Can what you eat support you through the menopause?
At all stages of life, nutrition is just one consideration when it comes to living as healthily as possible. This is also true of the peri-menopause (the time leading up to a woman’s last period) and the post-menopause phases. During the peri-menopause, levels of oestrogen start to lower that can result in a range of symptoms, the most common being: night sweats, brain fog, palpitations, thinning hair, aching joints and headaches. There are also the psychological effects including anxiety and low mood that are due to low levels of oestrogen impacting your body’s serotonin production. When it comes to your diet, unfortunately, there are no magic bullets that will alleviate all of your symptoms. What we do know is that 85% of women have symptoms and that some women have more symptoms or worse symptoms than others. What you eat or don’t eat won’t suddenly mean you will be symptom-free but eating well and being aware of changes you can make to your diet will support your overall health now and in the long term.
This is also a phase of life where your own self-care should be top of the list. Sleep is vitally important as are activities that help you to relax such as yoga, ‘walking and talking’ and hot baths. Weight gain, particularly around the waist, can also be an issue. This can be due to a decrease in metabolism, fatigue and increased stress leading to increased cortisol levels that encourages the body to store fat around the middle.
So let’s review what we should be eating to keep us as healthy as possible. Overall you need to be aiming for a balanced, nutrient-dense diet that is rich in wholefoods (these are plant-based food sources that are unprocessed and unrefined, or processed and refined as little as possible, before they are consumed).
I’ll focus on a couple of key areas of your daily diet.
This macronutrient becomes particularly important once you hit your 40s for both men and women. This is also the time to add resistance training (e.g. pilates, weights) into your exercise routine to prevent muscle loss - a natural part of ageing. Building muscle becomes harder and there is a general trend for our activity levels to decrease, although not for everyone! Ideally you should be eating around 25-35g of protein per meal to maintain your muscle mass. The exact amount you need will depend on your size and level of activity, with those who are heavier and/or conducting high levels of physical activity needing more than those who are smaller and conducting lower levels of physical activity. So what does 25-35g protein look like in a meal format? Some simple suggestions are: 3-egg omelette, baked potato with tuna (whole tin) or baked bean (half can) on toast.
Healthy fats / omega 3s
Omega 3 fatty acids are important to our health at all stages of life – research has identified that they are important for our heart and brain health. However, they are particularly important during the menopause when our cardiovascular risk increases due to lower levels of oestrogen. The advice for all of us, regardless of life stage, is to eat healthier sources of unsaturated fats and less saturated fats. This means less fat from meat, cheese and butter and more from oily fish (e.g. salmon, mackerel, trout, sardines) and plant-based sources such as chia or flax seeds. Saturated fats are also found in cakes, biscuits and pastries so these should be limited within reason – everything in moderation!
Lower levels of oestrogen can lead to a loss in our bone density, making our bones more brittle and fragile and putting us at an increased risk of osteoporosis. As calcium is a key micronutrient that supports our bone health, it is important to keep on eating sufficient calcium-rich foods to counterbalance the loss in bone density. So what counts at calcium-rich food?
· Dairy foods – cow’s milk, yoghurt, cheese etc.
· Certain types of fish with edible bones e.g. sardines, salmon and mackerel
· Soy beans and soy products e.g. tofu, edamame
· Green vegetables such as broccoli, kale and cabbage, although not spinach in this instance because it contains oxalate, a naturally occurring compound in plants that can interfere with the absorption of calcium and iron.
· Nuts and sesame seeds
· If you are following a plant-based diet or have a preference for dairy-free options check they are fortified with calcium and iodine.
Now we’ve talked about calcium, its important to talk about Vitamin D because it supports the uptake of calcium into the bones and it also supports your immune system. It is quite difficult to get vitamin D from diet alone (sources include oily fish, red meat and fortified products e.g. cereals and eggs). In this country we are advised by the government to take a supplement of 10 micrograms during the winter months. If you are post-menopausal, you should consider a 15 micrograms/day supplement.
Plant or Phyto-oestrogens
A topic under discussion is whether plant-based oestrogens such as isoflavones that are found in soy, tofu, linseeds, flaxseeds, alfalfa sprouts and lentils can mimic the body’s natural hormones and therefore reduce menopause symptoms. There is some evidence that they can help reduce hot flushes and vaginal dryness but as always, more research is needed particularly around the safety of isoflavone supplements. If you do increase your consumption of plant oestrogens it can take 2-3 months for the benefits to become evident so if you make these changes do try to stick with it. These types of foods should also be spread throughout the day rather than having a larger dose as part of one meal. They also seem to work better for some women than others, one potential explanation is the differences in our gut bacteria (read my blog post on gut health here).
Caffeine and alcohol
As both of these can lead to a worsening in symptoms such as hot flushes, it is wise to not overconsume them. As a reminder, caffeine is found in coffee, tea, green tea, colas and chocolate. Try to choose decaffeinated drinks particularly if you are sensitive to its effects. Remember also that caffeine can have an impact on your sleep so it should be avoided after 2pm. Alcohol consumption should follow the 2-3 units per day advice and if it makes your symptoms worse then consider reducing further. As we age, our bodies find it harder to metabolise alcohol and it also has an impact on our mood and memory. Try for a minimum of three alcohol-free days each week.
In summary, as with other life stages everyone will have a different peri-menopause experience. What we eat is just one factor in staying healthy and there are some aspects of our diet that may have a positive or negative impact on symptoms. Embrace this phase of life, try to eat as healthily as you can and take the time to prioritise your own self care.