Evidence on diet benefit for cardiometabolic risk factors in postmenopausal women inconclusive

Some whole-diet interventions, such as fat-modified diets, appear to exert favourable effects on some lipid profile markers, glycaemic indices, and blood pressure among postmenopausal women, as reported in a review. However, the findings are inconclusive, given the large heterogeneity in diets, comparisons, and population characteristics across a limited number of studies.

Researchers conducted a systematic review and accessed multiple online databases for studies that evaluated the effects of a whole diet (eg, low-fat, plant-based, low/high-carbohydrates diets) on lipid profile, glycaemic indices, and/or blood pressure among postmenopausal women.

Of the 2,134 references identified, 21 trials met all eligibility criteria. Most of the trials evaluated low/modified fat/fatty acids diets, while others examined Mediterranean diet, Paleolithic diet, healthy diet, diet based on American Heart Association recommendations, low-sodium DASH-type diet, high-protein diet, and plant-based diet among others. Four trials provided isocaloric diets, while five trials involved ad libitum or self-selected diets; the rest did not provide information on whether diets were isocaloric.

The intervention duration varied between 3 weeks and 12 months for most studies, one study lasted for 2 years, and one for 6 years.

Some studies showed that compared with the control diets, fat-modified diets produced improvements in total cholesterol (TC), low-density lipoprotein cholesterol (LDL), systolic blood pressure (SBP), fasting blood sugar (FBS), and apolipoprotein A (Apo-A). However, such diets also exerted some adverse effects on triglycerides (TG), very low-density lipoprotein cholesterol (VLDL), lipoprotein(a), high-density lipoprotein cholesterol (HDL), and the TC:HDL levels.

A small number of trials revealed that the Paleolithic, weight-loss, plant-based, energy-restricted diets, and American Heart Association recommendations conferred some benefit for TG, TC, HDL, insulin, FBS, and insulin resistance.

More well-designed clinical trials are needed to establish the benefits of whole-diet interventions on cardiovascular risk factors in the present population.