Moderate Consumption of Beer (with and without Ethanol) and Menopausal Symptoms: Results from a Parallel Clinical Trial in Postmenopausal Women

Abstract

The menopausal transition can be a challenging period for women’s health and a trigger of uncomfortable symptoms. Beer is the main food source of isoxanthohumol, a precursor of 8-prenylnaringenin, the strongest phytoestrogen identified to date. As phytoestrogens are reported to reduce perimenopausal symptoms, we evaluated if a daily moderate consumption of beer with (AB) and without alcohol (NAB) could improve menopausal symptoms and modify cardiovascular risk factors. A total of 37 postmenopausal women were enrolled in a parallel controlled intervention trial and assigned to three study groups: 16 were administered AB (330 mL/day), 7 NAB (660 mL/day), and 14 were in the control group. After a 6-month follow-up of the 34 participants who finished the trial, both interventions (AB and NAB) significantly reduced the severity of the menopause-related symptoms (p-value AB vs. Control: 0.009; p-value NAB vs. Control: 0.033). Moreover, AB had a beneficial net effect on psychological menopausal discomforts compared to the control group. As the sex hormone profile did not differ significantly between the study groups, the effects of both types of beers (AB and NAB) are attributed to the non-alcoholic fraction of beer. Furthermore, moderate NAB consumption improved the lipid profile and decreased blood pressure in postmenopausal women.

A Systematic Review of the Cardiometabolic Benefits of Plant Products Containing Mixed Phenolics and Polyphenols in Postmenopausal Women: Insufficient Evidence for Recommendations to This Specific Population

“…In postmenopausal women, SBP was not consistently reduced by the intake of (poly)phenols and both increases and decreases were reported. Nevertheless, some of the studies that indicated a decrease in SBP (even if not significant) reported reduction values between 2.0 and 11.0 mm Hg [26,29,32,37,44,45], suggesting that if these reductions were confirmed, the long term intake of (poly)phenols could have some impact in the cardiometabolic health of postmenopausal women but that this reduction would be more effective in women with only initial pre-hypertension [68] such as the significant reduction in SBP following the intake of blueberry powder containing mix (poly)phenols reported by Johnson et al [29]. Overall, it is tempting to hypothesize that (poly)phenols might be of help principally at early stages of the cardiometabolic disorders appearing in postmenopausal women but further studies are needed to confirm this.…”

“…From a methodological point of view, different elements may have affected the results and precluded a clear detection of potential benefits: (i) the small number of studies that could be selected and included in this review (21); (ii) the limited size of the sample populations involved in the studies, mostly between 15 and 20 per group (with a minimum size of 7 [32] to a maximum size of 120 participants per group [33]; (iii) differences in the source, nature and matrix of (poly)phenols (extracts, foods, beverages); (iv) presence of other constituents (i.e., fiber) which may have interfered with the effects of the (poly)phenolic compounds [54,55]; (v) not well designed control or placebo groups that should differentiate only in the (poly)phenols content [25,34,41,44]; and (vi) other general methodological specific issues such as the type of biological sample used (plasma, serum, fasting) or the analytical procedure applied. General recommendations regarding the RCTs have been thoroughly described indicating the need to improve the overall quality of the study design [56] and the presentation of the results in humans following intervention with bioactive compounds [57].…”

“…The postmenopausal participants included in this review were mostly described as overweight and/or obese but otherwise healthy women. Our analyses confirmed that at baseline most of them exhibited: (i) normal levels of glucose (<100 mg/dL) [60] with only two studies [31,36] displaying mean values that indicated impaired glucose values (100-125 mg/dL); (ii) average normal levels of TGs (<150 mg/dL) [61] except for one study where a mild hypertriglyceridemia was manifest [31]; (iii) high levels of HDL-C (>60 mg/dL) with only four studies reporting moderate baseline values and none of them exhibiting low values [28,31,32,45]; and (iv) normal DBP and SBP (<85 mm Hg and <130 mm Hg, respectively) [62] except for five studies [25,29,31,35,39] where SBP reached values slightly higher (130-140 mm Hg). Regarding LDL-C, values ranged from near/above optimal (100 to 129 mg/dL) [61] to borderline high (130 to 159 mg/dL) with one study [28] reaching rather high values (167 to 174 mg/dL) displaying (although not clearly reported) signs of moderate hyperlipidemia in many of the participants.…”

“…Our results show a general lack of significant and consistent effects of the intake of mix (poly)phenols with both increases and decreases reported for all the different biomarkers tested, and an ample variation in the size of these effects. In particular, the effect size in LDL-C ranged from an increase of +18.1 mg/dL following 90 d of consuming encapsulated isoflavones (100 mg/day) [36] to a significant reduction of −16.1 mg/dL (p = 0.016) after the intake of dealcoholized beer rich in phenylpropanoids (0.259 mg/day) during 180 d [32] or the intake of capsules containing green tea extract rich in flavanols (400 mg/day and 800 mg/day) for 60 d which showed a significant reduction in LDL-C (p = 0.021) for the two doses (7.4 and 8.1 mg/dL, respectively) [38]. The size of these effects would only achieve the targets associated with a reduction of CVDs risk (i.e., <70 mg/dL for patients at very high risk, or <115 mg/dL for low-risk individuals [63] should the LDL-C baseline values of the participants were in the near/above optimal ranges [61] but not for very high levels of LDL-C.…”

“…The number of participants included in each group (placebo/control or treatment) was found to be around 37; the smallest group was formed by 7 individuals [32], while the largest group was constituted by 120 participants [33]. With respect to the duration of the intervention, on average, most of the studies were carried out for six months, with the minimum intervention period being two weeks [34] and some studies lasting for up to a year [28,33,35].…”