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The Healthy Menopause Diet

Can I manage menopause with my diet?

It’s estimated that a third of the entire UK female population is perimenopausal or menopausal, with symptoms affecting over 75% of them. Dietary changes can improve menopausal health, so what should you be eating if you’re entering (or already in) this life stage? We turned to Field Doctor’s Dietitian Laura Tilt for advice.

 

Understanding Menopause    

Menopause is when your periods stop and your fertility comes to its natural end, officially reached 12 months after your last period. The transitional stage leading up to menopause is known as perimenopause (from the Greek word ‘peri’ meaning ‘near’).

 

Most women enter perimenopause in their mid-40s, reaching menopause at an average age of 51 in the UK. For 1 in 100 women, menopause happens before the age of 40 years. This is known as premature menopause, or premature ovarian insufficiency (POI).

 

Like most aspects of ageing, menopause doesn’t take place overnight. It’s a gradual process during which your ovaries become less responsive to two hormones (follicle-stimulating hormone and luteinising hormone) which tell your ovaries to release oestrogen and progesterone. As a result, your body produces less oestrogen and progesterone, which leads to many of the physical and mental symptoms associated with perimenopause and menopause.

 

Common Symptoms

Let’s talk about symptoms, which affect over 75% of women going through this life stage. There are more than 30 symptoms associated with menopause, the most common being a change in the pattern of your periods (which may become less frequent, heavier or lighter, shorter or longer than usual), and hot flushes or night sweats (known as vasomotor symptoms). On average symptoms persist for around 7 years, although for one in three women it’s more than 7 years.

 

Other symptoms can include:  

 

  • Vaginal dryness and reduced sex drive
  • Changes in body composition, with loss of muscle mass and an increase in weight gain around the tummy
  • Difficulties sleeping
  • Low mood, anxiety and changes in mental clarity - described as brain fog
  • Joint aches  
  • Headaches  

 

Oestrogen and Long-Term Health 

 

Of all the hormonal changes that take place in the transition to menopause, declining oestrogen levels are the most significant in terms of your health. As well as causing most perimenopausal symptoms, low oestrogen levels accelerate bone loss and increase LDL cholesterol (the type that’s causal in heart disease). A drop in oestrogen can also lead to changes in body composition, like an increase in body fat stored around the tummy.   

 

This means that women entering post-menopause (the years after menopause) are more vulnerable to heart disease, type 2 diabetes and osteoporosis. Whilst this sounds worrying, your best ally is knowledge of these changes and the steps you can take to help protect your health.  

 

Eating to Support Menopausal Health  

 

Hormone replacement therapy (HRT) remains the most effective treatment for easing menopausal symptoms and reducing the risk of heart disease and osteoporosis, but dietary and lifestyle changes play an important role in easing symptoms and protecting bone and heart health too. So, let’s look at which foods can help.

Phytoestrogens 

 

First up; phytoestrogen-rich foods. Phytoestrogens (plant oestrogens) are compounds found in various plant foods (including soybeans, beans and lentils, linseed, wholegrains, tofu and tempeh) that can weakly mimic the effects of oestrogen when your own levels are low.  

 

Some (but not all) studies have found that phytoestrogen-rich foods may reduce hot flashes and night sweats, which are one of the common (and most bothersome) menopause-related symptoms.  

 

In 2012 researchers combined the results from many phytoestrogen studies. Compared to a placebo, the combined results showed that 40-50 milligrams of soy isoflavones (a type of phytoestrogen) eaten daily reduced the frequency and severity of hot flushes by 20-30%. This is equal to 500 millilitres of soy milk - about two cups.

 

Be aware that it may take 2-3 months of eating phytoestrogen rich foods before you see any benefits.    

 

Protein Power 

 

Aging involves a gradual loss of muscle mass from around the 4th decade of life, and declining oestrogen levels can speed up this process. Maintaining muscle mass is important for your strength and bone health, so your best allies are consuming sufficient protein (at least 1 gram per kilogram of bodyweight) and strength training two to three times a week. As a side note, women who are physically active tend to report fewer hot flushes too.

