Abstract/Summary

Cardiovascular diseases (CVD) are the leading cause of death in women globally, with aging associated with progressive endothelial dysfunction and increased CVD risk. Natural menopause is characterised by raised non-fasting triacylglycerol (TAG) concentrations and impairment of vascular function compared with premenopausal women. However, the mechanisms underlying the increased CVD risk after women have transitioned through the menopause are unclear. Dietary fat is an important modifiable risk factor relating to both postprandial lipaemia and vascular reactivity. Meals rich in saturated (SFA) and monounsaturated fatty acids (MUFA) are often associated with greater postprandial TAG responses compared with those containing n-6 polyunsaturated fatty acids (PUFA), but studies comparing their effects on vascular function during the postprandial phase are limited, particularly in postmenopausal women. This review aimed to evaluate the acute effects of test meals rich in SFA, MUFA and n-6 PUFA on postprandial lipaemia, vascular reactivity and other CVD risk factors in postmenopausal women. The systematic literature search identified 778 publications. The impact of fat-rich meals on postprandial lipaemia was reported in seven relevant studies, of which meal fat composition was compared in one study described by three papers. An additional study determined the impact of a high fat meal on vascular reactivity. Although moderately consistent evidence suggests detrimental effects of high fat meals on postprandial lipaemia in postmenopausal (than premenopausal) women, there is insufficient evidence to establish the impact of meals of differing fat composition. Furthermore, there is no robust evidence to conclude the effect of meal fatty acids on vascular function or blood pressure. In conclusion, there is an urgent requirement for suitably powered robust randomised controlled trials to investigate the impact of meal fat composition on postprandial novel and established CVD risk markers in postmenopausal women, an understudied population at increased cardiometabolic risk.