Weight excess and inflammation in menopause: pathophysiology of dangerous liaison and role of lifestyles
1 – Department of Clinical Medicine and Surgery, Section of Endocrinology, University “Federico II” of Naples, Via Sergio Pansini, 5, Naples, Italy
2 – Unesco Chair “Health Education and Sustainable Development”, Federico II University, Naples, Italy
3 – Center for Gynecology and Medical Sexology – San Raffaele Resnati Hospital Milan, Italy; Graziottin Foundation for the treatment of pain in women, ONLUS, Italy
Corresponding Author: Gabriella Pugliese
Weight gain is a common condition in menopause. It recognizes both modifiable and non-modifiable multifactorial etiological mechanisms. They include age, climacteric hormonal changes, alteration of hunger and satiety circuits, sleep disorders, reduction of energy expenditure, sedentary lifestyle and nutrition, including the eating time (chrononutrition and chronotype). The redistribution of adipose tissue, mainly from the subcutaneous site to the visceral site, acts as a real endocrine organ capable of secreting adipokines and proinflammatory cytokines such as TNF-α, IL-1, IL-6 and leptin. This contributes to the menopausal chronic low-grade inflammation, that increases the risk of metabolic disorders, cardiovascular events and neurovegetative disorders. Lifestyles interventions are the first line approach to cope with this condition. To date there are no specific dietary and exercise recommendations to be prescribed in overweight/obese women at menopause. The purpose of this review is, first, to analyse the mechanisms that favour weight gain, with focus on the role of sleep disorders and of proinflammatory mediators produced by the adipose tissue; second, to provide practical recommendations focused on lifestyles, useful in the general clinical management of postmenopausal women. The potential role of bowel microbiota and chronotype will be finally briefly discussed.
Keywords: menopause; obesity; inflammation; sleep disorders; adipose tissue; adipokines.
Available in LRIOG Nr.1 – 2022