With hot flushes, night sweats and a depleted libido already taking their toll, the last thing many perimenopausal women want to think about is what to eat for breakfast, lunch and dinner.
But according to one expert, diet can play a powerful role in easing some of the most disruptive menopause symptoms – and could help women get a better hold of their fluctuating energy levels, food cravings, painful bloating, disruptive sleep and uncomfortable hot flushes.
Numerous studies have found that diet may influence menopause, even delaying its onset in some cases by several years.
Research in 2018 found that women who regularly ate oily fish such as salmon, mackerel and trout experienced menopause – when a woman’s periods end, signalling the end of her fertility – nearly three and a half years later than average.
Meanwhile, women who consumed legumes – such as lentils, chickpeas and kidney beans – on a daily basis delayed menopause by around a year.
Dr Linia Patel believes that eating foods that benefit the gut microbiome – the invisible, trillions strong army of friendly bacteria and fungi that helps us digest and absorb food – is one of the most effective ways to manage early menopause symptoms.
‘Having a diverse gut microbiota helps you thrive,’ the dietician and author of Food For Menopause tells the Daily Mail.
And it seems that feeling your best and ensuring you have optimal gut health is a two-way street.
Dr Linia Patel is a women’s health dietitian, author and performance nutritionist
She explains: ‘As a woman goes through the menopause transition, we see that if she’s not proactive about nurturing her gut microbiota, there’s a decline in the diversity of the gut bacteria.
‘This in turn means she’s no longer going to thrive, and that too is going to have an impact on her gut health.’
Dr Patel noticed that many women who visit her clinic complained of bloating and digestive discomfort during menopause – which she blames on an unbalanced gut microbiome.
‘They say, “I’ve got menopause bloat. Everything I eat makes me feel bloated. I must have an intolerance”,’ she explains.
‘But what they’re dealing with are gastric problems because they’ve got an imbalance of bacteria going on.
‘We know that when you don’t have a diverse microbiota, that also has an impact on inflammation. Colloquially that’s known as leaky gut.
‘So the more porous your gut, the more inflammatory markers can go through when they’re not supposed to go through, impacting inflammation.’
Leaky gut is a somewhat controversial idea which is popular in longevity circles that claims that the lining of the intestines can become damaged, meaning some digestive products can end up in the bloodstream, triggering inflammation as the body recognises them as ‘foreign objects’.
Dr Patel stresses that menopause symptoms are influenced by multiple factors but she firmly believes that gut health as ‘a massive piece of the puzzle’ – and says diet can play an important role in supporting it.
And, thankfully, she says making small but deliberate food swaps can have a huge impact on the health and diversity of our gut bacteria.
Rather than cutting carbohydrates entirely, Dr Patel recommends focusing on eating less refined options which will help keep blood sugar levels stable, improve energy and reduce cravings.
The key is to be adding more types of fibre to your daily diet – be it through wholegrains, beans, vegetables or fruits. This is because it is what the bacteria in the gut ‘eats’. The more you feed it, the more robust it will become.
‘The first thing is to get fibre right in your diet,’ she explains.
That could mean swapping sugary cereals for muesli or overnight oats; exchanging white bread and wraps for gut health boosting wholegrain or sourdough; and instead of white, sticky rice, dish up fibrous brown rice, black rice or quinoa.
A diet high in fibre could be the key to a better menopause, says Dr Linia Patel
And in what might come as a surprise for some people, she challenges the idea that rice cakes are a healthy snack, warning that they are often low in fibre. Instead, she says to opt for oatcakes or dark rice crackers.
Fruit juice should also be limited because of its high sugar content, she says, with eating whole fruit preferably thanks to the increase in available fibre.
‘Because fibre also helps fill you up, the more of the right things you’re eating, the less of the things that we don’t necessarily want you to be eating regularly will fall off the plate naturally,’ she adds.
Dr Patel also says women simply don’t eat enough protein and should be trying to up their intake, especially at breakfast.
Protein takes longer for the body to digest, helping you to feel fuller for longer while slowing the release of glucose into the bloodstream and stabilising blood sugar levels.
