Peri and Post-Menopausal Nutrition: What You Need to Know
Women 40 (sometimes mid-30s) and older face multiple challenges with nutrition and health. Undesirable weight gain, the loss of lean body mass, bone health concerns, and other issues that occur during the years leading to menopause and beyond can be very frustrating. While estrogen therapy has been proven to help with some of these age-related changes, it is no longer a standard of care for all women, due to other potential undesirable outcomes including increased breast cancer risk. Working with a dietitian to establish a personalized approach during this stage of life can empower women to remain healthy and strong throughout these changes.
As estrogen levels begin to decline during peri-menopause (when a woman’s body makes its natural transition to menopause, usually in the mid-40s), fat is metabolized differently, which can lead to weight gain. Menopause occurs about one year after the last period, typically in the early 50s.
Research shows that hormonal changes are responsible for the increase in visceral body fat, which places women at increased risk for cardiovascular disease and Type 2 Diabetes. Additionally, overall weight gain that occurs with age (about 1 lb per year) is mostly due to the effects of aging, including decreased activity and a loss of lean body mass, which is more metabolically active than fat.
While physical activity helps maintain and build muscle, women in midlife should include protein during meals to promote muscle-protein synthesis, which is essential to the body’s continuous growth, repair, and maintenance of skeletal muscle. In addition to eating sufficient protein and balancing intake across the day, eating the right amount and type of carbohydrate can help cut calories and control blood sugar.
The depletion of bone density often occurs after menopause, when the ovaries stop producing estrogen. Women can lose as much as 20% of their bone density five to seven years after menopause. Research suggests that it is important for women to enter menopause with sufficient bone density to minimize further losses.
A family history of osteoporosis is a risk factor for all women. Other lifestyle factors that can negatively affect bone health include a low body mass index, a suboptimal intake of Calcium and Vitamin D, smoking and excessive alcohol consumption. Certain drugs can also result in a depletion of bone density, including proton pump inhibitors used for reflux and serotonin uptake inhibitors often used to treat anxiety. Diabetes can also increase osteoporosis risk because bone turnover is slowed down in the presence of diabetes.
A dietary approach to consuming adequate Calcium and Vitamin D takes priority over supplementation, although supplementation may eventually be inevitable. Working with a dietitian will help you establish appropriate goals based on your individual circumstances.
Hot Flashes and Sleep Disturbances
Women in midlife can experience disrupted sleep patterns as they transition to menopause. According to the National Sleep Foundation, up to 61% of postmenopausal women report symptoms of insomnia, which includes trouble falling or staying asleep for three or more nights per week for one month.
The decline in estrogen and progesterone, which leads to hot flashes in about 75% to 85% of women, contributes to insomnia. Hot flashes can disrupt sleep as body temperature rises, leading to night sweats and wakefulness. Most women experience hot flashes for about one year, but some experience them for up to five years.
Sleep loss interrupts appetite regulation by increasing levels of the hunger hormone ghrelin and decreasing the satiety hormone leptin, which can raise the risk of weight gain. Working with a dietitian to address dietary factors that can interfere with sleep, such as caffeine and/or alcohol consumption too close to bedtime can be beneficial as part of a comprehensive nutrition plan to minimize the adverse effects of sleep disturbance.
If you can relate to any of the challenges described above, schedule an appointment with our dietitian, Allyson Balzuweit. A detailed analysis of your unique circumstances including health history, lab results, lifestyle, and food preferences combined with a personalized plan will ultimately yield results that will improve your health. Check out our website to learn more about the services that Allyson offers www.functionizethealth.com or email Allyson at firstname.lastname@example.org.