Following last week’s blog, this week we will be discussing menopause more in-depth, including the nutritional considerations at each stage. Menopause is when periods stop, and occurs when you have not had a menstrual period for the last 12 months. It usually happens to people between the ages of 45 and 55. There are three stages involved in menopause known as peri-menopause, menopause, and post-menopause. Read on to learn about nutrition and menopause.
The peri-menopause is the lead up to the menopause, lasting from a few months to several years. It is where you may notice most of the symptoms normally related to the menopause. In this period, you can experience changes such as weight gain, hot flushes, irritability, headaches, joint pains, and poor concentration. These symptoms are usually due to falling oestrogen levels, which can also cause your periods to become irregular or heavy at this time. Some other physical changes include high blood pressure, changes in cholesterol levels and the loss of calcium from bones. This can increase the risk of heart disease and osteoporosis for women going through the peri-menopause.
Menopause and Post-menopause
As previously mentioned, the menopause is when periods have been stopped for at least 12 months. Post-menopause is the period following this. Symptoms may ease or stop at this stage, but some people may experience symptoms for longer. Like the perimenopause, the risk of heart disease and osteoporosis can continue to increase. Urinary tract infections (UTIs) and urinary incontinence can also occur at this stage. UTIs can be prevented by ensuring that you are drinking enough water, to help flush our bacteria from your urinary tract, and by fully emptying your bladder when going to the toilet. Pelvic floor exercises can help to improve the symptoms of urinary incontinence .
Nutrition and menopause: what to consider
Hormone replacement therapy (HRT) is a treatment recommended to help control the symptoms of peri-menopause and for post-menopause. However, not all women take HRT due to personal choice or other health conditions that they may have. Therefore, nutrition can be a helpful tool to assist in the control of symptoms.
Weight gain is a symptom of menopause, due to a reduction in muscle mass, meaning that less calories are needed by the body. To prevent excess weight gain, follow a healthy, balanced diet, reduce portion sizes, and try to incorporate physical activity into your routine.
To keep bones healthy and decrease the risk of developing osteoporosis, ensure that you are consuming enough calcium. The recommended daily intake of calcium is two to three portions of calcium-rich foods a day, such as a matchbox-size piece of cheese; 120g plain yoghurt; 85g boiled broccoli; 100g calcium set tofu; 100ml calcium-fortified plant-based milk alternative; and 100ml milk. It may also be a good idea to take a daily vitamin D supplement (10mg) as vitamin D aids in the absorption of calcium into our bones. Some foods containing vitamin D include oily fish, mushrooms, red meat, fortified cereals and beverages, and eggs.
Heart health is also a concern for women going through the menopause. To decrease the risk of developing heart disease there are several lifestyle changes that can be made:
- Try switching saturated fats (butter, cakes, sausages, and hard cheese) in your diet to unsaturated fats (sunflower spread, olive oil, avocado, and nuts)
- Include plant-based protein sources such as nuts, beans, and pulses, in your meals at least twice a week
- Reduce your intake of refined sugars (fizzy drinks, cakes, and biscuits) and salt (processed foods, stocks, and added salt)
- Aim to reach your 5-a-day every day
- Choose wholegrain carbohydrates (brown rice, oats, and wholegrain bread) over refined carbohydrates (white rice, bread, and pasta)
- Try to eat at least two portions of fish a week, one of them being oily
Additionally, plant oestrogens (phytoestrogens) can be recommended to help to relieve menopausal symptoms. They are like human oestrogen so if eaten often and in good amounts, they can have similar effects to human oestrogen, which can help with the decline in oestrogen levels throughout menopause. Foods containing plant oestrogens include flax seeds, soybeans, dried fruit, seeds, berries, tofu, cauliflower, and cabbage. It is important to note that phytoestrogens may not work for everyone, and it can take months for their effects to be seen but can reduce symptoms such as hot flushes in some women. There is also evidence for the benefits of consuming plant oestrogens throughout the day, rather than in a single, large dose.
In terms of caffeine and alcohol, intake should be moderate as both products can worsen hot flushes. The recommended alcohol limit is no more than two to three units per day, and decaffeinated versions of coffee, tea, and fizzy drinks are recommended over their caffeinated alternatives .
Top Tips for Nutrition and Menopause
1. Follow a heart healthy diet to decrease the risk of developing heart disease
2. Try eating plant oestrogens to help alleviate menopausal symptoms
3. Consume 2-3 portions of calcium-rich foods per day to decrease the risk of developing osteoporosis
4. Supplement diet with vitamin D to increase calcium absorption
5. Control excess weight gain by following a healthy, balanced diet and incorporating physical activity into your routine
Caroline Hill is a specialist menopause dietitian supporting women making dietary change. Caroline uses her extensive knowledge, skills and expertise of food and nutrition to help women manage their symptoms and weight during menopause. Caroline believes in providing sustainable, individualised, evidence-based advice to women making dietary change.