Spanish Nutrition Agency to review menopause report after male-only research concerns

The Spanish Agency for Food Safety and Nutrition (AESAN) has asked its scientific committee to reassess the document, which was published in March and examines nutritional risks associated with the menopausal transition.

The move follows concerns raised by the Spanish Association of Women Researchers and Technologists (AMIT) over the evidence used to support some of the report’s recommendations, including those relating to iron and vitamin C.

AESAN sources acknowledged that the review had been requested ‘following the objection raised over the use of data corresponding to studies carried out on an exclusively male population’, according to Spanish media reports.

The agency has also recognised ‘the omission of a warning’ explaining the origins of some of the data.

Recommendations derived from European research

The disputed recommendations were not produced from original research carried out by AESAN, but were drawn from work by the European Food Safety Authority (EFSA).

Crucially, however, EFSA itself makes clear when evidence comes from studies involving men and when those findings have subsequently been extrapolated to women, including calculations based on differences in body weight.

The problem highlighted by researchers is therefore not simply that male data were used, but that AESAN’s menopause report did not make this limitation clear to readers.

The issue reflects a much wider and longstanding problem in medical and nutritional research. Women have historically been excluded or under-represented in many scientific studies and clinical trials, leaving researchers in some areas with insufficient sex-specific evidence.

As a result, findings obtained from male populations have sometimes been used as the basis for recommendations for women, despite biological differences potentially affecting disease, symptoms, nutritional requirements and responses to medicines and treatments.

AESAN has now stressed the need for further research to establish recommendations specifically for women during the menopausal transition and post-menopause.

Researcher says she raised concerns in March

According to reports in the Spanish media, the agency’s decision to review the document came after the issue attracted press attention, although concerns had already been raised directly with AESAN months earlier.

Sonia de Pascual-Teresa Fernández, a researcher at the Institute of Food Science, Technology and Nutrition (ICTAN-CSIC) and a member of AMIT, said she had initially tried to persuade the agency to correct the report without making the matter public.

‘In March I tried to get them to correct it without having to make it public and until it appeared in the press there was no response. In fact, they still haven’t replied to me and initially they told me that they considered there was no problem with the report,’ she told El Periódico.

She nevertheless welcomed AESAN’s subsequent decision, saying she was pleased that the agency was now correcting the situation and acknowledging the problem in the interests of the women for whom the guidance was intended.

De Pascual-Teresa stressed that AESAN itself was not responsible for the shortage of scientific studies involving women. Her objection was instead that the absence of female-specific evidence should have been explicitly stated in the official report.

Why the missing data matters

The researcher warned that presenting figures without making their limitations clear could have consequences beyond the wording of a government document.

She said inadequate or unrepresentative data could mislead women into believing that particular quantities of nutrients had been scientifically established specifically for them.

It could also discourage further research into women’s health if existing recommendations give the impression that the necessary evidence is already available, she argued, while potentially providing support for companies marketing nutritional supplements on the basis of such tables.

The AESAN report was intended to provide guidance aimed at reducing some of the health risks associated with menopause and ageing, including the loss of bone and muscle mass and increased cardiovascular risk.

Among its recommendations are adequate consumption of protein, omega-3 fatty acids, fibre, calcium, iron and vitamins, alongside regular physical activity, with particular emphasis on strength exercise.

Equality minister calls for change

Spain’s Equality Minister, Ana Redondo, has also intervened in the controversy, calling publicly for the document to be reviewed and urging authorities to ensure that similar situations ‘do not happen again’.

‘It is about time women were present in health agendas and studies, and the male body stopped being the universal reference point for everything, even for issues related to the menopause,’ Redondo said in a post on X.

The controversy has again drawn attention to the historic gender gap in medical research, in which knowledge about illnesses, symptoms, treatments and appropriate doses has frequently been developed using the male body as the default reference.

Researchers have increasingly warned that such gaps can have practical consequences for women, ranging from less precise health advice and prevention strategies to differences in diagnosis and treatment.

AESAN’s scientific committee will now review the menopause report following the objections over its use and presentation of male-only research data.