Changing Your Diet For The ‘Change Of ‘Life’
Changing your diet for the ‘change of ‘life’ can minimise the impact of menopause.
But before we launch in to discuss how to best maintain health and vitality through and after menopause, let’s pause to celebrate the fact that this period of time, which strikes dread into many 40-something year old women, actually signifies the end of one of the most debilitating aspects of life for some women.
The words ‘change of life’ or menopause can cause palpitations and hot sweats in women of all ages! My mum suffered through this stage of life when I was an oblivious self-absorbed teenager in the days before hormone replacement therapy. On reflection it seemed to be something that women accepted, suffered through and gained several pounds around the middle as a result of. But there were no decisions to make, no “will I take HRT or not”, and no real understanding of what health risk factors changed as a result of the metabolic consequences of the changing hormone levels.
Women are now much more informed about the decline in oestrogen levels before and during menopause; with resulting hot flushes, night sweats, palpitations, headaches, insomnia, fatigue, bone mineral density loss and vaginal dryness. Fewer are informed about reduced progesterone; causing periods to become irregular, heavier, and longer during perimenopause.
The fact that testosterone continues to be produced by the ovaries after menopause tends to result in the misinformation that this hormone increases during menopause. Rather levels decline to about half their peak level, so they are high relative to oestrogen, but not absolutely. So, what can be done from a dietary perspective to help minimise menopausal symptoms during perimenopause and offset any increases in health risk after menopause? I’m glad you asked!
Let’s look at combating the symptoms first. I am not a medical doctor, so I will leave the “HRT or no HRT” debate to the specialists, suffice to say that it is worth having a discussion with your medical professional that includes discussion of your own personal family history and risk factors in order to weight up the pros and cons for you.
DIET DURING PERIMENOPAUSE
- Analysis of clinical trials suggests that phytoestrogen supplementation is associated with modest reductions in the frequency of hot flushes and vaginal dryness but no significant reduction in night sweats. The use of dietary soy foods and phytoestrogen supplements may therefore be helpful for some women during menopause, to help mimic oestrogen in the body so it does not realise the natural levels are dropping, giving your body time to adjust.
Hint: Including whole soybean milk, tofu, tempeh, soy burgers, soy grits and linseeds on a daily basis may ease menopausal symptoms. If you are not a lover of soy, then consider a good quality phytoestrogen supplement from a pharmacy or health food store.
- A recent review of all the available literature relating to lifestyle changes during ‘the change of life’ reported that exercise alone or combined exercise and caloric reduction can “disrupt the process and patterns of weight gain and change in body fat distribution during the menopause transition stage”. Good news for all you women out there prepared to work that body to combat the body’s natural propensity to get thicker around the middle in mid-life! An added bonus of weight-bearing exercise is the maintenance of bone mineral density, particularly in the hip, a big advantage leading into later years when the risk of fractures increases.
Hint: Fewer calories eaten than calories being expended (through exercise and daily activity), but the calories in have to be valuable – high in nutrients to give us maximum nutrition per mouthful.
- Other dietary strategies to help alleviate peri-menopausal symptoms include avoiding hot drinks and spicy foods at times of day when symptoms are worst and avoiding caffeinated drinks after lunchtime to avoid insomnia. While these strategies can help some women, they may not help all, but are certainly worth a try.
DIET DURING MENOPAUSE
Post menopause, our dietary considerations turn to maintaining health and minimising risk of chronic disease. The key considerations here are that changes in hormone balance after menopause make women more susceptible to heart disease than they were before menopause, and also more susceptible to decreasing bone mineral density. Healthy, active older women can minimise these risks through diet and lifestyle without too much cost or reliance on supplements.
- From a heart health perspective, the usual recommendations still stand: eat at least 500 grams of fish per week (preferably deep sea fish), a handful of mixed unsalted nuts per day, at least 500 grams of vegetables per day (yes, that’s right!) and only choosing whole grain based bread and cereal products.
Hint: For those with a family history of cardiovascular disease, it is worth also considering including soy products daily, plant sterol fortified foods or supplements, soluble fibre (especially high in psyllium, chia seeds and legumes). Ask your dietitian about the ‘portfolio approach’ to managing cholesterol if you are averse to taking medication.
- Maintaining muscle mass and bone mineral density are critical to well-being during menopause, and hinge on activity and nutrition, in particular, Vitamin D and calcium. Lack of Vitamin D is increasingly being linked to a range of chronic diseases, including some cancers, heart disease, and diabetes, in addition to its’ known role in bone health. Although we get most of our vitamin D3 from the action of sunlight on the skin, women whose skin has limited exposure to sunlight (or routinely use sunscreen) are at particular risk of vitamin D deficiency, in particular, older women. Vitamin D3 supplementation has been shown to have a small positive impact on muscle strength, so is another worthwhile consideration for menopausal women. Food sources of Vitamin D contribute too, but it is the less potent vitamin D2, which needs to be converted to D3 to become active.
Hint: Expose your hands, face, and arms to the sun daily for 10 minutes (15 minutes if you have dark skin) in the early morning or late afternoon to avoid sun sun-related skin damage.
- I am sure you are all well aware of the importance of calcium for post-menopausal women, who have greater calcium requirements than other people. If you are unable or unwilling to consume the equivalent of 3 cups of milk and yoghurt each day, you may need to consider supplementation, or eating lots of tinned salmon or sardines, including the bones! If you drink soy milk, check that it is calcium-fortified. Other non-dairy sources of calcium (unless fortified) are not high enough to count as a serve – would you eat a half cup of sesame seeds in one sitting?
Hint: You can avoid calcium losses by not consuming excess meat, alcohol, caffeine, soft drink or salt, all of which leach calcium from your body. You may also benefit from drinking tea at a different time of day to when you eat calcium rich foods and remember that phytates from bran can also bind calcium, which can be tricky but worth considering if you eat bran cereals with milk for breakfast.
YOUR ACTION PLAN
My advise from here is to read and digest this information in light of where you sit on the ‘Menopausal spectrum” and your own personal genetic and hereditary factors in relation to health risk. We all need to focus more on some aspects of our health than others because we have our own “Achilles heal” – those chronic diseases that impact on our families. Then prioritise a few of the hints and suggestions to discuss with your doctor or dietitian, or implement as preventative measures to make your journey through menopause as pleasant and as health-full as possible.
By Keith Duncanson PHD from Gut Feelings