Nutrition for Menopause
Melissa Darlow, RD
Menopause is defined as the ceasing of menstruation, or “the permanent cessation of menstrual cycles following the loss of ovarian follicular activity.” While this is a natural transition that occurs in a woman’s life, there can be adverse and uncomfortable symptoms that last for many years. As hormones start to shift, many bodily processes are impacted including nutrient metabolism, fluctuations in body temperature, loss of bone density and more.
As a result, digestive issues, hot flashes, weight gain, low energy and muscle loss are common side effects. Menopause has also been shown to increase the risk of cardiovascular disease, metabolic syndrome and osteoporosis largely due to the loss of estrogen. While a cascade of hormonal changes may be out of one’s control, diet and lifestyle have a significant role in managing and mitigating symptoms.
Protein is the building block of muscles. In the menopausal transition, estrogen levels decrease and have been associated with a loss of lean body mass and an increase in fat mass. Menopausal women become at risk for sarcopenia, the age-related involuntary progressive loss of muscle mass and strength and may start to put on body fat more easily. Between hormonal shifts and the natural progression of aging, prioritizing protein rich foods is essential.
Researchers suggest that during perimenopause the body’s appetite for protein increases due to hormonally induced tissue protein breakdown, known as the Protein Leverage Effect. If the increased protein requirements go unmet, women are likely to over consume other forms of energy (carbohydrates and fat) which may further exacerbate weight gain and menopause related symptoms. For women over 50, it is recommended to aim for at least 1.2- 2 grams of protein per kg of body weight.
For example, if a woman weighs 140 lbs her minimum daily protein goal should be somewhere between 76- 127 grams per day. In addition to managing weight and maintaining muscle, sufficient protein intake also supports energy production, blood sugar control and can reduce cravings. Quality protein sources include eggs, lean meat, poultry, seafood, beans, legumes, tofu and dairy products. Ideally, protein is spread out across meals and snacks throughout the day.
Calcium + Vitamin D
Osteoporosis is a progressive disease caused by a decrease in bone mass and deterioration of bone structure. As previously mentioned, throughout the aging process bone density naturally starts to decrease. When coupled with the drop of estrogen, bone resorption occurs at a greater rate than bone formation, making menopausal women at an increased risk for osteoporosis. Studies suggest that one out of three women are affected by osteoporosis and are at increased risk of fracturing themselves even during routine activities such as walking or bathing. Adequate intake of nutrients specifically calcium, vitamin D, magnesium and vitamin K are essential to improving bone health.
Calcium is a major building block of bone with 99% of the body’s calcium found in skeletal mass. Thus, it is essential to consume calcium in the diet. The recommended consumption of calcium rich foods is 1200-1500 mg per day. A serving is considered to be 300 mg calcium which is equal to 1 cup of milk, 1 ⁄ 2 cup cottage cheese or an 8 oz yogurt. Calcium is also present in non-dairy foods such as kale, collard greens, tofu, tuna and walnuts.
Additionally, Vitamin D is another key nutrient that works as a helper for absorbing calcium and building bones. Vitamin D is a fat-soluble vitamin found in salmon, sardines, egg yolks and fortified foods such as certain milks and orange juices. Dietary sources do not always provide adequate amounts, therefore getting outside for sun exposure or speaking with your doctor about a supplement may be advised.
Magnesium is a mineral present in many foods and offered in supplemental form. Magnesium is found in a variety of vegetables, grains and nuts including cashews, spinach, pumpkin seeds, whole grains, almonds and more. Research demonstrates that magnesium is involved in hundreds of biochemical reactions throughout the body including mood regulation, supporting bone density, hormonal function and more.
While magnesium plays an important role in health throughout all life stages, it is especially vital during menopause. Up to 60% of magnesium is stored in bones and plays a role in preventing osteoporosis. Since one out of three postmenopausal women is shown to be at risk for osteoporosis, consuming enough magnesium along with the previously mentioned calcium and vitamin D is critical.
Studies suggest that sleep disturbances such as insomnia are frequently experienced by women during perimenopause and after menopause. Other menopause related symptoms such as night sweats, hot flashes and anxiety may also contribute to difficulty falling asleep or staying asleep in this population. Magnesium may help to improve sleep by regulating the body’s circadian rhythm and increasing muscle relaxation. An association between low magnesium intake and decreased sleep quality has even been found, further demonstrating the importance of adequate magnesium intake.
Besides food sources, there are various forms of magnesium offered in supplemental form. In regards to sleep and relaxation, magnesium glycinate and threonate may support sleep. Be sure to check with your healthcare provider before starting supplementation.
Fiber is the non-digestible carbohydrate found in foods such as fruits, vegetables, legumes, nuts and grains. Fiber can be categorized by soluble and fermentable or insoluble and non-fermentable. Soluble fiber can dissolve in water and be fermented by the “good” bacteria in the gut, while insoluble fiber does not dissolve in water. Most fiber rich foods contain an overlap between the two and provide a plethora of health benefits. A high fiber diet has been linked to improved bowel health, weight management, blood sugar control and so much more.
A high fiber diet is especially important for perimenopausal women. A recent study found that increased fiber intake is correlated with decreased rates of depression as women approach menopause. Fiber has been shown to support the gut microbiome and play a significant role in the direct relationship between the gut-brain axis. High fiber consumption can strengthen brain health and may help to protect against depressive symptoms.
The recommended dietary allowance for fiber consumption for women is at least 25 grams per day. This can be accomplished by consuming a variety of foods throughout the day. For example, just by adding 1 cup of raspberries to breakfast you will get 8 grams of fiber, or try adding ½ cup of chickpeas to lunch which provides an additional 7 grams of fiber.
Ultimately, menopause is a part of life for women. When perimenopause begins the body starts to undergo many changes potentially leading to side effects such as hot flashes, loss of lean muscle mass, weight gain and insomnia. Rather than crash dieting in hopes to lose weight or ward off symptoms, it is important to nourish your body with proper nutrition. While there are many nutrients one can consume to help support their overall health status, focusing on sufficient protein, calcium, vitamin D, magnesium and fiber are essential.