Menopause and hormone therapy in relation to dietary intake, physical activity, and sleep, and meeting lifestyle guidelines

OBJECTIVE: Menopause and hormone therapy (HT) may influence modifiable health behaviors (MHBs), but their independent and combined effects are not well understood. This study examined dietary intake, physical activity, and sleep, overall and in relation to guidelines, by menopausal and HT status. METHODS: This cross-sectional analysis used self-reported data from 10,381 females from the Canadian Longitudinal Study on Aging, classified into four groups: (1) pre/perimenopausal, (2) postmenopausal/never HT, (3) postmenopausal/current HT, or (4) postmenopausal/past HT. MHBs were self-reported. Diet was grouped into six categories; physical activity included walking/light, moderate-vigorous, and strength-based (min/wk); sleep was average nightly duration. Primary analyses used linear mixed models to compare MHBs across groups, and binary logistic regressions assessed meeting physical activity and sleep guidelines, adjusting for sociodemographic and lifestyle factors. When significant, secondary analyses for pairwise comparisons were conducted. RESULTS: Postmenopausal females who never used HT reported lower intake of fruit/vegetables (P = 0.012). Never-HT users were also 19% less likely to meet strength-based activity guidelines (P = 0.049). Sleep duration was shorter in postmenopausal females who had never used HT or had used HT in the past, compared to pre/perimenopausal females (P = 0.001, P = 0.035). The likelihood of meeting sleep guidelines was 14% lower in never, 26% lower in current, and 24% lower in past HT users compared with pre/perimenopausal females (P = 0.048, P = 0.004, P = 0.002). CONCLUSION: Menopausal and HT status are related to differences in MHBs, including meeting established physical activity and sleep guidelines. Findings highlight the need to consider hormonal and life-stage factors in strategies to support healthy aging of females.