In a recent study published in the journal JAMA, researchers from the Women’s Health Initiative examined the effectiveness of hormone replacement therapy, calcium and vitamin D supplementation, and low-fat diets as preventive treatments for postmenopausal women. The study included over 160,000 women and up to 20 years of follow-up. The researchers found that hormone replacement therapy was not effective in preventing cardiovascular disease, stroke, dementia, or other chronic diseases. However, it did help reduce vasomotor symptoms such as hot flashes. Additionally, the therapy significantly increased the incidence of breast cancer.
The study also found that calcium and vitamin D supplementation did not reduce the risk of fractures in postmenopausal women. While the participants received 1,000 mg of calcium and 400 IU of vitamin D daily, the researchers found no substantial benefit in preventing hip fractures. They did note that women who do not meet national dietary guidelines might benefit from taking supplements. Furthermore, additional research suggested that while supplementation might reduce the risk of cancer mortality, it could increase the risk of death from cardiovascular disease.
The participants in the study followed a low-fat diet that reduced their fat intake by about 20% and increased their intake of fruits, vegetables, and grains. The researchers found that the diet did not significantly decrease the incidence of breast or colorectal cancer. However, long-term follow-up did show a reduction in breast cancer mortality. The scientists suggested that the diet could be an option for postmenopausal women who want to reduce their risk of death due to breast cancer.
Dr. Nicole Weinberg, a cardiologist not involved in the study, noted that the study provided important information for treating women in different stages of menopause. She emphasized that hormone therapy should be used symptomatically for vasomotor symptoms but not to prevent cardiovascular disease. Dr. Cheng-Han Chen, an interventional cardiologist, recommended against using hormone replacement therapy for heart disease prevention based on previous research. He emphasized the importance of a heart-healthy diet, exercise, maintaining a healthy weight, and watching blood pressure, sugar, and cholesterol levels for cardiovascular risk reduction in postmenopausal women.
The researchers acknowledged some limitations to their study, such as using the most common hormone therapy treatment and the potential impact of non-study calcium and vitamin D supplements on the results. They also noted that the low-fat diet did not achieve the target fat reduction, making it difficult to distinguish the specific effects of reducing fat versus increasing fruits, vegetables, and grains. Overall, the study concluded that hormone replacement therapy, calcium and vitamin D supplementation, and low-fat diets are not highly effective in preventing certain diseases in postmenopausal women, and alternative treatments may be necessary to reduce the risk of these conditions.
