The theme of this year’s World Menopause Day on 18th October is cardiovascular disease (CVD), the aim being to highlight that menopause can increase a woman’s potential risk of CVD, including heart attacks, heart failure, stroke and coronary artery disease.
The menopause is a natural transition period that over half the UK population will go through, with approximately 13 million women in the UK currently at the perimenopause or menopause stage of life. CVD is responsible for 35% of women’s deaths each year, with a staggering 13 times as many women dying of CVD than of breast cancer. The complex hormonal changes that occur during the menopause process – levels of oestrogen, progesterone and testosterone all drop dramatically - can result in increased cardiovascular risks in the form of high blood pressure and increased cholesterol.
Oestrogen in particular has a protective effect on the heart, reducing the risk of fat building up in the arteries, keeping blood vessels healthy and helping to control cholesterol levels. When oestrogen levels decrease exponentially during menopause, fat can build up resulting in arteries becoming narrower and heightening the risk of heart disease, heart attack and stroke.
One of the most important things that you can do to mitigate the risk of coronary heart disease is to make healthier lifestyle choices like upping your exercise, cutting down on alcohol, cutting out tobacco, maintaining a healthy weight and eating a balanced diet. Even small steps can all add up and make a big difference towards alleviating menopause symptoms and maintaining a healthy heart.
Here’s what you need to know about eating for a healthy heart during and post menopause…
It’s a fact of life that your 50-year-old self is not going to look the same as your 20-year-old self! Many women cite weight gain as something they experience throughout the menopause process, although there are other factors contributing to this. As we age, we generally tend to become less physically active and the metabolism naturally slows down, leading to a reduction in muscle mass and an increase in body fat.
Menopausal weight gain is linked to the natural decline in oestrogen levels, one of the main female sex hormones. Oestrogen enhances the body’s fat-storing ability, especially around the hips and thighs, hence why many women tend to have more of an hour-glass figure in their younger years as opposed to in middle age. Declining levels of oestrogen trigger the body to start shifting fat from around the hips and thighs, where it is stored as subcutaneous fat just under the skin, to around the belly, where it is stored as deep visceral fat around the organs.
Menopause symptoms can lead to making poor food choices and emotional binge eating. This in turn can make it difficult to find the enthusiasm to exercise, another contributing factor to weight gain. Furthermore, the body releases the steroid hormone cortisol to deal with stressful situations, so if a woman experiences menopause related stress and anxiety, cortisol can cause extra calories to remain around the belly.
Insufficient or irregular sleep can also be a contributory factor, as sleep and blood sugar levels are interlinked. Blood sugar levels increase while we are asleep as part of our circadian rhythm – poor quality sleep causes spikes and dips in these levels which increases the likelihood of us eating more throughout the day and in turn, more weight gain.
Making Better Food Choices
A healthy, balanced diet is key to maintaining a healthy heart and circulation system and it’s important to find something that works for you and that you can stick to. As a general rule your diet should include a wide variety of unprocessed and fresh foods, at least five portions of fruit and vegetables, lean protein in the form of chicken, turkey, fish, beans and legumes, whole grains, nuts, complex carbohydrates, nutrient dense foods and healthy fats that contain Omega 3 such as olive oil and avocado.
Calcium-rich foods are ultra-important for maintaining bone health. Oestrogen plays a role in supporting bone density, so as levels decline during the menopause, women can be more prone to osteoporosis and fractures. Dairy products are also excellent sources of vitamin D and magnesium, both of which promote bone strength.
Soy products, including soybeans, tofu, tempeh and edamame, contain a high concentration of phytoestrogen, a plant oestrogen that is similar in function to human oestrogen albeit much weaker, and can help alleviate hot flashes and night sweats.
As oestrogen decreases so does muscle mass, resulting in the body having less capacity to store glucose and therefore more likely to store carbs and sugar as fat. Protein supports muscle health, metabolism, and hormone production, so upping your lean protein intake ticks a lot of boxes when it comes to menopause symptoms. UK guidelines recommend at least 1 gram of protein per kilogram of body weight every day, ideally split over meals and including sources such as a breast of chicken, 3 eggs, 3 tablespoons of hummus, a small tin of baked beans or a fillet of oily fish like salmon, tuna or mackerel.
Try to cut down on salt, excess sugar, fatty foods, refined carbohydrates, processed meat, fizzy drinks and fruit juice. Caffeine and alcohol, which often contains additional sugar and empty calories, can exacerbate symptoms like hot flushes as well as having a detrimental effect on sleep quality, so it’s a good idea to limit these as well. Make sure you drink lots and lots of water throughout the day to stay hydrated.
