One of my great aunts used to say repeatedly, “Getting old ain’t for sissies!” Most of us, I think, would agree with her.
While later life can bring certain enjoyments, more often we tend to think of the health-related challenges that come with it. One of the certain changes that tends to loom ahead for many women is menopause . . . .
Plus the heap of menopause diet culture that comes right along with it.
The transition through menopause brings with it a host of hormonal changes that have widespread impact in the body. One of the first symptoms people tend to think of related to menopause is hot flashes, those uncomfortable temperature fluctuations that can leave one sweating one minute and chilled the next. Other symptoms may include brain fog, irritability, difficulty sleeping, decreased sexual desire, and perhaps most dreaded, weight gain.
Many women seek advice on how to avoid weight gain in menopause.
But what is rarely acknowledged, is that the increase in weight that often occurs in menopause has a protective function.
Studies have shown that mortality rates are lower for older adults whose BMI falls in the “overweight” range than for people whose BMI is in the “normal” range. (Please note: I am not advocating for BMI as a helpful indicator of health here but rather noting that being at a lower weight is not always protective when it comes to health.) When illness strikes, the body benefits from having energy reserves to draw on in order to fight that disease. Our body is not meant to be the same size at sixty that it was at twenty. But knowing this doesn’t make changes in body size easy in a culture that worships thinness and tries to equate worth and status with body size.
But, while we overestimate the risks of weight gain in menopause, we may underestimate the real health shifts that accompany this stage of life.
Bone Health:
The decrease in estrogen leads to accelerated bone loss, which causes more significant decreases in bone density. Fractures later in life due to low bone density have more far-reaching impact than we tend to think. For a sixty-five-year-old woman who breaks her hip, the likelihood of her being able to live independently a year later is 50 percent, and there’s a 40 percent risk that she won’t be able to walk independently. The risk of death within a year of the fracture is increased by 17 percent. That fracture can radically alter a person’s later life years.
Hormonal Changes:
Decreases in the anabolic hormones testosterone and growth hormone also lead to decreases in muscle mass, which causes metabolism to slow and can make blood glucose control more challenging.
Heart Disease:
Menopause also brings with it an increased risk of cardiovascular disease (CVD). There are multiple reasons for this. The decrease in estrogen may be one factor, as estrogen may make blood vessels less susceptible to atherosclerosis and help to regulate inflammation. Certain other conditions that affect women, such as endometriosis and polycystic ovarian syndrome as well as gestational diabetes, may contribute to an increased risk of CVD, though it’s not entirely clear why.
The widespread changes that come with menopause can overwhelming and/or discouraging at times, but you don’t have to navigate this on your own; a dietitian can help!
There is an abundance of unhelpful information, especially online, that often is only a ploy to get people to spend money.
An RD can help you sort fact from myth as you seek to support your health through this transition and help you build a nutrition plan (your own personalize menopause diet) that's sustainable and meets your needs.
RDs can also work with you on developing improved sleep hygiene. (We talk about more than food!) Quality sleep can be more of a challenge during menopause, but it can also provide significant benefits. Sleep has been shown to increase the release of growth hormone, which can mitigate some of the decline in skeletal muscle and bone density.
Next, an RD can help ensure you’re getting the vitamins and minerals your body needs to support health later in life. For example, calcium and vitamin D play a crucial role in supporting bone health, especially as bone density declines. When adequate calcium and vitamin D are not present, the body breaks down bone to access the calcium in it, accelerating the decrease in bone density. At the same time, more is not always better. Taking supplements your body doesn’t need carries its own risks.
Finally, many women report an increase in body dissatisfaction during the menopausal transition. A qualified RD can work with you to strengthen body image and decrease the distress that can come with changes in body shape and size. This doesn’t mean changing your body, as research tells us that, contrary to popular opinion, that does not improve body image. Rather, we will work on forming a deeper connection with your body and helping peel away messages you may have received over the years about your body size being the most important thing about you.
While menopause can be stressful, you don’t have to face that transition alone. Having support
along the way can provide the confidence that comes from understanding the changes occurring in your body and knowing that you are navigating health concerns in a manner that is
best for you.
Please know the dietitians at Food Wonderful are here to assist you and would love to come alongside you in your menopause transition.
-Allison
Sources
Gunter, Jennifer. The Menopause Manifesto. Kensington Books, 2021.
Keay, Nicky. Hormones, Health, and Human Potential. Sequoia Books 2022.
Lucassen, E. A., et al. “Poor sleep quality and later sleep timing are risk factors for osteopenia
and sarcopenia in middle-aged men and women: The NEO study.” PLoS ONE 12, no. 5
Winter, J. E., et al. “BMI and all-cause mortality in older adults: A meta-analysis.” The American
Journal of Clinical Nutrition, 99, no. 4 (2014). https://doi.org/10.3945/ajcn.113.068122
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