Thank goodness we are finally talking about menopause!
It's on TV, in the news, on social media, and in the workplace. Women and men, from younger to older generations, are all coming to understand what it means for us as a society and how to navigate these years constructively. After all, it's a natural phase in every woman's life, and it touches everyone: a third of the population is either in menopause or going through the peri-menopausal transition (the few years before the final menstruation, when symptoms are many). But too often, discussions revolve around Hormone Replacement Therapy (HRT). While HRT undeniably helps many women manage menopausal symptoms, let's shine a well-deserved spotlight on another essential player in this journey: your diet.
Menopause - The Undeniable Facts:
First, let's reaffirm why menopause deserves all this attention:
30% of women in the Menopausal Club: This isn't a small club. You'll find many important women in your life going through it, be it a mother, sister, partner, friend, colleague, or teacher.
A Real Symptom Struggle: An astonishing 77% of women grapple with menopausal symptoms that they describe as 'exceptionally challenging' [1].
The Workplace Impact: For 45% of women, menopausal symptoms cast a shadow on their work-life. This can translate into reduced productivity and elevated stress levels [2]. The most bothersome symptoms in the workplace include reduced concentration, persistent fatigue, forgetfulness, emotional swings, and lowered confidence [3].
Job Exodus: Depressingly, 1 in 10 working women going through menopause has left their job due to these symptoms. This truly underscores the need for greater support and understanding of menopause in the workplace [1].
Menopause Symptoms and Diet
Menopause comes with a wide range of symptoms that can significantly impact women’s lives: hot flushes, night sweats, mood swings, joint aches, sleep disturbances, concentration & memory issues, reduced libido, weight gain, and more [4]. It's the gift that keeps on giving, right?
Health shops are eager to sell you supplements and multivitamins to help manage these symptoms. But before spending your money on expensive concoctions with limited scientific evidence, how about exploring your diet first?
A substantial body of research shows that diet and symptom experience (and their severity) are linked.
Hot Flushes and Diet: Research indicates that poor diet quality intensifies symptoms. A diet filled with processed foods, sugary drinks, and saturated fats worsens hot flushes. Conversely, a diet rich in fruits, vegetables, whole grains, and lean proteins may reduce both the frequency and intensity of hot flushes [5].
Smart Dietary Strategies: The most researched diet for menopause is the Mediterranean diet. Rich in plant-based foods, dietary fibre, polyphenols, and omega-3, it helps manage menopausal symptoms. There's also good evidence that incorporating phytoestrogen-rich foods like soy can alleviate some bothersome aspects of menopause. Meanwhile, reducing alcohol and caffeine, known triggers for hot flushes and sleep disturbances, can provide relief [5].
Body weight: For people with obesity, symptoms tend to be more severe, and weight loss has been associated with reduced symptoms, especially hot flushes [6]. But let's face it, this may feel like a catch-22 since weight loss is particularly challenging during this stage of life.
Weight changes and menopause - a complex connection
Unsurprisingly, weight gain is a major concern during menopause: Over 40% of women in the UK report that this weight gain affects their quality of life [7]. In fact, a staggering 72% of women actively seek strategies for weight management during this phase [8].
Anecdotally, what I see in my practice confirms these statistics. Eight out of ten of my clients are women around the age of 50 who come for help with their weight. They've noticed that the number on the scales is steadily going up, and their old weight loss tactics aren't working anymore.
So, what's going on?
While there's a prevailing belief that metabolism slows down during menopause, research is ambiguous, and a recent study suggests that metabolic rates remain surprisingly stable from the age of 20 to 60 [9]. The answer might be in some factors that come into play:
Oestrogen and body composition: Oestrogen levels affect where fat is primarily stored and the balance between muscle and fat. As oestrogen levels drop, fat tends to accumulate around the waist, and muscle mass reduces [10].
