Menopause and Diet

Menopause is a natural biological process that every woman will or has previously experienced. Menopause usually occurs between 40-60 years of age, with the average age for menopause being 50-51 years old. Perimenopause is usually 3-5 years in duration.

Here are some of the common terms used when talking about menopause;

Pre-menopause is the time frame where a person is in their reproductive years with regular menstrual cycles.

Perimenopause means 'around menopause'. The period leading up to the menopause is called the perimenopause, this is usually what women mean what they talk about ‘going through’ the menopause. Perimenopause is when hormones are starting to change, and periods are becoming irregular.

Menopause is diagnosed when you have gone a full year without a period. You can still have symptoms for 5 years after the cessation of periods.  

Post-Menopause is the term used when there has been no period for the previous 12 months.

What is happening during this time?

During perimenopause the body can change in many ways. Oestrogen is a powerful hormone that impacts various physiological processes in the body. Oestrogen levels fall at the onset of perimenopause. As a result, periods become less regular and/or heavy and fertility is reduced. Physical changes can also occur, including increased blood pressure, increased cholesterol (which increases the risk of heart disease), increased loss of calcium from your bones which increases the risk of osteoporosis). Other symptoms of the perimenopause include weight gain, hot flushes and night sweats, poor sleep, irritability, low mood, brain fog, headaches, and joint pain. Symptoms and severity may vary between individuals. It can be helpful to keep a diary of your symptoms to help manage them.

Hormone replacement therapy (HRT) can be used to help control these symptoms; however, some women cannot take HRT due to other health problems, whilst others choose not to. The decision to take HRT or not should be discussed with your doctor.

Diet and Lifestyle Changes

For all women, diet and lifestyle changes can help reduce symptoms.

Weight Gain and Loss of Muscle Mass

During menopause, muscle mass reduces, and body fat redistributes. Body fat moves centrally, so women may notice body fat moves from their hips to their abdomen. Changes in body composition, especially reduced muscle mass, reduces the amount of energy or calories our bodies need. Making dietary changes can help prevent weight gain.

Muscle mass decreases continuously from the age of 30 by 5% per decade. In menopause, DHEA which is a steroid hormone that converts into oestrogen is reduced which inhibits muscle building. Resistance training is important to preserve and build muscle. Aim for at least 30-45 minutes 3-4 times per week. Seeking support from a physiotherapist can help to develop a plan tailored to your needs if you are new to strength training.

Exercise also helps to release endorphins and boost serotonin which can help with feelings of low mood which can occur with a drop in oestrogen levels. Here is a list of benefits of exercise;

·         Lowers risk of cardiovascular disease (helps to lower blood pressure)

·         Promotes better glycemic control (blood sugar levels)

·         Regulates insulin and helps to prevent insulin resistance

·         Stimulates bone formation maintaining bone density

·         Resistance training helps to preserve and build muscle

·         Helps with brain fog

·         Helps to improve sleep

Support from a Dietitian to tailor nutritional support to your individual needs can help with weight management and muscle building

Bone Health

We reach peak bone density at around 30 years of age. During menopause reduced levels of the female hormone oestrogen increases the rate of bone and calcium losses, which then increases the risk of osteoporosis. Resistance exercise can help promote bone health alongside nutrition.

Calcium and vitamin D can help to keep bones healthy, so it’s important to have a balanced diet with lots of variety.

Calcium is essential for bone health, so making a effort to meet calcium requirements with high calcium foods is a great way to minimise the effect menopause has on our bone health 

Women post-menopause should be aiming for 1200mg of calcium per day.

We can achieve this by aiming for 2 or 3 portions of calcium-rich dairy foods every day

Calcium Content of Foods-some examples

Food Serving Size Calcium (mg)

Milk and Milk Alternatives

Soy, fortified with calcium 200ml 240

Cows milk (full, light, skim) 200ml 248

Cheese

Cheddar, Mozzarella 30 g 207

Cottage cheese 250g 146-265

Yoghurt

Greek yogurt, plain 120 g 144

Greek soy, plain 120 g 140

Kefir 200ml 230

Fish

Sardines with bones 75 g 286

Salmon canned, with bones 75 g 179-212

Mackerel, canned 75 g 181

Meat Alternatives

Tofu 100 g 401

Tahini/sesame seed butter 20g (1 x TBsp) 158

Other

Almond milk, fortified 200 mL 240

Coconut milk, fortified 200 mL 240

Vitamin D is also important for bone health by helping the body to absorb and use calcium. Your skin makes vitamin D when exposed to sunlight. In Ireland, our limited sunlight means we should be taking a daily supplement containing 15ug (micrograms) of vitamin D during from October to March.

Foods that contain vitamin D include oily fish, some mushrooms (check if Vitamin D is marked on packaging), fortified plant beverages (e.g. soya or oat drinks), fortified breakfast cereals and eggs.

Heart health

Menopause can increase cholesterol levels, redistribute the fat in our bodies to increase our central adiposity (fat) and increase our risk of developing heart disease and type 2 diabetes. Eating a diet that is good for the heart helps lower cholesterol and improve blood pressure. See articles on the website around managing cholesterol and blood pressure

Summary

·         Changing your diet and lifestyle can help to reduce symptoms of menopause, retain bone mass, preserve and build muscle and reduce your risk of heart disease.

·         Eating a heart healthy diet helps reduce your risk of raised cholesterol and heart disease.

·         Aiming for two to three portions of calcium-rich foods every day can to help maintain bone mass.

·         Reducing caffeine and alcohol intakes can help manage hot flushes.

·         Maintaining your weight or taking steps to achieve a healthy body weight is beneficial to overall health.

·         Taking regular moderate exercise, especially weight bearing activity and including some muscle strengthening exercises on three or more days each week helps maintain muscle mass.

·         If you think you might want to take nutritional supplements, get some advice from your dietitian, doctor or pharmacist, especially if you are taking regular medications.