I would love to be able to give you a prescribed diet and say - eat this drink this and it will give you the optimum health benefits. However, the world is not that simple. I have been doing literature searches on the topics to look at what the science says and the answer is "it's complicated". There are a number of factors that will indicate what is best for you.
There are nutritionists out there that can do blood or hormone screens and give advice on your bodies current needs, I can recommend a couple of amazing services that offer this. Also, our DNA also impacts on what food and nutrition supports us at being at our optimum. Contact me if you would like a DNA test that will prove a report of the diet which is optimum for your genetic needs.
There are so many factors that impact on diet and nutrition that all I can do within this blog is give you the clearest most current evidence and then for you to tune in to yourself and work out what is helpful and nurturing for you. In my experience the best chance of flourishing during menopause is by developing the skill to tune in to what you need, adhering to this and being compassionate as to when you do something unhelpful to get you back on track.
We can eat for a number of reasons. In my entire life I think I have only known a handful of people that eat just for the sake of nutrition. We eat for energy, for comfort, out of celebration, for taste. Our motivation towards eating is driven primarily by two hormones.
Ghrelin is the hormone that initiates a feeling of hunger and motivates us to eat.
One of the reasons we find calorie reduced diets hard is after a prolonged period of being in a calorie deficit our body creates a surge of ghrelin to send us a signal that it is using it's surplus energy (fat stores) and it wants to restock. HRT can increase our production of ghrelin.
Leptin is the hormone that tells us when we are full. It guides our calorie intake. leptin is actually produced in fat cells, although there is a suggestion that our fat cells can become leptin resistance when we are overweight, this means that our brain believes that we are still hungry as it is not receiving the signal that we are satisfied. During menopause leptin levels significantly decline. Therefore we may not be able to accurately rely on signals from our body to tell us that we are full and will need to use portion control and to slow down the speed of eating.
So when I talk about tuning in to what your body wants remember that the signals that you are getting may not be hat you need. Ask yourself have I had the level of macro nutrients that I need, I find MyFitnessPal a good free app for this. Also be mindful of portion sizes.
Each of the macronutrients: carbohydrate, protein and fat, has a unique set of properties that are a source of energy. There are different health implications of diets that emphasise one macro nutrient over another.
Carbohydrates
Carbohydrates are the quickest form of dietary energy and are used to quickly provide the energy mechanism glucose into the blood stream. We use glucose as the first and quickest form of energy and liver can store some excess to help maintain glucose levels however excess is converted into fat for long term storage.
We need the right balance of carbohydrates in our diet. Under consumption can lead to hypoglycemia or a break down in muscle tissue and over consumption can disrupt sleep, cause fatigue, cause weight gain and insulin resistance.
When we ingest carbohydrate our body turns these sugars to glucose. The pancreas increases its production of the hormone insulin which is used to regulate the blood sugars level. Insulin allows the liver, muscles and fat to take the glucose for storage of energy. When we then need energy the glucose can then be broken down to energy (Adenosine Triphosphate).
The speed at which glucose is taken up by the cells is measured by the Glycemic Index (GI). Fast uptake has a higher number. Simple carbohydrates are called sugars and have a quick uptake into the blood stream the NHS advises to have under 50 grams a day. Complex Carbohydrates are called starches and take longer to be broken down. Lower GI foods promote the feeling of "being fuller for longer" as they even out the release of energy and reduce the likelihood of spikes in insulin.
If we have a diet that is high in high GI carbohydrates we can increase our resistance to insulin resulting in the pancreas overworking potentiating to produce higher quantities of insulin.
Lower oestrogen levels are associated with insulin resistance therefore there are higher risks of diabetes and metabolic syndrome. Reducing the intake of sugar / high GI carbohydrates can help reduce the risks as well as maintain energy levels.
If you have Type 1 diabetes the menopause may impact the insulin levels that your require and you may find that you are experiencing more frequent hypoglycemia. If this occurs you may need to adjust your insulin levels.
When there is access to carbohydrates it the body has not need to utilise fat reserves for energy. When carbohydrates are scarce, the body runs mainly on fats.
Fats:
Fats can only be used as an energy when oxygen is present. Fats are broken down into fatty acids to provide fuel to the energy systems. Fatty acids that aren't needed right away are packaged in bundles called triglycerides and stored in fat cells. When we have utilised all the energy from carbohydrates these triglycerides transported to the powerhouse cells mitochondria which produce ATP.. We have an unlimited ability to store fat. There is a higher risk of health problems if your body tends to store fat around your belly. If most of our fat is around our centre is is often a sign of high levels of stress as it can be caused by excess cortisol (The stress hormone).
Protein:
Proteins are made up of chains of amino acids. Not all proteins are equal. To be a "complete" protein there will be all 20 amino acids. Theses amino acids have a range of functions to help with growth and eminence of the body. When there are a shortage of fats or carbohydrates it can be used to produce ATP when oxygen is available. Endurance exercises increases the use of amino acids in maintaining glucose levels and as a supply of ATP energy.
Protein consumption has been shown to release Leptin to give us a feeling of fullness.
Some plant based protein such as soy and chickpeas contain phytoestrogens (plant oestrogen) It has been suggested by some that this may decrease discomfort of menopause however there is no current evidence that demonstrates that this makes a significant difference.
In addition to what we eat, what we consume through drinking can also influence:
Caffeine: Caffeinated drinks can impact on hydration and they have been shown to have a small but significant link to hot flushes.
Alcohol: the evidence for alcohol is mixed.
Within the UK women are recommended to have no more that 14 units a week, this is the equivalent of 7 glasses of wine. Some days should be alcohol free and the units should be consumed over a few days.
Drinking a moderate amount of alcohol within the guidelines has been shown to have some correlated health benefits compares to those who are t -total or who drink above the recommended amount. A correlation does not mean that the alcohol causes or explains the benefit but that there is an association. These benefits include, increase bone density , delayed onset of menopause However the negative impact of alcohol can overrule these health benefits.
It used to be thought that alcohol consumption reduced the risk of heart disease however a number of studies in the last 5 years have found older research was flawed.
Alcohol intake, whilst increasing the speed at which you fall asleep does reduce the quality of sleep in particular the important later stages of REM
If you are experiencing hot flushes alcohol can acerbate these symptoms.
Alcohol does raise the bodies oestrogen levels however at the moment studies contradict as to if this has a negative or positive effect.
Drinking above the guidelines can increase risk of stroke, alcoholism, depression heart disease, cancer and metabolic syndrome.
Vitamin D and Calcium
As oestrogen can impact on bone density and muscle mass it is important to ensure you are getting vitamin D (which helps us absorb calcium. The Royal Osteoporosis Society has good quality information on this.
So have a think about the information I have given you. Was there any new information? Did it reinforce or challenge your previous understanding of how diet interplay with menopause. If there anything that you will be trying out differently or has it reinforced that you are doing what will nourish you?
Want to read more... see related blog Gentle Nutrition for the Menopause
Sarah is an Occupational Therapist and personal trainer who is passionate about helping people flourish @MoodLifterPT She is always happy to be contacted if you want to find out more.