Perimenopause and Nutrition

On today’s episode, Dr. Alicia Power speaks to Kristen Yarker, a registered dietician in Victoria, BC and founder of The Kristen Yarker Nutrition Agency, with a combined 30 years of training and experience guiding people through the perimenopause and menopause period. While this time of transition presents certain challenges, not unlike puberty it should be considered in a comprehensive way from how our diet, exercise, sleep, stress and mental health can impact the transition - and vice versa. 

What is Perimenopause?

Menopause is defined as a year without menstrual periods, typically around age 51. The transition leading up to it, known as perimenopause, and afterward span roughly a decade on either side. These hormonal shifts affect our bodies, metabolism, mood, sleep, and more. Yet, it's a phase often overlooked in discussions about health and nutrition.

Similar to puberty, this is a natural transition, but the lack of education and societal value placed on this phase can make it feel bewildering. The changes include irregular menstrual cycles, shifts in metabolism, mood swings, sleep disturbances, and bodily discomforts, akin to what happens during adolescence or pregnancy, due to hormonal fluctuations.

The cultural and societal lenses add more layers of complexity to this experience, shaping how we perceive and navigate menopause. While for many people with uteruses the change can feel like an ending of sorts or a lessening of “value”, we should also recognize this phase as a normal part of life and embrace the wisdom and confidence that can come with it.

Coupled with the mental and societal shifts are often changes in our bodies, specifically unwanted weight gain due to the complex interplay of hormonal changes, aging, and metabolic shifts. Our metabolism naturally slows with age, irrespective of menopause, making it challenging to pinpoint exact causes for weight changes during this time.

But despite the scientific quest to separate these factors, the holistic approach considers multiple facets impacting individuals. Understanding that menopause is part of a broader life context helps in providing more tailored advice and support.

What Changes Can I Expect?

As we age, our metabolism naturally slows down, demanding fewer calories to produce energy. This decline is partly due to reduced muscle mass resulting from decreased physical activity over time. However, while aging contributes, menopause specifically triggers shifts in hormone balance, notably dropping estrogen levels.

Estrogen impacts every cell in our bodies, and its decline leads to relatively higher testosterone levels. This hormonal shift alters fat distribution: during higher estrogen periods, fat tends to accumulate around the hips and legs, while declining estrogen prompts more abdominal fat storage, roughly a shift from “pear-shaped” to “apple-shaped” bodies.

Weight gain often begins about 5 to 10 years before the last menstrual period. Research suggests a correlation between increased follicle-stimulating hormone (FSH) levels, rising about a decade before menopause, and weight gain, though this cause isn't definitive. Weight gain tends to occur gradually rather than suddenly, reflecting a slow process rather than an abrupt change.

Apart from hormonal shifts and aging, the stress of busy lives during this phase - juggling careers, caregiving, and multiple responsibilities - often also introduces chronic stress, potentially elevating cortisol levels and affecting physical activity. This aspect remains largely underexplored in scientific literature. Another huge factor is sleep.

Sleep disturbances during menopause often remain overlooked, yet they profoundly impact weight and nutrition. Poor sleep can shift our body into fat storage mode instead of muscle building. It disrupts hunger signals, increasing appetite while reducing satisfaction from meals. Moreover, sleep deprivation affects brain chemicals, prompting cravings for sugary, refined carbs—leading to more fat storage.

Disturbances often stem from menopausal symptoms like hot flashes, but chronic stress might play a bigger role than acknowledged, impacting sleep more than solely menopause-related changes. Addressing how stress impacts lifestyle choices and finding ways to prioritize self-care amid myriad responsibilities might be crucial in understanding weight changes during menopause beyond purely a confluence of physiological factors.

How Can Diet Help?

When it comes to the best diet for menopause, a lot of the research is relatively young and has not studied a diverse cross-section of the population, so keep that in mind and always beware of bold claims! One study of over 4,000 women in the UK showed that those eating in a Mediterranean or UK Food Guide style prompts the least increase in waist size.

However, none of these diets prevented overall weight gain. Kristen’s advice? Eat a bit less overall due to a slowing metabolism and focus on a heart-healthy, blood sugar-managing diet that supports bone health.

Protein is key. It helps maintain muscle, supports bone health, and manages blood sugar. Include protein-rich foods at meals and snacks, think meats, seafood, beans, nuts, and yogurts. Protein also keeps you full longer, reducing snacking. To include more protein, try swapping rice or pasta for beans in dishes or pair snacks like apples with cheese or nut butter.

Don't forget plant-based options like tofu and lentils, which are fiber superstars, and great for heart health and, um, regularity! When making dietary changes, remember that small changes add up over time without overwhelming you or your family - sustainability is key!

What about other health issues tied with menopause?

During menopause, declining estrogen levels increase health risks like type 2 diabetes, higher cholesterol, fatty liver, osteoporosis, and cognitive decline. Estrogen plays a protective role in heart health, blood sugar regulation, bone strength, and cognitive function. Dietary adjustments aim to minimize these risks by supporting heart health, managing blood sugar, and promoting bone health.

For nutritional support, once again protein's a star, along with calcium-rich foods. Beyond dairy, plant-based alternatives like almond or oat milk, leafy greens, nuts, and seeds are great sources. Don't overlook fish with bones, like canned salmon or sardines, as they're calcium-packed and offer omega-3s.

Vitamin D supplementation is often needed, especially in places like Canada due to our latitude. For specific recommendations, it's best to consult a professional, but combining Vitamin D with K2, and magnesium-rich foods are beneficial - think leafy greens and nuts! Nuts and seeds daily can even help reduce cholesterol levels by 5 to 10%, supporting heart health. 

In essence, the perimenopause and menopause transition marks a significant chapter in our lives, and we urge you to acknowledge its normalcy, adapt to changing nutritional needs, and appreciate the wisdom and growth it brings along the way!

Remember, small nutritional tweaks contribute significantly to overall bone and heart health during menopause, as well as aiding to manage the waistline. Sleep is another important factor. And what about alcohol? Be sure to tune in to the full episode for even more facts and perimenopause nutrition tips, as well as checking out these resources!

• HealthLinkBC: provides non-emergency health information to the residents of British Columbia
• Menaupause.org: promoting women's health at midlife and beyond
• MenopauseandU.ca: the facts on menopause from Canada’s experts
• Taking you from anxious and overwhelmed to confident during your childbirth experience: Pregnancy to Parenthood Online Prenatal Masterclass