Loading ...

TOPLINE:

The low-insulinemic and planetary health dietary patterns — both emphasizing whole plant foods, healthy fats, and restriction of highly processed foods — were most associated with optimized weight management during menopause compared with other diets.

METHODOLOGY:

• Although a healthy diet is key to managing weight gain associated with menopause, the effectiveness of various diets for weight management during this period is unclear.
• Researchers conducted a prospective population-based cohort study of 38,283 US women (mean age, 45.6 years) enrolled in the Nurses’ Health Study II (1989-2019) to compare dietary patterns and their associations with weight gain and the risk for obesity in the 6 years before and after menopause, defined as the cessation of menstruation for at least 1 year.
• Participants’ diets were assessed every 4 years using validated semiquantitative food frequency questionnaires, and the following dietary patterns were evaluated: plant-based dietary index, healthy plant-based diet index, unhealthy plant-based diet index, Mediterranean diet, DASH diet, Planetary Health Diet Index (PHDI), low-carbohydrate diet, healthy low-carbohydrate diet, unhealthy low-carbohydrate diet, empirical dietary inflammatory pattern, empirical dietary index for hyperinsulinemia (EDIH), and ultraprocessed food intake.
• Outcomes measured were annual changes in self-reported body weight (kg/y) and incident obesity.

TAKEAWAY:

• Across the cohort, mean weight gain was 0.80 kg/y, and 5214 women developed obesity during 340,122 person-years of follow-up.
• After multivariable adjustment, a higher reverse EDIH, reflecting a lower insulinemic diet, was associated with the largest mean reduction in weight gain: -0.28 kg/y. For incident obesity, the lowest risks were observed for the PHDI (hazard ratio [HR], 0.46) and reverse EDIH (HR, 0.51).
• The EDIH showed the largest positive correlations with red or processed meats, sodium, and French fries, and the PHDI showed the largest positive correlations with nuts, unsaturated oils, whole-grain carbohydrates, and vegetable protein.
• Findings were consistent across premenopausal and postmenopausal strata and within 4- and 8-year windows around menopause.

IN PRACTICE:

“The findings support low-insulinemic and planetary health diets, low in red and processed meats, potatoes, and sodium and rich in nuts, legumes, fruits, vegetables, and whole grains, as an optimal strategy for weight management during menopause. Incorporating this dietary guidance into routine midlife care may help prevent obesity and support long-term cardiometabolic health in women,” the authors wrote.

SOURCE:

The study, led by Tong Xia, MD, PhD, MPH, Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, was published online in JAMA Network Open.

LIMITATIONS:

Food frequency questionnaires may have been subject to measurement errors. Self-reported weight is subject to error, even though it is highly correlated with measured weight. The study lacked detailed menopausal symptom data, temporally aligned sex-hormone measures, and sufficient clinical outcome events such as incident type 2 diabetes, cardiovascular disease, or cancer during menopause for robust analyses.

DISCLOSURES:

The Nurses’ Health Study II received support from National Institutes of Health (NIH) grants. The current study was funded by NIH grants and the Julie Wilcox Women’s Health and Nutrition Novel Research Fund. Two authors disclosed receiving grants from the Almond Board of California outside the submitted work; one author received grants from the Analysis Group outside the submitted work; and one author reported receiving NIH grants during the conduct of the study.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.