‘If you start strong, you’re setting yourself up strong,’ she says, urging women to ditch traditional choices like Marmite on toast and sugary breakfast cereals for eggs, greek yoghurt and scrambled tofu.
Dr Patel has three go-to breakfasts: eggs, muesli, and ‘something on toast’ – such as baked beans, avocado and salmon.
She avoids having milk with muesli, instead using the much higher protein Greek yoghurt – ‘a small swap that makes a big difference’. A sprinkling of nuts and seeds can also up protein levels, but be wary of fat content.
Beans, legumes and pulses are also on her list of “must eats” as they contain 50 per cent protein, 50 per cent carbs, and a lot of fibre.
Furthermore, they’re easy to incorporate into meals, and can be added to curries, rice dishes, salads and blended into soups. Dr Patel also suggests adding cooked chickpeas to chocolate chip cookie recipes as a way of increasing fibre and protein intake.
Another often overlooked factor of good perimenopausal gut health is hydration.
‘It is so simple but people do not get this right,’ she says.
‘Your body is 75 per cent water, your brain is 85 per cent water. If you’re mildly dehydrated you’re not going to operate well.
‘If you want to think clearly, have a better mood, go to the bathroom regularly, exercise, not be constipated, reduce your hot flushes – it all needs to start from a place where you’re well hydrated.’
When working with women struggling with hot flushes, Dr Patel first looks at hydration and blood sugar control, explaining that unstable blood sugar levels may increase the likelihood of night sweats and flushing.
‘Then I also suggest that they eat more plant oestrogens,’ she said.
Plant oestrogens, which have an official name of phytoestrogens, are natural plant compounds found in soy-based foods such as tofu, soy milk and edamame beans – which may help reduce the severity of hot flushes in some women.
Research has suggested women in Asian countries with traditionally high soy intake report fewer menopause symptoms, although the benefits appear to depend partly on the individual’s gut health.
‘It always comes back to gut health,’ she explains. ‘The healthier your microbiome is, the lesser the risk of some of the symptoms you’re experiencing.
‘I would definitely be saying that eating more plant-based oestrogens is fantastic. If you don’t like the taste of soy milk, then have edamame beans in everything.
‘Snack on edamame beans, throw them in your salad, throw them in soups. Nowadays, you even have the edamame nuts, which are the dry roasted ones. Find a way of getting those in. And tofu as well.
‘It could be that also you’re maybe mixing half normal beef mince with half soy-based mince, for example, if you don’t like the taste that could be a way to slowly incorporate it in your diet.’
Dr Patel also suggests women struggling with hot flushes may also benefit from reducing caffeine and alcohol intake, managing stress levels and wearing more lightweight clothing.
She warned alcohol can trigger flushing because it dilates blood vessels, while caffeine may worsen symptoms in some women.
Following these simple practices, she said, are the basics that all women should be striving for – rather than running to supplements and menopause-branded snacks and drinks.
‘What we need to get better at doing is focusing mainly on the pillars of menopause that we know are simple and be consistent with doing them,’ she said.
WHAT SHOULD A BALANCED DIET LOOK LIKE?
Meals should be based on potatoes, bread, rice, pasta or other starchy carbohydrates, ideally wholegrain, according to the NHS
• Eat at least 5 portions of a variety of fruit and vegetables every day. All fresh, frozen, dried and canned fruit and vegetables count
• Base meals on potatoes, bread, rice, pasta or other starchy carbohydrates, ideally wholegrain
• 30 grams of fibre a day: This is the same as eating all of the following: 5 portions of fruit and vegetables, 2 whole-wheat cereal biscuits, 2 thick slices of wholemeal bread and large baked potato with the skin on
• Have some dairy or dairy alternatives (such as soya drinks) choosing lower fat and lower sugar options
• Eat some beans, pulses, fish, eggs, meat and other proteins (including 2 portions of fish every week, one of which should be oily)
• Choose unsaturated oils and spreads and consuming in small amounts
• Drink 6-8 cups/glasses of water a day
• Adults should have less than 6g of salt and 20g of saturated fat for women or 30g for men a day
Source: NHS Eatwell Guide
