- The Optimal Menopause Diet
- 6 Foods to Avoid During Menopause
- Foods That May Worsen Menopausal Symptoms
- These Everyday Foods Can Help Prevent Hot Flashes
- Whole grain bread and pasta
- Avoid high-fat foods, alcohol, and excess salt
- Hot flushes
- Weight gain
- Dry skin
- Depression and irritability
- Bone health
- Eat more phyto-oestrogens
- The Perimenopause Diet: Must-Knows
- Non-hormonal treatments for menopausal symptoms
- On Nutrition
- Winning the weight battle after menopause
- Lifestyle changes may not always be enough to control biologically driven body changes.
The Optimal Menopause Diet
Water. Vaginal dryness and dry skin caused by a decrease in estrogen during menopause are common complaints among women at this time, but getting eight glasses of water a day can help maintain your skin’s moisture and offset dryness, Bunce says.
Drinking water also helps decrease the bloating that occurs with hormonal changes, she adds. This kind of symptom is most common in the years just before periods end for good, often referred to as perimenopause.
Calcium. Your calcium needs increase during menopause because the loss of estrogen can speed up bone loss, Bunce says. If you’re not taking estrogen replacement, aim to get at least 1,200 milligrams of calcium a day. If you do take hormone replacement therapy, aim for 1,000 milligrams a day, she says. Because that’s difficult for most women to achieve that through diet alone, consider a combination of calcium-rich foods in your diet, like milk and nonfat yogurt, and calcium supplements.
Vitamin D. Getting enough vitamin D is also critical for protecting your bones during menopause. Vitamin D comes from the sun, but many experts say it’s vital for women’s health to take a vitamin D supplement to ensure you’re getting enough, especially in winter and in non-sunny climates. Although the official recommended daily dose is only 600 international units for most people, Bunce says that many doctors recommend getting 1,000 to 2,000 international units of vitamin D a day. Talk to your doctor about the right amount for you.
Fruits and vegetables. Your metabolism slows down as you get older, and women in their mid-forties tend to become more sedentary. This all adds up to weight gain, one of the most dreaded menopause symptoms. By filling up on low-calorie fruits and vegetables, you can help minimize weight gain while getting the nutrients you need to stay healthy.
Whole grains. Some whole grains, such as steel-cut oatmeal, quinoa, barley, and brown rice, provide B vitamins — which help boost energy, manage stress, and keep the digestive system functioning, Bunce says.
Folic acid and fiber, also found in whole grains, help lower risk for cardiovascular disease, which rises after menopause.
Iron. Your iron needs actually go down during menopausal years, Bunce says, so focusing on eating lean cuts of beef, eggs, iron-rich cereals, and grains should put enough in your diet. Iron supplements (and that includes multivitamins with iron) are generally not recommended for women after menopause unless your doctor prescribes them.
Soy. Some experts recommend soy for relief of hot flashes, but the research is inconclusive, Bunce says. Soy compounds, called isoflavones, mimic estrogen in the body. Studies of the benefits of soy for women in menopause focus on women in Asia, who get their soy from food, Bunce says. If you want to try soy, eat edamame, tofu, and other soy foods as much as possible instead of processed foods like soy burgers. “Any time you can add plant-based foods to your diet, it’s a benefit,” she says.
Flaxseed. Flaxseed is a wonderful plant-based food with omega-3 fatty acids. Try sprinkling ground flaxseed on cereal, yogurt, and salads; it adds fiber to your diet, keeps your arteries healthy, and has some estrogen-like compounds, Bunce says.
Low-calorie foods in general. The plain truth is that your calorie needs decline with every decade of life. The less weight you gain during menopause, the better your menopause symptoms in general, so it’s worth adopting a diet of low fat, healthy foods, including fruits and vegetables, whole grains, and lean protein, that will help you maintain your weight.
