For women, menopause increases their risk of developing cardiovascular (CV) disease. This life-stage is associated with unfavourable changes in body composition, weight gain and harmful changes to blood glucose and measures of vascular health driven primarily by changes in hormones levels.
Adipose tissue becomes metabolically dysfunctional leading to insulin resistance, whereas a reduction in metabolically active lean tissue is associated with reduced muscle mass and a concomitant reduction in energy expenditure encouraging weight gain, even in the absence of significant changes to energy intake. Disturbed sleep, a common feature of menopause, is an independent risk factor for CVD and is associated with fatigue, disruption to the 24-hr body clock, and lower levels of physical activity, impacting energy expenditure.
Taken together these data suggest that just to maintain weight, energy intake may need to be reduced and/or physical activity increased. As such intervention is essential as a significant proportion of women will spend up to 40% of their lives postmenopausal. However, regardless of strong observational data showing menopause as a period of accelerated CV risk, behavioural interventions are inadequately represented in this group.
Time-restricted eating (TRE) is an example of an intermittent fasting regimen whereby timing of dietary intake is aligned to an individual’s body clock. TRE protocols consistently show improvements in CV risk factors without calorie counting and reductions in diet quality. Whereas intermittent activity (where activity is undertaken as small ‘snacks’ of exercise) is easily embedded into daily routines.
We propose to co-design and deliver a personalised intervention in post-menopausal women that examines the feasibility and acceptability of Time-Restricted Eating and Exercise Snacking (the TREES study). Uniquely we will use melatonin (a market of circadian rhythm) to personalise the eating window to each individual. We aim to show that timing of lifestyle behaviours is an effective, prevention-based approach to manage CVD risk in women experiencing menopause.
Last updated30 July 2025