Women in LOVe: Lacto-Ovo-Vegetarian Diet Rich in Omega-3 Improves Vasomotor Symptoms in Postmenopausal Women. An Exploratory Randomized Controlled Trial

Author(s): Ornella Rotolo, Iris Zinzi, Nicola Veronese*, Anna M. Cisternino, Rosa Reddavide, Rosa Inguaggiato, Gioacchino Leandro, Maria Notarnicola, Valeria Tutino, Valentina De Nunzio, Giampiero De Leonardis, Vito Guerra, Rossella Donghia, Fabio Fucilli, Raffaella Licinio, Anna Mastrosimini, Caterina C.M. Rinaldi, Tiziana Daddabbo, Nicola Giampaolo, Palma A. Iacovazzi, Sara Giannico, Maria G. Caruso.

Journal Name: Endocrine, Metabolic & Immune Disorders - Drug Targets
(Formerly Current Drug Targets - Immune, Endocrine & Metabolic Disorders)

Volume 19 , Issue 8 , 2019

Become EABM
Become Reviewer

Graphical Abstract:


Abstract:

Objectives: In the postmenopausal period, most women suffer vasomotor symptoms (VMS). It is well-known that VMS can worsen the quality of life. Diet seems to play a relevant role in the development of VMS, but the effect of diet on VMS is mainly limited to observational studies, and analyses of nutritional supplements. The aim of this study was thus to determine the efficacy of a lactoovo- vegetarian (LOVe) diet rich in omega-3 fatty acids vs. a lacto-ovo-vegetarian diet rich in EVO (extra-virgin olive oil) in reducing VMS frequency in postmenopausal women.

Methods: A two-arms (lacto-ovo-vegetarian diet with EVO vs. lacto-ovo-vegetarian diet rich in omega-3) randomized-controlled trial with a follow-up period of 16 weeks. We considered as primary outcome the change in the Kupperman index (follow-up vs. baseline evaluation, reported as delta, D) and in its subscales. Secondary outcomes included changes in common anthropometric and biohumoral measurements.

Results: Among 54 women randomly assigned to a study group, 40 (mean age 55.1±5.4 years) completed the study and complied with their assigned diet. Women randomized to the omega-3 group (n=18) showed significant improvements, compared to the EVO group (n=22), in Kupperman index (Δ=-11.4±9.8 vs. -5.9±8.2; p=0.045), hot flashes (Δ=-3.3±3.4 vs. -1.3±2.6; p=0.04), and a marginally significant improvement in nervousness (Δ=-1.7±1.7 vs. -0.8±1.5; p=0.07). No significant differences were observed for the secondary outcomes. No relevant side effects were reported.

Conclusion: After 16 weeks, a lacto-ovo-vegetarian diet rich in omega-3 reduced VMS frequency in postmenopausal women more than the lacto-ovo-vegetarian diet rich in EVO.

Keywords: Diet, menopause, omega 3, lacto-ovo-vegetarian, RCT, Kupperman index.

