Important Nutrients for Menopause

Important Nutrients for Menopause

Producer Potts  0:13  

We’re not getting any younger. What are the most important nutrients and lifestyle factors we can focus on to support our health? For those of us approaching or in perimenopause or full on menopause, full on menopause.

Dr. Sarah  0:32  

So I think that the way that I would like to answer this question is focusing on nutritional support and lifestyle factors that address challenges of perimenopause and menopause that are not helped by estrogen hormone replacement therapy, or that estrogen hormone replacement therapy just has kind of like a limited capacity to benefit. So starting with once you’ve completed the transition from perimenopause to menopause, the science has completely shifted from thinking that estrogen hormone replacement therapy might have been not good to Holy smokes, is it ever important to have so it very greatly reduces our risk of cardiovascular disease, of osteoporosis, in addition to improving a lot of the undesirable physiological changes that happen with perimenopause and menopause. So step one is understanding, and again, I’m not a doctor. This is a little bit tangential to my area of expertise. I know this more as a patient than I do as a professional, but estrogen hormone replacement therapy is like the first line for menopausal people. So you know, making sure that you’re talking to your doctor about that being really open and also tracking, because they can either do blood tests and kind of look at levels of luteinizing hormone and follicular stimulating hormone to kind of understand where you are in that transition, or they can look at records of when you’ve menstruated to understand where you are in that transition, because They don’t want to start that too early. So making sure that you have that data and you bring that data to your doctor is step one. So what are some things that happen in perimenopause and menopause, that are things that are sort of happening before you get to that point where you can start estrogen hormone replacement therapy and or things that are not actually typically helped by starting estrogen. So one of the things that happens during that perimenopausal period is the loss of muscle. It’s called sarcopenia. And during that perimenopausal time, females lose an average of 10% of their muscle mass, which is nuts. This was definitely my experience. I lost so much strength in that period of time. It was awful, because I enjoy powerlifting. So to be losing strength when I’m really trying to work to continue to build it was very demoralizing and contributed to a lot of the mental health challenges that I certainly faced that are also very common during perimenopause and menopause. So just understanding that these are symptoms, like people talk about night sweats and hot flashes all the time, right? That is like the stereotype of perimenopause. There’s so many symptoms that we go through in that transition and on the other side of that transition that are not talked about publicly. And I think that one of the greatest services that we can do for the younger generation is to actually to normalize some of these other things that happen. So losing muscle mass that can sometimes go with unwanted weight gain. Certainly, that was my experience. I didn’t change anything, and my body composition changed very dramatically over a fairly short period of time. So it was, it was not my favorite experience. So understanding that is part of the normal transition. So one of the big things that can help to prevent sarcopenia is increasing protein intake. So the Recommended Dietary Allowance for protein, if I remember correctly, is 0.8 grams of protein per kilogram body weight. Figure out that. Take your weight in pounds and divide by 2.2 that’ll give you your weight in kilograms, and then multiply by 0.8 that is the RDA. The RDA is very low, so where most of the science is. Is on supporting not just body composition and lean mass and like metabolic health. And if weight loss is a goal for you, weight loss goals, body composition goals, but also higher protein intake seems to also be protective against cardiovascular disease. So like, there’s other reasons to aim for more than that protein so more in the 1.2 to 1.6 grams per kilogram body weight, so like 50% to double the RDA of protein. So I personally aim for 100 grams of protein per day. That is my personal target. So just to give you a sense of what that actually translate to, so I would say take your weight in pounds, divide by 2.2 and then actually multiply by like 1.2 and then multiply by 1.6 and get get that range, and that it’s really hard to do if you only eat snacks or if you only eat two meals a day. It’s a lot easier to hit those higher protein goals if you eat three meals a day. I certainly would. I don’t think I’d be able to hit 100 grams of protein in two meals, I don’t think that it would be really hard to eat enough protein foods and still get, like, the full range of foods that we need to get all of the nutrients. So think about that. I think those protein goals are not very compatible with intermittent fasting, although some people certainly can. So just take that information and figure out how it fits into your life, and then it doesn’t matter if that protein is coming from plant foods or animal foods. So that can come from tofu or edamame or lentils or salmon or chicken or beef, like it really doesn’t matter our bodies use those protein the same and you don’t even if you follow a plant forward or plant based diet, you don’t even necessarily need to think about complete proteins, as long as you’re getting your protein from a variety of different sources. We use the amino acids as we get them. So we don’t actually even need to have, like, both the rice and beans at the same meal. So as long as our proteins come from different places, we really don’t, we don’t need to think about complete proteins. The only reason that’s like something that someone might want to think about is if you’re also on a very limited diet, then you would want to be paying attention to making sure you’re getting all nine essential amino acids. So upping protein intake can be very, very helpful for sarcopenia during perimenopause and menopause. That also is something that is relevant to males as they get older, they also tend to be faced with sarcopenia. They hit it a little bit later than females do, so more like 60 years old compared to 50 years old, but that increasing protein intake as we age is actually beneficial across the board. I mentioned mental health, so one of the other very common clusters of symptoms that go along with perimenopause and menopause is increased likelihood of insomnia and also increased likelihood of depression and anxiety. I actually have the statistics if you want me to look

Producer Potts  8:11  

them up, yeah, yeah, let’s do it. Let’s look them up.