What to avoid. Steer clear of alcohol, sugar, caffeine, and spicy foods, which can trigger hot flashes, aggravate urinary incontinence (another common problem during the menopause years), increase mood swings, and increase bone loss, Bunce says.
Among Bunce’s clients, the women who handle menopause symptoms the best are the ones who approach this time as a natural progression of their lives and roll with the punches, rather than see it as a struggle, she says.
“Many women have spent their entire lives taking care of others,” she says. “This is the perfect opportunity to look in the mirror and say to yourself, ‘I need to take care of myself now so I can have the quality of life I’m looking for.’”
6 Foods to Avoid During Menopause
During menopause, avoiding hot peppers and other spicy foods can help keep hot flashes at bay. Andy Richter/Getty Images
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Following a healthy, well-balanced diet is a good idea in general, but it’s especially true for women who are nearing or have just passed through menopause, says Amy Jamieson-Petonic, RD, a nutritionist and exercise physiologist in Cleveland.
“Good nutrition can make a big change in how you feel with regard to menopause symptoms like mood swings, hot flashes, and exhaustion, as well as bloating and possible weight gain,” Jamieson-Petonic says. Women of menopausal age should make sure to eat plenty of whole grains, fresh fruits and vegetables, and lean protein for optimal health, she says.
That advice is backed up by a survey of 400 post-menopausal women documented in an article published in April 2019 in journal Menopause, which found that women who ate a diet rich in fruits and vegetables were less likely to report having experienced menopausal symptoms than women whose diets contained more fatty foods and sweets. Decreasing your consumption of these and certain other foods may be able to ease a lot of the discomfort linked to this natural transition and help you stay healthy in the years to come.
Foods That May Worsen Menopausal Symptoms
Potato chips and cookies might taste good, but they’re usually high in sodium, loaded with added sugars, or both, which can make you retain water and feel bloated, Jamieson-Petonic says. If you’re craving a snack, try a healthier alternative, like string cheese, carrots dipped in hummus, or a few whole-grain crackers with peanut butter — they’ll satisfy your need to nibble without filling you up with the symptom-trigger stuff.
Think twice before you add that extra-hot salsa to your taco. Foods that rate high on the heat scale can trigger sweating, flushing, and other symptoms of hot flashes, according to the National Institute on Aging. If you’re looking to add some kick to a bland dish, Jamieson-Petonic suggests skipping the jalapeños and sprinkling on spices that provide flavor without as much heat, like cumin, curry, turmeric, and basil.
In a rush? Drive-through restaurants may be convenient when you’re short on time, but their meals often serve up a massive amount of fat, Jamieson-Petonic says. Fatty foods can increase your risk for heart disease, a condition that women are already at greater risk for after passing through menopause, according to the American Heart Association. “These foods also tend to promote weight gain, which can exacerbate menopause symptoms as well,” Jamieson-Petonic says. The better solution? Have quick, healthy foods on hand by freezing leftovers at home or packing a lunch. If you have to eat a meal on the fly, skip the cheeseburger and choose healthier menu options. A grilled chicken sandwich on a whole-grain bun with lettuce and tomato is a good alternative, she says.
Although it may not be necessary to swear off all cocktails and wine, there are plenty of good reasons to keep your alcohol consumption moderate. As suggested in the 2015–2020 U.S. Dietary Guidelines for Americans, moderate drinking for women is defined as one drink per day or less. Women who have two to five drinks a day have 1.5 times the risk for breast cancer as those who don’t drink at all, and heavy drinking can increase your risk for cardiovascular disease, according to the North American Menopause Society. Plus, some women find that alcohol makes them more susceptible to hot flashes, Jamieson-Petonic says.
“I tell women to listen to their bodies,” she says. “If alcohol aggravates their menopause symptoms they should try to avoid it.” If you still want to indulge occasionally, Jamieson-Petonic suggests trying a white wine spritzer with fruit, which is lower in alcohol than most standard drinks.
