Menopause nutrition – probably not top on your list of things to figure out this week if you haven't yet reached that stage of life, but you may be surprised at how high-priority – even for the spring chickens among us – it actually is.
It’s easy to think of menopause – and even perimenopause – as distant, something to worry about down the line, but the sooner you make the dietary tweaks needed (which, by the way, are the opposite of deprivation) the better.
In fact, researchers from George Washington University have found that women who cut out all animal products and up their intake of legumes - including half a cup of cooked soybeans, daily - suffered 88% fewer hot flushes twelve weeks later.
The results, published in the journal Menopause, made headlines globally, when it came out last year, with some outlets suggesting a vegan diet could be a stand-in for hormone replacement therapy (or HRT) - which is, lest we forget, the most effective way to manage menopause symptoms and support women's health as we age.
Other studies, such as research by PREDICT and run by Zoe, the personalised nutrition company, found that menopausal women had worse blood sugar responses and greater levels of inflammation after eating, which was thought to be down to changes in the gut microbiome that occur as a result of menopause.
While we certainly wouldn't want to suggest that healthy eating is a *replacement* for medication, it's true that knowing what's up when it comes to menopause nutrition can help us feel and function better during a notoriously challenging life stage.
‘Ideally, I want women to make sure they’re well prepped in advance, rather than waiting until their symptoms are impacting their wellbeing,' says Emma Bardwell, registered nutritionist and co-author of The Perimenopause Solution: Take Control of Your Hormones Before They Take Control of You (Vermillion, £14.99). ‘Forewarned is definitely forearmed.’
The average age to reach menopause is 51, with perimenopause kicking in in your 40s. It lasts four to seven years, and can include various symptoms, from mood changes to sleep problems to joint pain – all of which can be eased by getting your food intake sorted. Question is: how do we navigate menopause nutrition in a mindful and healthy way, and what can we do now to prevent severe symptoms later on?
How can I nourish my body during menopause?
Half the battle is knowing where to direct your menopause nutrition efforts in a world where everyone seems to be an expert. For Bardwell, those areas are protein, blood sugars, fibre and calcium. ‘In a nutshell, all women over 40 really need to be thinking about eating for their heart, brain and bone health,’ she explains.
Nourish your heart
Get plenty of heart-loving non-saturated fat from foods like oily fish, olive oil, avocados, nuts and seeds. Focus on fibre too; according to the British Dietetic Association, UK adults are only managing to get 60% of the recommended 30g a day. Upping it helps you to manage your weight (which is important going through menopause) and builds diversity in your gut microbiome, as different bugs eat different things so the more variety you give them, the more species thrive. ‘Fibre is key for managing cholesterol so think about adding in vegetables, wholegrains, beans, lentils, chickpeas and fruit’, says Bardwell.
Strengthen your bones
Calcium is key for bone health, which gets more urgent as we age; ‘after 50, we lose 1% bone mass a year so we need to do all we can before then to lay down bone mass and increase bone strength,’ says Bardwell. That requires Vitamin D and calcium; 700mg of calcium a day before 50 and almost double, 1200mg, after, according to Bardwell. Get it from food sources like dairy, sardines, kale, broccoli, dried figs, calcium set tofu and fortified plant milks.
Fuel your brain
‘The brain requires energy from calories to function well, but also plenty of nutrients to fuel the production of ‘happy' signallers, such as dopamine and serotonin,’ says Bardwell. Omega 3, and specifically the compounds DHA and EPA found in it, is important too. Research has shown that omega-3 fatty acids reduce depressive symptoms for women transitioning into menopause, so aim for two servings of oily fish a week.
Don’t like fish? Supplements-wise, the best choice is one made with fish oil, but for veggies or vegans, an algae-based supplement. ‘Nuts and seeds contain Omega 3, but it’s the inactive form, ALA, which your body has to convert into DHA and EPA and this conversion is extremely inefficient,’ explains Bardwell.
Why is protein important in menopause?