 

A helpful approach to consuming protein is to aim for 20–25 grams of high-quality protein with each of your main meals. Dividing your protein intake evenly across the day helps your body use this important nutrient for muscle building more effectively.

Mediterranean Diet 

 

Overall, a Mediterranean-style diet (which uses olive oil as the main source of fat, with plenty of fruits, vegetables, legumes) appears to be the most beneficial for menopausal health. Not only has following a Mediterranean diet been linked with fewer menopausal symptoms, a 2018 study found that post-menopausal women following a Mediterranean style diet had higher bone density and muscle mass.  

 

More recently, the European Menopause and Androgen Society (EMAS) released a statement that a Mediterranean Diet may improve vasomotor symptoms, improve heart health and bone mineral density.  

 

If you want to adopt a more Mediterranean-style diet, aim for these dietary habits:

  • Use olive oil as your main source of fat
  • Include 2 or more portions of vegetables each day
  • Include 3 or more portions of fruit each day
  • Include 3 or more servings of beans, peas or lentils each week
  • Aim for 3+ servings of unsalted nuts each week (a serving is a small handful)

 

Bone-Friendly Nutrients

 

Because bone health is at risk during menopausal transition, bone building nutrients should also be a focus. You can meet the recommended intake for calcium intake (700 milligrams per day) with three servings of calcium rich foods (e.g., a glass of milk or calcium fortified plant milk, 100g of calcium-set tofu and 30g of cheese).  

 

Vitamin D is essential too because it helps the body absorb calcium. A daily 10 microgram supplement is recommended during autumn and winter when sunlight (the best source) is insufficient to keep levels optimal. If you are African, African-Caribbean, or South Asian, vitamin D supplements should be taken year-round, as darker skin produces less vitamin D. Equally if you have an office job and don’t spend much time outdoors, a year-round supplement is a good safeguard.

 

Learning More about Menopause

  

The British Menopause Society (BMS) recommends that all women should be able to access advice on how they can optimise their menopause transition and long-term health. They have a great resource centre which you can find here. In addition, you can find trusted websites and factsheets in our Field Doctor menopause hub.

References

NHS England. (n.d.). Menopause in the workplace. Retrieved October 6, 2023, from https://www.engage.england.nhs.uk/safety-and-innovation/menopause-in-the-workplace/  

British Dietetic Association. (2019). Menopause and diet: Food fact sheet. https://www.bda.uk.com/resource/menopause-diet.html  

Taku K, Melby MK, Kronenberg F et al. Extracted or synthesized soybean isoflavones reduce menopausal hot flash frequency and severity: systematic review and meta-analysis of randomized controlled trials. Menopause. 2012;19(7):776-90.  

​​Buckinx, F., & Aubertin-Leheudre, M. (2022). Sarcopenia in Menopausal Women: Current Perspectives. International Journal of Women’s Health, 14(June), 805–819. https://doi.org/10.2147/IJWH.S340537 

Stokes, T., Hector, A. J., Morton, R. W., McGlory, C., & Phillips, S. M. (2018). Recent perspectives regarding the role of dietary protein for the promotion of muscle hypertrophy with resistance exercise training. Nutrients, 10(2). https://doi.org/10.3390/nu10020180 

Murphy, M. B., Dunne, N., Keegan, B., & Heavey, P. M. (2022). Menopausal symptoms and adherence to a Mediterranean dietary pattern in women living in Ireland. Proceedings of the Nutrition Society, 81(OCE4), 2022. https://doi.org/10.1017/s0029665122001434  

BRITISH MENOPAUSE SOCIETY. (n.d.). What is the menopause? Retrieved October 6, 2023, from https://thebms.org.uk/wp-content/uploads/2023/08/17-BMS-TfC-What-is-the-menopause-AUGUST2023-A.pdf 

Vetrani C, Barrea L, Rispoli R, et al. Mediterranean Diet: What Are the Consequences for Menopause?. Front Endocrinol (Lausanne). 2022;13:886824. Published 2022 Apr 25. doi:10.3389/fendo.2022.886824