Evidence-Based Nutritional Management of Menopausal Symptoms: A Pathophysiological Reasoning Approach to Personalized Nutrition Practice.

This case report presents the methodology and the outcomes of a Personalized Nutrition intervention with a menopausal female over seven weeks and two online consultations. The report details the pathophysiological reasoning approach to the patient assessment and the recommendation of interventions with the supporting clinical evidence and learnings. A 47 year old working mother (Patient A) with maternal family history (FH) of osteoporosis (OP), a body mass index (BMI) of 24.2 kg/m2 and a waist-to-hip ratio (WHR) of 0.86. Patient A had seen her medical practitioner (MP) regarding fatigue, lack of concentration and low mood and was prescribed hormone replacement therapy (HRT). Patient A's sleep and mood remained unstable, and she presented with late afternoon fatigue, lower belly bloating and mild headaches. A chiropractor had diagnosed scoliosis. Patient A was seeking support for energy and bone health. Analysis of dietary recall and frequency data indicated that her current macronutrient intake was contributing to blood sugar imbalance, influencing energy levels and impacting hypothalamic-pituitary-adrenal (HPA) axis function, potentially exacerbated by a change in estrogen levels. A FH of OP encouraged the practitioner to promote bone health. Adjusted macronutrient intake was recommended to support blood sugar balance, increase and sustain energy and promote muscle synthesis. A supplementation plan with regular weight-bearing exercise aimed to support bone mineral density. Caffeine reduction, yoga and meditation to help rebalance the HPA axis. Patient A reported an increase in energy, a reduction in snacking and improved sleep. There was no change to her mood and bloating persisted. Her headaches worsened and the MP prescribed amitriptyline (10 mg) toward the end of the therapy period. Her bone health was not measured. This case provides observational evidence of the potential efficacy of personalized nutrition utilizing pathophysiological reasoning to assess health status, an evidence-based approach to support intervention decisions and coaching skills to embed dietary change.