Menopause is the time in a woman’s life when her childbearing years end. It is part of a biological process experienced by all women. During this transition, the ovaries start producing lower levels of natural sex hormones—oestrogen and progesterone. Oestrogen promotes the normal development of a woman’s breasts and uterus, controls the cycle of ovulation (when an ovary releases an egg into a fallopian tube) and affects many aspects of a woman’s physical and emotional health. Progesterone controls menstruation and prepares the lining of the uterus to receive the fertilised egg.

The symptoms of menopause are not an illness, just a natural consequence of aging. All women experience ‘the change’ in different ways. Some will have no symptoms or only mild issues while others will battle a range of annoying alterations in their bodies like hot flashes or mood swings that can negatively affect their daily lives.

Nutritional management

Avoid highly spiced foods: Spicy foods such as hot curry and hot chilly dishes can make hot flushes worse. So go easy on spicy meals.

Heart diseases after menopause: Before the menopause, oestrogen protects women from coronary heart disease, heart attack and stroke. But during the menopausal and postmenopausal stages, oestrogen levels drops, which increases the risk of heart diseases in women. When oestrogen levels decline, levels of LDL cholesterol (harmful / negative kind) increases and levels of HDL cholesterol (protective / positive kind) decreases, leading to built up of fat and cholesterol in the arteries that contribute to heart attack and stroke. This is why women develop heart disease 10 years later than men, but by age 65, their risk is equal to that of men.

Alfalfa, barley, flax seeds, sesame seeds, sunflower seeds, pumpkin, apples, pomegranate, carrots, plums, cucumber, peas, garlic, soybean sprouts are sources of Plant Oestrogen. Avoid foods high in saturated fat and trans fat. Saturated Fat is found mostly in foods from animals and some plants. Foods from animals include beef, beef fat, lamb, pork, lard, poultry fat, butter, cream, milk, cheeses and other dairy products made from whole and 2% milk. Foods from plants that contain saturated fat include coconut, coconut oil, palm oil, palm kernel oil (often called tropical oils) and cocoa butter. During food processing, fats may undergo a chemical process called hydrogenation. Trans Fatty Acids are formed during this process. Cookies, biscuits, margarine, cakes, French fries, donuts are examples of foods high in trans fats.

Alcohol: Heavy drinking is defined as consuming more than 1 glass of wine, 12 oz. of beer, or 1.5 oz. of liquor daily. Heavy drinking can trigger some symptoms of menopause like hot flashes and increased sleep disruptions. Instead, drink diluted fruit juices, calcium fortified juices, vegetable juices, fat-free milk or calcium-fortified soymilk and herbal teas like ginger tea or green tea.

Caffeine: This stimulant in coffee and tea can modestly increase calcium excretion and reduce absorption. Moderate caffeine consumption like 1 cup of coffee or 2 cups of tea per day has no negative effects on bones.

Minerals

Sodium: Salty or high sodium foods are not recommended in a healthy menopause eating plan, so restrict your intake of foods like processed frozen entrees and processed cold cuts, canned soups, regular stock or bouillon, foods canned in salted water, salted nuts, ketchups and packaged sauces. Ginger, garlic, basil or fresh herbs can be used to enhance the flavour of food in the same way as salt.

Calcium: Menopause leads to bone loss because decrease in oestrogen production decreases calcium absorption and increases the loss of calcium from bones. On average, only 15-20% of calcium you eat is absorbed and this decreases with age. This explains the higher recommended calcium intakes for ages ≥51 years especially for menopausal women. Therefore, diet rich in calcium is very important for menopause women. Increased calcium intakes during menopause do not completely offset this bone loss. Hence, it is a good idea to exercise on a regular basis, especially weight bearing exercises such as walking, jogging, hiking, dancing, step aerobics, tennis, basket ball, and stair climbing as this encourages dietary calcium to enter the bone and helps maintain the strength of bones.
Food sources: Emphasize on a variety of low fat milk and milk products, baked beans, tofu, sardine, shrimps and salmon.

Phosphorus: Helps in prevention of osteoporosis.
Food sources: Milk and milk products, except their fatty parts such as cream, butter and ghee, carrot, cauliflower, corn, peas, potato, banana, pumpkin seeds, fish, and eggs.

Magnesium: It is used by the body to help maintain muscles (magnesium glycinate acts as muscle relaxant), nerves and bones. It helps combat menopause-associated conditions like osteoporosis, fatigue, coronary artery disease, anxiety and depression.
Food sources: Food sources high in calcium also contain magnesium, pulses, figs, lemon, grapefruit, corn, almonds, soybeans, dark green vegetables, and shell fish.

Potassium: Essential for maintaining the acid-base balance of the body. Used together with magnesium, it has been found to relieve menopausal fatigue.
Food sources: Potatoes, whole-wheat products.

Selenium: Helps combat fibrocystic disease of breast cancer.
Food sources: Brazil nuts, wheat germ, tuna, tomatoes and broccoli.

Manganese: Helps combat arteriosclerosis (hardening of arteries) in later life.
Food sources: Wheat bran, nuts.

Zinc: Helps combat osteoporosis in later life.
Food sources: Lean steak, pork, wheat germ, pumpkin seeds, and eggs.

Vitamins

Vitamin A: Low levels of vitamin A contribute to heavy menstrual bleeding, possibly cervical cancer and age-related skin conditions like leucopoenia.
Food sources: Carrots, spinach, turnips, apricots, liver, melon and sweet potato.

Vitamin B complex: Several B vitamins are beneficial during menopause. VtaminB6 supplementation is typically important for patients on Hormone Replacement Therapy (HRT). Folic acid may help prevent precancerous changes in the cervix. Low levels of vitamin B complex can lead to emotional stress, fatigue and depression.
Foods sources: Folic acid is found in green leafy vegetables, nuts, peas, beans, liver and kidney. Vitamin B3 is found in poultry, fish, beans, and whole wheat bread. Vitamin B6 is found in poultry, fish, bananas, whole grain cereals and dairy products. Vitamin B12 is found in fish, poultry, eggs, milk, B12 fortified foods.

Vitamin C: This is the healing vitamin and very helpful during menopause. Since the need for collagen (fibrous protein in the bone) regeneration increases with age, so does the need for Vitamin C. It also helps the adrenal gland and the body’s immune system, which needs more help as women enters menopause.
Foods sources: Fortified breakfast cereals, citrus fruits (orange, lemon), amla, guava, mango, black currants, broccoli, sprouts, Kale, peppers.

Vitamin D: It is important in the prevention of osteoporosis. It is also needed for the proper absorption of calcium and phosphorus - responsible for healthy bones and teeth.
Food sources: Cod liver oil, oily fish, milk, breakfast cereals and egg.

Vitamin E: Some times it is called the ‘menopausal vitamin’ because it may have chemical activities similar to oestrogen. Vitamin E has been used with some success as an oestrogen substitute. Vitamin E may relieve hot flashes as well as psychological symptoms of menopause. It is also a powerful antioxidant that helps keep cells disease free.
Food sources: Wheat germ oil, sunflower oil, corn oil, almonds, hazelnut, eggs, green leafy vegetables, cereals, and dried beans.

Bioflavonoid: Taken together with vitamin E, this is one of the most important nutrients for menopausal women. It produces chemical activity similar to that of oestrogen and can be used as an effective substitute known to control hot flushes. It also offers relief from menopause-related symptoms such as irritability and mood swings.
Food sources: All citrus fruits

Menopause is a time in a woman’s life, which needs special dietary and supplemental attention so that you can ensure the very best quality of life.

Pic: Wong Mei Teng