The foods you can eat to help before, during and after the menopause? 


When the symptoms of the menopause hit, some women manage as best they can, others try hormone replacement therapy (HRT). But there is another scientifically proven measure that can help — adjusting your diet.

Not only can the type of food you eat affect the intensity of symptoms such as hot flushes and night sweats, it can also delay the onset of the menopause, in some cases by years.

This has been proven by good quality research, including a 2018 study by the University of Leeds, where women who ate 90g of oily fish (such as mackerel, salmon or trout) a day were found to go through the menopause nearly three and a half years later than average (the average age was 51).

Those who ate legumes (such as lentils, chickpeas and kidney beans) daily delayed their menopause by around a year, reported the Journal of Epidemiology and Community Health.

Meanwhile, women eating a lot of refined foods (such as pasta and rice) went through the menopause on average one and a half years earlier.

Not only can the type of food you eat affect the intensity of symptoms such as hot flushes and night sweats, it can also delay the onset of the menopause, says Dr Megan Rossi Not only can the type of food you eat affect the intensity of symptoms such as hot flushes and night sweats, it can also delay the onset of the menopause, says Dr Megan Rossi

Not only can the type of food you eat affect the intensity of symptoms such as hot flushes and night sweats, it can also delay the onset of the menopause, says Dr Megan Rossi

It's more important than ever to pack your diet with plant foods (aim for 30 different types a week) and oily fish, for your gut microbes to feast on (file image) It's more important than ever to pack your diet with plant foods (aim for 30 different types a week) and oily fish, for your gut microbes to feast on (file image)

It’s more important than ever to pack your diet with plant foods (aim for 30 different types a week) and oily fish, for your gut microbes to feast on (file image)

This is more than coincidence.

Oily fish and legumes are just the kind of foods your gut microbes need to thrive — and one of the numerous roles these little guys have is to ‘recycle’ oestrogen. It’s the drop in the production of this hormone that underpins many menopausal symptoms.

Oestrogen is made mainly in the ovaries and gets pumped around the blood, playing a part in regulating the health of the heart and blood vessels, brain, bones, skin and more.

When ‘old’ oestrogen reaches the gut after its tour of the body, it is either expelled in poop or a group of gut bacteria (known as the estrobolome) produce an enzyme, beta-glucuronidase, that in effect reactivates it.

This recycled oestrogen gets pushed back into the blood, where it can get to work again.

That’s why as women enter their 40s, when typically oestrogen production starts to wane, if they don’t have a good community of gut microbes recycling what oestrogen they do have, they’re probably going to be hit earlier and harder with menopausal symptoms.

So at this stage it’s more important than ever to pack your diet with plant foods (aim for 30 different types a week) and oily fish, for your gut microbes to feast on.

And limit processed foods, which research increasingly suggests may damage that microbe community. 

Once your periods stop, the make-up of your gut microbes changes and becomes less diverse and more like men’s, according to research last year in the International Journal of Women’s Health. 

DID YOU KNOW?  

A single tree can produce up to six different fruits. 

Developed in Australia, ‘Fruit Salad’ trees are produced by grafting fruits from the same family on to one tree.

So the stonefruit version might have red and yellow plums, white and yellow peaches, apricots and nectarines; the apple one, varieties from Granny Smith to Red Lady. 

Each fruit retains its distinct flavour, appearance and ripening time.

It’s not only the microbes in your gut that change; researchers now believe that your chance of developing menopause-related vaginal dryness and tissue thinning may be related to the community of bacteria in your vagina (yes, you have them there, too).

For example, a recent study in the journal Frontiers in Reproductive Health noted that post-menopausal women with vaginal dryness and tissue thinning tend to lack lactobacilli, beneficial bacteria present in our bodies but also found in fermented foods such as sauerkraut, kimchi and yoghurt.

So you might want to consider adding a daily portion of, say, live yoghurt to that diverse plant- rich diet.

These changes may also cut hot flushes. When U.S. researchers analysed the diets of 17,000 women, they found that those who reduced their fat intake and increased fruit and veg (to five portions a day) and wholegrains (to six portions a day) were significantly more likely to banish their hot flushes.

And don’t forget to add oily fish to that diet either — here’s why.

Oestrogen has an anti-inflammatory effect and acts as an antioxidant — i.e. it tackles the oxidative damage that occurs as a part of normal metabolism or as a result of exposure to everyday things in our environment.

