Nutrition Needs for Menopause

As Registered Dietitians (RDs) we often discuss how nutrition recommendations are individualized to each person. Nutrition guidelines for a 17 year old male athlete aren’t going to be the same as a 55 year old woman who has reached menopause. As we go through our life cycle, it’s essential to check in with nutrition recommendations that are best suited to our specific demographic.

The same is true for physical activity, especially for women navigating menopause (for more specifics on the different stages of menopause and hormone fluctuation, see Menopause & Activity). But it’s most helpful to change our nutrition in line with adapting our physical activity throughout our lives. 

There are changes in menopause that impact our health. Hormonal fluctuations can impact cardiovascular health, metabolism, bone health, and lean muscle mass. One of the many changes mentioned is cardiovascular, as estrogen is protective of cardiovascular health. The decline in estrogen has been linked to changes in vascular function and inflammation. This increases the risk of cardiovascular diseases during the menopausal transition. This is why the risk factor for cardiovascular disease is significantly higher in women than men, which makes the incorporation of appropriate exercise even more impactful to the health of women.  On the neuromuscular side, hormonal fluctuations experienced during menopause can cause disruptions in this system affecting the proper functioning of muscles, tendons, and ligaments. This can worsen age related musculoskeletal conditions such as sarcopenia and osteoporosis. Sarcopenia is age-related loss of muscle mass, strength, and muscle function.  Due to this, there are several things nutritionally we can do to be preventive and protective of these changes: 

1. Increase Protein Intake:

• Did you know, as we age our lean body mass declines? This is especially true for women, as it can start as early as our third decade of life. Having adequate protein intake going into menopause can help preserve this lean body mass, and protect our metabolism from causing significant changes. 
• Sources:
  • Animal sources: Beef, poultry, fish, pork, eggs, dairy products, whey or collagen protein powders
    1. Animal proteins are more digestible and bioavailable than most sources of plant protein, due to being a complete protein. This means they contain all the essential amino acids that are needed for your body.
  • Plant sources: tofu, nuts, beans, legumes, quinoa, plant based protein powders (normally have pea protein + brown rice protein)
    1. Plant proteins, while less digestible and bioavailable than animal proteins, are still extremely important! Many of them contain fiber, which can aid in proper digestion. 
• Tips to increase intake:
  • Consider starting your day with a higher protein breakfast! Make an egg frittata or breakfast veggie egg hash ahead of time and reheat the morning of! 
  • Add cottage cheese to your next egg scramble, dip, or have on its own with fruit! You can put it in the food processor to create a smoother texture. 
  • Meal prep a protein source for the week that can be changed into multiple different meals. For example, make chicken in the crockpot, then put it over a salad one day and into a wrap the next! 

2. Include Heart Healthy Fats:
   • Due to shifts in hormones, women are more at risk for cardiovascular disease. Having adequate intake of unsaturated fats can be protective of our heart health.  They are also essential to help absorb fat soluble vitamins, such as vitamin D. 
   • Sources:
     • Fatty fish:  salmon, sardines, mackerel, herring 
     • Nuts/nut butters: walnuts, almonds, pecans
     • Seeds: flax seed, chia seeds, pumpkin seeds (pepitas), sunflower seeds
     • Avocado
     • Oils: avocado oil, olive oil, flaxseed oil
   • Tips to increase intake:
     • Add some avocado to your favorite breakfast sandwich or on top of chili for some creaminess.
     • Make a chia pudding for a dessert! Add in citrus and coconut for a tropical twist!  
     • Consider having salmon for breakfast! It goes great with eggs and capers.
3. Check in on Calcium:
   • Did you know that due to the loss of estrogen during menopause, bone loss is more likely to occur? This makes the intake of calcium and vitamin D essential for preservation. Calcium is actively absorbed from the small intestine in the presence of vitamin D. A recent meta-analysis found that vitamin D supplementation significantly reduces the risk of hip fractures (by 18%) and other nonvertebral fractures (by 12%) when taken together with calcium. This further proves how the combination of vitamin D and calcium can be beneficial for us as we age. 
   • Sources:
     • Calcium
       1. Dairy products such as milk, yogurt, cheese
       2. Leafy greens
       3. Plant-based milks such as almond, soy, tofu, fortified
       4. Sardines, salmon with bones
     • Vitamin D:
       1. Milk, fortified
       2. Almond milk, fortified
       3. Mushrooms
       4. Yogurt
       5. Kefir
       6. Fish – Salmon, tuna, sardines
   • Tips to increase intake:
     • Have sauteed kale or spinach in a frittata, or on the side of your protein at dinner. Add a sprinkle of parmesan cheese!
     • Add a dollop of Greek yogurt to your tacos or chili.
     • Add a leafy green to a morning smoothie for a boost!
     • Make a cool salmon salad for your next lunch prep.  

