By: Cat Ebeling, RN, MSN-PHN, co-author of the best-sellers: The Fat Burning Kitchen, The Top 101 Foods that Fight Aging & The Diabetes Fix
Let’s address a topic that isn’t discussed out in the open that much. Menopause. Most every woman goes through this at some point, so it’s important to consider that this passage is not a disease or dysfunctional health. It’s NORMAL but the symptoms can vary widely, depending on several factors—many under your control.
In fact, at this very moment, one-third of the women in the United States are going through some stage of menopause—whether its peri-menopause, menopause or post menopause. Menopause has a wide range of symptoms and those symptoms affect every woman differently.
Some of the symptoms—hot flashes, insomnia, brain fog and mood changes can be severe enough to make it difficult to get on with normal day to day living, and while many women are (understandably) desperate for relief, traditional hormone replacement therapy can have some negative effects on long-term health. And—also very frustrating—is that only 1 out of 5 OB/GYN’s actually ever study menopause issues in medical school, leaving you in the dark when it comes to getting some relief!
There are many things you can do naturally to help ease the symptoms and your best bet is to work on diet and lifestyle changes first, then look for other natural options such as supplements and bioidentical hormone therapy.
The most common menopause symptoms that are bothersome include:
• Hot flashes, sweating
• Mood swings
• Anxiety and depression
• Vaginal dryness, pain with sex, and decreased sex drive
• Weight gain, especially around the midsection
• Lethargy and loss of energy
• Dry skin, wrinkles
• Breast changes-larger or smaller
• Higher risk for chronic age-related diseases such as diabetes, heart disease, osteoporosis, arthritis, etc.
Diet, Inflammation and Estrogen
Inflammation can most definitely exacerbate the hormonal symptoms that go along with peri- and menopause—and diet and lifestyle practices can play a huge role in this.
Here is something to consider: Only about 10 percent of women in China, and 20 percent of women in Japan experience hot flashes and the other uncomfortable symptoms of menopause.
Why is that?
While the differences may be due partly to cultural differences, it’s a fact that the majority of Asian women follow very different diet and lifestyle practices than women here in the US, which may be a big part of the reason for the differences in menopause symptoms. Let’s explore some of the reasons for that.
For one thing our Standard American Diet is highly inflammatory. We eat large quantities of meat raised on inflammatory grains, full of pesticides, antibiotics and hormones. Conventional meat is also full of inflammatory omega 6 fats, instead of anti-inflammatory omega 3 fats that are in wild caught fish and grass fed meats. Women on the western side of the globe consume more than twice as much red meat, and four times as much fat (usually in the form of inflammatory omega 6 fats), as women on traditional Asian vegetable, fish and rice based diets.
Most of the meat eaten in this country comes from Concentrated Animal Factory Operations (CAFO’s). The beef, pork and poultry are fed a diet primarily of corn and soy products, creating meat that is high in inflammatory omega 6 fats.
In addition, the feed operations that supply food to our livestock are full of pesticides, and usually genetically modified. Cattle, chicken and pork are given hormones and antibiotics to unnaturally speed up growth. And cows raised for dairy products are pumped full of hormones to create perpetually pregnant or lactating cows.
All of this not only creates higher levels of inflammation in our bodies, but the growth hormone and antibiotics in conventional meat also makes our own hormone go haywire—and that especially affects women in menopause.
Could it Be the Fiber?
Contrast the standard American diet with Asian women eating a traditional diet heavy in vegetables, rice and fish and you will find that only about 10-20% of the Asian women reported menopause symptoms—compared to 80% of American women. As the traditional Asian diet gets replaced with a more Westernized diet heavy in CAFO and processed meats, starchy, sugary foods and processed grain/seed oils, you will find that the incidence of menopause symptoms goes up.
Research is showing that women who eat a high-fat/ low-fiber diet experience higher estrogen levels at all points in their lives. Consequently, as the ovaries slow the production of estrogen, the women on the high fat/low fiber diets have the most dramatic drop in estrogen. Because Asian women eat diets that are far lower in fats and higher in fiber, over the course of their lives, they tend to carry lower amounts of estrogen as well, and they seem to have far less symptoms of estrogen withdrawal because of this.
More evidence of the diet and hormone link comes from a study from the University of California who interviewed Greek and Mayan women about their experiences going through menopause. About three-quarters of the Greek women had hot flashes, but they were considered minor, normal events and did not cause the women to seek medical treatment.
The Mayan women did not even have a word for hot flashes, as they did not normally occur. The Mayan diet of the women in the study consisted of corn, beans, tomatoes, squash, sweet potatoes and a variety of other vegetables, with very little meat or dairy products. In other words, very high in fiber.
