Structured counseling about lifestyle modifications on diet and exercise may help mitigate disease risk and symptomology among menopausal women, according to findings presented in a poster session at the 2022 North American Menopause Society (NAMS) Annual Meeting held October 12 to 15 in Atlanta, Georgia. The lead author Eshani Dixit, BA, of Rutgers Robert Wood Johnson Medical School, was the recipient of a NAMS New Investigator Award for this research.

“Menopausal individuals are eager to talk about diet and exercise changes with their health care providers; providers can and should use visits to discuss the positive impact that exercise and dietary modifications can play in the management of menopausal symptoms and the prevention of disease, such as osteoporosis,” Dixit said in an interview.

“As is the case with most patient/provider conversations, the conversation around lifestyle modification is an opportunity for shared decision-making,” Dixit said. “While the evidence gives us guidelines for changes to recommend, effective counseling involves introducing sustainable goals. We also found that group counseling, if possible, is a useful tool.”

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Study Rationale

Current recommendations for managing menopause symptoms include altering diet and exercise behaviors. These lifestyle changes may also mitigate the risk for diseases that increase in incidence in women following the transition into menopause, including cardiovascular disease, osteoporosis, and cancers of the reproductive tract.

To substantiate many of the popular beliefs on the role of lifestyle modifications in menopause, Dixit and colleagues Gloria Bachmann, MD, MMS, and Juana Hutchinson-Colas, MD, MBA, performed a literature search for studies published between 1995 and 2022.

Key Findings on Diet and Exercise in Menopausal Individuals

For improving vasomotor symptoms, study findings suggest that menopausal individuals should consume a diet high in fiber and fruits. This diet has been shown to alter the level of circulating sex hormone levels and may be protective against breast and gynecologic cancers.

Exercise, including weight-bearing exercise, also has been associated with relief of vasomotor symptoms associated with menopause for some women. In addition, exercise has been found to increase high-density lipoprotein cholesterol levels in this age group and can potentially reverse bone loss among those with osteoporosis along with increased dietary calcium and vitamin D, the study authors noted.

Findings from the FLAMENCO trial show that a 16-week exercise program (60-minute sessions 3 days per week) improved menopause-related symptoms including vasomotor symptoms, psychological state, and couple relationships. Data from another study found that group counseling improved diet, exercise, and foot-care behaviors among women with diabetes in menopause.

In general, menopause individuals report interest in participating in lifestyle-focused programs that provide recommendations for diet and exercise modifications aimed at improving menopause-related symptomology, the study authors said.

This review may have been limited by not performing a consensus analysis. These findings should be confirmed in a controlled study, they added.

WPSI Obesity Prevention Recommendations for Women at Midlife

These findings are in line with the WPSI recommendations to discuss obesity prevention strategies with all women aged 40 to 60 years even if they are not overweight.

“Many of the strategies that are considered part of obesity prevention are also strategies that are protective for heart health and bone health, among other things,” Dixit said. “Setting aside BMI and weight management, diet and exercise modification have myriad other benefits for the menopausal woman. If individuals see a desired, healthy reduction in weight through these changes, that could be a bonus, but the goal should be to create sustainable behaviors that demonstrate an improvement in their overall health.”


Education that provides lifestyle counseling about diet and exercise targets that can ease menopause-associated symptoms and mitigate disease risk may be beneficial, the researchers concluded. A separate visit to discuss lifestyle for perimenopausal care may be the optimal opportunity for starting these conversations with patients, they noted.

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Dixit E, Bachmann G, Hutchinson-Colas J. Enhancing diet and exercise counseling for menopausal women. Poster presented at: 2022 NAMS Annual Meeting; October 12-15, 2022; Atlanta, GA.