Left unchecked, this can damage cells and lead to illnesses such as heart disease and osteoporosis. In the absence of oestrogen such problems become more likely.

Oxidative damage is also linked to menopausal symptoms — a 2019 study in the journal PLOS One found that the more oxidative markers women had in their blood, the more severe their hot flushes were.

As well as oily fish, if you’re post-menopausal eat plenty of other antioxidant-rich foods such as almonds, walnuts, berries, spinach, tea, dark chocolate (with 90 per cent cocoa solids), coffee — and, in moderation, red wine.

As well as adding these foods to your diet, watch your blood sugar levels.

Post-menopausal women are more likely to have higher blood sugar and insulin levels after they’ve eaten than pre-menopausal women, according to research published in the Lancet last year.

One theory is that it’s related to inflammation, but in any event, you want to avoid blood sugar spikes as they can leave you feeling tired when your blood sugar levels crash back down. You then want more sweet foods to get your energy back up.

So when you eat sugar — and anything that is digested down into sugars, including complex carbs such as bread — have it with protein (e.g. hummus) or a healthy fat (e.g. avocado) as this will slow down that sugar release.

Similarly when you eat fruit (and please do, as your gut bacteria love it, and it has impressive antioxidant potential), have it with yoghurt.

Cutting down on the sweet stuff will also help with that dreaded weight gain around the middle that menopausal women are prone to — also because oestrogen affects metabolism and the distribution of fat.

This is made worse by the fact that the menopause occurs at an age when we start to lose muscle mass — another cause for weight gain. So try to keep exercising, even if you feel lethargic.

And although it can be hard when your hormones are working against you, focus on good sleep practices.

My colleagues at King’s College London found that people tend to eat an extra 385 calories per day when sleep deprived.

So stick to good sleep hygiene habits: expose yourself to bright light at soon as you get up (this regulates your sleep hormone production), limit caffeine after lunchtime, and put your screens away after 8pm.

But if you do nothing else — keep eating those plant foods. It will pay dividends.

TRY THIS: BREAKFAST BEAN WRAPS

Kick-start your day with a plant-filled breakfast that will keep those cravings satisfied and blood sugar levels stable throughout the morning.

SERVES 6

  • Olive oil
  • 1 onion, sliced
  • 1 red pepper, sliced
  • 1 yellow pepper, sliced
  • 1 tbsp tomato paste
  • 1 can kidney beans, drained and rinsed
  • 4 large tomatoes, chopped
  • 1 tbsp paprika
  • 1 tbsp cumin
  • 1 tsp chilli powder
  • 2 handfuls rocket
  • Optional: Natural yoghurt
  • 6 large lettuce cups or wholemeal tortilla wraps

Heat olive oil in a frying pan and cook onion and peppers over low heat for 10 mins, until softened. Stir through tomato paste. In a bowl, take half of the kidney beans and mash to create a coarse paste.

Mix in remaining whole beans, finely chopped tomatoes, spices — and season. Place mixture into the pan with the onions and peppers to combine.

Cook for around 5 mins until heated through, adding the handfuls of rocket at the final minute to allow for wilting.

Spread a few tablespoons of yoghurt (if using) into the lettuce cups or tortilla wraps. Place the filling into the centre of each cup/wrap, then fold.

 ASK Megan 

I’m middle-aged, have coeliac disease and have been gluten-free for almost 20 years. I miss porridge more than I miss bread! Is there a gluten-free substitute that can have the same effect on cholesterol as oats?

Lisa Cozens, by email.

Standard oats are often manufactured in the same place as wheat, barley and rye and there is therefore a risk of cross-contamination with gluten.

But you can get gluten-free oats. Even though these contain a protein, called avenin, which is similar to gluten, research suggests that most people with coeliac disease can tolerate this protein.

But if you are one of those who can’t have avenin either, rest assured that you can get the cholesterol-lowering fibre found in oats (known as beta-glucan, it binds to cholesterol, limiting its absorption in the gut) in other gluten-free foods.

These include seaweed, certain types of mushroom such as reishi and shiitake, as well as nutritional yeast (which has a delicious cheesy flavour and is available in most supermarkets).

Contact Dr Megan Rossi

Email [email protected] or write to Good Health, Daily Mail, 9 Derry Street, London, W8 5HY — please include contact details. Dr Megan Rossi cannot enter into personal correspondence. Replies should be taken in a general context; always consult your GP with health worries