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NUTRITION FACTS

Menopause on the Menu

This page was reviewed or revised on Monday, October 20, 2003.

Menopause … what is it? And how can wise food choices help set the stage for a smooth and healthy shift to the years that follow? After all, a woman still has a lot of living to do after menopause - a third or more of a lifetime’s worth!

Menopause is a gradual process. The body slowly begins to cut back on production of the female hormones, estrogen and progesterone, for several years before menopause officially begins. This time is referred to as perimenopause. Menopause becomes "official" when a woman has had no menstrual periods for 12 months in a row. For many, this occurs just after age 50, but it can happen well before that.

During perimenopause, women can experience stronger than usually PMS-like sensations. These differ from person to person but could include feeling tired, mood swings, bloating, breast tenderness, headaches and food cravings. Unpredictable periods, vaginal dryness, sleep troubles and hot flashes become more common as menopause draws closer. About 15% of women sail through this time of change without noticing any symptoms at all. Most women do, however, experience some symptoms.

Female hormones, like estrogen, protect women from heart disease. One theory is that they help to keep the level of "good" cholesterol in the blood high and the "bad" cholesterol level low. Sadly, after menopause, women lose this special protection and their risk of stroke and heart disease increases to a level similar to that of men.

Estrogen also helps to build bones and keep them strong. Without estrogen, bones lose calcium faster. They can become thin, weak and easy to break. This condition, called osteoporosis, affects one in four women after menopause. Building strong bones with a calcium-rich diet earlier in life can protect a woman from this disease. But, even after menopause, diet has a role in helping to slow bone loss.

It’s more important than ever to take care of yourself now

Choosing a healthy diet is one way to help reduce your risk not only of heart disease and osteoporosis, but also of diabetes and some types of cancer. As a bonus, healthy food choices may help ease some menopausal discomforts. So, let the following nutrition guide steer you.

Cut down on fat…

Try new ways of cooking that use little or no fat. Find tasty, lower-fat or fat-free versions of mayonnaise, salad dressings and dips. Make a switch to lower-fat milks, cheeses, yogurts and dairy desserts. Lighten up munchies by offering bread sticks, plain popcorn, pretzels, rice cakes, bagel chips or fresh fruit and veggie sticks instead of traditional high-fat items like potato chips and regular taco chips. Choose lean meats and trim away any fat you see.

Eat more vegetables and fruits…

Fresh, frozen or canned, and juices. Aim for at least five servings every day. They are a natural source of certain vitamins and other compounds believed to be disease fighters. Excellent choices include broccoli, sweet red peppers, spinach, carrots, brussels spouts, tomatoes, cantaloupe, oranges, mangoes, strawberries, and kiwi.

Eat more grain foods…

Especially whole grain breads, cereals, rice and pastas. Most are naturally low in fat, yet satisfying – the perfect solution for food cravings. And some studies show that the carbohydrates in starchy foods may help to soothe your mood or give it a mild lift.

Enjoy legumes (cooked dried beans, peas, and lentils) often…

They’re low in fat but rich in fibre and many other nutrients. Try a pea or lentil soup, baked beans or kidney bean chili. Check out vegetarian or ethnic cookbooks for other ideas. Note that soybean-based foods like tofu and soy drinks may be of special interest to women going through menopause. There’s evidence that plant estrogens in soy foods help to relieve hot flashes and other symptoms. How much and what kinds of soy foods are best? We don’t know yet, but they do have other health benefits, so adding them to your menu can’t hurt.

Bone up on calcium…

With three or more servings of lower-fat dairy foods, including milk, every day. Milk, unlike cheese and yogurt, has vitamin D added. Your body needs this vitamin to help absorb the calcium in foods. Other foods in a mixed diet will add calcium too – some more than others. Canned salmon and sardines (with the bones), tofu made with calcium, broccoli, kale, almonds, and soybeans are quite good sources.

If you don’t drink milk, it can be a challenge to get enough calcium and vitamin D from foods alone. Fortunately, a fortified soy beverage is now available in Canada. It has calcium, vitamin D and some other nutrients added in amounts close to what you would find in cow’s milk. Ask for it at your local grocery store. The soy and rice "milks" that have been on the market for some time now are not fortified and do not make good replacements for cow’s milk or for this new soy beverage.

Choose iron-rich foods daily…

Especially important if you often feel tired or have heavy periods. Include lean red meats, whole grain and enriched cereals, legumes and dried fruits. You’ll get more iron from plant foods when you eat them along with foods with vitamin C. So have a glass of orange juice with your cereal, or a tomato-based sauce on your spaghetti.

Limit alcohol and caffeine…

Foods and drinks with caffeine like coffee, tea, cola and chocolate trigger hot flashes for some women. So can alcohol, heavy meals, fatty, salty or very spicy foods. Avoid the foods and drinks that are triggers for you. And if you perspire a lot, don’t forget to drink more liquids. Water, milk, fruit juices and caffeine-free herbal teas are good choices.

