Eat your way through the menopause

Older women face many challenges due to hormonal changes, but good nutrition will help, says Margaret Jennings.

Eat your way through the menopause

IT’S not surprising women often feel out of control when hot flushes, mood changes and an expanding waistline are just some of the woes inflicted on them by their changing hormone levels in midlife.

But are there certain foods that pack a punch for the ageing woman? And how beneficial are diet-based phytoestrogens, in rebalancing the hormone-loss at menopause?

Much as women reach out for all sorts of solutions, the most important thing — as in all stages of life — is to eat a healthy varied diet, says dietician, Paula Mee.

“After that it’s the balance, the food patterns and the quantities of food we eat that needs tailoring at this time, when hormones are fluctuating,” she says.

So here is her expert view on dealing with some of the main issues that arise:

WEIGHT GAIN: Women frequently report losing their waist-line and a difference in fat distribution after menopause. Fat concentrates more in the abdomen and above the waist, whereas before, they were prone to fat deposits on the hips and thighs.

We need fewer calories as we age. Whether weight gain is linked to the menopause itself or our declining activity, or soothing ourselves during this challenging time with comfort eating and extra glasses of wine, studies demonstrate that weight gain during those years can be improved by lifestyle improvements in exercise and diet.

“Our hormones are also key here,” says Mee.

“High cortisol levels increase fat around the middle and a reduction in testosterone leads to less muscle mass and a slower metabolism. Lower oestrogen levels also means the body retains more fat cells.”

PHYTOESTROGENS: “Oestrogens are highly complex substances,” says Mee.

“When a substance is not given as a drug, in a predetermined dose, but is part of the diet, the amount ingested can be highly variable. And research is contradictory regarding the benefits.”

The evidence to suggest phytoestrogen supplements protect against osteoporosis is poor and long-term safety isn’t established.

“The assumption that plant oestrogens are as effective but safer than synthetic o hormones is an unsafe premise,” says Paula.

Legumes such as soya beans are naturally rich in phytoestrogens and modest amounts, taken as part of a balanced diet, appear to be safe. Studies have shown that 20-60g of soya protein daily can moderately reduce the incidence and severity of hot flushes. However this amount of plant protein is difficult to eat if you are not a fan of soya beans, tofu and soya milk.

Because soya beans are a valuable addition to the diet — containing soluble fibre, some protein, vitamins and minerals, as well as phytoestrogens — it’s good to include them anyway.

HEALTH RISKS: Postmenopausal women are at an increased risk of heart disease, bone loss and certain cancers. If they ensure a good supply of fruits and vegetables, especially legumes, seafood, poultry, lean meat, low-fat dairy, wholegrains, nuts and seeds. This helps not only to manage menopause symptoms but immune, cardiovascular and bone health also.

HOT FLUSHES: “Caffeine, spices, and alcohol are known triggers of hot flushes and what you exclude, can be as effective as what you include,” says Mee.

There is also some evidence that 40g of linseed daily can significantly improve hot flushes.

“This amount of linseed is high in omega 3 fatty acids and calories and so it’s best to cut other less nutritious fats from your diet if you want to avoid weight gain,” says Mee. “Also don’t eat excessive amounts of linseed if you take a blood thinner.”

Mee refers to The Women’s Health Council report, which gives a summary of the evidence base in Managing Menopause, A review of the Bio-Medical Evidence.

* Avoiding spicy foods and drinking cool beverages instead of hot, can relieve hot flushes.

* Adequate calcium and vitamin D has been shown to reduce bone loss in peri- and postmenopausal women.

* A high salt intake is linked with high blood pressure, and women with higher blood pressure excrete more calcium in their urine. Calcium lost in urine is replaced by calcium stripped from bones. Therefore lowering the salt content of the diet is beneficial for both stroke prevention and bone health.

Vitamin E was thought to be a natural treatment for hot flushes but there is very little evidence to demonstrate its effectiveness. Women are best to ensure an adequate intake of vitamin E from food rather than from supplements, advises Mee.

However she points out: “Many women navigate through this natural life stage with little discomfort. They take a fresh outlook by making small deliberate changes to prioritise and nurture themselves. What they eat, is a huge part of that.”

Paula Mee is a dietician working in www.Medfit.ie  and a member of the Irish Nutrition and Dietetic Institute.

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