The Role of Diet in Menopause and Andropause

Dear Colleagues,

Optimal body functioning and good health demand ideal body composition and distribution of tissues and organs. This homeostasis is required to support the physiological and biochemical processes underpinning a healthy trajectory of life. The energy required for maintaining body composition (BC) depends on the nutritional status. There is a bidirectional link between BC and the quantity and quality of energy intake. This relationship changes during transition menopause. The modified hormonal milieu in women, together with increasing age and lower energy expenditure, causes an important change in fat distribution, leading to central obesity, and insulin resistance. Recent longitudinal studies suggest that fat and lean mass increase prior to menopause transition (MT), and at the start of MT, the rate of fat gain doubles, and the lean mass declines; these gains and losses continue for two years after the final menstrual period (FMP). Changes in BC occur to a lesser extent in men. The decline in serum testosterone (T) levels is less profound than the cessation of estrogens in women and does not affect all men. A large cross-sectional survey showed that progressively lower total and free testosterone in older men were associated with increasing BMI, obesity, waist circumference (as a proxy of adiposity), and co-morbidities, independently of sex hormone-binding globulin (SHBG) levels. In addition to the increase of intra-abdominal fat mass, the simultaneous reduction in skeletal muscle mass and muscle strength represents the main BC change associated with aging in men. However, it is not completely elucidated whether low T levels may increase the risk for developing visceral fat or the opposite, since this relationship may be bidirectional.

Thus, with advancing age, there are many alterations in the endocrine system, which may ultimately change human physiology and body composition both in women and in men, influencing the growth of muscle and bone and regulating the metabolism. Among the factors that can modulate hormone secretion, there are diet and exercise, two of the few known lifestyle-related features that can be modified. Although limited data exist about whether dietary modifications can affect fat distribution during menopausal transition, evidence suggests that continuous and regular exercise may be more efficacious than dietary intervention and that these two determinants act synergistically for the promotion of a healthy body composition profile, characterized by the preservation of lean mass and a significant decrease in body fat. However, the physiological effects of physical activity and exercise on glucoregulatory hormones in elderly subjects are relatively understudied, and further research is necessary to elucidate whether physical exercise together with diet can act as a countermeasure to endocrinological and body composition-related modifications occurring during the process of aging.

Prof. Maurizio Muscaritoli
Prof. Marcello Maggio
Guest Editors

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• Diet
• Metabolic Syndrome
• Physical Activity
• Andropause
• Menopause