Menopause: The Journal of The North American Menopause Society Vol. 22, No. 7, pp. 750/757 DOI: 10.1097/gme.0000000000000378 * 2014 by The North American Menopause Society
Adherence to Mediterranean dietary pattern and menopausal symptoms in relation to overweight/obesity in Spanish perimenopausal and postmenopausal women Carmen Sayo´n-Orea, MD, PhD,1 Susana Santiago, PhD,2 Marta Cuervo, PhD,2,3 Miguel A. Martı´nez-Gonza´lez, MD, MPH, PhD,1,3 Aquilino Garcia, PharmD, PhD,4 and Jose Alfredo Martı´nez, MD, PharmD, PhD2,3 Abstract Objective: This study aims to assess the relationship of adherence to the Mediterranean dietary pattern, as well as the presence of menopausal symptoms, with overweight/obesity in Spanish perimenopausal and postmenopausal women. Methods: Participants in this cross-sectional study were 8,954 Spanish perimenopausal or postmenopausal women. Anthropometric measurements were recorded, and all women were interviewed to assess their adherence to the Mediterranean dietary pattern, using a validated questionnaire and the Menopause and Health subscale of the validated Cervantes Scale. A logistic regression model was used to investigate the association between categories of adherence to the Mediterranean diet and the odds of being overweight/obese. Multinomial logistic regression was used to study the association between menopausal symptoms and the odds of being overweight/obese (reference categories: participants in the low-adherence category and participants with no menopausal problems). Results: After adjustment for relevant confounders, the odds ratio (95% CI) for being overweight/obese among women in the highest category of adherence to the Mediterranean dietary pattern was 0.68 (0.60-0.78; P for trend G0.001). The odds ratio (95% CI) for being overweight/obese was 3.05 (1.98-4.71) for the category Bsevere problems[ in comparison with the category Bno problems.[ Conclusions: Higher adherence to a healthy dietary pattern (Mediterranean diet) is inversely associated with overweight/obesity in perimenopausal and postmenopausal women. The occurrence of low to severe problems during perimenopause or postmenopause is positively associated with overweight/obesity. Therefore, high adherence to the Mediterranean dietary pattern and a body mass index of 25kg/m2 or lower might improve quality of life in women at these stages. Key Words: Menopausal symptoms Y Mediterranean diet Y Overweight Y Obesity.
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xcess weight and obesity are major health problems in developed countries, being strongly related to risk factors for many chronic diseases such as diabetes, cardiovascular events, and some cancers.1 Moreover, excess weight and obesity are also related to worse self-esteem and quality of life.2,3 Globally, 1.4 billion adults are now classified
Received May 19, 2014; revised and accepted September 23, 2014. From the 1Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; 2Center for Nutritional Research, Department of Food Sciences and Physiology, University of Navarra, Pamplona, Spain; 3CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain; and 4Spanish Pharmacists Council, Madrid, Spain. J.A.M., M.A.M.-G., A.G., S.S., M.C., and C.S.-O. contributed to study design. C.S.-O. analyzed the data and drafted the manuscript. J.A.M., M.A.M.-G., A.G., S.S., and M.C. edited and critically reviewed the manuscript. All authors approved the final version of the manuscript. Funding/support: This work was supported by the Spanish Pharmacists Council. Financial disclosure/conflicts of interest: None reported. Address correspondence to: Jose Alfredo Martı´nez, MD, PharmD, PhD, Center for Nutritional Research, Department of Food Sciences and Physiology, University of Navarra, C/ Irunlarrea 1, Pamplona 31008, Navarra, Spain. E-mail: [email protected]
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as overweight or obese4; according to the latest statistics for Spain, 44.1% of women older than 18 years are overweight or obese.5 Menopause is the cessation of reproductive capacity in a woman’s life and is associated with a variety of physiological changes. Menopausal symptoms include, among others, hot flashes, night sweats, menstrual irregularities, vaginal dryness, palpitations, headaches, and insomnia. Worldwide, natural menopause occurs between ages 45 and 55 years.6 In Spain, menopause has been documented to occur within the age range of 48 to 54 years (mean age, 51.4 y).7 To date, available information on the presence of menopausal symptoms (which reduce quality of life and which might be associated with overweight/obesity in women at this stage) has been limited and contradictory.8
