Effects of a dietary intervention and weight change on vasomotor symptoms in the Women’s Health Initiative

Abstract

Objective To evaluate whether a dietary intervention designed to reduce fat intake and increase intake of fruit, vegetables, and whole grains, and weight loss, reduce vasomotor symptoms (VMS, i.e., hot flashes or night sweats) in postmenopausal women. Methods We included 17,473 postmenopausal U.S. women, ages 50–79 at baseline who participated in the Women’s Health Initiative Dietary Modification (DM) trial and were not taking menopausal hormone therapy. Logistic regression was used to evaluate associations. Results In multivariate-adjusted analyses, with simultaneous adjustment for the intervention and weight change, assignment to dietary intervention vs. control arm was significantly (OR=1.14, 95%CI: 1.01–1.28) related to a higher likelihood of symptom elimination among women with VMS at baseline. Additionally, women with symptoms at baseline who lost ≥10 lbs (OR=1.23, 95%CI: 1.05–1.46) or lost ≥10% of their baseline body weight (OR=1.56, 95%CI: 1.21–2.02) between baseline and year 1 were significantly more likely to eliminate VMS compared with those who maintained weight. Upon examining the joint effect of the dietary modification and weight loss, compared to women in the control arm who maintained weight, women who lost substantial weight (≥10%) as a part of the intervention (OR=1.89, 95%CI: 1.39–2.57), but not control arm (OR=1.40, 95%CI: 0.92–2.13), were significantly more likely to end VMS, though these two groups did not differ significantly from each other. Large weight loss (>22 lbs) but not dietary changes were related to elimination of moderate/severe VMS. Conclusions Weight loss as part of a healthy dietary modification may help to eliminate vasomotor symptoms among postmenopausal women.

Fruit, Mediterranean-style, and high-fat and -sugar diets are associated with the risk of night sweats and hot flushes in midlife: results from a prospective cohort study

“…Nevertheless, the effect of usual diet on VMSs has not been well studied. One recent study found that women who lost weight during participation in a dietary modification trial designed to reduce fat and increase fruit, vegetable, and fiber intakes reported a reduction or elimination of VMSs over 1 y (10). This association is consistent with our findings.…”

“…A recent study found that women with VMSs who followed a diet low in fat and high in whole grains, fruit, and vegetables were more likely to reduce or eliminate VMSs after 1 y (10). Until now, however, very little was known about the associations between overall dietary patterns and risk of VMSs.…”

Treatment of Symptoms of the Menopause: An Endocrine Society Clinical Practice Guideline

“…Being overweight or obese is a risk factor for VMS (26,210,211), and weight loss may reduce hot flash frequency (212,214).…”

Progesterone for treatment of symptomatic menopausal women

“…Menopausal women with sleep-disturbing VMS need to correct VMS-increasing factors like life stressors 30 , cigarette use, sedentary behavior and obesity 40 . If making these lifestyle changes does not improve VMS sufficiently so they wake a fewer number of times than twice a week, I suggest that they need therapy.…”

“…How are VMS typically treated? Almost everything imaginable has been tried, from sleeping on a metal-threaded cloth to all manner of herbs 38,39 and diets 40 (especially since low blood sugar, perhaps through a brain stress pathway 41 , is associated with VMS). Drugs include anti-anxiety medications to antidepressants 42 and other neuroactive interventions such as gabapentin, acupuncture 43 , clinical hypnosis 44 and stellate ganglion blockade 45 .…”