While nutritional problems of women in the reproductive age have attracted considerable attention, the subject of nutrition in menopause has evoked little interest. Menopause is a natural phase in a woman’s life and it is at this stage that a woman’s menstrual period permanently ends and therefore she is no longer fertile.
Although the age of onset of menopause is different for each woman, it normally occurs any time from the ages of 40 to 49 years and is a process that can take a number of years. Menopause is divided into three phases:
Pre-menopause phase during which the ovarian function is disrupted, but the menstrual cycle remains regular. Some symptoms may begin to occur in this phase.
Peri-menopause phase which is characterised by declining ovarian function along with menstrual irregularities. Symptoms commonly start and become troublesome during this phase. Post-menopause phase where there has been no menses for 12 months.
Menopause sets in a rollercoaster of physiological changes that alters the body’s equilibrium resulting in unpleasant, but not life-threatening symptoms. These symptoms vary from woman to woman and may be gradual or sudden, mild or severe. Common symptoms at the onset of menopause include irregular periods, hot flushes, night sweats, decreased libido, palpitations, vaginal dryness or itching, headaches, dizziness, itching sensation on the skin, dry hair, muscular and joint pain along with emotional changes such as mood swings, anxiety, irritability, tiredness, lack of concentration and crying spells.
Oestrogen, the female sex hormone which regulates reproduction, affects bones and ligaments, body temperature and even moods. Before menopause, oestrogen naturally protects a woman from cardiovascular disease, diabetes, osteoporosis, memory problems and breast cancer. At menopause, the levels of oestrogen drop to around 40 per cent of the levels produced during a woman’s reproductive life. It is therefore very important that a woman understands that once she reaches menopause, her vulnerability to developing degenerative disorders like heart disease, osteoporosis (bone loss), memory problems and breast cancer increases.
The most noticeable change observed by most women nearing or entering menopause is weight gain possibly due, in part, to declining levels of oestrogen.
Oestrogen deficiency leads to deposition of fat in the abdomen leading to abdominal obesity, which is a risk factor for diabetes, hypertension and cardiovascular diseases. Reduced physical activity and lowered basal metabolic rate also contributes to weight gain during these years.
During this phase it is very important to eat a balanced diet as many of the critical changes such as weight gain and osteoporosis can be managed by a healthy diet. Eating healthy also helps minimise most of the unpleasant symptoms.
Food selection should include whole grain cereals, legumes, pulses, sprouts, vegetables, fruits, dry fruits and protein foods along with small amounts of added sugars, salt and oils.
Excessive intake of carbohydrate rich foods should be avoided as they cause elevated insulin levels, which can exacerbate menopausal symptoms such as hot flushes, palpitations, anxiety and depression.
Since menopause increases a woman’s risk of developing heart disease, it is wise to reduce the intake of saturated and trans fats in the diet. Remove all visible fat from red meats and the skin of chicken. Consume red meats as a garnish to a vegetarian dish rather than as a main ingredient. Skim off the fat layer that has formed on top from meat or chicken stocks, soups and stews by refrigerating them for a few hours. Use low fat or toned milk.
Bakery goods like pattices, khari biscuits, cheese straws, pastries, cookies, etc, premixed, ready-to-eat fast foods and other processed foods that are prepared using vanaspati or partially hydrogenated vegetable oils or margarine and foods that are deep fried in oils that have been repeatedly re-heated are rich in trans fats and need to be eaten sparingly. Have a fistful of roasted nuts instead to obtain heart friendly fats.
Meet your fatty acid requirement by following the traditional method of using a specific fat or oil for a specific recipe and make your meals lower in calories by learning how to cook food with less oil by using cooking methods such as steaming, baking, poaching, grilling or stewing instead of frying.
Fish is an ideal source of protein for menopausal women as it contains omega-3 fatty acids that are cardio-protective and also reduce vaginal dryness and hot flushes. Eat fish at least thrice a week.
Eggs, including the yolk are very nutritious and provide proteins, vitamins and minerals. Studies have shown that breakfasts that include eggs provide greater satiety and keeps one full for longer by reducing mid morning hunger pangs.
To be continued. . .
(The writer is a consultant nutritionist with 17 years of experience, practising at Panaji and can be contacted on email@example.com)