Indirect impact of menopausal symptoms: Weight is influenced by genetics, physical activity, mental health, environment, and behaviours... and menopausal symptoms can indirectly affect these factors. For example:
Sleep: 40 to 60% of menopausal women experience sleep problems [11]. This may lead to cravings for calorie-dense foods and reduced motivation for exercise, resulting in eating more (calories in) and burning less energy (calories out).
Physical activity: The natural loss of muscle mass makes it harder to exercise at the same intensity, leading to fewer calories burned.
Low mood and anxiety: Menopause is associated with frequent mood swings and higher levels of anxiety, which can lead to more cravings and emotional eating.
The truth is the body is evolving, and we need to work with it. But it doesn't mean that this weight gain is inevitable. Focusing on nourishing the body properly, staying active, resting adequately, and monitoring your health are more important than ever. Forget crash diets and extreme fitness goals. Sustainable changes are key at this stage of life. If you're confused about where to start and what to focus on, seek support from a registered nutritionist or a dietitian. They have a deep understanding of how to tailor the existing evidence for your overall and long-term health.
Diet beyond weight: safeguarding bone and heart Health
Menopause symptoms and weight gain often take the spotlight during this life stage, but it's crucial to recognise that dietary considerations reach far beyond these visible aspects, encompassing equally vital, albeit less obvious, dimensions of your health: your bone and heart health.
Bone health: caring for your skeleton
As oestrogen levels decline during menopause, women become more vulnerable to a condition called osteoporosis. This silent disease weakens bones, making them fragile and more prone to fractures [12]. So here are a few tips to support your bone health:
Calcium-Rich Foods: Ensure an adequate intake of calcium. Menopausal women should aim for about 1,200mg of calcium per day, compared to 700mg for adults. Traditional sources of calcium include dairy products, but if you prefer dairy alternatives, choose fortified options with approximately 125mg of calcium per 100ml. Incorporate 3-4 portions of these alternatives into your daily diet to meet your calcium needs.
Vitamin D Supplementation: Alongside calcium, vitamin D is essential for bone health. As it can be challenging to obtain sufficient vitamin D from food alone, especially during the winter months, consider a daily vitamin D supplement (10mcg or 400IU). This ensures your body has the necessary tools for optimal calcium absorption and bone maintenance.
Protein: Bones, like all tissues, are made out of protein compounds (amino acids). So add some good sources of protein to every meal. These can be animal-based (eggs, dairy products, poultry, lean meat) or plant-based (tofu, lentils, beans, peas, nuts and seeds, combined with some whole-grains)
Exercise: In particular weight bearing (e.g., jogging, walking, dancing) and resistance training (e.g. weight lifting, resistance bands) stimulate bone regeneration.
Cardiovascular health: nurturing your heart
With menopause comes an increased risk of cardiovascular diseases [13] so it might be time to adopt a more heart-friendly diet. Here's what you can do:
Plant-based foods: Embrace a diet rich in plant-based foods like vegetables, fruits, legumes, whole grains, nuts, and seeds. These nutrient-dense choices provide essential vitamins, minerals, dietary fibre, and polyphenols. Aim to fill at least half your plate with colourful vegetables and explore the diverse world of plant-based options. Despite carbs having a bad reputation, whole grains (e.g., oats, brown rice, quinoa, wholewheat bulgur) are particularly good for a healthy heart.
Omega-3 fatty acids: Include sources of omega-3 fatty acids in your diet, such as oily fish like salmon, sardine and mackerel. Omega-3s contribute to heart health by reducing inflammation and improving blood vessel function.
Unsaturated fats: Opt for sources of mono- and polyunsaturated fats like nuts, seeds, olive oil, and avocado. These healthy fats help lower bad cholesterol levels, reducing the risk of heart disease.
Moderation with meat: While meat can be part of a heart-healthy diet, consume it in moderation. Prefer lean cuts and avoid processed meats like sausages, bacon, and ham. And how about exploring plant-based protein sources like legumes and tofu?
