Metabotyping in the Postmenopausal Stage

Menopause is defined as the absence of menstrual periods for twelve consecutive months. Although the onset may vary, natural menopause occurs between the ages of 45 and 55 and is considered a stage in the aging process for women. Menopause is a stage strongly conditioned by hormonal modulations with effects on the cardiovascular system associated with abdominal obesity, insulin resistance, decreased energy expenditure, endothelial dysfunction, hypertension, and dyslipidemia. Furthermore, an increase in the production of proinflammatory cytokines involved in numerous pathologies such as osteoporosis has been observed.

The results of several studies suggest that intestinal microbiota (IM) profile may be related to menopause condition by several means, although the data are stil inconclusive.

Estrogen reduction leads to a progressive loss of bone density, a reduction in the bone formation/resorption balance and an increased risk of bone fractures among postmenopausal women. Recently, the alternative to estrogen therapies to reduce the risk of fractures are nutritional strategies fundamentally based on the use of probiotics, whose effect are associated with beneficial modulations of IM.

SHE-HEALTH is a study in which, in a cohort of postmenopausal women, metabolomics, transcriptomics and metagenomics will be combined with the analysis of usual anthropometric and clinical biomarkers and also with genetic and epigenetic analyses to identify population groups (clusters). This study will allow establishing solid scientific bases to define, in future projects, effective nutritional strategies based on group nutrition in postmenopausal women.

The main objective of the present study is to obtain clusters of postmenopausal women, identifying metabotypes (similar metabolic profiles) and enterotypes (similar IM profiles), and combining complementary variables such as classical anthropometric, biochemical and clinical biomarkers.

The secondary objectives of the study are to characterize: 1) The genetic profile of the study cohort; 2) The epigenetic profile of the study cohort; 3) The gene expression profile of the study cohort.

Cross-sectional observational study in which samples of blood, faeces, urine, hair and hair follicles will be collected to characterize the metabolic profile, intestinal microbiota (IM), gene expression profile, genetic and epigenetic profile of postmenopausal women. Data on lifestyle habits, anthropometric measurements and nutritional and hormonal status will also be collected.

The study will be conducted in a cohort of 200 postmenopausal women.

Each volunteer will make 2 visits:

* A pre-selection visit (to check inclusion/exclusion criteria) (V0) and, if the inclusion criteria are met,
* A study visit (V1) in which samples will be collected from faeces, urine, blood, hair and hair follicles.

In V1, the participants must present themselves fasting for 8 hours to obtain blood and urine collected during the last 24 hours. In addition, during the visit the sample of hair and hair follicles will be collected. Participants are given a basic guide of healthy eating and lifestyle recommendations suitable for postmenopausal stage.

Eligibility Criteria:
Inclusion Criteria:

* Women between 40 and 63 years old with amenorrhea for a period of time equal or greater than 12 months.
* Without hormone replacement therapy.
* Sign the informed consent.

Exclusion Criteria:

* Women diagnosed with diabetes (or serum glucose ≥ 126 mg/dL) or other chronic pathologies (coronary, cardiovascular, celiac disease, Crohn's disease and chronic kidney diseases (or serum creatinine ≥ 1.5 mg/dL).
* Women taking medications prescribed for hypertension and dyslipidemia. Women who have consumed during the week prior to start to start of the study anti-inflammatory drugs.
* women with chronic gastrointestinal problems.
* Women with a body mass index (in kg/m2) \<18 or ≥35.
* Women who are participating in another clinical trial or following a prescribed diet for any reason, including weigh loss, during the last month.
* Women who consume more than 14 alcoholic beverages per week.
* Women current smokers.