Dr. Sarah  8:14  

So there’s a section in my book on the importance for vitamin b6 for helping to reduce risk of menopause, insomnia and depression, and so that’s where I have the statistics from. So a whopping 42% of menopausal and perimenopausal females experience depression. The risk of depression being nearly double compared to premenopausal people, which is not cool, the risk of insomnia also about doubles in menopause, affecting more than a quarter of post menopausal people and upwards of 44% of those who also experience severe hot flashes. So they often go together. Those are both situations that are not helped substantially by estrogen hormone replacement therapy. Now, if you are facing depression symptoms, please talk to your doctor and discuss your options. You know, think about seeing a therapist. There’s lots of other important resources, and I would never want to imply that nutrition should be a first line treatment, that it should definitely be supportive and that’s it, complimentary to all of the other tried and true things for addressing mental health challenges. But vitamin b6, is one of the most important nutrients for, basically, for like, the neurotransmitters that are involved in both sleep and sleep onset and sleep maintenance. So things like melatonin production and GABA as well as the neurotransmitters that are involved in depression and anxiety, like serotonin and dopamine, so vitamin b6 has been shown to help improve sleep quality. Quality, reduce the length of time it takes to fall asleep, reduce the nights of insomnia, and it’s been shown to improve depressive symptoms in a wide range of people. So both like people that this is my current phase of life, as well as like college students. So they’ve done studies where they’ve given college students high doses of vitamin b6 and shown that they have fewer symptoms of anxiety. So vitamin b6 actually, what’s really cool is that poultry is one of our best food sources of vitamin b6 so it’s also a really good protein, so eating some chicken checks both of those boxes. And then the last big challenge, at least, that comes to mind when you ask me this question, that is that sort of just goes along with the change in hormone environment, is the increased risk of osteoporosis. So something like half of menopausal females will develop osteoporosis, which increases the risk of like, you know, bone fracture. But the the big, the big worry is a hip fracture, because that is a major driver of morbidity in older adults. It can be very, very costly, a very, very long recovery period. And, and it can, I mean, it can be, it can be dangerous and, and so having strong bones as we age be very, very helpful. So the muscle helps to reduce the risk of frailty, and the bones mean that if we do fall, hopefully strong bones mean they dont they don’t break. So we kind of want both strong bones and strong muscles for good quality of life through healthy aging. So with bone health, definitely estrogen replace replacement therapy helps a lot, but there’s some really important nutrients that dramatically reduce the risk of osteopenia and osteoporosis, as well as bone fractures as well. So I think people are really familiar with calcium as being important for strong bones, thanks to got milk ads dating back several decades. But our bones are really complex. They use a lot of different nutrients. The scaffold is actually made out of collagen protein, and that’s what the calcium hydroxyapatite binds to. So so we need protein. We need vitamin D helps to control calcium absorption. Vitamin K helps to make sure that calcium gets to the right place and is used in the right way. So we need a vitamin K to help with with our bone. So our bones are constantly kind of like in this equilibrium of being broken down and built back up. So that actually is a really cool thing. So our bones are constantly being demineralized and re mineralized, and as long as the fat is kind of that equilibrium is equal, you have strong bones. As soon as demineralization, like, increases over mineralization. That’s where your bones become less dense and weaker over time, and that’s what’s happening in osteopenia and osteoporosis. So we want to make sure that we’re doing all of the things to keep that mineralization as high as that you know, to be at least as at least as high as the demineralization. So vitamin D is really important for that. Vitamin C is really important for that, getting enough calcium. But there’s other minerals that are in our bones, and Vitamin K is really important for making sure that all of the right signals are there for bone re mineralization, and that’s also where lifestyle factors become really important. So weight bearing exercise, which means walking, is a really, really important signal to our bones that actually helps to drive mineralization. So they’re really cool. This is not my area of expertise, but we have these really cool, like sensors in our biological sensors in our bones that are sensing impact, and that’s actually causing changes to help keep our bones strong. So we basically know that if you walk a lot, where you do other weight bearing activities, like jogging, dance, sports of any kind, weight lifting, of course, anything where you’re sort of putting load on your bones, that that actually helps to create stronger bones. Exercise also has a really profound impact on mental health. So there are studies that pit exercise to SSRIs and show that exercise can in some situations. To be equally as effective to SSRIs for depression, I would never again say, go off your SSRIs and just exercise again. We want to use all of the tools available to us, and I have been in a situation where knowing that exercise will help does not mean that I have the mental energy to exercise like physical energy, sure, but not mental energy, no. So please understand that I would never want to imply that diet lifestyle factors can take the place of tried and and and true medical intervention, especially for for these really challenging, really challenging mental health disorders that can even be challenging pharmaceutically to get the right the right mix for you so but knowing that exercise can be really, really helpful for depression and anxiety and can help improve sleep quality, I think is really empowering and maybe motivation to get out and exercise, and it can also help build muscle and strengthen bones. So exercise is kind of like the big thing that, like all of those things, can be benefited by. So I would say that’s another big priority ideally, actually, before perimenopause, I am glad I went into that phase of life with as much strength and muscle mass as I did. So I think that, I think exercise at all, at all periods of time of our lives is beneficial. All the science backs me up on that. So definitely making sure it’s a priority through that transition and into our older years, I think, is also really important. And then also, you know, making sure that we’re giving our bodies time to repair with enough sleep is also really important. So there’s a lot of studies showing that inadequate sleep can increase risk of other things, other health related challenges that come up as we age, like increasing risk of cardiovascular disease, type two diabetes, so making sure we’re getting enough sleep. Also helps to support things like muscle recovery after a workout. It helps with mental health. It helps with the energy. It just helps with everything. Helps with even affecting our cravings and appetites, so that we maybe enjoy more of that, like chicken and those leafy vegetables with that vitamin K and our dairy products. So yeah, those are sort of our big nutrients that are particularly important through menopause, but also remember that all nutrients are important. Like every biological system requires multiple nutrients, and we don’t want to overdo it right? We don’t want to overdo chicken for the vitamin b6 and the protein and then not be getting something else really important, so making sure that we’re still eating a nutrivore diet, which means for getting the full range of nutrients that our bodies need, is also a really important thing to keep in mind that dietary diversity is equally as important at this phase of life as it is in all phases of life.

