Nutritional Status of menopausal women and formulation of functional foods

Abstract

Menopause represents a natural and permanent cessation of menstruation, and generally occurs between 45 and 55 years of age. With the postmenopausal period extending to almost 30 years, representing one-third of a woman’s life, menopause has emerged as a significant public health concern. In this context, the present study aimed to assess the nutritional status of menopausal women and develop functional foods tailored to their needs. The study was conducted among 300 menopausal women aged 45–55 years, selected through stratified random sampling. Data was collected using a pre-tested interview schedule to obtain information on socioeconomic status, dietary patterns, menopausal history, and symptom severity. Socioeconomic status was assessed using the updated Kuppuswamy Scale (2024). The Menopause Rating Scale (MRS) was used to assess symptom intensity. Anthropometric measurements, body composition analysis, and dietary intake assessments (24-hour recall, food frequency and one-day food weighment) were conducted. Clinical and biochemical examinations were carried out in a subsample of 30 women by qualified medical practitioner. Results revealed that 72.33% of the participants were between 50–55 years, and 27.67% were between 45–50 years. The nuclear family system was predominant, and most women were engaged in sedentary or moderately active occupations. A large proportion (58.67%) reported health issues and 55.00% were on medication. However, regular exercise (36.67%) and adequate sleep (43.00%) were practiced by less than half. The most common comorbidities included diabetes mellitus, osteoporosis, and hypertension, while severe hair fall and fatigue were the most reported symptoms. Natural menopause was experienced by 84.00% of women, while 16.00% underwent surgically induced menopause; the latter was more common among women who had their first child birth at a later age. Women from lower socioeconomic groups experienced more severe symptoms. Menopausal symptoms spanned somatic, psychological, and urogenital domains. Among the somatic symptoms assessed, joint and muscular discomfort was the most common, reported by 89.33% of the women, followed by sleep problems (95.00%), heart discomfort like palpitations, breathing difficulty, variation in blood pressure (99.00%), and hot flushes (86.33%). Although hot flushes were widespread, they were mostly mild to moderate in severity, whereas joint and muscular discomfort showed a larger proportion of moderate to severe cases, indicating a greater impact on daily functioning. Only 1% of women reported an absence of heart discomfort such as palpitation, variation in blood pressure and breathing difficulty, while 5% did not experience sleep problems. These findings reveal that somatic symptoms were prevalent among nearly all participants. Anthropometric and body composition assessments revealed a high prevalence of overweight and obesity, with only 10.67% having normal BMI, 43.33% overweight, and 45.67% obese. Central obesity was evident in 63.67% with waist to hip ratio >0.85. High fat mass (25.00%), visceral fat (19.33%), and low skeletal muscle mass (31.33%) indicated a tendency toward sarcopenic obesity. Higher BMI, fat mass, and visceral fat were positively correlated with greater symptom severity, whereas lower bone and protein mass were associated with more severe menopausal manifestations. Clinically, hair thinning (33.33%), joint pain (43.33%), and hot flushes (23.33%) were predominant, with skin dryness and pigmentation more common among surgically induced menopausal women. Dietary assessment revealed that 97.33% were non vegetarians, though only 6.00% were aware of phytoestrogens and 3.00% recognised foods beneficial during menopause. 24-hour recall method revealed a marked imbalance in the intake of macronutrients and essential micronutrients. Protein intake was nearly adequate (92–93% of RDA), while fat intake exceeded the recommended levels (111–119% of RDA). In contrast, energy intake was inadequate, meeting only 56–74 per cent of the RDA. The intake of critical micronutrients such as calcium (17.41–18.09%), iron (21.44–21.48%) and zinc (21.81–22.12% of RDA) was alarmingly low, largely attributable to inadequate consumption of milk and milk products, green leafy vegetables and fruits. A similar dietary pattern was observed in the subsample of 30 menopausal women assessed using the one-day food weighment method. Energy intake met only 59–79.50 per cent of the RDA, whereas protein and fat intakes were comparatively satisfactory, meeting 84.90–90.80 per cent and up to 107.20 per cent of the RDA, respectively. However, pronounced deficiencies in essential minerals persisted, with calcium intake ranging from 16.81–18.61 per cent and iron from 11.10–17.72 per cent of the RDA. The overall findings indicate a dietary pattern characterised by high intake of visible fats, animal protein sources and inadequate intake of mineral dense plant foods, thereby increasing the risk of osteoporosis, anaemia and compromised immunity during the menopausal transition. Based on the identified nutritional gaps, functional foods rich in fibre, unsaturated fatty acids, calcium, vitamin D, and phytoestrogens were developed to support menopausal health. Two products, nutrimix powder and crackers were formulated and evaluated. The nutrimix powder, optimised with 20% defatted soy flour, 30% jackfruit seed flour, 30% malted ragi flour, 10% quinoa seed flour, 5% chia seed flour and 5% almond flour incorporation, showed excellent sensory acceptability by 20 judges. Physico-chemical analysis over four months of storage indicated a gradual increase in moisture (4.95% to 6.12%), with stable water absorption and solubility indices, confirming good storage stability. Similarly, composite crackers formulated with oats (50%), whole wheat (25%), defatted soy flour (5%) and 20% other ingredients demonstrated high organoleptic scores. During four months of storage, moisture increased, and energy declined, with minimal changes in other nutrients. The production cost per 100g was 66/- for nutrimix and 44/- for crackers, indicating affordability and feasibility for large scale preparation. The study highlights the nutritional vulnerability of menopausal women, characterised by poor diet quality, obesity, and micronutrient deficiencies, which collectively intensify menopausal symptoms. The developed nutrimix powder and composite crackers proved to be nutritionally rich, shelf stable, microbiologically safe, and organoleptically acceptable, demonstrating potential as functional foods to improve the nutritional well-being of menopausal women.