Menopause: Nutrition interventions for symptom support
These were the main nutrition takeaways from a ‘Riding through menopause’ webinar hosted last month by experts in hormonal health.
Hormones and health
Dr Nicky Keay, lecturer at University College London, explained the importance of sex steroid hormones for women: “Oestrogen and progesterone are really important for bone, soft tissue health, cardiovascular health, neurological function, and response to exercise and much more.”
She said menopause involved the shift and fixing of these hormones at around 45 and 55 years of age, stressing that women will spend around one third of their lives in menopause.
“But in my opinion, it’s the perimenopause and the lead up to menopause which is the tricky part. And this can occur from 40 onwards, with cycles becoming more erratic,” she pointed out.
Keay explained that whilst menopause experiences are highly variable and appear gradually in many women, the most common of the 48 symptoms reported include irregular cycles, low mood, hot flushes, urinary issues, and sexual dysfunction.
“The recommendations from NICE, the NHS, and the British Menopause Society, are to review three different lifestyle areas. These include exercise, nutrition, and recovery. And optimising these areas will keep the hormones as happy as they can be.
“Whilst HRT can be very helpful, there’s no point just going on it without reviewing these areas first,” she added.
Lifestyle interventions
Anita Bean, nutritionist and health writer, discussed the practical steps that can be taken to minimise menopausal symptoms.
Exercise
Bean explained the association between weight gain and menopause, highlighting that the Zoe Predict study observed a clear link between the two, particularly around the midsection, due to dropping oestrogen levels.
“But the truth is that is not the menopause itself that causes this weight gain. Essentially it happens at a time in your life when a lot of other things are going on metabolically in the body,” she asserted.
She explained factors such as age, reduced activity levels, muscle mass, and metabolism levels can play a key role in this weight gain, whilst a reduced gut diversity can lower SCFA production and disrupt appetite regulation.
Thus, she said these changes can be mitigated by daily strength and aerobic exercises, which has been found to reduce hot flash occurrence and improve bone health.
Diet
Bean highlighted the importance of diet for influencing menopausal symptoms and long-term health risks, such as osteoporosis, dementia, and cardiovascular disease, either directly, by reducing chronic inflammation, or indirectly, through the gut microbiome.
She pointed out recent research identifying that the estrobolome - a collection of bacteria in the gut which is capable of metabolising and modulating the body's circulating estrogen - can ‘recycle’ oestrogen and increase the amount reabsorbed.
She stressed that the consumption of fibre, polyphenols, fermented foods, and probiotics can promote the growth of these bacterial species to alleviate menopausal symptoms.
She spotlighted the anti-inflammatory activities of pulses, whole grains, nuts and seeds, fish, fruits and vegetables, olive oil, and herbs and spices.
Bean added: “Foods rich in phytoestrogens are also important, which include soy products like tofu, edamame, and yoghurt, but also pulses and seeds. Specifically, isoflavones can mimic the effects of oestrogen by binding to these receptors in the body. We know that women in China and Japan have a high soy intake, and they experience far less symptoms.
“To give you an idea of the huge difference, in the UK we have intakes of 2mg per day of isoflavones, compared with 50mg in Japan. Another study from 2023 found that those who had a plant-based diet had 88% fewer hot flashes. But these effects of soy can vary due and is very much dependent on your gut microbiome and how diverse it is,” she stressed.
She said that supplementation with soy isoflavones may be beneficial in those with a diverse microbiome.
In addition, due to a significant loss of muscle mass from increased anabolic resistance, which reduces the body’s ability to convert amino acids into lean body tissue, she stressed women should aim for a minimum of 20-25g of protein per meal.
She added the importance of omega-3 intakes for maintaining cognition, and reducing depression risk and inflammation, highlighting supplements as a good option for those with plant-based diets.
Keay said that based on available evidence, additional supplementation with magnesium for sleep and relaxation may be beneficial, whilst a daily vitamin D supplement of 10 micrograms a day was recommended for maintaining bone strength, mood, and immunity.
Fasting
Bean regarded recent trends and discussions around intermittent fasting which have proposed benefits to weight loss, inflammation, and blood sugar control.
“But the most recent research has shown that these fasting periods can affect your hormonal balance, creating greater fluctuations, increasing stress and cortisol levels, and increasing muscle mass loss which can worsen menopausal symptoms,” she warned.
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