Identifying the type of body fat distribution is crucial because the accumulation of fat in the abdominal region is directly linked to metabolic changes that can lead to the development of cardiovascular diseases and diabetes mellitus. During the menopause, the decrease in estrogen and the overall increase of body weight are concurrent with the augmentation of visceral fat (abdominal). This characterizes an android profile associated with higher cardiovascular risks in postmenopausal women [27]. Toth et al. reported a 49% increase in abdominal fat and 22% of subcutaneous fat in postmenopausal women compared to women between the first and last natural menstruation [2]. In this study, the prevalence of high WC as a cardiometabolic risk factor was high (92.1%), as well as glucose levels (62.8%) and triglycerides (59.1%) (Table 2). Cardiometabolic risk factors and diet quality are not significantly associated in this study (Table 2), corroborating the findings reported by Tardivo et al. [21]. These authors also found an association between diet quality and total body fat estimated by skinfold, a measurement not collected measurement in the present study. Nonetheless, this study showed that women under 65 and overweight have a higher prevalence of hypertension and hyperglycemia and that the excessive intra-abdominal fat relates to glucose intolerance and insulin resistance (Table 5).
The high WC as surrogate measure for the accumulation of intra-abdominal fat, is directly associated with the prevalence of diabetes, increasing the risk of cardiovascular disease. Before menopause, women have lower levels of blood pressure than men of the same age group do. After menopause, the blood pressure levels of women exceed those of men in the same age range. Hypoestrogenism during the postmenopause causes a tendency to increase blood pressure thus increasing the risk of cardiovascular diseases [1]. The mean daily sodium intake was of 2829.9 mg (Table 1), is above the maximum recommended intake for adults (2400 mg) [14] and less than that reported by the Research Project on Household Budgets (POF) 2008–2009 (12 g of salt or 4700 mg of sodium) [22]. Women (7%) also reported adding salt to prepared meals. Being aware that this is quite a popular practice, we may consider this figure underrated. Martinazzo et al. reported a prevalence of 16.7% of excessive sodium intake, which is roughly 2.4 fold higher than the level found in this study [28]. However, this level of excessive sodium intake was associated with higher serum concentrations of total cholesterol and LDLC, increased lipids and dietary cholesterol, and even lack of hormone replacement therapy (Table 4).
The profile of inadequate dietary intake of sodium and lipids is associated with lower levels of estrogens and favors atherogenesis. Along the aging process, women experience variations in their metabolic profile leading to changes in the composition and distribution of adipose tissue, favoring not only weight gain, but also the progression of atherosclerotic processes. Estrogen deficiency is not the only predisposing factor for weight gain after menopause. It is often parallel to lower basal metabolic rate and a tendency to adopt a more sedentary lifestyle, subsequent to the aging process [29].