Limit saturated fats and added sugars: Minimise consumption of saturated fats found in butter, cream, processed meats, and palm oil. Similarly, reduce your intake of added sugars and alcohol. These dietary changes can have a significant impact on heart health.
Do you feel a bit clearer on what might be relevant for you?
As you navigate this transformative journey called menopause, remember that your lifestyle play an important role in shaping your wellbeing. This includes your diet of course but not only. Movement and exercise, sleep, social connection - all of these matter too. Some might be more in your control than others and it can feel overwhelming to know where to start. So if you need guidance on how to better nourish yourself during this life stage and transform some of your lifestyle habits, make sure you seek help from reliable, evidence-based experts such as registered nutritionists or dietitians. They can provide the tailored guidance you need for your overall and long-term health, taking your individuality into account, in an empowering, achievable, and non-judgemental way.
Hello, my name is Clem.
I’m an evidence-based, award-winning nutritionist (MSc, RNutr) and workplace wellbeing specialist.
I help organisations and individuals make sense of nutrition to nurture their health and wellbeing.
If you want to know more about nutrition and health, subscribe to my newsletter or get in touch with me
References
[1] Fawcett Society Report 2022 - Menopause and the workplace. Available at: https://www.fawcettsociety.org.uk/Handlers/Download.ashx?IDMF=9672cf45-5f13-4b69-8882-1e5e643ac8a6
[2] British Menopause Society Survey 2017. Available at: https://thebms.org.uk/wp-content/uploads/2017/10/EMBARGOED-UNTIL-18-OCT-2017-00.01_BMS-Survey-Results-2017_Press-Release.pdf
[3] Griffiths, A., MacLennan, S. J., & Hassard, J. (2013). Menopause and work: an electronic survey of employees' attitudes in the UK. Maturitas, 76(2), 155–159.
[4] El Khoudary, S. R., Greendale, G., Crawford, et al (2019). The menopause transition and women's health at midlife: a progress report from the Study of Women's Health Across the Nation (SWAN). Menopause (New York, N.Y.), 26(10), 1213–1227. https://doi.org/10.1097/GME.0000000000001424
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[6] Herber-Gast, G. C., & Mishra, G. D. (2013). Fruit, Mediterranean-style, and high-fat and -sugar diets are associated with the risk of night sweats and hot flushes in midlife: results from a prospective cohort study. The American journal of clinical nutrition, 97(5), 1092–1099. https://doi.org/10.3945/ajcn.112.049965
[7] Nappi, R. E., Siddiqui, E., Todorova, L., Rea, C., et al (2023). Prevalence and quality-of-life burden of vasomotor symptoms associated with menopause: A European cross-sectional survey. Maturitas, 167, 66–74. https://doi.org/10.1016/j.maturitas.2022.09.006
[8] Marlatt, K. L., Beyl, R. A., & Redman, L. M. (2018). A qualitative assessment of health behaviors and experiences during menopause: A cross-sectional, observational study. Maturitas, 116, 36–42. https://doi.org/10.1016/j.maturitas.2018.07.014
[9] Pontzer, H., Yamada, Y., Sagayama, H., et al (2021). Daily energy expenditure through the human life course. Science (New York, N.Y.), 373(6556), 808–812. https://doi.org/10.1126/science.abe5017
[10] Abildgaard, J., Ploug, T., Al-Saoudi, E., et al (2021). Changes in abdominal subcutaneous adipose tissue phenotype following menopause is associated with increased visceral fat mass. Scientific reports, 11(1), 14750. https://doi.org/10.1038/s41598-021-94189-2
[11] Nelson H. D. (2008). Menopause. Lancet (London, England), 371(9614), 760–770. https://doi.org/10.1016/S0140-6736(08)60346-3
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[13] Gordon, T., Kannel, W. B., Hjortland, M. C., & McNamara, P. M. (1978). Menopause and coronary heart disease. The Framingham Study. Annals of internal medicine, 89(2), 157–161. https://doi.org/10.7326/0003-4819-89-2-157