Integration of Precision Nutrition, Digital Health, and Functional Foods in Postmenopausal Women: A Comprehensive Review and a Novel Tiered Framework for Clinical Implementation

The postmenopausal period is associated with a significantly increased risk of metabolic disorders, osteoporosis, and cardiovascular disease, highlighting the need for innovative nutritional approaches. This comprehensive review summarizes data from 187 selected publications across three major databases (PubMed/MEDLINE, Scopus, and Web of Science), with a specific focus on systematic reviews, meta-analyses, and randomized controlled trials (RCTs). We critically assessed precision nutrition strategies that integrate omics technologies, including nutrigenomics, metabolomics, and microbiome analysis, and digital health tools, such as artificial intelligence (AI)-based apps, continuous glucose monitoring systems, and wearable biosensors, to address postmenopausal health challenges. Moreover, we evaluated the evidence for the effectiveness of functional foods and nutraceuticals, focusing on dietary patterns (Mediterranean, Dietary Approaches to Stop Hypertension (DASH), and plant-based diets); key bioactive compounds (phytoestrogens such as soy isoflavones and lignans, plant sterols/stanols, marine-derived omega-3 fatty acids, and antioxidants/polyphenols); baseline calcium/vitamin D supplementation; microbiome-targeted interventions (probiotics, postbiotics, and prebiotics); novel nutraceuticals (collagen peptides, coenzyme Q10, and myo-inositol). Finally, we distinguished approaches supported by robust clinical evidence from those requiring further validation. As a key new contribution, we propose a tiered implementation framework (basic, advanced, and detailed) to facilitate clinical integration from phenotype-based approaches to multi-omics personalization, with clear biomarker cutoff values and multidisciplinary engagement. This review highlights the promising, yet still evolving, potential of a systematic approach to precision nutrition to improve long-term health outcomes for a growing number of postmenopausal women, while emphasizing the need for further research to address gaps in the evidence base.