Menopause is defined as the absence of menstruation for 12 successive months, indicating the end of ovarian function and a womanβs 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 womanβs 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.Β
Nutrients can be divided into two categories: macronutrients and micronutrients.Β Macronutrients, such as carbohydrates, protein, and fats fuel a healthy body and energy production.Β 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 bodyβs 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 are likely to be minimized, and the risk of chronic diseases associated with aging is 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 medicine, as well as valuable lifestyle and dietary modifications to more easily navigate menopause.
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How Nutrient Needs Change During Menopause
Research reveals that during menopause, minor adjustments to the balance of macronutrients in a woman's daily nutrition could lessen or even prevent associated symptoms. In particular, an increase in protein consumption is helpful in the prevention of weight gain and muscle loss, two common complaints 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 reveal that higher protein intake is associated with leaner body mass in postmenopausal women, lowering the risk of frailty and improving physical function as they age. In addition to more protein, it appears that consuming a lower carbohydrate diet, with moderate healthy fat intake, lowers the risk of weight gain in postmenopausal women.Β
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 cognitionΒ
- Deficiency is associated with neuropathy, fatigue, cardiovascular disease, cognitive decline, anxiety, and depression.Β
- Food sources: animal proteins such as poultry, meat, fish, and dairy
Calcium
- Important for bone health, nerve function, muscle contraction, and blood clottingΒ
- Deficiency is associated with osteoporosis, clotting disorders, myalgia, and muscle crampingΒ
- 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 moodΒ
- Deficiency associated with osteoporosis, metabolic disease, hypertension, muscle tension, insomnia, and anxiety/depression.Β
- Food sources: seafood, poultry, red meat, whole grains, nuts, and seeds
Practical Strategies for Using Food as Medicine
One of the best ways to support the health of our patients as they age is to teach them to employ food as their primary source of medicine. This is one of the foundational components of a functional medicine treatment plan and is valuable when treating most health concerns, including those associated with menopause.Β
A 2017 study revealed that the Mediterranean diet has 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 patients to employ key components of the Mediterranean diet to create healthy meals lends to a leaner body composition throughout the menopause transition.Β Β
Inspiring patients 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, patients 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 protective anti-inflammatory and antioxidant actions as we age.
Several studies have revealed that a Mediterranean-focused nutrition plan aids in weight control during menopause, thereby reducing the risk of obesity and cardiometabolic disease. A study reviewing the value of the Mediterranean diet in reducing hot flashes and night sweats during menopause found a 20% reduction in vasomotor symptoms in women who followed the diet.Β
Many strategies support better compliance with a healthy nutrition plan. One of the simplest to employ is meal planning. Encouraging patients 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 run 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 bodyβs needs.Β Β
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, can reduce symptoms of hot flashes and vaginal dryness in menopausal females. Fermented foods such as yogurt and fermented vegetables provide beneficial probiotics to strengthen gut health and protect from vaginal dysbiosis. The brassica family of vegetables, including broccoli, cauliflower, Brussels sprouts, and cabbage, shift estrogen metabolism to reduce the risk of breast cancer.Β
Lifestyle and Dietary Modifications
As women transition through the 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 oneβs body weight in ounces per day is a reasonable goal for adequate hydration.Β
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 Isnβt Enough
Despite the strong food security present in most homes in the United States, our US adult population is deficient in 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 diseases, which influence biochemistry and the bodyβs 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.Β
Studies have found that supplemental micronutrients help alleviate several menopause symptoms, including hot flashes, night sweats, insomnia, depression, and fatigue.Β 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.Β
- While the decline in hormone production and hormone-related symptoms are most noted, changes in a womanβs body during menopause affect multiple systems that influence many systems, including metabolism, body composition, cardiovascular function, and bone health.Β Β
- 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.Β
- As a womanβs 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 is less likely to struggle with symptoms associated with menopause while reducing her risk of chronic disease as she ages.Β
- Teaching women to adopt a food-first approach to their health encourages them to use food as medicine in their quest to age gracefully, embrace the transition, and feel well in body and mind.
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