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Nutrition and Menopause

image for menopause articleThe aging process is associated with many changes in hormonal and physiological function, some of which are gender-related. In women, one of the most dramatic hormonal changes is the striking reduction in estrogen production that comes with menopause. This period of life has special nutrient requirements.

Menopause occurs when a woman stops having her monthly period. The time around menopause is called perimenopause. During perimenopause, a woman's body adjusts to a waning and then absent menstrual flow, as well as to the associated bodily changes that result from lower estrogen levels. A woman is postmenopausal after her periods have stopped for 1 year.

Eating a Healthy Diet

Although researchers continue to study the special nutrition needs of menopausal women, it is generally agreed that a diet rich in fruits, vegetables, and grains and lower in fat and calories is a wise choice for women at midlife.

Osteoporosis

Estrogen levels decline during menopause, and this reduction makes bone more susceptible to calcium loss. Increased calcium intake and moderate weight-bearing exercise may be able to minimize the development of osteoporosis. How much calcium should you take each day? The recommended daily allowance for women age 51-70 years old is 1,200 mg a day. The recommended daily allowance of vitamin D which helps the body absorb calcium, is 600 units a day for women 19-70 years old and 800 units a day for women older than 70 years.

Heart Disease

Prior to menopause, estrogen helps protect a woman's arterial walls from fat and cholesterol buildup by raising the levels of HDL ("good") cholesterol and lowering the levels of LDL ("bad") cholesterol. As menopause drives down estrogen levels, this protection diminishes and leaves women as vulnerable to heart disease as men. To compensate for this loss of protection, women should adopt a diet that is low in total and saturated fats and cholesterol and high in complex carbohydrates, such as grains, fruits, and vegetables.

Hot Flashes

Caffeine can increase the number and intensity of hot flashes and has also been implicated in osteoporosis. It is best that women limit caffeine intake at menopause.

Watch What You Eat and Keep Fit

Menopause is associated with reduced resting- and physical activity-related energy expenditure and increased central fat stores (stomach and thighs), which are risk factors for heart disease. To maintain body weight at premenopausal levels, women may need to cut back their caloric intake and increase physical activity.

Although menopause presents special challenges to women, consuming adequate amounts of calcium, limiting animal fats, eating plenty of whole grains, legumes, fruits and vegetables, and frequent exercise can help ensure women a healthy passage through menopause.

RESOURCES:

The North American Menopause Society
http://www.menopause.org

Office on Women's Health—US Department of Health and Human Services
www.womenshealth.gov

CANADIAN RESOURCES:

The Canadian Women's Health Network
http://www.cwhn.ca

Dietitians of Canada
http://www.dietitians.ca

REFERENCES:

Barrett-Connor E. Epidemiology and the menopause: a global interview. Int J Fertil.1993;38:6-14 (supplement 1).

Calcium. Office of Dietary Supplements website. Available at: https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/. Updated November 21, 2013. Accessed January 27, 2016.

Menopause. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 13, 2015. Accessed January 27, 2016.

Osteoporosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 13, 2014. Accessed March 19, 2014.

Margolis A, Greenwood S. Menopausal syndrome. In: Tierney L, McPhee S, Papadakis M, Schroeder S. ed. Current Medical Diagnosis and Treatment. Norwalk, CT: Appleton and Lange;1994:591-592.

Matthews K, Meilahn E, Kuller LH, et al. Menopause and risk factors for coronary heart disease. N Engl J Med.1989;321:641-646.

Ravnikar VA. Diet, exercise, and lifestyle in preparation for menopause. Obstet Gynecol Clin North Am.1993;20:365-378.

Vitamin D. Office of Dietary Supplements website. Available at: http://ods.od.nih.gov/factsheets/vitamind-HealthProfessional. Updated November 10, 2014. Accessed January 27, 2016.

Last reviewed January 2016 by Michael Woods, MD