Love your morning cup of joe? It could be worsening your menopause symptoms. A Mayo Clinic study published in February 2015 in the journal Menopause found that menopausal women who consumed caffeine were more likely to have hot flashes than women who didn’t consume caffeine. If you’re craving a warm drink, try a cup of hot ginger or peppermint tea — both caffeine-free — Jamieson-Petonic says. Or if you’re in need of some extra energy, try going for a quick walk instead of relying on caffeine for a kick.
Besides being high in saturated fat, foods like brisket and bacon can lower the body’s serotonin levels, Jamieson-Petonic says. “When serotonin drops, we feel angry, grumpy, and irritable,” she says. When you’re shopping for meats, skip the greasy, marbled cuts in favor of trimmer alternatives, like chicken, turkey, and ground beef that’s 90 percent lean or better.
The foods that are good for you during menopause are good for you at any stage in your life. Build healthy eating habits now and you’ll enjoy better health for years to come, including through menopause.
These Everyday Foods Can Help Prevent Hot Flashes
Menopause and its side effects (insomnia, dry skin, and hot flashes, oh my) are daunting to many women, especially those who don’t know how to help alleviate the transition. There are lifestyle changes you can make each day to help prevent the hot flashes associated with menopause — and recent studies show it is never too early to change your diet.
One of the studies, published in the American Journal of Clinical Nutrition, disclosed the connection between women’s’ diets and hot flashes and supported the idea that your food choices could relieve the aggravating menopausal symptom. We rounded up the everyday foods can help prevent hot flashes as well as the foods to avoid.
Salmon is a great protein source to include in your diet. | iStock/Getty Images
Following a typical Mediterranean diet, or one that’s plant-based and pescetarian can help ward off hot flashes. It’s important that menopausal and premenopausal women eat food high in the nutrients their body needs, including those that women’s diets are generally low in like iron and calcium.
Fish is a good dairy-free source of calcium that’s easy to incorporate into your diet. Nutritionists recommend getting around 1,200 milligrams of calcium per day. Other healthy sources of calcium include fat-free Greek yogurt, milk, and plant-based proteins like nuts and tofu.
Broccoli is high in iron. | phasinphoto/iStock.com/Getty Images
Broccoli serves its hot-flash ridding purpose twofold: it’s a good source of both calcium and iron, another nutrient women’s diets are often low in. Women over 50 should get around 8 milligrams per day of iron. While iron is found in lean red meat and poultry, vegetarians have a tougher time getting the nutrient than meat-eaters do.
Leafy green vegetables, nuts, and black beans are great sources of iron that vegetarians can incorporate into their diet to meet their iron requirement.
Whole grain bread and pasta
Whole grain bread is your best choice for sandwiches. | iStock
Fiber can help combat fatigue and weight gain in menopausal women as well as lower cholesterol, blood glucose, and help keep your digestive system running smoothly. Foods high in fiber like whole-grain bread and pastas, cereal, rice, fresh fruits, and vegetables can all help you meet your 21-gram per-day fiber recommendation.
By lowering cholesterol, fiber can help to alleviate hot flashes and their aggravating symptoms in women. Nutritionists recommend bread that’s high in fiber (at least 2 grams a slice) and whole grains but still low-calorie and low-sugar. Try Ezekiel’s 4:9 Sprouted Whole Grain Bread and Dave’s Killer Bread Thin-Sliced 21 Whole Grains and Seeds.
Avoid high-fat foods, alcohol, and excess salt
While adding calcium, iron, and fiber-rich foods into your diet, be sure to cut out those that could promote your hot flashes (or make them worse)! High-fat foods and saturated fats raise your cholesterol and boost your risk for heart disease as well, while a high-sodium diet can lead to higher blood pressure.
Monitor your drinks as well when trying to manage hot flashes. “Hot flashes often flare up when women drink wine or coffee, which, which acidifies the blood and strains the liver. One way to avoid this acidification is to cut down on these beverages and to drink more fresh vegetable juices, which counteract the effect by alkalinizing the system,’ Eve Campanelli, a holistic family practitioner, told Prevention.
