Eat to ease the menopause

With a well-balanced diet and a regular exercise routine, you can look after your waistline, your blood pressure and your cholesterol levels, all of which will influence a woman’s heart health in her middle years. The combination of weight-bearing exercise and what you eat will either be a solid foundation for strong bones, or a weak support that will prematurely age you.

Many symptoms associated with the menopause can be minimised or managed by lifestyle, including choosing a healthy balance of the right foods, in the right quantities. Many symptoms are the result of the declining female hormones – oestrogen and progesterone. Here we look at how you can manage symptoms with your diet.

Declining oestrogen levels

As the ovaries decrease their production of oestrogen, the body tries to compensate for the loss. During the middle years, the body preferentially produces fat cells rather than muscle cells in a bid to counteract falling oestrogen levels. Regrettably, more fat cells mean weight gain around the middle.

What to do:

Eat a well-balanced diet including foods containing plant oestrogens. Avoid weight gain by reducing your calories, especially if you’re not as active as you were in your younger years.

Declining progesterone levels

Progesterone prepares the body for pregnancy if the egg is fertilised after ovulation. Post menopause, falling progesterone levels cause some women to feel bloated and too snug in their clothes due to increased water retention.

What to do:

Avoid salty foods and hidden salt in foods which aggravates water retention. Excessive water retention can adversely affect blood pressure.

Irregular menstrual periods

The majority of women experience between four and eight years of menstrual cycle changes before reaching menopause. Bleeding may last fewer days or more days, with blood flow heavier or lighter than what was the norm.

What to do:

When your periods are heavier, avoid iron deficiency anaemia by making sure you include lean red meat three times per week. Have one oily fish and one white fish dinner each week. Chicken, eggs and turkey also provide a little iron.

Weight gain

Body shape can change from the classically curvy pear shape to the apple shape, resulting in a thickening waistline and an extra layer of belly fat. It is estimated that weight gain can be about 0.5kg a year during the years leading up to and after menopause.

What to do:

Have clear rules to help you (eg: alcohol only at weekends) and activity scheduled in your diary weekly.

Visualise

the new you doing the things you won’t do now because you are overweight. Repeating this exercise regularly helps to see yourself as who you want to be.

Make life easier by making sure

your personal trigger foods are out of reach.

Realise that you always have choices. Make them consciously, not on automatic pilot.

Weigh up the consequences of your food decisions and then choose.

As a rough guideline, 1,500 kcal per day is usually effective to support weight loss. Many free food-diary apps calculate calories

on smart phones or tablets.

Hot flushes and night sweats

Hot flushes are an intense build-up of body heat. This happens as blood vessels near the surface of the skin start to dilate, increasing blood flow and giving a red, flushed look to the face and neck. In an attempt to cool the body down, some women perspire, often profusely.

Hot flushes may be associated with palpitations and feelings of anxiety. As with other menopause symptoms, they follow a pattern unique to each woman and there is no way of predicting when they will start or stop.

What to do:

Phytoestrogens are naturally occurring compounds found in plant foods. They have a similar but not identical structure to oestrogen. Some studies suggest that eating phyto-oestrogen rich foods helps diminish hot flushes and night sweats. Natural foods are best including:

Isoflavones mainly found in soya (edamame) beans and soya products (tofu, miso, tempeh), chickpeas and other legumes, nuts and nut butters and whole grains.

Lignans primarily found in seeds and seed oils (such as linseed/flaxseed oil) and legumes.

Food supplements are not recommended. Certain preparations can inhibit important thyroid enzymes. This is a real health concern, especially where there is borderline iodine deficiency.

Sleep disturbances or insomnia

A poor pattern of sleep may be a consequence of night sweats but can also be an independent symptom of hormonal change. Sleeping less than six hours per night increases the risk of high blood pressure, high blood sugar, greater inflammation, irritability and obesity.

What to do:

Avoid big heavy meals at night. Lean proteins such as white fish and egg dishes are easier to digest if the evening meal is delayed.

Magnesium and iron deficiencies may cause restless leg syndrome and insomnia.

Avoid caffeine and cut down on fluid in the evening. Drinking too much of anything can disrupt sleep.

Milk contains tryptophan, the raw material the brain uses to build both serotonin and melatonin.

These compounds help us relax and prepare for sleep. While the amount of tryptophan in a glass of milk may not be enough to cause any real drowsiness, a glass of warm milk warms the body and helps muscles relax.

Warm baths, lavender, layered cotton bed linen are helpful to some.

Fatigue and flagging energy levels

Exhaustion breaks us down physically and emotionally. It can also affect our food choices and disrupt our immune system.

What to do:

Eat a low GI carbohydrate-rich source of B vitamins at breakfast such as porridge with fruit and low-fat milk or wholemeal toast, nut butter and chopped banana. Try an energy-boosting snack such as oatcakes with edamame dip; banana, orange or grapes; carrot sticks with guacamole; Greek yogurt and peach chunks; handful of nuts, seeds and edamame beans.

Include a protein-rich food at lunch such as tuna or chicken salad with wholegrain crispbreads; hummus/falafel with cherry tomatoes and lettuce in a warm wholegrain pitta bread; omelette with roasted veg and rocket leaves; bean or lentil veg soup with rye crackers.

Eat an early evening meal: seafood/poultry/lean meat stir-fry with wholegrain rice and generous portions of iron and folate rich green leafy vegetables.

Drink 1-2 litres of fluid throughout the day. Try green tea or red bush tea.

To sustain your energy throughout the day avoid the following:

High sugar foods:

After the initial surge of glucose comes a slump, because this type of energy is not sustained.

Alcohol:

Aim for two or more alcohol-free days a week. Somewhere below the 11 standard drinks per week is advisable. As we get older we simply cannot

metabolise large volumes of alcohol.

Anaemia

Check blood test results to ensure that ferritin/iron levels are not low. A lack of iron leads to anaemia and fatigue. Check for vitamin B12 deficiency. This causes pernicious anaemia and fatigue. Check for low folate levels. This cause megaloblastic anaemia and fatigue.

Underlying illness

Thyroid problem can lead to low energy levels and fatigue.

Paula Mee is a dietitian and a member of the Irish Nutrition and Dietetic Institute pmee@medfit.ie @paula_mee