Diet to Reduce the Metabolic Syndrome Associated with Menopause. The Logic for Olive Oil

Abstract

The rates of metabolic syndrome are increasing in parallel with the increasing prevalence of obesity, primarily due to its concomitant insulin resistance. This is particularly concerning for women, as the years around menopause are accompanied by an increase in visceral obesity, a strong determinant of insulin resistance. A fall in estrogens and increase in the androgen/estrogen ratio is attributed a determining role in this process, which has been confirmed in other physiological models, such as polycystic ovary syndrome. A healthy lifestyle, with special emphasis on nutrition, has been recommended as a first-line strategy in consensuses and guidelines. A consistent body of evidence has accumulated suggesting that the Mediterranean diet, with olive oil as a vital component, has both health benefits and acceptable adherence. Herein, we provide an updated overview of current knowledge on the benefits of olive oil most relevant to menopause-associated metabolic syndrome, including an analysis of the components with the greatest health impact, their effect on basic mechanisms of disease, and the state of the art regarding their action on the main features of metabolic syndrome.

Keywords: healthy ageing; menopause; metabolic syndrome; obesity; olive oil; women.

Figure 1

Literature search flowchart. The bars in the insert represent the trend in the numbers of papers published per year between 2000 and 2020. The year 2020 is incomplete because the search only included papers published until 1 October.

Figure 2

The metabolic syndrome (MetS) is defined as a cluster of four different risk factors, namely, dysglycemia, dyslipidemia, increased blood pressure, and central visceral obesity. While these affect both sexes, at midlife, women go through the menopause, which involves a rapid fall in estrogens and a very slow decline in androgens. Both the reduction in estrogens and the increase in the androgen/estrogen ratio have been attributed to promoting central obesity. Increased insulin resistance may then affect the other three factors in the cluster. HDL: high-density lipoprotein.

Figure 3

Olive oil is a source of unsaturated fat, whose two main components are oleic acid, a monounsaturated fat making up 70% of the total fat, and linoleic acid, a polyunsaturated fat representing 15% of the total fat content.

Figure 4

Polyphenols are a family of vegetal compounds characterized by phenol rings as part of their molecular structure. While the family includes a long list of compounds, current data can be found on the health benefits of some, with most available information centered on hydroxytyrosol, oleocanthal and oleuropein.