General guidelines for what to avoid to prevent hot flashes:
- Limit fats to between 25% to 35% of your total daily calories
- Beware of saturated and trans fats
- Use sugar and salt in moderation
- Lay off the smoked, salt-cured, canned, and charbroiled foods that are salted and have high nitrate levels
- Limit alcohol consumption to one or fewer drinks per day
Not going through menopause? There are five other reasons you could be experiencing hot flashes.
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About the menopause
Most women dread the word menopause. In reality it affects women in completely different ways, but the most common symptoms include hot flushes, sweating, insomnia, anxiety, impairment of memory and fatigue. Long term consequences can include a decline in libido, osteoporosis, heart disease, even dementia – all linked to reduced oestrogen levels.
Typically, a woman’s ovaries stop releasing eggs in her early 50s, and the menstrual cycle stops. Some women can sail through with only the odd hot flush, but others can struggle with symptoms such as weight gain and fluctuating emotions. The physiological reason why the body starts changing is largely down to the drop in oestrogen production and the effect this has on other hormones.
As the ovaries stop manufacturing the hormones oestrogen and progesterone, symptoms may begin. For example, oestrogen helps lift our mood so, when levels drop, we may feel depressed. Some women opt for hormone replacement therapy (HRT); others try natural remedies. Whether or not you decide to take HRT, following the guidelines below won’t hurt and will assist in the pursuit of an all-round healthy lifestyle.
It has been noted that eating, and avoiding, certain types of foods can make the menopause a lot more bearable. Here are common problems those going through the menopause may face and some foods to watch out for…
Try to cut down on foods that are likely to trigger or worsen hot flushes and night sweats. For instance, avoid stimulants such as coffee, alcohol and chocolate and spicy foods, especially at night – they’re notorious for setting off hot flushes.
Avoid snacking on sugary foods – all too often a sharp rise in your blood glucose level may be followed by a sharp dip which leaves you feeling tired and drained. Choose fresh fruit with a few nuts instead.
Many people associate the menopause with weight gain but, as we get older, we need fewer calories. Eating a bit less sounds a simplistic solution but it will help. Watch the amount of fat in your diet and cut back on sugar. Eat complex carbohydrates, such as brown grains, wholemeal pasta, bread and rice, as they will help balance blood sugar levels and keep you feeling fuller for longer.
Legumes, nuts and seeds such as pumpkin, sunflower, almonds contain vitamin E, zinc and calcium. These nutrients and the oils in nuts and seeds may help prevent dry skin and normalise hormone levels.
Depression and irritability
Ensure you eat enough protein foods which contain the amino acid tryptophan. You can find it in turkey, cottage cheese, oats and legumes. Tryptophan helps manufacture the neurotransmitter serotonin. Serotonin helps moods and may help control sleep and appetite which can make you feel better in yourself. Other useful strategies to help you feel less irritable are to eat breakfast and not miss meals in order to ensure you keep your blood sugar stable. Erratic blood sugar levels may lead to irritability and mood swings.
Women going through the menopause should increase their intake of food sources of calcium, magnesium and vitamins D and K to maintain integrity of the skeleton. In addition, high amounts of phosphorous – found in red meat, processed foods and fizzy drinks – should also be avoided. Too much phosphorous in the diet accelerates the loss of minerals such as calcium and magnesium from bone. Reducing sodium, caffeine and protein from animal products can also help the body maintain calcium stores.
Eat foods high in magnesium and boron. These are minerals which are important for the replacement of bone and thus help to reduce the risk of osteoporosis. Apples, pears, grapes, dates, raisins, legumes and nuts are good sources of boron.
