Menopause is associated with postprandial metabolism, metabolic health and lifestyle: The ZOE PREDICT study

Kate M Bermingham; Inbar Linenberg; Wendy L Hall; Kirstin Kadé; Paul W Franks; Richard Davies; Jonathan Wolf; George Hadjigeorgiou; Francesco Asnicar; Nicola Segata; JoAnn E Manson; Louise R Newson; Linda M Delahanty; Jose M Ordovas; Andrew T Chan; Tim D Spector; Ana M Valdes; Sarah E Berry

doi:10.1016/j.ebiom.2022.104303

Menopause is associated with postprandial metabolism, metabolic health and lifestyle: The ZOE PREDICT study

EBioMedicine. 2022 Nov:85:104303. doi: 10.1016/j.ebiom.2022.104303. Epub 2022 Oct 18.

Authors

Kate M Bermingham¹, Inbar Linenberg², Wendy L Hall³, Kirstin Kadé², Paul W Franks⁴, Richard Davies², Jonathan Wolf², George Hadjigeorgiou², Francesco Asnicar⁵, Nicola Segata⁵, JoAnn E Manson⁶, Louise R Newson⁷, Linda M Delahanty⁸, Jose M Ordovas⁹, Andrew T Chan¹⁰, Tim D Spector¹, Ana M Valdes¹¹, Sarah E Berry¹²

Affiliations

¹ Department of Twins Research and Genetic Epidemiology, King's College London, London, UK.
² Zoe Ltd, London, UK.
³ Department of Nutritional Sciences, King's College London, London, UK.
⁴ Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Nutrition, Harvard Chan School of Public Health, Boston, MA, USA.
⁵ Department CIBIO, University of Trento, Trento, Italy.
⁶ Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
⁷ Newson Health Research and Education, Stratford-upon-Avon, UK.
⁸ Diabetes Center, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
⁹ JM-USDA-HNRCA at Tufts University, Boston, MA, USA; IMDEA Food Institute, CEI UAM + CSIC, Madrid, Spain; UCJC, Madrid, Spain.
¹⁰ Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, MA, USA.
¹¹ School of Medicine, University of Nottingham, Nottingham, UK; Nottingham NIHR Biomedical Research Centre, Nottingham, UK.
¹² Department of Nutritional Sciences, King's College London, London, UK. Electronic address: sarah.e.berry@kcl.ac.uk.

Abstract

Background: The menopause transition is associated with unfavourable alterations in health. However, postprandial metabolic changes and their mediating factors are poorly understood.

Methods: The PREDICT 1 UK cohort (n=1002; pre- n=366, peri- n=55, and post-menopausal females n=206) assessed phenotypic characteristics, anthropometric, diet and gut microbiome data, and fasting and postprandial (0-6 h) cardiometabolic blood measurements, including continuous glucose monitoring (CGM) data. Differences between menopausal groups were assessed in the cohort and in an age-matched subgroup, adjusting for age, BMI, menopausal hormone therapy (MHT) use, and smoking status.

Findings: Post-menopausal females had higher fasting blood measures (glucose, HbA1c and inflammation (GlycA), 6%, 5% and 4% respectively), sugar intakes (12%) and poorer sleep (12%) compared with pre-menopausal females (p<0.05 for all). Postprandial metabolic responses for glucose_2hiauc and insulin_2hiauc were higher (42% and 4% respectively) and CGM measures (glycaemic variability and time in range) were unfavourable post- versus pre-menopause (p<0.05 for all). In age-matched subgroups (n=150), postprandial glucose responses remained higher post-menopause (peak_0-2h 4%). MHT was associated with favourable visceral fat, fasting (glucose and insulin) and postprandial (triglyceride_6hiauc) measures. Mediation analysis showed that associations between menopause and metabolic health indicators (visceral fat, GlycA_360mins and glycaemia (peak_0-2h)) were in part mediated by diet and gut bacterial species.

Interpretation: Findings from this large scale, in-depth nutrition metabolic study of menopause, support the importance of monitoring risk factors for type-2 diabetes and cardiovascular disease in mid-life to older women to reduce morbidity and mortality associated with oestrogen decline.

Funding: Zoe Ltd.

Keywords: Age-matched subgroups; Menopause; Postprandial metabolic responses.

MeSH terms

Aged
Blood Glucose Self-Monitoring*
Blood Glucose* / metabolism
Female
Humans
Insulin
Life Style
Menopause / metabolism

Substances

Blood Glucose
Insulin

Grants and funding

P30 DK111022/DK/NIDDK NIH HHS/United States