- In a major new series, the Daily Mail reveals everything you need to know
- Top specialists will tell you about cutting edge treatments and latest thinking on hormone replacement, as well as the supplements which work
- Today, it kicks off with the menopause diet – a way to minimise symptoms
Some women sail through the menopause, but for others ‘the change’ can be extremely tough, physically and emotionally.
Today, the Daily Mail launches a major new series revealing everything you need to know to ensure your menopause is as smooth as possible.
We’ve done the research for you, working with top specialists to bring you cutting edge treatments and the latest thinking on hormone replacement, as well as the supplements that really work.
Today, we kick off with the menopause diet — a simple but highly effective way to minimise any symptoms.
On Monday, we reveal how you can carry on feeling — and looking — sexy through the menopause. Tuesday focuses on the many and varied symptoms, and how to tackle them.
Wednesday covers the thorny issue of HRT — should you or shouldn’t you take it? On Thursday, we’ll show you which drug-free solutions work best. Finally, on Friday, the focus switches to the man in your life and what he could do to help you through the menopause — or if he’s going through a ‘manopause’ of his own.
WHY DIET MATTERS
Many specialists believe that switching to a healthy diet is the most effective thing you can do to reduce the impact the menopause has on your life, both now and in the future.
That’s because the drop in oestrogen not only causes classic menopause symptoms such as hot flushes, but also increases the risk of serious longer-term health problems such as osteoporosis. Oestrogen has a protective effect on the bones, and with declining levels that protection is removed. It is also thought to protect the heart.
For this reason specialists are now increasingly urging women to make lifestyle changes in their 40s and 50s to protect their long-term health as oestrogen levels decline.
‘People underestimate the beneficial effects of nutrition and adequate sleep,’ says Dr Heather Currie, a consultant gynaecologist at Dumfries and Galloway Royal Infirmary in Scotland. ‘Simple lifestyle changes not only reduce the severity of symptoms — both perimenopausal and menopausal — but mean women can get an early start on protecting themselves against bone and joint problems, heart disease and breast cancer to mitigate future risk.’
A healthier diet could even banish hot flushes and night sweats entirely, according to a U.S. study published in 2012.
This found that women who cut their fat intake and increased their consumption of fruit, vegetables and wholegrains improved their symptoms, with some banishing flushes and sweats.
Simple, yet effective: Many specialists believe that switching to a healthy diet is the most effective thing you can do to reduce the impact the menopause has on your life – both now and in the future
The researchers were surprised to find that although many of the women lost weight, even those who gained weight experienced an improvement in symptoms.
The basic rules for a menopause diet are essentially common sense: have at least five portions of fruit and vegetables a day; most of your grains should be wholegrains; and keep sugar, fizzy drinks, coffee and alcohol to a minimum.
But women approaching and going through the menopause need to be especially careful about junk food, refined carbohydrates, alcohol and caffeine.
SO WHAT IS THE MENOPAUSE?
Most women start producing fewer eggs from the age of 40 and their levels of the hormones oestrogen and progesterone naturally start to decline.
This marks the start of the perimenopause — technically the four to ten years before ovulation stops altogether.
While many women talk about going through the menopause, officially the term refers to the day of your last period (the average age for this is 51); ‘post-menopause’ is the blanket term for the years that follow. Hormone levels don’t tend to drop in a steady and consistent way — they can suddenly spike sharply or dip, triggering flushes, night sweats and disturbed sleep, depression, irritability, anxiety and memory problems.
That’s because there’s evidence that these can make menopausal symptoms worse (caffeine and alcohol and the blood-sugar dips caused by processed carbs can trigger the stress hormone cortisol, leading to flushes). They can also compound the negative health effects of the menopause such as heart disease.
But your good menopause diet is not just about eating healthily. Research is beginning to suggest that certain foods could have a particularly potent menopause-busting effect.
These include foods such as lentils and chickpeas, which contain phytoestrogens, a natural form of oestrogen found in plants.
Other menopause-busting foods include those rich in omega-3 fats (oily fish, nuts and seeds), thought to help counter menopausal memory loss.
Meanwhile, tryptophan, found in foods including turkey, might help to ease mood swings by stimulating the feel-good brain chemical serotonin.
Switch to a menopause-supporting diet in your 40s, and you’ll be doing the best you possibly can to protect yourself against menopausal symptoms as well as post-menopausal health problems.
