As women move through menopause, weight often shifts toward the midsection, a frustrating change that’s easy to write off as cosmetic. But new research suggests those extra inches at the waist could be signaling something deeper.
A study published in Menopause, the journal of The Menopause Society, found that women with higher levels of abdominal fat showed greater declines in key areas of cognitive function, including memory and attention.
The study builds on earlier evidence that menopause-related changes in hormones and metabolism affect more than just body composition. Estrogen levels fall during the transition, reducing insulin sensitivity and increasing inflammation. That, researchers say, can make visceral fat, the kind that accumulates around the organs, particularly harmful to both the body and brain.
“Addressing modifiable risk factors early and often is critical to maintaining optimal health and independence as women age,” said Dr. Monica Christmas, associate medical director for The Menopause Society. “The metabolic and cognitive changes that commonly occur during and after the menopause transition often catch women off-guard and are more difficult to address after the diagnosis has been made.”
The research drew on data from more than 700 women, ages 42 to 58, enrolled in the Kronos Early Estrogen Preventive Study (KEEPS), which examined how hormone therapy affects postmenopausal health. Participants were within three years of their last menstrual period and were randomly assigned to receive either oral estrogen, a transdermal patch or a placebo. Scientists then tracked their waist-to-hip ratios and cognitive performance across several domains over four years.
Women with larger waistlines at the start of the study performed worse on measures of attention and executive function. Those results held true even after accounting for overall body fat or cardiovascular risk. While hormone therapy did not appear to change the relationship between abdominal fat and cognitive outcomes, the findings suggest that early signs of central weight gain could serve as a simple, visible marker of brain risk.
The good news: the same lifestyle choices that protect the heart also support the brain. Diets rich in whole grains, fruits, vegetables and healthy fats, along with regular physical activity and stress management, can help reduce visceral fat and support insulin sensitivity. Experts say paying attention to waist-to-hip ratio, rather than just the number on the scale, may help women and their health care providers spot risk earlier.
This research was conducted through the Kronos Early Estrogen Preventive Study (KEEPS), supported by the Kronos Longevity Research Institute with additional funding from the Aurora Foundation and multiple grants from the National Institutes of Health, including the National Institute on Aging.