Addressing Nutrient Deficiencies: Using Food as Medicine in Menopause

Menopause is defined as the absence of menstruation for 12 successive months, indicating the end of ovarian function and a woman’s reproductive years. This transition takes place most often between the ages of 45 and 56, with a median age of 51 in the United States. Menopause is accompanied by a decline in estrogen and progesterone levels, which can significantly impact a woman’s health and well-being.

In addition to hormone-related symptoms such as hot flashes, night sweats, and vaginal dryness, menopause is associated with weight gain, mood changes, cognitive decline, and various cardiometabolic concerns. These symptoms result from changes throughout the body during the transitional years surrounding menopause. During this time, as the female biochemistry changes, so do the demands for various nutrients throughout the body. 

Nutrients can be divided into two categories: macronutrients and micronutrients.  Macronutrients, such as carbohydrates, protein, and fats fuel a healthy body and energy production.  Micronutrients are a group of nearly 30 vitamins and minerals that the body requires in very small quantities to support the critical processes involved in healthy biochemistry.

As a woman approaches menopause, the body’s nutrient requirements change to accommodate hormonal shifts, metabolism, cardiovascular function, and bone health. As her body changes, a woman needs to be mindful of her nutrition to ensure she is consuming adequate amounts of both macronutrients and micronutrients. In doing so, symptoms of menopause may be minimized, and the risk of chronic diseases associated with aging could be reduced.

This article explores how nutrient needs change during menopause and how to tailor nutrition to these changes. We review practical strategies for employing food as a supportive tool, as well as valuable lifestyle and dietary modifications to more easily navigate menopause.

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How Nutrient Needs Change During Menopause

Research suggests that during menopause, minor adjustments to the balance of macronutrients in a woman's daily nutrition could help manage associated symptoms. In particular, an increase in protein consumption may support the management of weight and muscle maintenance, two common concerns during this time of change. This is because aging increases dietary protein requirements as skeletal muscles reduce their protein synthesis activity in response to exercise.

In fact, studies show that higher protein intake is associated with leaner body mass in postmenopausal women, potentially lowering the risk of frailty and supporting physical function as they age. In addition to more protein, it appears that consuming a lower carbohydrate diet, with moderate healthy fat intake, may help manage weight in postmenopausal women. 

Common Micronutrient Deficiencies in Menopause

The most common micronutrient deficiencies in menopause vary between individuals. However, as menopause approaches, the female body is in high demand for the following nutrients. Adequate levels of each support the female body as hormone production declines.

Vitamin D:

• Important for bone mass, cardiovascular health, immune function, mood, and skeletal muscle mass
• Deficiency is associated with osteoporosis, cardiovascular and metabolic disease, certain cancers (lung, ovarian, and breast), muscle atrophy, and depression.
• Food sources: fortified dairy, oily fish (salmon, mackerel, and sardines)

B Vitamins:

• Important for metabolism of carbohydrates, protein, and fat to create energy, nervous system function, cardiovascular health, detoxification, neurotransmitter production affecting mood and cognition 
• Deficiency is associated with neuropathy, fatigue, cardiovascular disease, cognitive decline, anxiety, and depression. 
• Food sources: animal proteins such as poultry, meat, fish, and dairy

Calcium

• Important for bone health, nerve function, muscle contraction, and blood clotting 
• Deficiency is associated with osteoporosis, clotting disorders, myalgia, and muscle cramping 
• Food sources: dairy, fortified dairy alternatives, leafy greens, nuts and seeds, legumes, and whole grains

Zinc

• Important for immune function, integumentary health, vision, body composition, cognition and mood
• Deficiency is associated with recurrent illness, macular degeneration, and mood concerns.
• Food sources: seafood, poultry, red meat, whole grains, nuts, and seeds

Magnesium:

• Important for bone health, insulin sensitivity, muscle recovery, blood pressure regulation, restful sleep, and healthy mood 
• Deficiency associated with osteoporosis, metabolic disease, hypertension, muscle tension, insomnia, and anxiety/depression. 
• Food sources: seafood, poultry, red meat, whole grains, nuts, and seeds

Practical Strategies for Using Food as a Supportive Tool

One of the best ways to support the health of individuals as they age is to teach them to employ food as a primary source of support. This is one of the foundational components of a functional medicine approach and is valuable when addressing most health concerns, including those associated with menopause. 

A 2017 study suggested that the Mediterranean diet may have significant benefits for women during the menopause years due to its cardioprotective effect. Adherence to the Mediterranean diet was positively correlated with lower total cholesterol, triglycerides, and C-reactive protein. Key components of this diet include antioxidant-rich vegetables and fruits, lean protein such as fish and legumes, as well as whole grains, nuts, and olive oil. Encouraging individuals to employ key components of the Mediterranean diet to create healthy meals may contribute to a leaner body composition throughout the menopause transition.  