Some healthy food swaps to try
· Going veggie a couple of times a week and missing out meat completely can help lower blood pressure, improve cholesterol levels and reduce the risk of type 2 diabetes and heart disease. Try making a spinach and courgette lasagna, spaghetti with a lentil ragout instead of bolognese, falafel burgers or a Moroccan sweet potato, apricot and chickpea tagine – so tasty, you won’t even miss the meat
· If you don’t fancy eating completely vegetarian, try swapping out some of the meat content in your recipes for pulses. Make a chilli with half mince and half kidney beans, a chicken curry with half chickpeas or a cottage pie with half lentils for tasty alternatives to family favourites
· Opt for white or oily fish instead of meat. White fish is a low-fat source of protein and vitamin B6 which helps fight inflammation, as well as being low in LDL cholesterol. Oily fish like salmon and mackerel contains long-chain omega-3 fatty acids which can help to prevent heart disease
· Swap white bread for wholemeal which contains more nutrients and is harder to digest, meaning that it keeps you feeling fuller for longer
· Replace white pasta and rice with wholewheat varieties – eating wholegrains, which have had very little removed in the processing, instead of refined grains is a great way to get more fibre into your diet
· Mix root veg like sweet potato, turnip, carrot or beets in with potatoes for a delicious mash that’s lower in calories and packed with fibre, antioxidants carotenoids and vitamins
· Sweeten cereal with your favourite fruit rather than sugar. Bananas are an excellent source of potassium, which helps maintain a healthy heart and blood pressure, whilst berries can help lower cholesterol and improve artery function
· Ordering a skinny cappuccino or latte instead of a full-fat version will save you around 90 calories a time. Try gradually reducing the sugar in all of your hot drinks until you can cut it out altogether. Green tea with lemon is a fantastic, healthy heart alternative to a milky brew and rich in immunity-boosting antioxidants
Intermittent Fasting
Intermittent fasting – essentially not eating for a specific period of time – can be a useful tool, helping to reduce overall calorie intake and therefore managing menopausal weight gain and potentially lowering the risk of chronic heart disease. The theory behind it is that if you don’t eat for 10-16 hours, the body performs natural cleansing processes, begins to repair itself, releases ketones into the bloodstream and looks to stored fat for energy.
There are several options here, including overnight fasting, time-restricted eating, the 5:2 method and alternate day fasting – and it’s all about finding the best one for you. Overnight fasting, which quite simply involves not eating for 12 hours, is probably the easiest to follow – by not eating between 8pm and 8am, for instance, you will have fasted for 12 hours, probably with fairly minimal effort as it’s likely you’ll have been in bed for a good portion of that time.
The other popular fasting method that’s pretty easy to follow is time-restricted eating, where you confine your calorie consumption to a set time window. 16:8 fasting, for example, involves eating between 9-5pm or 12-8pm and fasting for the remaining 16 hours. Make sure you drink plenty of water, outside of your designated eating window to stay hydrated. You can also have non-calorific drinks like herbal infusions, tea and coffee.
Best supplements for menopause
Taken in combination with a healthy, balanced diet, menopause supplements can provide much-needed additional nutritional support during this life stage.
· Vitamin D – key for bone health, immune function and mood regulation
· B Vitamins – B6, B9 (folate) and B12 are important for energy production, mood regulation and cognitive function. Correct dosage can reduce the cognitive decline through the menopause and even decrease the risk of dementia
· Calcium – essential for maintaining bone density and preventing fractures. Oestrogen plays a significant role in calcium absorption, so its decline during menopause can lead to a higher risk of osteoporosis
· Zinc – plays a crucial role in various bodily functions including hormone regulation, immune system function and cell growth. Zinc supplements can help alleviate menopausal symptoms such as hot flashes, night sweats, and mood swings
· Magnesium – plays a role including in muscle and nerve function, blood sugar regulation, bone formation and mental health. Magnesium is beneficial in promoting heart health, reducing blood pressure, lowering the risk of diabetes and combating osteoporosis
· Omega 3s – these fatty acids are important for heart, brain and eye health, as well as being involved in the function of the immune system and a potent anti-inflammatory
· Vitamin C – Vitamin C is important for maintaining bone density and helping to protect against fractures and osteoporosis. Its antioxidant effect may also help reduce the risk of heart disease which is more common after menopause, as well as helping to ease hot flushes
Sally-Ann Turner, MD and Founder of Bodyline Medical Wellness Clinics, has this to say:
“Ensuring optimal health and wellbeing through the menopause life really is key, especially with regards to heart health. Small changes to your diet can go a long way to not only managing your menopause symptoms, but also reducing the risk of cardiovascular disease. By starting now and setting yourself achievable goals, you should quickly start to notice the benefits – you’ll feel healthier and stronger, as well as having more energy and sleeping better.
“Long term, you’ll be helping to reduce your risk of heart disease, high blood pressure, high cholesterol and type 2 diabetes as well as maintaining a healthy weight. Gradual changes are much more likely to result in a positive and permanent change.”