Producer Potts  18:18  

Wow. Dr, Sarah, I just got an education that was amazing. So helpful. I think to myself, I will be re-watching this video back to take some notes. So this was really good information. That was a lot. So just to recap, good communication with your doctor, nutrient density, find some sort of movement you love, and continue to work on your sleep. So it really comes back to these very basic things that we’re all told. These are the things that make up, you know, the foundation of a healthy lifestyle. But I think you explaining all that, just like reinforces why focusing on those basics all the way through is just so important and not to get lost in the the details you know, just to understand, to know all the details, but then to come up on that higher level of like, okay, well, it doesn’t have to be overwhelming, like, it’s just about focusing on these basics. And now your personal habit of gardening is like, that’s everything, that’s all the things right there. And it also makes me so incredibly happy, because my mom has just taken up gardening, and she’s in her older years. So it just makes it all make sense if you can find a hobby like that, where you can, kind of like, achieve all those things, gosh, we should all just become gardeners. This is making so much sense to me. I love this so much.

Dr. Sarah  20:01  

I would add that at least it was my experience that a lot of the healthy habits that I was working on but really kind of struggling to be consistent with the symptomatology that I had through perimenopause and menopause was just that, like, extra little kick in the pants to finally, like, figure those things out and really get into a much healthier routine for both my physical health and my mental health. Like, I’ve really made a lot of changes over the last four years that were largely driven by the challenges of sort of abruptly going into menopause, much, much younger than my mom was so unexpectedly for me. So it was at least my experience that how rotten I felt just because I had no estrogen anymore, I think was a nice nudge for me. I don’t expect that it would work that way for everybody, but I definitely feel better now than I probably ever have in my whole life, and a lot of that is good communication with my doctor and finding some good solutions through medical care. But then also, you know, the diet and lifestyle changes that I’ve made over the last four years kind of in response to, yeah, my body doesn’t respond the same way to things as it used to, and it’s a lot less tolerant of me, you know, not looking after it. And I think, um, I think that for me it’s like the glass half full moment. It’s the silver lining that even though it was a tough time to kind of get to this point. I feel fantastic now and I think that I kind of had to go through some of that experience in order to, like, Finally, really turn things that I knew I needed to develop as healthy habits into finally, like, yeah, it’s automatic. It’s part of my routine that is just part of my daily healthy habits. So yeah, there’s a lot of good lessons to be learned in things being hard. And I wish that I had known when I was going through a very short perimenopausal period, that all of the things that I was dealing with that seemed really hard that I didn’t realize were related to menopausal nobody told me, post nasal drip could be a menopause symptom. Who talks about this? Not very many people. And I think that the you know, all of the diet, lifestyle stuff aside, I think the most important message is that if you think it’s related to menopause, it probably is, and please mention it to your doctor, and please know that it’s normal, and please talk about it. Because I think the more of us that talk about that experience, the easier it is for others going through it to understand what’s normal, what’s not, and what can help what Yeah,

Producer Potts  23:30  

and this is you’ve given us such a thorough answer. So I know this is a longer video we’re getting to here, but if someone wants to focus on the nutrient density piece, of course, please go pick up Dr Sarah’s book nutrivore. It’s really simple and easy and straightforward, and it really helps you key on on getting all of the nutrients you need from the foods you eat without having to, like, spend a ton of money on supplementation and all of that stuff. So I highly recommend it.