Hot flushes may be helped by reducing consumption of caffeine, alcohol and spicy food, but there is considerable variation between individuals. Additionally, limiting alcohol has other health benefits, such as a lower risk of heart disease, liver disease, osteoporosis, type 2 diabetes, and certain types of cancer such as breast cancer. Therefore, it is advisable to stay within the recommended alcohol limits of a total of 14 units per week (2 units per day- a medium glass of wine, a can of beer or a pint of low strength beer).
Bone health after the menopause
Oestrogen plays an important role in bone health, and declining levels lead to softer bones (osteoporosis), which can cause low energy fractures. A 50 year old woman only has a 2% risk of osteoporosis, compared with a 25% risk in an 80 year old woman, due to considerably lower levels of oestrogen. Diet can play an important role in bone health:
• Protein: Include lean protein foods at every meal such as dairy, meat, poultry, seafood, beans and legumes.
• Calcium: is an important mineral for bone health, and as an adult you need to take between 700-1000mg per day, which is about: two slices of wholemeal bread / one portion of spring greens / a portion of broccoli / 200mls of dairy milk or fortified plant based milk / half a tin of tinned fish / a yogurt. If you are unable to have enough in your diet, you might be prescribed a supplement.
• Vitamin D: is produced by the action of sunlight on our skin during exposure outside. However current NHS guidance is for women to consider taking a supplement of 10mcg (400IU) during the autumn and winter months as it can be difficult to produce enough. Vitamin D is found in food like egg yolks, oily fish and some fortified foods, but at low levels, so it is difficult to get all of the Vitamin D you need from diet alone.
• Vitamin K: is a micronutrient that has an important role in bone strength. The term vitamin K, covers a number of different molecules, and these are found in green vegetables, fermented food, dairy, and meat. You need to eat a range of these items to ensure you get all the different elements that make up Vitamin K. There is mixed evidence as to whether Vitamin K supplementation improves bone strength and reduces fractures (16), but enough for a number of countries like Japan, to now include Vitamin K supplementation as treatment for osteoporosis. It is possible to have too much through supplements, and we don’t know what these effects might be, so do avoid taking Vitamin K supplements if you are on blood thinning medication.
• Phosphorus: is important and usually abundant in our diet, found in foods such as poultry, meat, dairy, oily fish, potatoes, wholegrains, pulses and beans.
• Magnesium: again is usually abundant in our diet but good sources include wholegrains, spinach, pumpkin seeds, almonds and beans.
• Resistance exercise: is very important for bone strength, and the NHS advise that adults over the age of 35 years, undertake 30 minutes of this type of exercise at least twice per week. Examples include brisk walking, yoga, squats, weight training, resistance bands, Pilates, and gardening
Cardiovascular Disease (CVD)
After the menopause, the risk of cardiovascular disease increases. This is partly related to the aging process, and also the effects of declining oestrogen. Cardiovascular disease is a general term used for conditions affecting blood vessels and the heart by narrowing of the arteries (atherosclerosis) and an increased risk of blood clots. Additionally, weight gain associated with aging and also declining oestrogen levels, leads to an increased risk of obesity, type 2 diabetes, higher blood pressure, and higher (LDL) cholesterol levels; these are all well recognised as factors for CVD. To try reduce your risk, evidence suggests a diet with the following principles:
• Reduce the fat in your diet
• Include more olive oil, rapeseed oil, avocado, seeds, nuts
• Eat at least 5 portions of fruit and vegetables a day- fresh, frozen, tinned or dried.
• Replace refined carbohydrates (white bread, white rice) with whole grains (brown rice, brown bread, millet, bulgur wheat).
• Make Friday and Tuesday ‘fish’ night, where you and the family can enjoy a meal with oily fish. Or make yourself a big salad with mackerel. You can used tinned, smoked or some fresh from your fishmongers.
• Have at least 4 portions of unsalted nuts, seeds and legumes (like beans, lentils and chickpeas) each week- dried or tinned are all good.
• Try reduce the amount of processed products as they have high amounts of sugar and salt. And remove hidden sources of sugar, the NHS has a list to help you know where there might be hidden sugars in your food
• Choose wholegrain carbohydrates such as root veg like parsnips, butternut squash, swede, and wholegrain rice and bread
• Try to keep alcohol consumption to 14 units or less of alcohol per week (maximum of 2-3 units per day) for women- A medium glass of wine is 2 units, and a large glass 2 units. A pint of medium strength beer or lager is 2 units, and a stronger lager 3.