By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.
For many women, passage through the pre-menopause and menopause years – starting typically in the forties – can be a rocky road. Most women experience some of the following symptoms to one degree or another: hot flashes, persistent fatigue, vaginal dryness, mood changes, memory slippage, disturbed sleep, low libido, depression, and increased belly fat.
With menopause also comes an increased risk of weaker bones and heart disease.
Behind menopause, and the new risks, is the decline in the protective sex hormones estrogen and progesterone.
To be sure, hormone replacement therapy is a common strategy when symptoms are severe. If you’re looking into taking this route, I recommend that you consult with an anti-aging doctor who uses bio-identical natural hormones instead of the pharmaceutical hormones that have serious health risks. My first recommendation, however, is to pursue lifestyle remedies – such as regular exercise and a menopause-tailored diet – to support your body’s innate capacity to heal and regulate itself.
In my book, The Healing Kitchen, I dedicate a chapter to such a diet and nutritional program. Below you’ll find a dozen basic menopause dietary facts I’ve excerpted from the book, including foods that help and those that don’t.
1. The healthiest diets on the planet, associated with the lowest incidence of chronic illnesses, are traditional Mediterranean and Asian diets. I am enamored of them both so much that I have combined their best features into what I call the Pan-Asian Modified Mediterranean Diet (PAMM). It turns out that these same diets – emphasizing plant-based foods – are associated with the lowest rates of menopause-related problems, much lower in incidence and severity than incurred by women in the United States. Mediterranean and Asian women also experience less breast and other cancers, as well as less osteoporosis.
2. Significant credit for this discrepancy goes to phytoestrogens, that is, plant-based compounds with estrogen-like properties that replace some of the lost estrogen. Such compounds have been found to reduce hot flashes and other symptoms while protecting heart and skeletal integrity.
3. Soy is one such estrogen-like food, and namely tofu, tempeh, soy nuts, miso soup, and soy milk. They all contain isoflavone, a widely researched phytoestrogen. Some 80% of American women experience menopause-related hot flashes, compared to 16 percent of Asian women, who eat some form of soy practically every day. The research indicates that women who have hot flashes, particularly many on a daily basis, can significantly reduce the problem by eating soy.
4. Yams are yummy! Adding them to your diet is a tasty way to help relieve menopausal discomfort. They contain a phytoestrogen called diosgenin.
5. Increase your intake of organic vegetables and fruits. One overlooked reason is that most produce contains the mineral boron that enhances the ability to retain and utilize residual estrogen in the body. Boron also boosts bone health. Produce with boron and phytoestrogens include cabbage, broccoli stems, beets, bell peppers, asparagus, cauliflower, carrots, cucumbers, onion, lettuce, dates, grapes, raisins, nuts, oranges, raspberries, blackberries, strawberries, apples, bananas, tomatoes, and pears. That’s a lot of options – so eat richly with variety!
6. Fatty by-products of hormonal breakdown are also involved in generating menopause symptoms. One way to clear the deck of these menopause mischief makers – literally mop them up − is to eat more whole grains. I like brown rice and oatmeal, however just about every whole grain contains fiber that binds to these fats in the intestines and takes them out through the stool. Whole grains not only contain fiber but also help supply tryptophan, an amino acid that boosts serotonin, a brain chemical that helps you maintain a sunnier mood.
7. Be carb smart. Grains, of course, are carbohydrates. You definitely want to emphasize 100% whole grains – complex carbohydrates − and stay away as much as possible from refined, processed carbohydrates, such as white bread, bagels, pasta, cakes, and cookies made from white flour, wheat flour, and enriched flour – all of which are synonyms for refined flour. And they break down rapidly, causing the glucose (blood sugar) level to rise and the body to overproduce insulin to reduce the level. Over time, the blood sugar roller coaster leads to pre-diabetes, diabetes, and weight gain. It will certainly cause fatigue.
8. Added sugar is a real no-no. Sodas, candy, sugar-laden cookies and cakes can ignite the glucose roller coaster, and cause energy busts, serotonin dips, and mood swings. Be sure to read labels and walk away from anything with added sugar or high-fructose corn syrup. Incorporating more healthy fats like avocado and olive oil into your diet can help keep you satiated and off the wild sugar ride.
9. You don’t have to be a vegetarian for relief from menopause misery, but I do recommend you consume red meat moderately. Shun processed meats entirely (bacon, cold cuts, sausages, canned meats). Eat fish often – at least twice a week – because of the excellent protein and heart-healthy omega-3 fatty acids. Seafood can dramatically reduce the risk of heart disease. My favorites are wild salmon, mackerel, and sardines. Poultry is OK, but look for free-range and organic birds.
10. Maintain a healthy calcium intake to protect your bones because menopause generates bone density loss that leads to osteoporosis. Calcium-rich foods include milk, yogurt (but please, not the junky low-fat versions with added sugars), leafy greens like collards and turnip greens, and tofu. You’ll need a calcium supplement if you can’t get enough in your diet.
11. Go nuts! Nuts are excellent sources of healthy fat, fiber, and magnesium. Research shows that women who snack on nuts daily are more likely to have fewer hot flashes. My preference is raw and unsalted.
12. Flax to the max! Flaxseeds are high in good fatty acids and particularly rich in phytoestrogenic lignans, compounds that help reduce hot flashes. Purchase whole seeds, grind them in your coffee grinder, and blend together with yogurt or sprinkle on fruit cereal.
For more information, practical tips, supplement recommendations, and condition-specific recipes, read The Healing Kitchen.
And if cooking is not your thing, or something you have time for, you might want to consider a customized meal delivery service tailored for menopause symptom management. WeTheTrillions, a health-tech company, offers an easy option to design and deliver customized meals tailored to help pre-menopausal and menopausal women manage symptoms, control their weight, and achieve hormonal balance naturally through delicious, ready-to-eat plant-based meals.
© 2015, 2019 Stephen Sinatra, MD. All rights reserved.