Adherence to Mediterranean dietary pattern and menopausal symptoms in relation to overweight/obesity in Spanish perimenopausal and postmenopausal women Carmen Sayo´n-Orea, MD, PhD,1 Susana Santiago, PhD,2 Marta Cuervo, PhD,2,3 Miguel A. Martı´nez-Gonza´lez, MD, MPH, PhD,1,3 Aquilino Garcia, PharmD, PhD,4 and Jose Alfredo Martı´nez, MD, PharmD, PhD2,3 Abstract Objective: This study aims to assess the relationship of adherence to the Mediterranean dietary pattern, as well as the presence of menopausal symptoms, with overweight/obesity in Spanish perimenopausal and postmenopausal women. Methods: Participants in this cross-sectional study were 8,954 Spanish perimenopausal or postmenopausal women. Anthropometric measurements were recorded, and all women were interviewed to assess their adherence to the Mediterranean dietary pattern, using a validated questionnaire and the Menopause and Health subscale of the validated Cervantes Scale. A logistic regression model was used to investigate the association between categories of adherence to the Mediterranean diet and the odds of being overweight/obese. Multinomial logistic regression was used to study the association between menopausal symptoms and the odds of being overweight/obese (reference categories: participants in the low-adherence category and participants with no menopausal problems). Results: After adjustment for relevant confounders, the odds ratio (95% CI) for being overweight/obese among women in the highest category of adherence to the Mediterranean dietary pattern was 0.68 (0.60-0.78; P for trend G0.001). The odds ratio (95% CI) for being overweight/obese was 3.05 (1.98-4.71) for the category Bsevere problems[ in comparison with the category Bno problems.[ Conclusions: Higher adherence to a healthy dietary pattern (Mediterranean diet) is inversely associated with overweight/obesity in perimenopausal and postmenopausal women. The occurrence of low to severe problems during perimenopause or postmenopause is positively associated with overweight/obesity. Therefore, high adherence to the Mediterranean dietary pattern and a body mass index of 25kg/m2 or lower might improve quality of life in women at these stages. Key Words: Menopausal symptoms Y Mediterranean diet Y Overweight Y Obesity.
E
xcess weight and obesity are major health problems in developed countries, being strongly related to risk factors for many chronic diseases such as diabetes, cardiovascular events, and some cancers.1 Moreover, excess weight and obesity are also related to worse self-esteem and quality of life.2,3 Globally, 1.4 billion adults are now classified
Received May 19, 2014; revised and accepted September 23, 2014. From the 1Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; 2Center for Nutritional Research, Department of Food Sciences and Physiology, University of Navarra, Pamplona, Spain; 3CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain; and 4Spanish Pharmacists Council, Madrid, Spain. J.A.M., M.A.M.-G., A.G., S.S., M.C., and C.S.-O. contributed to study design. C.S.-O. analyzed the data and drafted the manuscript. J.A.M., M.A.M.-G., A.G., S.S., and M.C. edited and critically reviewed the manuscript. All authors approved the final version of the manuscript. Funding/support: This work was supported by the Spanish Pharmacists Council. Financial disclosure/conflicts of interest: None reported. Address correspondence to: Jose Alfredo Martı´nez, MD, PharmD, PhD, Center for Nutritional Research, Department of Food Sciences and Physiology, University of Navarra, C/ Irunlarrea 1, Pamplona 31008, Navarra, Spain. E-mail: [email protected]
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as overweight or obese4; according to the latest statistics for Spain, 44.1% of women older than 18 years are overweight or obese.5 Menopause is the cessation of reproductive capacity in a woman’s life and is associated with a variety of physiological changes. Menopausal symptoms include, among others, hot flashes, night sweats, menstrual irregularities, vaginal dryness, palpitations, headaches, and insomnia. Worldwide, natural menopause occurs between ages 45 and 55 years.6 In Spain, menopause has been documented to occur within the age range of 48 to 54 years (mean age, 51.4 y).7 To date, available information on the presence of menopausal symptoms (which reduce quality of life and which might be associated with overweight/obesity in women at this stage) has been limited and contradictory.8