Talk to your doctor about whether you may benefit from a calcium supplement. Other vitamins and minerals that are vital for bone health are magnesium, vitamin E, vitamin D and zinc. Weight-bearing exercise is important too, but if you have been diagnosed with any form of bone loss, check with your doctor that you can exercise safely and effectively.
Find out more about the best sources of calcium and learn about what affects osteoporosis and bone density.
Eat more phyto-oestrogens
Phyto or plant oestrogens found in certain foods are oestrogenic compounds that bind with oestrogen receptor sites in the body cells, increasing the total oestrogenic effect. By acting in a similar way to oestrogen, they may help in keeping hormones a little more in balance. A high intake of phytoestrogens is thought to explain why hot flushes and other menopausal symptoms rarely occur in populations consuming a predominantly plant-based diet. Increase your intake of phyto-oestrogens by eating more: soya milk and soya flour, linseeds, tofu, tempeh and miso, pumpkins seeds, sesame seeds, sunflower seeds, celery, rhubarb and green beans.
This page was last reviewed on 8 August 2018.
Kerry Torrens is a qualified Nutritionist (MBANT) with a post graduate diploma in Personalised Nutrition & Nutritional Therapy. She is a member of the British Association for Nutrition and Lifestyle Medicine (BANT) and a member of the Guild of Food Writers. Over the last 15 years she has been a contributing author to a number of nutritional and cookery publications including BBC Good Food.
All health content on bbcgoodfood.com is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. If you have any concerns about your general health, you should contact your local health care provider. See our website terms and conditions for more information.
The Perimenopause Diet: Must-Knows
What to add
- Omega-3 fatty acids
When it comes to healthy eating, it’s helpful to look at all the foods you should be eating versus the few foods that lack nutritional value. Fruits, vegetables, whole grains, and low-fat dairy are all good choices.
Perimenopause is a time when your body is going through numerous changes. Because of those changes, your body could use a little bit more of certain nutrients. For example, your muscle mass starts to decrease during perimenopause. So you’ll want to up your daily intake of protein, says Sonya Angelone, M.S., R.D.N., C.L.T., a San Francisco-based dietitian. Protein can assist in maintaining muscle mass.
With fluctuating hormones, balance is the name of the game. Protein can also help by regulating appetite and blood sugar levels. It may even help balance your hormone levels.
To get maximum benefits, Angelone recommends spreading your protein intake out over three meals and a snack. Instead of plain toast, top it with some peanut butter. Add baked salmon or chicken to a salad for a protein boost at lunch. For dinner, beans are a great protein add-in for any number of entrees, including tacos. Make your own nut mix, with your flavor of spices, for a perfect anytime snack. Eggs, lentils, and yogurt are other great high-protein choices.
Omega-3 fatty acids
Omega-3 fatty acids have been associated with decreased inflammation, as well as improved moods. Omega-3s have also been linked to decreased depression, which is something many women experience during perimenopause.
Angelone recommends two 4-ounce servings of fish per week. You can also talk to your doctor about taking fish oil supplements. Another option is adding flaxseed oil into your diet to combat mood swings and irritability.
Fiber is another go-to during perimenopause. It helps keep you feeling full longer, which can curb cravings. This will go a long way toward weight-loss efforts, which can be especially tough as you age and your metabolism slows down.
Fiber has also been shown to decrease your risk of certain diseases of aging, notes Angelone. These include heart disease, stroke, and cancer.
You should aim for at least 21 grams of fiber each day. Fruits and vegetables are a great place to find fiber. Whole grains and beans are also good source. In general, the more processed an item is, the less fiber it’ll offer.
As you age, your risk of osteoporosis increases. To keep your bone health in check, up your intake of calcium to 1,200 milligrams daily. Vitamin D is also important in this regard. You’ll want to check with your doctor for individualized recommendations, as not all physicians agree on the optimal intake for bone health.
For women, menopause is a reality check that your body is changing. This is a time to take care of yourself by making healthy lifestyle choices. Eating well and being physically active will make this midlife transition easier.
