Getz, M.J., Aronoff, Jacob E., Jenkins, Carson L., Ghafoor, Suhail, Vazquez, J., Appel, N.T., Gatz, Margaret, Cummings, Daniel, Hooper, Paul L., Beheim, Bret A., Buetow, Kenneth, Finch, Caleb Ellicott, Thomas, Gregory, Stieglitz, Jonathan, Gurven, Michael, Kaplan, Hillard and Trumble, Benjamin C. (2025) Higher blood lipid levels after the transition to menopause in two forager-horticulturalist populations. Evolution, Medicine, and Public Health, 13 (1). pp. 201-214.

Abstract

Reproduction affects health and longevity among females across the life course. While significant focus has been devoted to the role of menarche, menopause remains understudied. Most menopause research is conducted in industrialized populations, where the risk of cardiovascular diseases increases progressively during the menopausal transition.
Methodology

We worked with the Tsimane, Indigenous Bolivian forager-farmers with physically active lifestyles, and the Moseten, genetically and culturally related horticulturalists experiencing greater market integration. We assessed relationships between menopause status and lipid biomarkers (HDL, LDL, non-HDL, total cholesterol, triglycerides, and apolipoprotein-B). Using linear mixed-effects models, in an all-age sample of n = 1,121 women (15–92 years) we found positive associations between menopausal status and most lipid levels.
Results

Menopause was associated with 5.0% higher total cholesterol (b = 7.038 mg/dL, P = .001), 9.4% higher LDL (b = 5.147 mg/dL, P = .017), 5.9% higher non-HDL cholesterol (b = 8.071 mg/dL, P < .001), 11.3% higher triglycerides (b = 19.119 mg/dL, P < .001), and 1.5% higher apolipoprotein-B (b = 0.248 mg/dL, P = .001), controlling for age, body mass index (BMI), year of data collection, and population. In contrast, HDL did not vary with menopause status.
Conclusions

After controlling for age, BMI, and year of data collection, post-menopausal lipid profiles among the Tsimane across six biomarkers are 2–7 times lower than those documented in U.S./U.K. populations. These results support existing literature that documents distinct shifts in lipid profiles during and after the menopause transition in industrialized populations. Further, our results suggest lipids increase post-menopause similarly to those of industrialized populations, despite the differential diet, physical activity, fertility, and hormone exposure in industrialized environments.
Lay Summary

Menopause is a relatively rare life history trait primarily studied in industrial populations. We examined relationships between menopause and cardiovascular disease risk biomarkers in two forager-horticulturalist populations. We found positive associations between menopause and total cholesterol, HDL, LDL, non-HDL, triglycerides, and apolipoprotein-B, suggesting lipid increases post-menopause are a human universal.