Here, we explain the simple rules to help you make the best food choices for the menopause. And to help you see how these rules might work in practical terms, we’ve provided a three-day menu plan with appetising recipes. Remember, this is not a strict diet regimen, it’s about easing you through this stage in your life.
With the help of dietitian Dr Sarah Schenker, we have devised this simple set of eating rules to support your hormones and boost your health.
- Make sure you have three meals a day: skipping meals will lead to dips in your blood sugar, which can play havoc with already erratic hormones. It’s a vicious circle, as fluctuating levels of oestrogen and progesterone can in turn affect blood sugar (they influence your levels of the hormone insulin, which mops up sugar from the blood).
- Also, the surge in adrenaline you get if you let yourself become hungry can be enough to trigger a hot flush.
- Include protein with every meal to maintain muscle and keep your blood sugar levels steady: choose lean meat, fish, soya and eggs, and aim to eat a fist-sized portion with every meal.
- Avoid sugar and refined white carbohydrates (biscuits, cakes, pastry). Fast-acting carbohydrates cause insulin levels to become erratic, which in turn affects the levels of other hormones and can exacerbate menopausal symptoms.
Studies show that women who eat lots of high-sugar foods (and that includes alcohol) are more likely to produce poor-quality eggs, which in turn pump out less oestrogen and progesterone, so potentially making perimenopausal symptoms worse.
Instead, choose low-GI food such as wholegrains, which release their energy slowly and keep blood sugar levels steady. Wholegrains are also rich in B vitamins, which help to boost energy, manage stress and keep the digestive system functioning effectively. Vitamin B9 (folic acid) helps to lower the risk of cardiovascular disease, which rises after menopause.
- Have oily fish twice a week or get your healthy omega-3 oils from nuts and seeds. These fatty acids may help to counteract the menopausal symptoms of dry hair, dry skin, cracked nails, fatigue and low mood. Omega-3s may also help to lubricate aching joints. A small portion of salmon (4oz/110g) can contain up to 3,600mg of omega-3 essential fatty acids (the same amount of cod provides only 300mg).
- Choose low-fat dairy products. In a major study published in 2013, researchers from Harvard University found that women who had skimmed-milk products, including low-fat cheeses and yoghurts, delayed their menopause by just over three-and-a-half years. The scientists believe that skimmed cow’s milk contains a number of enzymes that boost the amount of oestrogen in a woman’s system. Milk and yoghurt are also important sources of calcium to protect your bones.
- Include foods that contain the amino acid tryptophan, such as turkey, oats, legumes (such as peanuts) and cottage cheese: tryptophan helps the body to manufacture serotonin, a chemical messenger that boosts mood and may help to control sleep and appetite.
- Eat foods rich in calcium and magnesium — wholegrains such as brown basmati rice, nuts and green leafy veg. Also eat plenty of foods rich in vitamin D (found in oily fish and eggs) and vitamin K (in green leafy veg) for bone health.
- BORON is another mineral important for bone health. The nutrient is found in nuts, dates, raisins, grapes, apples and pears.
- EAT five to seven portions of fruit and vegetables a day.
Many fruits and vegetables contain plant oestrogens as well as valuable nutrients and fibre (a recent study of breast cancer survivors found that high fibre intake was linked with a reduction in hot flushes over a 12-month period).
Eat as many different colours and varieties of vegetables as possible, and aim to fill half your plate with them at each meal.
EAT MORE OF…
Studies suggest you may help to balance hormone levels by eating foods rich in plant oestrogens. These bind with oestrogen receptors in the body’s cells, increasing the total oestrogen effect.
WILL I PUT ON WEIGHT?
It is very common to gain weight around the menopause.
Most women put on around 1lb a year after the age of 40, and many notice a thickening around the abdomen and waist — even supermodels like Cindy Crawford look rounder than they did in their 20s.
Fat tends to ‘move from the breasts and hips’ to the middle after the age of 50, explains Eddie Morris, consultant gynaecologist at the Norwich and Norfolk.
Hormones certainly play a part. This may be linked to the stress and anxiety that often accompany menopause.
These can increase levels of the hormone cortisol, which triggers weight gain (it interferes with the action of the hormone insulin, which helps the body store fat).
Also, naturally falling levels of testosterone — which women produce in small amounts, declining with age — slow metabolism, making weight gain at menopause more likely.
Once it’s there, the fat accumulated at middle age can be hard to shift. This is because fat cells produce small amounts of oestrogen and some specialists believe the body naturally tries to hold on to the remaining oestrogen stored in the fat cells as an alternative source of the hormone.
