to protect and enhance our health. In this chapter we explore the link between diet and hormones and the nutritional deficiencies that aggravate symptoms of menopause.
Menopause is often a time when nutritional deficiencies start to become apparent. Years of wear and tear, pregnancy, and breastfeeding can all challenge our nutrient stores. If we don’t know how to replace what time and nature have taken away, we may be left in a nutritionally depleted state, which can affect our brain chemistry and our hormone balance.
You may think your diet is healthy, but if you start to analyze it more closely, a different story might emerge. A few years ago, a group of staff at a magazine company in the UK completed questionnaires for me about their diet and nutritional health. Not one of the participants was consuming an adequate diet, and all had some signs of nutritional deficiencies. Most of us lack knowledge about how to meet all our body’s nutritional needs.
Today’s diet is very different from that of our Stone Age ancestors. Three million years ago, vegetable matter, including hard seeds and plant fiber such as roots and stems, was the mainstay of our diet, rather than the large amounts of animal protein many people consume today. And the meat produced by intensive farming is much higher in fat, especially saturated fat, than the wild meat eaten by our ancestors.
Our lifestyle is also very different even from that of just seventy-five years ago, when three balanced meals, with just the occasional between-meal snack, were the norm. Today, many of us struggle to eat one or two balanced meals a day, with several snacks. We often eat convenience food and commercially prepared meals on the run, rather than the wholesome, home-cooked foods favored by many of our grandmothers.
Add to this the fact that we exercise much less than we used to, and it’s not surprising that we suffer from conditions such as heart disease, cancer, diabetes, and osteoporosis to a far greater degree than people did even a few decades ago. The incidence of conditions such as irritable bowel syndrome, constipation, diarrhea with painful gas, bloating, migraine headaches, nervous tension, irritability, insomnia, and feelings of aggression and fatigue are also on the rise.
Are You Fit for Midlife? Results from a Survey
My team and I conducted an online survey of more than 1,200 women between the ages of thirty-five and sixty-four to assess their health prospects for midlife. We found that lifestyle factors such as poor diet, lack of exercise, alcohol intake, and smoking seemed to be strongly linked with mental and physical health problems. Only a quarter of the women in the survey were achieving the following five targets for a healthy midlife:
• Eating two 4-ounce servings of fish a week, including at least one serving of oily fish
• Eating five servings of fruit and vegetables a day
• Exercising at least five times a week
• Consuming no more than seven large glasses of alcohol a week
• Not smoking
In addition, almost 50 percent of respondents said they did not feel as healthy as they used to. Seventeen percent smoked more than ten cigarettes a day, and 8 percent smoked between one and ten cigarettes a day.
On a more positive note, 75 percent of the women said they would be willing to modify their diet. A similar percentage said they would be willing to do more exercise. Fifty-five percent said they would consider taking supplements, and 40 percent were willing to incorporate relaxation into their timetable.
Interestingly, respondents who were achieving all five targets reported much higher libido than the others in the group. Their energy levels and their general sense of well- being were noticeably better too.
What we eat influences our health and hormone function. In particular, hormonal balance can be affected by the amount of fat and fiber in our diet, as well as by levels of individual essential nutrients.
Although we still don’t fully understand the relative importance of these factors, it is safe to say that they have been largely overlooked in the treatment of midlife symptoms, even though research now shows that billions of women around the world have nutritional deficiencies. Dietary changes offer one alternative to hormone therapy for the control of estrogen withdrawal symptoms. A change of diet may also help lower the risk of heart disease and hormone-related cancers of the breast and uterus.
Scientific interest in the effect of dietary fat on health originally arose because of the strong links between fat consumption and both heart disease and breast cancer. Women in countries where the diet is typically high in fat, especially the saturated fat found mainly in animal products, have high rates of breast cancer. We don’t yet know whether reducing animal fat intake reduces the risk of breast cancer, but we do know that the fat and fiber content of our diet can affect hormone function. Fiber binds to estrogen in the small intestine, helping to balance our hormone levels.
A diet high in animal fat and low in fiber is associated with relatively high levels of circulating estrogen. The US Food and Nutrition Board of the National Institute of Medicine recommends that women under fifty consume 25 grams of dietary fiber per day, while those over fifty should consume 21 grams (to correspond with an overall reduction in food intake for older women). Most Americans, however, get only 15 grams per day. It may be that Western women who have followed high-fat, low-fiber diets are more likely to experience estrogen withdrawal symptoms at midlife because their bodies are used to a relatively high level of estrogen. As a result, they don’t tolerate the natural drop in estrogen at menopause as well as women who have lower levels of circulating estrogen.
In theory, this means that making a dramatic change to a low-fat, high-fiber diet could aggravate symptoms of estrogen withdrawal in some women. This effect is likely to be offset by the fact that the diet is healthier, which in turn has a positive effect on hormone function. But if you do change your diet at the time of menopause, it makes sense to do so gradually. For example, don’t suddenly go from being a meat eater to following a weight-loss vegan diet. You need to give your body time to adjust.
Our body requires many nutrients in order to produce hormones and enable them to do their job properly. Severe nutritional deficiencies are rare in countries like the United States, Canada, Australia, and the United Kingdom, but our surveys suggest that many women in these countries have chronic deficiencies of essential nutrients, beginning well before menopause. For example, 50 to 80 percent of women with PMS have low levels of magnesium, B vitamins, vitamin D, zinc, iron, calcium, and EFAs. Low levels of important nutrients leave women in what I call “economy mode.” Below I discuss some essential nutrients and their function. Foods rich in these nutrients are included in the list beginning on page 222.
Iron
Iron is essential to the production of hemoglobin, the compound in our red blood cells that transports oxygen from our lungs to all the cells in the body. The muscles and brain also need iron, and it is a vital component of many of the enzymes that drive the chemical reactions in our cells. Low levels of iron can lead to brittle and split nails, hair loss, and anemia, which can cause fatigue. Around 4 percent of women of childbearing age are anemic; severe anemia can cause periods to stop. An additional 10 percent of menstruating women suffer from a mild iron deficiency. Heavier periods, common in perimenopause, can further deplete iron levels.
B Vitamins
Broadly speaking, B vitamins are involved in releasing energy from food. A severe deficiency in vitamin B12 can cause periods to become irregular, a symptom that may be confused with perimenopause among women in their early forties. A lack of vitamin B12, which is found in red meat and other foods, can occur in vegans and