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Abstract and Introduction
Abstract
Objective: The aim of this study was to determine whether a dietary intervention designed to reduce fat intake and increase intake of fruit, vegetables, and whole grains, and weight loss, reduces vasomotor symptoms (VMS; ie, hot flashes or night sweats) in postmenopausal women.
Methods: We included 17,473 postmenopausal US women, ages 50 to 79 years, at baseline who participated in the Women’s Health Initiative Dietary Modification 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 the dietary intervention versus the control arm was significantly (odds ratio [OR], 1.14; 95% CI, 1.01-1.28) related to a higher likelihood of symptom elimination among women with VMS at baseline. In addition, women with symptoms at baseline who lost 10 lb or more (OR, 1.23; 95% CI, 1.05-1.46) or lost 10% or more 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 with 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 as part of the control arm (OR, 1.40; 95% CI, 0.92-2.13) were significantly more likely to end VMS, although these two groups did not differ significantly from each other. Large weight loss (>22 lb), but not dietary changes, was related to the elimination of moderate/severe VMS.
Conclusions: Weight loss as part of a healthy dietary modification may help eliminate VMS among postmenopausal women.
Introduction
Vasomotor symptoms (VMS) include hot flashes and night sweats and are thought to result from vasodilation of the blood vessels close to the skin. Up to 80% of perimenopausal and postmenopausal women report having VMS, with up to half reporting moderate or severe symptoms. Vasomotor symptoms peak during the menopausal transition, but they can persist for years—longer than a decade in some women. Up to one quarter of women in their 60s and 70s report having hot flashes.
Vasomotor symptoms can negatively affect a woman’s quality of life by disrupting sleep, interfering with work and leisure activities, and exacerbating anxiety and depression. In multiple observational studies, women with a larger body size, either higher body mass index or greater percentage body fat, have reported more frequent or severe vasomotor symptoms compared with women with a lower body mass index or percentage body fat.
Although high body weight is linked to greater vasomotor symptomatology, little is known about weight change and VMS—whether weight gain might exacerbate and weight loss might ameliorate symptoms. Two studies have reported that weight gain, or fat gain, is associated with reporting more VMS, and one small randomized weight loss intervention trial (N = 338) reported that women in the intervention group had fewer and less bothersome hot flashes than did women in the control group at the end of the trial.
Because most women tend to gain weight with age, weight loss or prevention of weight gain, in addition to other potential health benefits, may offer a viable strategy to help alleviate VMS. In addition, dietary patterns might also influence VMS. Most studies have focused on the effect of soy and other isoflavonoid intake on symptoms, and there is evidence that high fiber and low fat intake may be related to a reduced likelihood of these symptoms; nonetheless, there is limited research on dietary patterns and VMS.
The Women’s Health Initiative (WHI) Dietary Modification (DM) trial consisted of a dietary intervention aimed at reducing fat intake and increasing fruit, vegetable, and whole grain intake. Although weight loss was not a goal, participants assigned to the intervention lost, on average, approximately 2 kg between baseline and year 1 compared with the control group, providing the opportunity to examine whether this dietary intervention, weight change, and weight change resulting from a low fat dietary pattern intervention were associated with the reduction or elimination of VMS.
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