Every woman has to face this “change of life” at the time of her last period. On average, women reach menopause at age 51, but it can happen earlier or later. Menopausal symptoms vary with every woman. Common symptoms include hot flashes, night sweats, weight gain around the middle, sleep disturbances and mood changes. However, some women go through menopause with no real symptoms.
What causes menopause? Hormones. As women age, your ovaries produce less estrogen and progesterone, two of the main hormones for reproduction. As estrogen levels go down, one of the first signs of “menopausal transition” is irregular periods in which bleeding is unusually heavy or light; the time between periods also may become longer.
Weight Gain with Menopause
Due to lowering hormone levels and the natural aging process, many women find it harder to keep extra pounds off in their 40s and 50s. Often women lose muscle and gain fat, mainly in the belly area. Lifestyle factors come into play, too — menopausal women tend to be less active and eat more calories than they need.
Health Risks Associated with Menopausal Weight Gain
Let’s face it: When we gain weight, we don’t feel good. It can be uncomfortable and cause low self esteem. But that’s not all. Weight gain is related to health issues including high cholesterol, high blood pressure and insulin resistance (a condition in which your body cannot use insulin correctly, which can lead to diabetes).
Avoiding a “Midlife Metabolic Crisis”
Plan for your body’s natural metabolic slowdown. As with any time in life, there are no quick fixes when it comes to weight loss. There are, however, ways to avoid a midlife crisis when it comes to a slowing metabolism.
Be physically active. Adults should do at least 30 minutes of moderate-intensity exercise most days of the week. Exercise doesn’t have to mean a trip to the gym. You can be active doing daily activities. Take the stairs; park further away from your destination and walk; garden; or dance. Aim for strength-building exercises at least twice per week. Not only will strength training replace your lost muscle mass, but it also helps to slow mineral loss in your bones which can lead to osteoporosis. Most importantly, exercise should be fun. Pick activities you enjoy and get moving with friends and family.
Eat right. Foods such as vegetables, fruits, whole grains, low-fat dairy products and lean protein foods such as beans and lentils contain the nutrients you need and should make up the majority of your meals and snacks. If you drink alcohol, limit yourself to one drink a day. If you suffer from hot flashes, try cutting back on caffeine and spicy foods, which could trigger hot flashes in some people. Watch your sodium intake and aim to cook most of your meals at home rather than eating out.
Drink plenty of water. Water helps move fiber through your system, keeps you hydrated and may mitigate hot flashes. Remember that fruits and vegetables are loaded with water, and health-boosting nutrients, too.
When menopause has you down, remember it’s a temporary state. The healthy diet and exercise habits you put in place during menopause will keep you feeling great after the hot flashes, mood swings and sleepless nights pass.
Non-hormonal treatments for menopausal symptoms
The epidemiological studies of Issacs, Britton and McPherson found that women doctors had a high incidence of HRT use.1,2 In their 10-year follow-up of women doctors aged 50-64 years current use remained at 38.1% but ever-use increased from 53.4% in 1993 to 66.2% in 2003 (p
However, use of HRT and the breast cancer rates and mortality sharply declined in hormone taking countries after the results of the Women’s Health Initiative randomised double-blind controlled study in 1992 which found increases in breast cancer and vascular diseases with no overall health benefits.3 It is a shame that women doctors seem more likely to believe the widespread promotional propaganda that HRT is needed for symptom relief and osteoporosis prevention. Neither of these claims stand up to detailed biochemical investigation in my experience.4,5
Hot flushes are part of an allergic reaction
Women suffering from hot flushes can easily prove that hot flushes are part of an allergic reaction to common foods or chemicals. In 1979 I published the results of a study entitled “Food allergies and Migraine” (Lancet 1979;1:966-69). 60 migraine patients stopped all medications, including contraceptive and menopausal hormones, and also stopped smoking and drinking alcohol. The patients followed the “lamb and pears diet” of Dr John Mansfield. The aim of the diet is to avoid common foods for 5 days, when withdrawal symptoms can occur but then hidden or masked food allergens can be unmasked. Common foods causing vascular reactions like flushing, headaches, pulse or blood pressure rises, or other symptoms, were wheat (78%), orange (65%), eggs (45%), tea and coffee (40% each), and corn, cane sugar and yeast (33% each). No patients needed medication when avoiding their main food and chemical allergens and 85% of patients became headache-free. Those with hypertension became normotensive. The commonest chemical allergens were cigarette smoke and domestic gas. Women who have been taking progesterones and/or oestrogens or antibiotics often have positive gut fermentation tests and also need anti-fungal medication, probiotics and a strict low yeast diet.6
Reactions to foods and chemicals increase if zinc, copper and magnesium, and B vitamins and essential fatty acids are deficient and supplementation is usually needed to replete these deficiencies. Deficiencies of zinc and copper can severely disturb immune system homeostasis including lymphocyte and antibody production (Nutrition and Immunology 2000, Humana Press).
