The Spanish Agency for Food Safety and Nutrition (AESAN) has ordered a review of its recently published nutritional guidelines for perimenopausal, menopausal, and post-menopausal women, following criticism that the recommendations were based on research conducted exclusively on men.
Guidelines Under Review
The guidelines, released in March, aimed to reduce health risks associated with menopause, such as bone density and muscle mass loss. They emphasized consuming a diet rich in protein, iron, calcium, omega-3 fatty acids, and vitamins, alongside regular strength training. However, the document did not explicitly state that the reference studies relied solely on male populations. This omission was highlighted by members of the Spanish Association of Women Researchers and Technologists (AMIT), who pointed out the historical underrepresentation of women in medical research.
Following the criticism, AESAN acknowledged the "omission of a warning" and initiated a formal review by its scientific committee. Spanish Minister for Equality, Ana Redondo, also called for the document's revision, stating, "It is about time women were present in health agendas and studies, and the male body stopped being the universal reference point for everything, even for issues related to the menopause."
Broader Implications for Medical Research
The controversy underscores a persistent issue in medical research where women are often under-represented or excluded from crucial studies and clinical trials, while men are over-represented. According to a 2022 study, women comprised only about 40% of participants in clinical trials for three major diseases affecting women: cancer, cardiovascular disease, and psychiatric disorders.
Using male physiology as the default in medical research can overlook critical biological and hormonal differences. The hormonal fluctuations experienced by menopausal women significantly impact bone health, body composition, cognition, and cardiovascular risk. Furthermore, nutritional needs can differ between sexes and change with age. For instance, while 1,000 milligrams of calcium is recommended for men aged 19-70 and women up to age 50, women over 51 are advised to increase their intake to 1,200 milligrams. Other nutritional differences include recommended daily intake for vitamin A, iron, and potassium, which vary between men and women.
Experts suggest that beyond adequate protein, calcium, and vitamin D intake, a predominantly plant-based diet or one that avoids rapid blood sugar spikes can help manage hormones that influence hunger and appetite, potentially mitigating menopausal weight gain. The current review by AESAN is expected to address these disparities and ensure future health guidelines are more inclusive and scientifically accurate for women.