Inspiring individuals to create colorful dishes with veggies and fruits is an effective way to ensure they are getting sufficient dietary micronutrients. By making meals rich in protein, produce, and fiber, individuals consume foods that stabilize blood sugar, allow for satiety, and reduce the tendency to reach for sweets. The high phytonutrient content of the Mediterranean diet provides supportive anti-inflammatory and antioxidant actions as we age.

Several studies have suggested that a Mediterranean-focused nutrition plan may aid in weight management during menopause, thereby supporting a healthy weight and cardiometabolic health. A study reviewing the value of the Mediterranean diet in managing hot flashes and night sweats during menopause found a 20% reduction in vasomotor symptoms in women who followed the diet. 

Many strategies support better compliance with a healthy nutrition plan. One of the simplest to employ is meal planning. Encouraging individuals to take some time each week to map out what they will eat during the majority of their meals and create a grocery list is an effective approach to improving compliance with healthy eating. Prepping vegetables for roasting or salads once they arrive home from the grocery store and before storing them in the refrigerator will reduce meal prep time throughout the remainder of the week. It is important to leave some flexibility in this plan, but these simple steps add ease to clean eating.

Balanced Nutrition & Functional Foods

Healthy eating is about more than the individual foods we choose to eat. Healthy eating also involves combining foods to create balanced meals that provide adequate macronutrients and micronutrients for the body to function optimally. Encouraging women to include lean protein, colorful veggies, and fiber-rich whole grains in each meal is a strategy for creating strong nutrition. When combined, these foods create a balanced meal that supports the body’s needs.  

During the menopausal years, several functional foods may provide a benefit beyond their basic nutritional value. One example of this is calcium-rich foods to support strong and healthy bones. These include dairy products, legumes, dark leafy greens, nuts, and seeds.

Foods rich in phytoestrogens, such as soy, flaxseeds, lentils, and sunflower seeds, may help manage symptoms of hot flashes and vaginal dryness in menopausal females. Fermented foods such as yogurt and fermented vegetables provide beneficial probiotics to support gut health and maintain a healthy balance. The brassica family of vegetables, including broccoli, cauliflower, Brussels sprouts, and cabbage, may support healthy estrogen metabolism. 

Lifestyle and Dietary Modifications

As women transition through menopause, focusing on lifestyle and nutrition proves rewarding in many ways. Hydration becomes even more important amid hot flashes and night sweats, as older individuals may replenish fluids at a slower rate. Aiming to consume half of one’s body weight in ounces per day is a reasonable goal for adequate hydration. 

Another foundational component to a healthy transition through menopause is a consistent exercise habit. Exercise routines throughout menopause and beyond should include cardiovascular exercise, weighted workouts, and stretching. This type of comprehensive exercise plan is conducive to maintaining endurance, strength, flexibility, and balance.

Supplements: When Food Isn’t Enough

Despite the strong food security present in most homes in the United States, our US adult population may not always meet the recommended levels of a few key micronutrients. Several factors contribute to this, including the rise in consumption of low-nutrient/high-calorie processed foods and the increase in sugar consumption, which requires nutrients such as B vitamins and magnesium to metabolize.

The development of nutrient deficiency is also influenced by agricultural practices that deplete soil nutrients. In addition, several deficiencies can result from chronic conditions, which influence biochemistry and the body’s nutrient demands. However, even in the presence of healthy nutrition, ensuring adequate micronutrient levels to support optimized biochemistry is of value. This is particularly true during menopause. 

Studies have found that supplemental micronutrients may help manage several menopause symptoms, including hot flashes, night sweats, insomnia, mood changes, and fatigue.  However, it can be overwhelming to identify which nutrients to supplement and find a brand of good quality and appropriate dosing. Working closely with a provider who understands the importance of high-quality, absorbable nutrients and proper dosing provides a way to safely and confidently design an effective supplement regime.

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Key Takeaways

• The transitional years surrounding menopause are marked by changes throughout the body, which alter the demand for various nutrients. 
• While the decline in hormone production and hormone-related symptoms are most noted, changes in a woman’s body during menopause affect multiple systems that influence many systems, including metabolism, body composition, cardiovascular function, and bone health.  
• Navigating a changing body can be difficult at times; however, menopause is a natural part of aging that allows one to assess and improve lifestyle habits to support health. 
• As a woman’s body changes, it is important for her to be mindful of healthy nutrition to ensure both macronutrient and micronutrient levels can support her biochemistry. In doing so, she may be less likely to struggle with symptoms associated with menopause while supporting her overall health as she ages. 
• Teaching women to adopt a food-first approach to their health encourages them to use food as a supportive tool in their quest to age gracefully, embrace the transition, and feel well in body and mind.