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Introduction

Most women notice a change in their metabolism as they get older. The dietary needs of menopausal women are different than for women who are younger. Attention needs to be paid both to calories and developing habits for heart and bone health. Dr. Lisa Parviskhan of Paoli Hospital summarizes the "how to's" of healthy eating and exercise.

Quick Tips

• Don't skip meals. In fact have several smaller but more frequent meals. Lower blood sugar levels have been found to increase some menopausal symptoms; therefore by eating more frequently women can avoid these drops in sugar level and actually feel better.

• Avoid snacking. Women often realize that they can eat less and still gain weight. Therefore, decreasing snacks is a good idea.

• Eat foods that are as unprocessed as possible. The more processed or refined a food is the fewer nutrients it will contain.

• Eat lots of fruits, veggies and whole grains. These foods contain much needed vitamins and minerals and also are a great source of fiber. Fiber can reduce the risk for colon cancer and can also help decrease constipation by increasing bowel motility. You should try to have 20-30 grams of fiber per day.

• Eat your smallest meal at night. Metabolism is slower at night so try not to eat after 8pm.

• Avoid eating trigger foods. Most women find that caffeine, tea, coffee, alcohol and spicy foods can all make hot flashes worse.

• Eat low fat dairy products. These are rich in calcium. Calcium can reduce the risk of osteoporosis. Other foods rich in calcium are oysters, sardines with bones, and leafy green vegetables like broccoli and spinach.

• Choose foods that are low fat, low saturated fat and low cholesterol. Women in menopause are just as likely as men to have a heart attack. Maintaining good cholesterol levels lowers the risk of heart disease. Also fat contains more calories than proteins or carbohydrates. Keeping excess calories to a minimum helps in controlling weight. Try to keep your daily fat calories to be less than 30% of your total daily calories.

• Supplements: The best way to get all the nutrients you need is by consuming nutrient rich foods. If it is not possible to eat as nutritiously as you'd like supplements may be helpful. Always check with your doctor first before using any supplements as too many of certain vitamins can be dangerous and some supplements could even interfere with medications you may be taking.

Menopausal women should have 1,200-1,500 mg of calcium per day. Calcium carbonate is the most easily absorbed form of calcium and it should be taken in divided doses and after meals. Also our bodies need Vitamin D to be able to absorb the calcium from our food or supplements. We naturally form Vitamin D when our skin is exposed to the sun. But in menopause it becomes more difficult for the skin to absorb adequate sunlight. Compound that with the fact that we tend to spend less time in the sun because of the danger of skin cancer and it's easy to see how Vitamin D can become deficient. Too much Vitamin D is toxic. The RDI (recommended daily intake) is 400IU per day.

Soy
Soy is a natural way of dealing with hot flashes and night sweats. It is rich in omega-3 fatty acids, fiber, folic acid, calcium, and potassium, magnesium, and B vitamins. It is also low in saturated fat and cholesterol free. Soy contains estrogen-like substances called phytoestrogens also called isoflavones. In Japan where the diet is high in soy it has been reported that women have significantly less symptoms during menopause than Western women. There are ongoing studies to look at the potential benefits that soy has on lowering the risk of heart disease, osteoporosis, breast cancer, and even prostate cancer. The FDA has approved a statement that 25grams of soy protein per day along with a low fat, low cholesterol diet may reduce the risk of heart disease. Keep in mind soy protein and isoflavones are not the same thing. The FDA has not yet decided whether it is the soy protein, the isoflavones or both that provides this benefit.

Herbal Supplements
There are many products available that claim to help with menopausal symptoms. Just because something is herbal or natural doesn't mean it is safe or effective. Natural products can interfere with medications and can also have unwanted side effects. Herbs such as Black Cohosh, Red Clover, and Dong Quai are commonly advertised for having beneficial effects in menopause but none have been proven effective. In fact, results from a recent study revealed the use of Black Cohosh did not improve menopausal symptoms. Safety of these therapies is still questionable. Once again,.To date they are still being studied for their efficacy and safety which has yet to be proven. Once again, it is always best to consult with you doctor before you take any supplement, even if it is natural.

Exercise
We cannot talk about a healthy diet without mentioning exercise. In menopause exercise is just as important as eating right. Women who participate in regular aerobic activity (biking, running, jogging, swimming) or strength training (use of weights, resistance bands, yoga) along with a balanced diet are less likely to develop heart disease, obesity, high blood pressure or osteoporosis. Active menopausal women tend to maintain better strength, flexibility, mood, and overall energy. Regular exercise has also been found to reduce some common symptoms such as hot flashes, anxiety, irritability, insomnia and joint pain. Make sure you talk to your doctor first before starting any rigorous exercise program so together you can find which exercises are best for you.

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This article is intended as an information resource providing guidelines for women. As always, check with your own healthcare practitioner with your specific concerns and questions.