It is indeed a real problem that the best tests to see what is going on, especially when women take hormonal contraception or HRT, have not become generally available. I wonder why? Has too much time and money has been spent on psychology and flawed epidemiological studies? Important investigations include estimating levels of white cell zinc, red cell magnesium, superoxide dismutase activities, functional B vitamin tests, metallothionein, DNA adducts, ATP profile, lymphocyte sensitivity tests, and red cell essential fatty acid profiles.
2 Isaacs AJ, Britton AR, McPherson K. Why do women doctors in the UK take hormone replacement therapy. Epidemiol Community Health. 1997 Aug;51(4):373-7.
3 Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, et al. Writing Group for the Women’s Health Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomised controlled trial. JAMA 2002;288:321-33.
4 Grant ECG. The pill, hormone replacement therapy, vascular and mood over-reactivity and mineral imbalance. J Nutr Environ Med 1998:8:789-91. DOI:10.1080/13590849862131
5 McLaren-Howard J, Grant ECG, Davies, S. Hormone replacement therapy and osteoporosis: bone enzymes and nutrient imbalances. J Nutr Environ Med. 1998;8:129–138.
6 Grant ECG. Food allergies and migraine. Lancet 1979;1:966-69
Menopause marks the end of a woman’s menstrual cycles, a biological transition that shifts hormones as well as nutritional needs and health concerns. Complicating matters are life changes that often coincide with it — such as becoming an empty nester — and may alter eating habits. Meal-skipping, grazing all evening instead of cooking dinner, and more frequent restaurant or takeout meals can make it harder for women to get the nutrients they need as they grow older.
Here’s what you need to know:
Reducing menopausal symptoms
Menopause comes with a variety of symptoms, including “brain fog,” sleep disturbances and mood changes, but of these, hot flashes are perhaps the most uncomfortable — and embarrassing. Many women turn to herbal remedies like black cohosh and licorice extract for hot-flash relief, but whether they actually help is unclear. Foods containing soy can be a more effective nutritional remedy, but only for some women. Because hot flashes are much less common among women in Asia compared with North American women, researchers theorized that the isoflavones in soy foods — consumed regularly in traditional Asian diets — might serve as a sort of “natural” hormonal therapy. Isoflavones are phytoestrogens, plant-based compounds that can behave somewhat like estrogen.
That said, current research suggests that soy isoflavones only benefit women who have gut bacteria that can convert daidzen — an isoflavone found in soy as well as in most plant foods — into its more active form, equol. About 30 percent of women living in North America have this gut bacteria. The bottom line is that while soy is a healthful, plant-based source of protein, it won’t help all women reduce hot flashes.
Protecting bone and muscle
According to the National Osteoporosis Foundation, the sharp decrease in estrogen during menopause can cause bone loss and increase the risk of osteoporosis, with one in two women over the age of 50 breaking a bone because of it. In some women, this bone loss can be rapid and severe, with a loss of up to 20 percent of bone density during the five to seven years following menopause. Women who experience menopause before age 40 also have a greater risk of developing osteoporosis.