A 2021 study found that compared to early perimenopausal women, late perimenopausal women had 9% lower muscle mass and postmenopausal women had 10% less. It’s thanks to a phenomenon called sarcopenia, and it’s why protein matters when we're talking menopause nutrition. ‘If your diet during menopause is protein-deficient, you will start quickly losing muscle mass, which means you will lose strength and will have a smaller capacity to store glucose, making it easier for your body to store carbs and sugar as fat,’ says Licensed Specialist Registered Dietitian Rachel Clarkson. ‘Strive for good quality protein at every meal.’ Research backs this up, finding that when older adults up their protein intake by 20%, they have a 32% lower risk of frailty - thanks to preserved muscles mass.
Bardwell agrees, and points to other symptoms protein can tame; ‘We need it for energy production, sleep and mood; it’s also great for curbing cravings, filling you up and keeping blood sugar levels steady. In a nutshell, protein ticks a lot of boxes when it comes to perimenopause symptoms.’ Bardwell suggests perimenopausal women should get 1g of protein per kilogram of body weight per day, or 1.2-2g if you’re very active; ‘so a 70kg woman needs around 70–100g of protein a day, ideally split across meals as your body can’t break down large amounts in one go.’ Think a palm-sized portion at each meal; a chicken breast, fillet of mackerel, half a cup of lentils, three eggs or half a block of tofu.
What is the best diet for menopause?
That doesn’t have to mean dousing everything in turmeric, though research has found that taking curcumin (found in turmeric) and vitamin E significantly reduces hot flushes, but eating an anti-inflammatory diet is one of the best things you can do. ‘Pre-menopause, the female body produces oestrogen and progesterone, which have a protective effect on women’s health,’ says Clarkson. ‘However, post-menopause, the levels of these hormones decrease dramatically, and risk of diseases increases. The most potent anti-inflammatory nutrient is omega 3, other nutrients that display anti-inflammatory effects are Vitamin C, vitamin E, vitamin A and carotenoids.’
Going through perimenopause puts your body under stress, stress causes inflammation, and chronic inflammation is linked to diseases including arthritis, Alzheimer’s and heart disease. The best way to eat to dial that down is by eating a Mediterranean style diet, based around vegetables, fruit, legumes, grains, olive oil, nuts and seeds, herbs and spices, some fish and seafood, moderate dairy and a limited amount of meat. ‘It’s a way of eating, not a written-in-stone diet, and can be adjusted according to taste, budget and preferences,’ says Bardwell.One study even found that a high intake of oily fish and fresh legumes was associated with delayed natural menopause, while refined carbs brought it on earlier.
What foods should I avoid during menopause?
Want to know what to avoid? Avoidance. ‘The keto and paleo diets mean many women avoid carbs and grains,’ says Bardwell. ‘Headaches, irritability, fatigue, constipation, sugar cravings, high cholesterol and bloating can all be down to a lack of complex carbs in your diet. Yet, despite the fact these common perimenopause symptoms could potentially be improved so easily, carbs are still plagued by controversy and often shunned.’
She cites the annoyingly pervasive notion that carbs make you bloated, inflamed, sluggish and unable to lose fat; ‘This isn’t true, carbs contain just 4 calories per gram, they fuel our muscles, pack in fibre and, when chosen wisely, are an excellent source of vitamins and minerals,’ she says. If nothing else, think of your brain! ‘It’s the hungriest organ in your body, using up around 20 per cent of the energy you consume in a day in its resting state, and carbs are its favourite food. Research suggests our brains use the equivalent of over 400 calories of glucose a day, which goes some way to explaining why low-carb diets can blunt your mental acuity, make your mood swing wildly and give you brain fog,’ explains Bardwell. So welcome good-quality complex carbs, mostly derived from plants, back into your diet.
Then there’s the trend for dodging dairy or gluten, with no medical need. ‘Dairy is a widely available and relatively cheap form of calcium and protein, plus it provides iodine which is crucial for thyroid health,’ says Bardwell ‘Plant milks can match the calcium if they’re fortified but it’s hard to find one that contains iodine and because they’re predominantly water, they’re not a good source of protein, unless we’re talking about soy.’
