Effects of nutritional interventions on the severity of depressive and anxiety symptoms of women in the menopausal transition and menopause: a systematic review, meta-analysis, and meta-regression

Abstract

Importance: Depression and anxiety may significantly affect women during the menopausal transition. In addition to traditional treatment strategies such as hormone therapy, antidepressants, and psychotherapy, nutritional interventions have been increasingly studied, but there is no consensus about their role in this patient population.Objective: This systematic review and meta-analysis aimed to evaluate the effect of nutritional interventions on the severity of depressive (DS) and anxiety (AS) symptoms in women during the menopausal transition or menopausal years.Evidence Review: Electronic search using databases PubMed, Cochrane, and Embase to identify articles indexed until January 31, 2021, focusing on randomized placebo-controlled trials documenting the effect of diet, food supplements, and nutraceuticals on DS and AS.Findings: Thirty-two studies were included (DS, n = 15; AS, n = 1; DS and AS combined, n = 16). We found two studies that demonstrated data combined with other interventions: one with lifestyle interventions (vitamin D plus lifestyle-based weight-loss program) and another with exercise (omega 3 plus exercise). The pooled effect size favored the intervention group over placebo for both DS and AS (DS: standardized mean difference, −0.35 [95% confidence interval, −0.68 to −0.03; P = 0.0351]; AS: standardized mean difference, −0.74 [95% CI, −1.37 to −0.11; P = 0.0229]). There was significant heterogeneity in the pooled results, which can be attributed to differences in assessment tools for depression and anxiety as well as the variety of nutritional interventions studied. The subgroup analysis showed a statistically significant effect of menopausal status (perimenopausal or menopausal) but not the type or duration of nutritional intervention. Older age was the only significant predictor of the effect size of nutritional interventions in the meta-regression.Conclusions and Relevance: Nutritional interventions are promising tools for the management of mood/anxiety symptoms in women during the menopausal transition and in postmenopausal years. Because of significant heterogeneity and risk of bias among studies, the actual effect of different approaches is still unclear.

Treatments and Management of Menopausal Symptoms: Current Status and Future Challenges

“…The guiding principle must be variety in moderation, cutting out excess fat and too salty foods, drinking at least 25 milliliters (ml) of water per kilogram (kg) of body, and giving preference to spices. Obese or over-weighted women need to change their lifestyle and follow a more moderate diet, while the literature discuss the usefulness of some drugs such as orlistat [95][96][97][98].…”

Systematic Reviews to Inform Practice, March/April 2023

“…This is true during pregnancy when increased physical activity is associated with decreased risk for gestational diabetes, preeclampsia, and gestational weight gain 1 . For those who have experienced menopause, 2 recent meta‐analyses have highlighted the importance of exercise during menopause to improve or decrease the severity of mental health issues such as depression and anxiety 2 , 3 . The current physical activity recommendations for all adults, including those who are pregnant, is 150 minutes of moderate‐intensity physical activity and 2 days of muscle strengthening a week 4 .…”

Effects of Omega-3 Polyunsaturated Fatty Acids Intake on Vasomotor Symptoms, Sleep Quality and Depression in Postmenopausal Women: A Systematic Review

“…However, another study failed to observe any significant alterations in VMS and sleep quality when compared to a placebo [28]. A comprehensive review of 32 studies underscored the vulnerability of menopausal women to depression and anxiety [29]. Exploring the interplay of HF, sleep patterns, and depression in women undergoing menopause induced by a Gonadotropin-releasing hormone (GnRH) agonist medication, a study revealed significant associations between increased sleep interruptions, nocturnal HF, and heightened depression scores [30].…”