What can you do? Start with nutrition.
“Women should check their vitamin D levels and supplement to reach an adequate level to promote bone health,” said Judy Simon, MS, RDN, owner of Mind Body Nutrition in Bellevue. “Be sure to include healthy sources of calcium, vitamin K and magnesium.” After menopause or age 50, women need 1,200 milligrams of calcium from food and/or supplements each day. Food sources include dairy foods, canned salmon and sardines with bones, dark leafy greens, and fortified foods and beverages. Aim to get 1,000 IU of vitamin D from supplements, fortified foods or fatty fish. Getting adequate protein is also important to protect bones and prevent the muscle loss that can also accelerate around menopause. Current evidence recommends 1-1.2 grams of protein per kilogram of body weight for older adults.
As important as nutrition is for strong bones and muscles, it’s not enough. Staying physically active is also key. Include weight-bearing, muscle-strengthening types of physical activity to stress your bones and muscles in a good way. Dancing, jogging, brisk walking, jumping rope and jumping jacks are options, as well as lifting weights with machines or free weights (dumbbells and barbells), using resistance bands, or doing body weight exercises like push-ups, squats and lunges. Simon also recommends Pilates and forms of yoga that require more strength.
Preventing heart disease and cancer
A woman’s risk of cardiovascular disease increases after menopause, as the protective effects of estrogen fade. Women who start menopause after age 55 have an increased risk of breast, endometrial and ovarian cancers. A 2018 study out of Harvard University found that eating a Mediterranean-style diet was associated with a 25 percent lower risk of cardiovascular events — including heart attack and stroke — over the study’s 12 years of follow-up. Research out of the Fred Hutchinson Cancer Research Center for the Women’s Health Initiative — which randomly assigned 48,835 postmenopausal women to a low-fat diet (20 percent fat) or their usual diet — found that women in the low-fat diet group were more likely to survive if they were diagnosed with breast cancer. A high-quality diet is also associated with increased survival after an ovarian-cancer diagnosis.
Protect yourself by building a diet rich in vegetables and fruit, protein that comes at least partly from plants (soy, beans and lentils) and seafood, whole grains, healthy fats (nuts, seeds, olive oil, avocados and fatty fish), and lower-fat milk, yogurt and other dairy. Keep alcohol intake moderate and intake of sugar, salt and refined flour low.
“I frequently see women in perimenopause, menopause and post menopause who are unhappy with their bodies,” Simon said. Metabolism tends to slow during menopause, especially if muscle loss is also occurring. At the same time, the drop in estrogen contributes to distribution of excess body fat around the abdomen, even in women who have always carried most of their body fat around their hips and thighs. “I encourage mindful eating and becoming attuned to their body’s signs for hunger and fullness rather than a calorie-restricted diet,” she said.
Simon said that in addition to weight gain, digestive issues, fatigue and depression are other concerns she hears from women going through menopause. In addition to discussing food and movement habits, she talks to them about sleep habits and self-care. That matters, because excess stress — and the stress hormone cortisol — contributes to unhealthy shifts in body composition, including loss of muscle and increase in fat around the waist. “Most importantly, I share they are not alone and there are lifestyle changes they can make to improve their health and wellness,” she said.
Winning the weight battle after menopause
Lifestyle changes may not always be enough to control biologically driven body changes.
Published: August, 2019
You spend hours in the gym every day. You eat nothing but grilled chicken, fish, and salads. Yet the numbers on the scale don’t budge — or worse, they slowly creep up, along with your waist measurement.
Welcome to menopause.
“The change” actually does bring changes for many women, including weight gain that can resist even the most diligent efforts to reverse it, says Dr. Fatima Cody Stanford, instructor in medicine at Harvard Medical School.
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