The problem is that excess weight can worsen symptoms, says Dr Currie, exacerbating hot flushes and sweats. It can also raise your risk of heart disease and breast cancer.
The menopause friendly diet should help you maintain your weight naturally — another move that will ease menopause symptoms and improve your post-menopausal health.
There are many different types of phytoestrogens including isoflavones (found in soya), lignans (found in cereals and vegetables but particularly in linseeds), and coumestans (found in alfalfa and mung bean sprouts).
In Asia, where the average woman’s daily intake of isoflavones is 20-80mg a day (in the form of tofu, miso and soy sauce or lentils), hot flushes are reported by only 14 per cent of menopausal women. But in the West, where our isoflavone intake is 1-3mg per day, flushes affect 80-85 per cent of women.
Although the plant version of oestrogen is much weaker, clinical trials have shown that boosting intake can reduce the incidence and intensity of flushes.
One small study found flaxseed reduced the frequency of hot flushes by 50 per cent in women not taking hormone replacement therapy — sprinkle ground flaxseed over salads or cereal, blend them into smoothies, or take a flaxseed oil supplement.
But it might be sensible not to over-do it. Some studies have suggested that high intakes of soy may increase the risk of oestrogen-responsive cancers such as breast cancer.
However, no one knows whether the phytoestrogens in foods can have a similarly strong oestrogenic effect. The charity Breast Cancer Care says the role of phytoestrogens and their effect on breast cancer recurrence is unclear.
It’s also unclear what effect phytoestrogens have on the body when taken in greater amounts than those found in a normal diet. In fact, isoflavones exhibit some antioxidant activity, which may contribute to cancer prevention.
Good sources of phytoestrogens include: lentils, chickpeas, aduki beans, kidney beans, peas, garlic, celery, seeds (particularly pumpkin, crushed linseed and sunflower seeds). You’ll also get phytoestrogens from: wholegrains, apples, plums, cherries, broccoli, carrots and rhubarb.
CUT BACK ON…
There is a growing argument for cutting back on carbohydrates to ease your passage through menopause. Oestrogen has been shown to increase insulin sensitivity — your body’s ability to use carbohydrates as fuel instead of storing them as fat — so as oestrogen levels fall, your body’s response to insulin is reduced to the point where many menopausal women become insulin-resistant. This also occurs naturally with ageing.
As a result, excess sugar is deposited as fat around the abdomen, while your body is valiantly pumping out increased quantities of insulin — which boosts hunger levels.
Avoid: Studies show women who eat lots of high-sugar foods are more likely to produce poor-quality eggs, which pump out less oestrogen and progesterone, – potentially making perimenopausal symptoms worse
Some women notice no change, but menopause certainly alters the way a woman’s digestion works. Lower oestrogen levels mean food can spend twice as long in the digestive tract.
This is because oestrogen has a calming effect, while lack of it gives the stress hormone cortisol freer rein, slowing the release of stomach acid and emptying of the stomach into the small intestine.
This can lead to increased carbohydrate absorption (because food spends longer in the gut), raising insulin levels further.
Overeating carbohydrates can exacerbate weight gain and erratic moods, while a lower-carb diet has been shown repeatedly to increase and even re-establish insulin sensitivity.
CUTTING CARBS MADE SIMPLE
- Regard carbohydrates (bread, potatoes, pasta, rice) as an accompaniment rather than a main dish.
- Have one no-carb meal a day (eggs for breakfast, soup for lunch, meat or fish and a big salad for dinner).
- Eat protein (meat, fish, pulses, cheese) in every meal to stop you feeling hungry.
- Switch from white carbs (white bread, rice, pasta) to brown.
- Cut back on sugar in any form.
- Avoid fruit juice and eat no more than two pieces of fruit a day.
- Drop all forms of ‘empty calories’, ie, anything you eat or drink that gives you nothing nutritionally and that you eat without thinking (or necessarily enjoying).
Alcohol is thought to raise oestrogen levels temporarily, but the sudden drop once the alcohol is metabolised can trigger a hot flush. Excess alcohol can also increase breast cancer risk. However, the occasional glass of red wine may be beneficial for the heart. Red wine contains resveratrol, a phytoestrogen that has oestrogen-like effects.
Caffeine is thought to be bad for bone health (increasing the amount of calcium excreted) and can exacerbate the bladder problems that often occur with the menopause. Studies show any more than three to four caffeinated drinks a day can make flushes worse.
PUBLISHED: 13 March 2015 | UPDATED: 13 March 2015. By Louise Atkinson
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