Slimming down in menopause with the Mediterranean diet. Scientific study

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Slimming down in menopause is possible, without the need for freak diets or gymnastic obsession. An authentic Mediterranean diet makes it possible to lose fat mass and maintain muscle in the same way as women of childbearing age, with stable long-term effects. The scientific study published in Nutrients. (1)

Menopause, visceral fat and ginoid lurking

Weight gain is a very common phenomenon during the menopausal transition. The average gain is 1-2 kg, with higher levels in less lifestyle-conscious women.

The hormonal changes that accompany menopause promote a shift in fat accumulation, from the hips to the waist. Accordingly,

Visceral fat mass, that which surrounds the internal organs, increases by an average of 44% (2)

gynoid fat mass, on thighs and buttocks, increases by about 32 percent.

Female obesity risk

The changes described above are unfortunately often accompanied by a reduction in physical activity in women’s routines. To which is often added the drift of unbalanced energy intake, particularly from ultra-processed foods (junk food) and alcoholic beverages. This increases the risk of developing noncommunicable diseases.

The statistics are clear. Up to age 45, the incidence of obesity is more common in men than in women. Beyond this stage, the trend reverses. Metabolic syndrome, cardiovascular disease, and type 2 diabetes are found in postmenopausal women three times more often than before.

Slimming down in menopause, the study

Aiming to test whether menopause affects weight loss and changes in body composition, researchers recruited 89 women, assigned to two groups. The former composed of fertile women (over 45), the latter of women already in menopause. All with a body mass index (or BMI, Body Mass Index) between 25 and 45, a detector of overweight and obesity. (3)

All participants followed a low-calorie diet plan, with a deficit of 500-600 kcal/day relative to energy expenditure. According to the Mediterranean diet model, tailored to each participant. With a request to limit oneself to minimal aerobic exercise.

Mediterranean diet, the Nicotera model

The dietary regimen applied in the study is based on the Nicotera model. A small town in Calabria (now the province of Vibo Valenzia) that was taken as a model for a rural area in the South, in the
Seven Countries Study
by Dr. Ancel Keys that enshrined the Mediterranean diet. (4)

Many plant foods, such as fruits, vegetables, legumes and grains. And a breakdown of energy intake (the kcal of individual foods) composed as follows:

– 50-59% grain,

– 13-17% extra virgin olive oil,

– vegetables 2.2-3.6%,

– potatoes 2.3-3.6%,

– legumes 3-6%,

– fruit 2.6- 3.6%,

– fish 1.6-2%,

– 2.6-5% meat,

– dairy products 2-4%

– red wine 1-6%,

– Minimal amounts of eggs and animal fats.

Recommendations are to use herbs and spices instead of salt, eat fish at least twice a week, and limit red meat to no more than twice a week. The main daily sources of fat are extra virgin olive oil (25-35 g) and a handful of walnuts (20 g).

The composition of the recommended diet for the study participants, divided into three meals and two snacks, is organized as follows,

– carbohydrates 50-60%,

– 10-15% protein (of which more than 50% from plant protein),

– total fat <30% (saturated fat less <7% and cholesterol consumption less than 300 mg per day)

– More than 30 g of fiber.

The results

After two months , all women-fertile and postmenopausal-had improved body composition, with reduction in fat mass (- 2.3 kg on average, +2.1 kg) and maintenance of lean mass. With an appreciable peculiarity in the group of postmenopausal women, a marked decrease in low-density lipoprotein (LDL, or ‘bad’ cholesterol).

The results are therefore encouraging. Counteracting overweight and obesity during the menopausal transition is possible and does not require excessive effort. To improve the figure but more importantly reduce cardiovascular and metabolic risk factors.

Marta Strinati

Notes

1) Lombardo, M.; Perrone, M.A.; Guseva, E.; Aulisa, G.; Padua, E.; Bellia, C.; Della-Morte, D.; Iellamo, F.; Caprio, M.; Bellia, A. (2020). Losing Weight after Menopause with Minimal Aerobic Training and Mediterranean Diet. Nutrients 2020, 12, 2471. https://doi.org/10.3390/nu12082471

2) On the risks related to abdominal obesity, see Alberto Zambon, Michela Marchiori, Enzo Manzato,
Visceral obesity and dyslipidemia: pathophysiological mechanisms, clinical implications, and therapy.
, Department of Medical and Surgical Sciences, University of Padua, Italy.

3) Body mass index is used to assess overweight and related health risks. It is calculated by dividing the weight (kg) by the square of the height (m). Exceeding 25, one is overweight. A BMI calculator is available on the Ministry of Health website.

4) De Lorenzo A, Alberti A, Andreoli A, et al. (2001). Food habits in a southern Italian town (Nicotera) in 1960 and 1996: still a reference of the Italian Mediterranean diet? Diabetes, nutrition, and metabolism. 2001 Jun; 14 (3): 121-125.

Marta Strinati

Professional journalist since January 1995, he has worked for newspapers (Il Messaggero, Paese Sera, La Stampa) and periodicals (NumeroUno, Il Salvagente). She is the author of journalistic surveys on food, she has published the book "Reading labels to know what we eat".