Lifestyle approach against obesity in menopause: role of the new short questionnaire to assess adherence to the Mediterranean Diet andnutritional sustainability MedQ-Sus

INTRODUCTION: The changing hormonal milieu in post-menopausal women (PMW) predisposes them to increase cardiovascular (CV) risk, due to a constellation of risk factors, suchas visceral obesity, atherogenic dyslipidaemia and arterial hypertension. Our ongoing study aims to evaluate the impact of dietary changes in CV risk in PMW by means of a newMediterranean Diet (MD) adherence questionnaire "MedQ-Sus" (1) which excludes alcohol consumption and introduces a sustainability score. METHODS: For 1 year, 65 PMW with BMI 24-39 Kg/m2 and at least another CV risk factor were followed-up (FU) each 3 months. Anthropometric parameters and blood pressure weretaken. Questionnaires on medical history, lifestyles, food frequency (FFQ) and adherence to MD such as MEDAS and MedQ-Sus were administered. Balanced low-calorie dietary planwith quantitative advice were released. Repeated measures ANOVA at 1 year were performed RESULTS: We observed at 1 year a significant increase (p<0.01) in MD adherence by means of MedQSus (Δ=1.08; 95%CI 0.35-1.80) due to the significant increase (p<0.05) in theconsumption of cereals and derivatives (>195 g/day from 33.9% to 52.3%) and fresh fruit (>300 g/day from 24.6 to 26.2%) and reduction in consumption of dairy products (<180 g/dayfrom 10.8% to 18.4%). No change was observed with MEDAS questionnaire due to the significant reduction in the consumption of wine (≥7 glasses/week from 21.5% to 10.8%) andsautéed (≥ 2 times/week from 40% to 29.2%). One-year sustainability score assessed with MedQ-Sus was significantly increased (from 4 to 4.9 points; p<0.05). If we considered tertilesof MedQ-Sus score at baseline (Fig. 1), the MD adherence significantly increased at 1 year in the first and second tertiles while stable in the third. Those changes were mainly due to adecreased consumption of animal proteins (Δ= -5.3%) and an increased consumption of plant protein (Δ= +5.3%), reduction in fats consumption of animal origin (Δ= -8.4 g/day) and inparticular of saturated fatty acids (Δ= -5.0%). We observed at 1 year significant reductions (p<0.01) in weight (Δ=-4.3 Kg), BMI (Δ=-1.6 Kg/m2), waist (Δ=-4.1cm) and hips (Δ=-3.0cm)circumferences, subscapular (Δ=-5.2mm), suprailiac (Δ=-2.9mm) and triceps (Δ=-4.5mm) skinfolds, adipose area of the arm (AFA) (Δ=-6.4cm2) and fat mass (Δ=-4.2kg) withoutvariation of the lean mass (Δ=-0.2 kg, p=0.48). All those reductions were followed by change in the obesity prevalence (-21.1%), in the fat mass distribution with 10% reduction inabdominal and truncular obesity, and in systolic (Δ=-7.4mmHg) and diastolic (Δ=-3.6mmHg) BP (Fig 2). CONCLUSIONS: The study underlines the medium-term utility of a 1 year balanced low-calorie diet in PMW with elevated CV risk factors. Furthermore, the new MedQ-Susquestionnaire is effective in evaluating and monitoring adherence to MD and the sustainability of DM, allowing a better counseling in menopausal women. 1) Ruggeri S et al. New Validated Short Questionnaire for the Evaluation of the Adherence of Mediterranean Diet and Nutritional Sustainability in All Adult Population Groups. Nutrients2022, 14, 5177.