What helps brain fog during menopause?
Brain fog, the inability to think clearly, is a common problem in perimenopause and menopause, and hydration is one key way to overcome it. ‘Your brain mass is about three-quarters water. When that level dips, even a little, it can result in sluggishness, fatigue, brain fog, sleep problems and low mood,’ says Bardwell. Use a jug or a bottle and keep sipping all day.
Keep up your exercise regime, too ‘aerobic exercise is key to keeping your brain oxygenated and can actually halt the brain shrinkage that we rather alarmingly all go through as we age,’ says Bardwell. Eat the rainbow, and include rich colours like dark purple berries ‘they increase BDNF which is like fertiliser for the brain, meanwhile herbs and spices contain chemical compounds that may slow brain ageing and improve blood flow.’ For low mood, diet can also play a role ‘protein-rich foods like milk, fish, beans, eggs and meat have been shown to increase our happy hormones, serotonin and dopamine,’ says Clarkson. ‘These protein rich foods also contain compounds like L-arginine and carnitine that improve blood flow which can improve libido.’
How can I keep my blood sugar stable during menopause?
‘When blood-glucose levels peak or trough outside the optimal range, your endocrine (hormone) system is put on high alert and focuses all its attention on trying to stabilise them. This means it has less time for regulating hormones like oestrogen, progesterone and testosterone, potentially resulting in the low libido, PMS-type symptoms, acne, fat around the middle and increased appetite often reported by perimenopausal women,’ says Bardwell.
If you’re lethargic and lacking in energy, work on spreading your protein intake throughout the day – research shows that women back-load it, eating less protein at breakfast and lunch. ‘Start the day with a protein-based breakfast – think eggs, scrambled tofu or Greek yoghurt,’ says Bardwell. ‘This gives you a sustained energy release and keeps you off the blood sugar rollercoaster.’ Swerve refined carbs instead opting for complex wholegrain options like brown rice, jumbo oats, beans, vegetables and fruit.
Don’t go into full deprivation mode, though; ‘If you want to eat a sweet treat, tagging it on to the end of a meal, as opposed to eating it as a snack, will reduce the spike,’ says Bardwell. ‘Movement after a meal can also help bring down high glucose levels.’ Finally, step away from the blender; ‘Eat fruit whole rather than juicing it, or better still, add some fats, have pumpkin-seed butter with your banana, add an egg to your avocado toast,’ suggests Bardwell.
What helps menopause symptoms naturally?
Perimenopause and menopause are associated with as many as 35 symptoms, but according to Clarkson, eating soy products can help; ‘Foods like tofu, tempeh, miso, edamame and soy milk contain compounds called plant oestrogens that mimic the hormone oestrogen in the body and can help with symptoms,’ she says.
Slay the coffee beast; too ‘reducing caffeine from coffee, tea, green tea and even chocolate six hours before bedtime can help improve sleep duration and quality.’ In terms of aching joints, again the anti-inflammatory Mediterranean diet is your friend, and for Bardwell ‘motion is lotion; even though you might feel achy and stiff, try to keep moving.’ She also recommends trying taking 400mg magnesium bisglycinate daily, as well as at least 10mcg of vitamin D, and not forgetting that HRT is very helpful for many symptoms, including joint pain.
What is the best thing to do for menopause?
1. Add, don't subtract
'Perimenopause, when your body is undergoing significant adjustments, is not a time for deprivation,’ says Bardwell. Reject the food avoidance mentality and instead nourish your body with added healthy proteins, fats and fibre.
2. Think bones, muscles, brain
Have omega-3 for your brain and joints, protein for your muscles, calcium and soya for your bones, and Clarkson recommends complimenting this by incorporating muscle strengthening exercise 2-3 times per week.
3. Be kind, be steady
This isn’t about turning everything you knew about nutrition on its head, just make a few tweaks. Eat regularly, up your plant-based fibre, make sure every plate is balanced and avoid foods that send your blood sugars soaring.
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