[1]
Freedman, R.R.; Norton, D.; Woodward, S.; Cornélissen, G. Core body temperature and circadian rhythm of hot flashes in menopausal women. J. Clin. Endocrinol. Metab., 1995, 80(8), 2354-2358.
[PMID: 7629229]
[2]
Reed, S.D.; Lampe, J.W.; Qu, C.; Gundersen, G.; Fuller, S.; Copeland, W.K.; Newton, K.M. Self-reported menopausal symptoms in a racially diverse population and soy food consumption. Maturitas, 2013, 75(2), 152-158.
[http://dx.doi.org/10.1016/j.maturitas.2013.03.003] [PMID: 23562010]
[3]
Dibonaventura, M.D.; Chandran, A.; Hsu, M-A.; Bushmakin, A. Burden of vasomotor symptoms in France, Germany, Italy, Spain, and the United Kingdom. Int. J. Womens Health, 2013, 5, 261-269.
[http://dx.doi.org/10.2147/IJWH.S39027] [PMID: 23737678]
[4]
Smoller, J.W.; Pollack, M.H.; Wassertheil-Smoller, S.; Barton, B.; Hendrix, S.L.; Jackson, R.D.; Dicken, T.; Oberman, A.; Sheps, D.S. Prevalence and correlates of panic attacks in postmenopausal women: results from an ancillary study to the Women’s Health Initiative. Arch. Intern. Med., 2003, 163(17), 2041-2050.
[http://dx.doi.org/10.1001/archinte.163.17.2041] [PMID: 14504117]
[5]
Cohen, L.S.; Soares, C.N.; Joffe, H. Diagnosis and management of mood disorders during the menopausal transition. Am. J. Med., 2005, 118(12)(Suppl. 12B), 93-97.
[http://dx.doi.org/10.1016/j.amjmed.2005.09.042] [PMID: 16414333]
[6]
Thurston, R.C.; Blumenthal, J.A.; Babyak, M.A.; Sherwood, A. Association between hot flashes, sleep complaints, and psychological functioning among healthy menopausal women. Int. J. Behav. Med., 2006, 13(2), 163-172.
[http://dx.doi.org/10.1207/s15327558ijbm1302_8] [PMID: 16712434]
[7]
Ohayon, M.M. Severe hot flashes are associated with chronic insomnia. Arch. Intern. Med., 2006, 166(12), 1262-1268.
[http://dx.doi.org/10.1001/archinte.166.12.1262] [PMID: 16801508]
[8]
Beezhold, B.; Radnitz, C.; McGrath, R.E.; Feldman, A. Vegans report less bothersome vasomotor and physical menopausal symptoms than omnivores. Maturitas, 2018, 112, 12-17.
[http://dx.doi.org/10.1016/j.maturitas.2018.03.009] [PMID: 29704911]
[9]
Jacobs, D.R., Jr; Orlich, M.J. Diet pattern and longevity: Do simple rules suffice? A commentary. Am. J. Clin. Nutr., 2014, 100, 313S-319S.
[10]
Molfino, A.; Amabile, M.I.; Monti, M.; Muscaritoli, M. Omega-3 Polyunsaturated Fatty Acids in Critical Illness: Anti-Inflammatory, Proresolving, or Both? Oxid. Med. Cell. Longev., 2017.20175987082
[http://dx.doi.org/10.1155/2017/5987082] [PMID: 28694914]
[11]
Sofi, F.; Dinu, M.; Pagliai, G.; Cesari, F.; Gori, A.M.; Sereni, A.; Becatti, M.; Fiorillo, C.; Marcucci, R.; Casini, A. Low-Calorie Vegetarian Versus Mediterranean Diets for Reducing Body Weight and Improving Cardiovascular Risk Profile: CARDIVEG Study (Cardiovascular Prevention With Vegetarian Diet). Circulation, 2018.117030088
[12]
Cobin, R.H.; Futterweit, W.; Ginzburg, S.B.; Goodman, N.F.; Kleerekoper, M.; Licata, A.A.; Meikle, A.W.; Petak, S.M.; Porte, K.L.; Sellin, R.V.; Smith, K.D.; Verso, M.A.; Watts, N.B. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the diagnosis and treatment of menopause. Endocr. Pract., 2006, 12(3), 315-337.
[http://dx.doi.org/10.4158/EP.12.3.315] [PMID: 16772207]
[13]
Kupperman, H.S.; Blatt, M.H.; Wiesbader, H.; Filler, W. Comparative clinical evaluation of estrogenic preparations by the menopausal and amenorrheal indices. J. Clin. Endocrinol. Metab., 1953, 13(6), 688-703.
[http://dx.doi.org/10.1210/jcem-13-6-688] [PMID: 13061588]
[14]
Blatt, M.H.; Wiesbader, H.; Kupperman, H.S. Vitamin E and climacteric syndrome; failure of effective control as measured by menopausal index. AMA Arch. Intern. Med., 1953, 91(6), 792-799.
[http://dx.doi.org/10.1001/archinte.1953.00240180101012] [PMID: 13050216]
[15]
de Boer, M.R.; Waterlander, W.E.; Kuijper, L.D.J.; Steenhuis, I.H.M.; Twisk, J.W.R. Testing for baseline differences in randomized controlled trials: an unhealthy research behavior that is hard to eradicate. Int. J. Behav. Nutr. Phys. Act., 2015, 12, 4.
[http://dx.doi.org/10.1186/s12966-015-0162-z] [PMID: 25616598]
[16]
Ranganathan, P.; Pramesh, C.S.; Aggarwal, R. Common pitfalls in statistical analysis: Intention-to-treat versus per-protocol analysis. Perspect. Clin. Res., 2016, 7(3), 144-146.
[http://dx.doi.org/10.4103/2229-3485.184823] [PMID: 27453832]
[17]
Lucas, M.; Asselin, G.; Mérette, C.; Poulin, M-J.; Dodin, S. Effects of ethyl-eicosapentaenoic acid omega-3 fatty acid supplementation on hot flashes and quality of life among middle-aged women: a double-blind, placebo-controlled, randomized clinical trial. Menopause, 2009, 16(2), 357-366.
[http://dx.doi.org/10.1097/gme.0b013e3181865386] [PMID: 19034052]
[18]
Cohen, L.S.; Joffe, H.; Guthrie, K.A.; Ensrud, K.E.; Freeman, M.; Carpenter, J.S.; Learman, L.A.; Newton, K.M.; Reed, S.D.; Manson, J.E. Efficacy of omega-3 treatment for vasomotor symptoms: a randomized controlled trial: omega-3 treatment for vasomotor symptoms. Menopause, 2014, 21(4), 347.
[PMID: 23982113]
[19]
Munro, I.A.; Garg, M.L. Dietary supplementation with long chain omega-3 polyunsaturated fatty acids and weight loss in obese adults. Obes. Res. Clin. Pract., 2013, 7(3), e173-e181.
[http://dx.doi.org/10.1016/j.orcp.2011.11.001] [PMID: 23697585]
[20]
Craig, W.J. Nutrition concerns and health effects of vegetarian diets. Nutr. Clin. Pract., 2010, 25(6), 613-620.
[http://dx.doi.org/10.1177/0884533610385707] [PMID: 21139125]
[21]
Alder, E. The Blatt-Kupperman menopausal index: a critique. Maturitas, 1998, 29(1), 19-24.
[http://dx.doi.org/10.1016/S0378-5122(98)00024-3] [PMID: 9643513]
[22]
Gracia, C.R.; Sammel, M.D.; Freeman, E.W.; Lin, H.; Langan, E.; Kapoor, S.; Nelson, D.B. Defining menopause status: creation of a new definition to identify the early changes of the menopausal transition. Menopause, 2005, 12(2), 128-135.
[http://dx.doi.org/10.1097/00042192-200512020-00005] [PMID: 15772558]


Rights & PermissionsPrintExport Cite as

Article Details

VOLUME: 19
ISSUE: 8
Year: 2019
Page: [1232 - 1239]
Pages: 8
DOI: 10.2174/1871530319666190528101532
Price: $65

Article Metrics

PDF: 31
HTML: 3
EPUB: 1
PRC: 1