Reach and stay at your healthy weight…

The body’s metabolism slows down over time, in part because we lose muscle as we age. Ounce for ounce, muscle burns more calories than other body tissues, so muscle loss can mean that, even if you eat and exercise the same as always, extra pounds can creep on. Switching to a healthier eating style and staying active can help keep weight in check. Build up bones and muscles with a regular aerobic activity like brisk walking, and with strength training.

Whether menopause is still years away or your body is hinting that it’s just around the corner, your healthy food choices can help you make the most of all the living you have to do!

Hormone replacement therapy (HRT)…

You may hear and read lots of differing ideas about hormone replacement therapy. It is very important to discuss your own health situation with your health care provider and to weigh the pro’s and con’s in deciding whether or not HRT is a good choice for you.

About nutrition supplements and menopause…

These days, health food and drugstore shelves seem full of nutrition supplements and other products that claim to relieve menopause symptoms. But, these claims are no guarantee that products work or are safe. Steer clear of items that come with too good to be true promises. Before you spend your hard-earned dollars, check things out. Talk to people who have tried any product of interest to you. Ask a dietitian, a public health nurse or your doctor for information. Here are some of the supplements you may have heard of…

• Evening primrose oil is rich in fatty acids that the body needs to make prostaglandins. Prostaglandins play a role in female hormone balance. There is some evidence that evening primrose oil can help to relieve breast tenderness, but evidence that it helps with other symptoms is less convincing. This product seems to be harmless when taken as recommended, but it’s an expensive way of getting essential fatty acids. Whole grain cereal products, nuts and seeds, legumes and vegetable oils are some of the best food sources.
  
  
• Vitamin A is claimed to correct problems with estrogen balance and help reduce water retention but this is still unproven. Overloading on vitamin A can be dangerous. Too much can lead to liver damage and to birth defects if a woman is pregnant. So if you do decide to take a supplement, it’s best to limit yourself to no more than 5,000 IU (International Units)/1500 RE (Retinol Equivalents) daily – especially if there’s any chance of becoming pregnant.
  
  
• Vitamin B6 is said to reduce water retention when taken in large daily doses. But vitamin B6, like vitamin A, can be hazardous when taken in amounts much larger than what’s naturally found in a varied diet. There is evidence that 50 mg or more daily, if taken long enough, can cause nerve damage. We don’t know that benefit outweighs possible harm, but if you do decide to take B6, keep the amount small.
  
  
• Vitamin C is sometimes promoted to relieve hot flashes, but so far there is little proof. In any case, five or more servings of vegetables and fruits daily provide plenty of vitamin C. If you take a supplement, note that too much vitamin C may lead to unpleasant side effects, like diarrhea or skin rashes. Limit yourself to no more than 500 milligrams once or twice daily.
  
  
• Vitamin E is said to ease symptoms like vaginal dryness, hot flashes and breast tenderness. It does seem to work for breast tenderness with some women, but there’s no solid proof that it helps with other discomforts. 100 to 400 IU (International Units) daily is considered safe for most people, but talk to your doctor first. Some health conditions and medications don’t mix well with this vitamin.
  
  
• Ginseng is said to relieve hot flashes and boost energy levels but these claims have not been proven. Ginseng products can vary a great deal in the amount of active ingredients they contain. Ginseng can increase the risk of symptoms many women are trying to avoid, like sleeplessness and diarrhea. High blood pressure has also been noted in some long term users.
  
  
• Dong Quai is a Chinese herb containing plant sterols that have estrogen-like effects. It has been promoted to relieve hot flashes and as a "female hormone balancer". Its active ingredients are coumarins which in theory relieve some menopause symptoms, but evidence is lacking, and since coumarins can be toxic, dong quai should be avoided.
  

Nutrition and Menopause: References

Beatty, D. Menopause on the menu. Canadian Living, February 1997.

Weinstein, S. New attitudes towards menopause. FDA Consumer, March 1997.

Special report. The 7 habits of highly health-oriented postmenopausal women. Advice for staying well during life’s second half. Tufts University Health & Nutrition Newsletter, June 1997.

Tyler, V.E. The new honest herbal. George F. Stickley Company, Philadelphia, 1993.

EN’s nutrition advice for women of ‘a certain age’. Environmental Nutrition, August 1996.

Marshel, J. and Konner, L. Trouble-free menopause. Avon Books, New York, 1995.

Menopause: let’s talk about it! Society of Obstetricians and Gynaecologists of Canada, 1996.

Unsubstantiated claims and documented health hazards in the dietary supplement marketplace. Department of Health and Human Services, Public Health Service, Food and .Drug Administration, Rockville, MD, 1993.

Are herbal remedies good medicine? Consumer Reports on Health, April 1995.

Getting enough calcium? Health News, University of Toronto, April 1996.

Dietary reference intakes of calcium, phosphorus, magnesium, vitamin D and fluoride. Food and Nutrition Board of the U.S. National Academy of Sciences and the Food Directorate of Health Canada, 1997.

Building better bones. A guide to active living. Osteoporosis Society of Canada, 1996.

Menopausal hormone replacement: yes or no? Health News, University of Toronto, June 1995.

Internet Resources:

Produced by Public Health Nutritionists/Dieticians in Ontario, April 1998. may be reproduced without permission provided the source is acknowledged. Distributed by Health Promotion and Program Support.

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