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Menopause is associated with postprandial metabolism, metabolic health and lifestyle: The ZOE PREDICT study

Bermingham, Kate M; Linenberg, Inbar; Hall, Wendy L; Kadé, Kirstin; Franks, Paul W; Davies, Richard; Wolf, Jonathan; Hadjigeorgiou, George; Asnicar, Francesco; Segata, Nicola; Manson, JoAnn E; Newson, Louise R; Delahanty, Linda M; Ordovas, Jose M; Chan, Andrew T; Spector, Tim D; Valdes, Ana M; Berry, Sarah E


Kate M Bermingham

Inbar Linenberg

Wendy L Hall

Kirstin Kadé

Paul W Franks

Richard Davies

Jonathan Wolf

George Hadjigeorgiou

Francesco Asnicar

Nicola Segata

JoAnn E Manson

Louise R Newson

Linda M Delahanty

Jose M Ordovas

Andrew T Chan

Tim D Spector

Sarah E Berry


Background: The menopause transition is associated with unfavourable alterations in health. However, postprandial metabolic changes and their mediating factors are poorly understood.

Methods: The PREDICT 1 UK cohort (n=1002; pre- n=366, peri- n=55, and post-menopausal females n=206) assessed phenotypic characteristics, anthropometric, diet and gut microbiome data, and fasting and postprandial (0–6 h) cardiometabolic blood measurements, including continuous glucose monitoring (CGM) data. Differences between menopausal groups were assessed in the cohort and in an age-matched subgroup, adjusting for age, BMI, menopausal hormone therapy (MHT) use, and smoking status.

Findings: Post-menopausal females had higher fasting blood measures (glucose, HbA1c and inflammation (GlycA), 6%, 5% and 4% respectively), sugar intakes (12%) and poorer sleep (12%) compared with pre-menopausal females (p<0.05 for all). Postprandial metabolic responses for glucose2hiauc and insulin2hiauc were higher (42% and 4% respectively) and CGM measures (glycaemic variability and time in range) were unfavourable post- versus pre-menopause (p<0.05 for all). In age-matched subgroups (n=150), postprandial glucose responses remained higher post-menopause (peak0-2h 4%). MHT was associated with favourable visceral fat, fasting (glucose and insulin) and postprandial (triglyceride6hiauc) measures. Mediation analysis showed that associations between menopause and metabolic health indicators (visceral fat, GlycA360mins and glycaemia (peak0-2h)) were in part mediated by diet and gut bacterial species.

Interpretation: Findings from this large scale, in-depth nutrition metabolic study of menopause, support the importance of monitoring risk factors for type-2 diabetes and cardiovascular disease in mid-life to older women to reduce morbidity and mortality associated with oestrogen decline.


Bermingham, K. M., Linenberg, I., Hall, W. L., Kadé, K., Franks, P. W., Davies, R., …Berry, S. E. (2022). Menopause is associated with postprandial metabolism, metabolic health and lifestyle: The ZOE PREDICT study. EBioMedicine, 85, Article 104303.

Journal Article Type Article
Acceptance Date Sep 23, 2022
Online Publication Date Oct 17, 2022
Publication Date Nov 1, 2022
Deposit Date Dec 9, 2022
Publicly Available Date Dec 13, 2022
Journal eBioMedicine
Electronic ISSN 2352-3964
Peer Reviewed Peer Reviewed
Volume 85
Article Number 104303
Keywords Menopause, Postprandial metabolic responses, Age-matched subgroups
Public URL
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