During perimenopause there are many different changes that occur in a woman’s body. While the range and severity of symptoms experienced varies from woman to woman, the longer-term impact from the reduction in oestrogen can last for years well beyond.
“What we eat and drink during and after the menopause matters!”
The decline in oestrogen levels which happen around menopause have effects beyond fertility. It can affect a woman’s heart health, bone health, weight and cognition. The physical changes can include an increase in blood pressure and cholesterol levels, both of which increase the risk of heart disease. The loss of calcium from bones, raises the risk of osteoporosis. Changes in body composition with loss of muscle mass and increase ins adipose tissue in the abdomen (1). The loss of the neuroprotective effect of oestrogen can reduce the working memory, attention, and verbal memory (2).
However, there are lots we can do from a dietary perspective, to help support better longer-term health in these areas. In this month’s blog we talk through dietary choices to support health after menopause. Much of this advice is the same for eating a healthy balanced diet, so it’s an approach the whole family can take!
1. Sustaining Heart Health
Oestrogen is cardioprotective, however by the age of 65 the risk of heart disease in women is the same as men. Therefore, postmenopausal women are at a higher risk of hypertension, experience an increase in cholesterol and triglycerides, diabetes and severe cardiovascular disease compared with premenopausal women (3).
A Mediterranean diet can be cardio-protective, consequently making some small changes to what we eat, can be helpful to reducing cholesterol and blood pressure levels. Some of these include:
- Increase fibre intake – through having oats or oat cereals for breakfast, oatcakes for snacks and pearl barley in soups or stews.
- Reduce salt intake – through reducing processed foods (processed meats, fast food) and sugars and trans fats (cakes, biscuits, etc)
- Increase omega-3 intake- by including oily fish at least twice weekly, such as salmon, mackerel, trout or herring.
- Aim for at least 5-7 portions of fruit and vegetables a day to ensure you get lots of antioxidants.
Adding fruit to your breakfast or snacks and increasing the vegetables on your plate at dinner.
- Food and drinks fortified with plant sterols and stanols, which have been proven to lower cholesterol levels.
2. Continue to support bone strength!
Postmenopausal women are at risk of osteoporosis, this is because oestrogen is critical for skeletal homeostasis and it regulates bone remodelling. The rate of bone loss increases significantly post menopause (4). In order support in minimising bone loss, it’s important to ensure an adequate intake of:
- Calcium: aiming for 3 portions of calcium rich foods each day. These can be milk, cheese, and yoghurt, tinned salmon or sardines, dark green vegetables (like kale, spinach, chard) and fortified foods like cereals.
- Vitamin D: obtained from sunshine during the summer months, egg yolks, salmon, mackerel and fortified milks and cereals. A daily 15 μg vitamin D supplement is now recommended for older adults, as intake from sunshine and food is not sufficient during the extended winter months (5).
- Magnesium: obtained from wholegrains, dark green vegetables, nuts, seeds and legumes.
Physical activity is also very important for bone health, especially weight hearing exercises (walking, weight training) to help stimulate bone formation and slow down bone loss.
3. Food matters for mood & cognition
Eating well supports better energy levels, improves our mood and can help combat fatigue. So essentially, as Dr Lisa Misconi outlines in her book The XX Brain Food, “food matters for your grey matter” (6).
- Aiming to choose foods high in essential fats like Omega-3 (EPA and DHA) found in oily fish (salmon, mackerel, herring, sardines) and if these don’t sit well flaxseed, chia seed, olives, almonds, avocados and soya beans can be good alternatives.
- Foods high in B vitamins – a range of foods like dark green veg, wholegrains, eggs, fish, chicken, meat and nuts & seeds will provide a variety of B vitamins.
- Keep well hydrated: two litres of sugar-free fluid per day, ideally water.
- Keep caffeine to a minimum: choose de-caffeinated colas, teas and coffees.
- Wholegrain varieties of foods: breakfast cereals, oats, brown rice and whole-wheat pastas are higher in fibre and all help the slow release of energy.
4. Changes in body shape are inevitable
Menopause by its nature and the associated change in hormones can lead to a change in body composition. This means more adipose tissue, accumulating mostly in the abdominal area and there is also an increase in total visceral adipose tissue (4). Consequently, for many women their body shape changes. Though this is different for everyone. Acceptance of this can be hard, however gratitude for the body we have and nourishing it to stay healthy, is a beneficial approach for our body and mind!
- Aiming for 3 meals a day – if you’re not very hungry have a smaller portion.
- Including a protein with each meal – this will help you feel fuller for longer & reduces cravings.
- Eating mindfully – try to eat without distraction so that you can listen to your body and hear the signals of hunger and fullness.
Eating well and increasing exercises such as weight training can help to preserve or even build muscle mass can make a positive difference. Managing stress helps too, as this can impact on our mental and physical health. If you are struggling talk to your GP – it’s ok to ask for help and they can advise on other options like HRT that maybe appropriate and helpful for you!
(1) Knight, M.G. et al. (2021) ‘Weight regulation in Menopause’, Menopause, 28(8), pp. 960–965.
(2) Conde, D.M. et al. (2021) ‘Menopause and Cognitive Impairment: A narrative review of current knowledge’, World Journal of Psychiatry, 11(8), pp. 412–428.
(3) Polotsky, H. and Polotsky, A. (2010) ‘Metabolic implications of menopause’, Seminars in Reproductive Medicine, 28(05), pp. 426–434.
(4) Knight, M.G. et al. (2021) ‘Weight regulation in Menopause’, Menopause, 28(8), pp. 960–965.
(5) Food Safety Authority of Ireland – https://www.fsai.ie. Available at: https://www.fsai.ie/getmedia/b80b486e-7eab-423a-b336-30e666b2f26c/vitamin-d-scientific-recommendations-for-5-to-65-year-olds-living-in-ireland.pdf (Accessed: 25 September 2023).
(6) Mosconi, L. (2020) The XX Brain: The groundbreaking approach for women to prevent dementia and Alzheimers disease and improve Brain Health. Crows Nest, NSW: Allen & Unwin.