Most women will experience some symptoms during the menopause but, as Angie Jefferson explains, it should be a time to embrace health, not fear the symptoms
The menopause is a natural part of ageing for women, usually occurring between 45 and 55 years (average age is 51) of age.
“The average age for the menopause is 51„
Why does this happen?
Levels of a key hormone called oestrogen decline, and periods stop, ending a woman’s fertile years. The menopause doesn’t just arrive out of the blue (unless as a result of surgery removing the ovaries), and signs develop over several years, leading up to the time when periods stop – this is called the perimenopause. Three quarters of women experience one or more of the noticeable signs of the perimenopause/menopause, which include hot flushes, night sweats, problems sleeping and changes to memory and concentration. Periods may become irregular. When periods have stopped for 12 months, the menopause has officially started.
For most women, the menopause is an ideal time to take stock of eating habits and begin some gradual changes to help ensure the best health possible while entering this new phase of life. Taking steps to achieve a healthy diet, a good level of fitness and an ideal body weight can help to ease immediate symptoms such as hot flushes, and improve longer term health.
Many women want to know what the most important areas of diet to focus on are, so these are summarised in my top nutrition tips for the menopause.
“Common menopausal symptoms include hot flushes, night sweats and fatigue„
BATTLING THE BULGE!
Weight gain isn’t inevitable however hormone changes mean a tendency to shift from a ‘pear’ shape (hips wider than the waist) to an ‘apple’ shape (waist wider than the hips). Fat carried around the middle (abdominal fat) increases risk of heart disease and diabetes and so taking steps to stop ‘middle-aged spread’ are important.
In terms of food intake, don’t make this too hard. Take stock of your portion sizes – serve a little less on your plate, but add extra vegetables or salad to fill you up. Keep puddings and cakes as a treat rather than every day, and focus on fruit or low-fat dairy desserts instead. Watch in-between meal nibbles too; they may be tasty, but it’s easy to eat more than you realise. Make sure you’re active every day.
MAKE TIME FOR REGULAR MEALS
Eating regular meals, including breakfast, not only helps with weight control but may also help to relieve some of the mood swings and fatigue that can come with the menopause.
BOOST FIBRE FOR GREAT DIGESTIVE HEALTH
Changing hormones of the menopause may exacerbate any tendency towards sluggish digestion, bloating and constipation. The best way to tackle this is to choose higher fibre foods, especially those which contain natural bran. Look for ‘high fibre’ or ‘bran’ on labels, and check the nutrition panel – foods with at least 3g per 100g are a source of fibre or 6g per 100g means a high fibre food. Fruit, vegetables, beans and pulses are great sources of fibre too.
CLUE UP ON CALCIUM
Throughout life, bones constantly undergo a cycle of breakdown and repair. Up until your mid 30’s more calcium is put into bones than is removed and bones become stronger. Beyond that calcium starts to be slowly lost from bone and these losses increase dramatically for around five to ten years around the menopause, increasing the risk of osteoporosis. Checking you’re eating enough of both calcium and vitamin D (which helps the body to absorb and use calcium) is important.
Women are advised to get 10 micrograms of Vitamin D daily, but on average have only one quarter of this amount. To get sufficient vitamin D from diet alone is challenging and so for most women a daily supplement of vitamin D will be needed. On average, women just about eat enough calcium, but some countries recommend a higher calcium intake during the menopause years so checking you’re eating plenty of calcium rich foods is essential for all women. In the UK, milk and dairy foods remain our most important source of calcium, followed by bread (which is fortified with calcium). Ideally, aim to eat a low-fat dairy food three times each day (for example, a generous serving of milk on cereal, skinny latte, low fat fruit yoghurt or reduced fat cheese). If using an alternative, such as soya or nut products, then check it’s fortified with calcium and if not, take a supplement.
FIGHT THE FLUSHES
Eating more foods rich in phytoestrogens such as soya, soya foods, tofu and linseeds, may help to reduce the number and severity of hot flushes. This works better for some women than others, but the only way to find out if it will help you is to try it for three months and see. To reduce menopausal hot flushes, an intake of around 50-80mg plant oestrogens per day is needed. This is equivalent to 2-3 servings of soya or other plant oestrogen rich foods a day. Quite an undertaking, but worth a try if your hot flushes are frequent and/or severe. Soya protein can also help to lower blood cholesterol which is another great reason to eat more of these foods. For some women hot drinks, alcohol or spicy foods can trigger hot flushes so try to identify your triggers and control these.
Evidence suggests that women tend to decrease their regular exercise during middle age due to the competing demands of others (family members, aging parents, work etc). As a result, daily calorie requirement falls and lean muscle declines so energy intake from food and drinks will need to fall if weight gain is to be avoided.
Muscles burn more energy than fattier tissues and so a combination of aerobic activity for fitness and strength training is ideal. The NHS Livewell website has lots of ideas and resources to get you started: https://www.nhs.uk/livewell/fitness/Pages/Fitnesshome.aspx
BE CHOLESTEROL AWARE
If you’ve never had a cholesterol test, now is the time to ask for one from your GP. As oestrogen levels drop cholesterol levels tend to rise, increasing risk of heart disease. Steps to help control cholesterol include cutting back on saturated fat (butter, fat on meat, pastry, cakes and biscuits) and replacing these with unsaturated fats such as olive oil and sunflower spreads. Choose lower fat dairy foods, include fish (especially oily fish) twice each week, fill up on fibre and boost intake of fruit and vegetables. Eating oily types of fish (such as salmon, mackerel, herring and trout) once or twice a week is also a great habit.
The menopause is a time to embrace health, not fear the symptoms. So, take time for yourself, be active and give heart and bone health some thought.
References available upon request.
Since qualifying as a Registered Dietitian, Angie Jefferson BSc (Hons) RD, R.Nutr has researched, written and discussed with consumers and health professionals almost every aspect of diet and health. Her overriding aim is to deliver simple positive messages for optimal nutrition within a healthy lifestyle. www.angiejefferson.co.uk