Weight excess and inflammation in menopause: pathophysiology of a dangerous liaison and role of lifestyles


Eccesso ponderale e infiammazione in menopausa: fisiopatologia di un binomio pericoloso e ruolo degli stili di vita
La Rivista Italiana di Ostetricia e Ginecologia, 2021, 4, 87-98
Weight gain is a common condition in menopause. It recognizes both nonmodifiable and modifiable multifactorial etiological mechanisms. The first include: age, climacteric hormonal changes, alteration of hunger and satiety circuits, reduction of energy expenditure and sleep disorders; while among non-modifiable factors: 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-a, 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:
1) 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;
2) 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.

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