4. Feel good about fiber:
   • Not only does fiber help with digestive health that can be altered as we age, but it can help us feel more satisfied at meals and aid in feeling fuller longer. There are two types of fiber, soluble and insoluble. Soluble fiber is a type of fiber that absorbs water, forming a gel in the digestive tract and making stools easier to pass.  Insoluble fiber bulks up the stool and makes it softer and easier to pass. The combination of these two types of fiber contribute to regular bowel movements and satiety.
   • Fiber also can aid in improving cholesterol levels. Fiber binds to the cholesterol in our digestive system, and prevents it from being absorbed into the bloodstream, lowering cholesterol levels. This can be helpful for cardiovascular health! 
   • Sources:
     • Beans and legumes
     • Whole grains
     • Produce with skin on and seeds in where appropriate
     • Nuts and seeds
   • Tips to increase intake:
     • Try sprinkling chia seeds onto a yogurt parfait, or with your oatmeal. It’s an easy staple to have on hand in your fridge that needs no prep!
     • Prep a fruit salad for the week to have a consistent high fiber side to your lunch or as a snack!
     • Create your own high fiber trail mix, which includes your favorite nut, seed, and whole grain snack (ex: whole grain pretzels, popcorn, etc.)
5. Ensure Adequacy with Water:
   • Did you know hot flashes make you more at risk for dehydration? Having adequate water intake can help regulate body temperature, support your digestion as you increase fiber intake, and reduce day to day bloating.
   • Sources:
     • Sparkling waters/beverages
     • Coffee
     • Tea
     • Protein shakes
     • Smoothies
   • Tips to increase intake:
     • Consider having a water bottle or glass next to you at all times. If it’s always there, you’re more likely to drink it!
     • Experiment with different fruit infusions (see examples How to Drink More Water) from whole fruits, think of what seasonal produce is available for guidance. 

Always be sure to check with your RD for further specific recommendations and nutrition guidance!

Sources:

• https://www.eatingwell.com/article/7962360/what-is-the-difference-between-insoluble-and-soluble-fiber-according-to-a-dietitian/
• NASM Women’s Health Fitness Specialization Curriculum.
• Pataky MW, Young WF, Nair KS. Hormonal and Metabolic Changes of Aging and the Influence of Lifestyle Modifications. Mayo Clin Proc. 2021 Mar;96(3):788-814. doi: 10.1016/j.mayocp.2020.07.033. PMID: 33673927; PMCID: PMC8020896.
• Berrazaga I, Micard V, Gueugneau M, Walrand S. The Role of the Anabolic Properties of Plant- versus Animal-Based Protein Sources in Supporting Muscle Mass Maintenance: A Critical Review. Nutrients. 2019 Aug 7;11(8):1825. doi: 10.3390/nu11081825. PMID: 31394788; PMCID: PMC6723444.
• Khazai N, Judd SE, Tangpricha V. Calcium and vitamin D: skeletal and extraskeletal health. Curr Rheumatol Rep. 2008 Apr;10(2):110-7. doi: 10.1007/s11926-008-0020-y. PMID: 18460265; PMCID: PMC2669834.
• https://www.dietaryguidelines.gov/resources/2020-2025-dietary-guidelines-online-materials/food-sources-select-nutrients/food-sources-vitamin-d