The Greek women’s diet contained plenty of vegetables, but also lots of fish, meat and dairy. The difference between Americans and Greeks and other Europeans for whom hot flashes are common, and the Mayans and Asian women on the other hand, for whom hot flashes are rare or unknown, appears to be diet-related. The study’s conclusion was that the higher fiber diets contributed to fewer menopausal symptoms.
What does fiber have to do with estrogen?
Fiber helps regulate and balance estrogen. In one study, researchers found that among 250 women ages 18 to 44, those who reported eating the most fiber had the lowest blood levels of estrogen and other reproductive hormones.
High-fiber diets, they explain, decrease activity in certain intestinal enzymes, leading to less estrogen re-absorption in the colon. Fiber actually causes more estrogen to be excreted from the body in feces. This is a good thing, health-wise. It helps prevent the problems of estrogen dominance which can be detrimental to health.
A low fiber diet actually allows for more re-absorption of estrogen through the digestive system, which is then re-released into the bloodstream. Higher levels of estrogen worsen menopause and peri-menopause symptoms, increase risks of fibroid tumors, but also contribute to higher risks of breast, ovarian and uterine cancers. Higher levels of estrogen also contribute greatly to weight gain.
By contrast, a diet high in processed starches, sugars and unhealthy fats is very low in fiber, AND it also causes weight gain, obesity and inflammation. The more weight gained, the higher the levels of inflammation in the body. It’s a vicious cycle.
Women who consume higher amounts of processed vegetable oils, high sugar/starch diets have the highest levels of inflammatory biomarkers, body weight (BMI) and menopausal symptoms such as hot flashes, night sweats, muscle and joint issues and bladder problems. Women on this type of diet also report far more negative symptoms in the perimenopausal period as well.
Excess fat also produces estrogen, especially as the ovaries slow down during menopause. Higher levels of estrogen indicates a higher than normal risk for postmenopausal breast cancer, according to the Nurses Health Study.
As the drops in estrogen become more dramatic during peri-menopause and menopause, the negative symptoms of menopause become more and more noticeable.
However, this study from Tehran University of Medical Sciences on women, menopause and diet showed that the women who consumed the highest levels of vegetables had the lowest reported menopause symptoms and also lower BMI.
And in one of the biggest studies on diet and menopause, this one-year intervention study of over 17,000 menopausal women, showed that the women who consumed the most vegetables, fruit, fiber and soy experienced an average of 20% reduction in hot flashes compared to the control group. This reduction in hot flahses was attributed to the healthier diet, high levels of antioxidants, plentiful fiber, and weight loss.
In addition to eating more vegetables and (small amounts of) fruit, it is important to include a particular type of vegetables, especially. Cruciferous vegetables. Cruciferous vegetables include broccoli, cauliflower, kale, brussels sprouts, arugula, kohlrabi and cabbage.
One study on cruciferous vegetables showed that increased intake was linked to lower levels of estrone (a more harmful type of estrogen). And this study, it was showed that an increased consumption in the brassica type of vegetables (cruciferous) changed estrogen hormone metabolites to significantly lower the risk of breast cancer in postmenopausal women.
Grain, Inflammation Hormones and Weight Gain
Grain of all kinds—whether ‘whole-grain’ or ground into a processed flour and made into breads, pastas, crackers, pizza crust, etc. is highly inflammatory and high-glycemic as well, meaning it raises blood sugar. In other words, any type of grain will raise blood sugar.
Foods that spike blood sugar are not only physically addictive, but they increase inflammation in the body. Grains also do more than raise blood sugar; they also raise insulin levels, cause problems with thyroid hormones, and interfere with optimal levels of leptin (a hunger/satiety hormone), causing people to overeat.
In addition, menopause itself is somewhat inflammatory, and can be a cause of low-level inflammation and elevated CRP, a primary inflammatory marker that is connected to heart disease and other chronic health issues.
An inflammatory diet that includes grain can make this risk even worse. A high-glycemic diet is also associated with oxidative stress in pre-and post-menopausal women. This study of over 117,000 men and women aged forty to seventy found that higher carbohydrate intake (mainly from white rice and refined wheat products) and dietary glycemic load were associated with an increased risk of heart disease in both women and men.
Grains also contain potentially harmful anti-nutrients, along with gluten, a protein in wheat that causes inflammation and autoimmune reactions. These include agglutinins, which is a type of lectin that is associated with leaky gut, inflammation and overgrowth of bad gut bacteria; phytates, which also cause leaky gut, and block absorption of calcium, iron, magnesium, potassium and zinc; and digestive enzyme inhibitors which contribute to undigested proteins leaking into the blood and overstimulating the immune system.
And–there’s the gluten issue. Gluten is just one of the proteins in wheat that can cause a variety of symptoms including bloating, nausea, diarrhea, and gut inflammation. Even if you are not having a strong reaction to gluten, it can still be triggering reactions and inflammation. Gluten’s ability to create inflammation, weight gain, digestive issues, and mess with hormone levels should not be overlooked.
