue Nutrition Challenges for Middle-Aged and Older Women)

14 pages, 1321 KiB

Open AccessReview

Evaluation of Clinical Meaningfulness of Red Clover (Trifolium pratense L.) Extract to Relieve Hot Flushes and Menopausal Symptoms in Peri- and Post-Menopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

by Wiesław Kanadys, Agnieszka Barańska, Agata Błaszczuk, Małgorzata Polz-Dacewicz, Bartłomiej Drop, Krzysztof Kanecki and Maria Malm

Nutrients 2021, 13(4), 1258; https://doi.org/10.3390/nu13041258 - 11 Apr 2021

Cited by 12 | Viewed by 8132

Abstract

The meta-analysis presented in this article covered the efficacy of red clover isoflavones in relieving hot flushes and menopausal symptoms in perimenopausal and postmenopausal women. Studies were identified by MEDLINE (PubMed), Embase, and the Cochrane Library searches. The quality of the studies was evaluated according to Cochrane criteria. A meta-analysis of eight trials (ten comparisons) demonstrated a statistically significant reduction in the daily incidence of hot flushes in women receiving red clover compared to those receiving placebo: weighted mean difference (WMD—weighted mean difference) −1.73 hot flushes per day, 95% CI (confidence interval) −3.28 to −0.18; p = 0.0292. Due to 87.34% heterogeneity, the performed analysis showed substantive difference in comparisons of postmenopausal women with ≥5 hot flushes per day, when the follow-up period was 12 weeks, with an isoflavone dose of ≥80 mg/day, and when the formulations contained a higher proportion of biochanin A. The meta-analysis of included studies assessing the effect of red clover isoflavone extract on menopausal symptoms showed a statistically moderate relationship with the reduction in the daily frequency of hot flushes. However, further well-designed studies are required to confirm the present findings and to finally determine the effects of red clover on the relief of flushing episodes. Full article

(This article belongs to the Special Issue Nutrition Challenges for Middle-Aged and Older Women)

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17 pages, 784 KiB

Open AccessReview

The Diverse Efficacy of Food-Derived Proanthocyanidins for Middle-Aged and Elderly Women

by Toru Izumi and Masakazu Terauchi

Nutrients 2020, 12(12), 3833; https://doi.org/10.3390/nu12123833 - 15 Dec 2020

Cited by 6 | Viewed by 3575

Abstract

Middle-aged and elderly women are affected by various symptoms and diseases induced by estrogen deficiency. Proanthocyanidins, widely present in many kinds of fruits and berries, have many beneficial effects, such as antioxidative, anti-inflammatory, and antimicrobial activities. We researched the effects of proanthocyanidins for middle-aged and elderly women, finding that it has been revealed in many clinical trials and cohort studies that proanthocyanidins contribute to the prevention of cardiovascular disease, hypertension, obesity, cancer, osteoporosis, and urinary tract infection, as well as the improvement of menopausal symptoms, renal function, and skin damage. Thus, proanthocyanidins can be considered one of the potent representatives of complementary alternative therapy. Full article

(This article belongs to the Special Issue Nutrition Challenges for Middle-Aged and Older Women)

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