While many doctors can test for gluten sensitivity, it may not show up—depending on the test. Standard blood tests for gluten sensitivity only have about 15-20% percent accuracy rate. Gluten has to have significantly destroyed the gut wall for the blood testing to be actually be effective. And in many people, gluten damages other tissues in the body.
Current tests only screen for one component of wheat, alpha gliadin. Yet people can react to at least 12 different portions of the wheat protein. What does this have to do with menopause? It seems during perimenopause and menopause, hormone changes, inflammation and long term sensitivity to certain proteins such as gluten, can suddenly rear its head, so on top of the classic symptoms of menopause can come digestive issues, bloating, weight gain, and diarrhea as well.
All this can cause menopause symptoms to drastically intensify, in addition to being linked to an increased risk of osteoporosis, thyroid disease, anemia, and even diabetes. And it’s not just the gluten in wheat that can be a problem, rye, barley and sometimes oats can cause similar reactions. Corn, and even rice can also have a cross-reactivity reaction as well, so truthfully, you are better off avoiding all grains—even the whole grain ones.
It’s a fact that women with un-diagnosed celiac disease and those who are diagnosed celiac or gluten sensitive but don’t follow a strict gluten free diet, will have a much harder time going through perimenopause and menopause. Women who have gluten sensitivity or celiac disease can also enter menopause earlier, have higher than normal occurrence of osteoporosis, and other serious health issues.
While giving up your bread, pasta, pizzas, crackers, and other baked goods may seem like a huge sacrifice, the rewards of your health, well-being, hormone balance and even weight loss should make it all worthwhile. And fortunately, there are some great grain substitutes available now like tortillas made from coconut flour or almond flour, noodles and pasta made from black beans, breads made from almond flour or garbanzo beans and even pizza crust made from cauliflower.
Diet for Easier Menopause
So, what’s the bottom line for a diet to help with menopause symptoms?
1. Keep the fiber high
Eat plenty of organic vegetables and a couple servings of fruit. Try to get in a pound of veggies a day, which isn’t too hard if you throw some greens in with your eggs or smoothie in the morning, eat a big salad for lunch and have a dinner with healthy proteins and a big serving of veggies. This will help fill you up with antioxidants, vitamins, minerals and other phytochemicals—all of which help ease menopause, lower inflammation and help you feel full. Fiber helps to gently lower estrogen levels in the body, and eases the symptoms. This helps with weight loss too! Be sure to include plenty of cruciferous vegetables like cauliflower, cabbage, brussels sprouts, broccoli, arugula, etc. And add in some non-GMO, fermented soy such as tempeh or miso to help further balance hormone levels.
2. Avoid sugars and grains completely—especially from processed foods
Keeping your blood sugar stable helps to balance hormones, calm your nerves, give you more energy, and stop the blood sugar ups and downs which sap your energy. Lower glycemic foods and lower blood sugar levels help you continue to burn fat for energy, keep insulin levels lower which helps fight cancer, helps you lose weight and helps to lower levels of unhealthy estrogens.
Lower blood sugar also goes a long way towards lowering inflammation levels which in turn drastically reduce heart attack, diabetes and cancer risks. Avoiding grains also help your body to better absorb nutrients from foods. You will get all the fiber you need from vegetables. Many studies find that the glycemic load of a postmenopausal woman’s diet is a strong predictor of her fat mass. Keep in mind glycemic load basically means carbohydrates and sugars.
3. Eat healthy proteins, naturally raised
Be sure to get in 50-100 grams of protein per day from natural sources. Natural sources include grass fed meats which are high in omega 3 fats, lower in omega 6 fats and high in conjugated linoleic acid (CLA) which fights cancer, protects the heart and burns fat better. Other natural proteins are pasture raised eggs, also high in omega 3 fatty acids and other valuable nutrients, pastured chicken, and wild caught fish.
Avoid as much as possible any animal products from conventionally raised animals, including dairy, as these foods all contain harmful disrupting hormones, antibiotics, pesticides and unhealthy fats.
What really does seem to work best for menopause is the classic paleolithic diet: naturally raised meats and protein, fruit, nuts, vegetables, eggs, berries, and fish. AVOID grains, most legumes, sugars, dairy, potatoes, and added salt.
Over 24 months, menopausal women on a paleo diet lost more fat, more waist circumference, and lowered their levels of dangerous triglycerides than those on a standard so-called “healthy” diet.
While it may be difficult to stick at first, getting your diet in line, along with a few lifestyle changes like making sure you add in small amounts of exercise daily (outdoors if possible), avoiding smoking, drinking one drink or less per day, and cutting back on caffeine will go a long ways towards easing menopause symptoms. You can take back your life, regain control over your hormones—and your health, lose weight, and start feeling awesome. The next chapter in your life is about to begin!
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