White bread’s the enemy, says leading nutritionist

So often, women who are struggling with some of the more unpleasant physical symptoms of menopause don’t make the connection between what they’re eating and how lousy they feel.

But it’s an incredibly important link to make because if you get the nutrition right — using food to support your body instead of working against it — this can make a huge difference to how you cope with that inevitable stage in a woman’s life.

The problem is that many of us arrive at the menopause still eating and drinking as we did in our youth.

Instead, we need to accept that the days when we could skip meals, eat on the hoof and still feel fresh as a daisy after indulging in several glasses of wine the previous evening are, to put it bluntly, long gone.

So often, women who are struggling with some of the more unpleasant physical symptoms of menopause don’t make the connection between what they’re eating and how lousy they feel (file photo)

Menopause is a time of physical transition. If you are a mother who has seen a child through puberty then you will, no doubt, have made sure that they were well-nourished throughout. But it’s not just a child’s developing body that needs regular meals which are balanced, healthy and bursting with nutrients.

If you’re approaching or going through the menopause, then your body will also be working overtime as it adjusts to the associated hormonal changes.

In other words, you need to start taking care of yourself the same way you would a pubescent child.

Unfortunately, as women, we’re not exactly primed to put our own needs first. We’re hard-wired to nurture; to make sure that those we love have everything they need without giving the same consideration to what we might be lacking. Indeed, many of us have a blind spot when it comes to recognising the relationship between our physical ailments and not taking good enough care of ourselves.

Combating hot flushes and night sweats

Hot flushes can range from the occasional sensation of a slight increase of your inner thermostat to making you feel like a scarlet, dripping wreck.

In some cases, hot flushes can be so severe that you almost feel as if you’re on fire.

Menopausal night sweats can be highly disruptive to sleep, too. You get hot, the bed gets hot and it can be very tough if you’re sharing the bed with your partner.

Try eating:

• Phytoestrogens, which are plant compounds that bind to oestrogen receptors in the body and may help with hot flushes. Good food sources include soya products, flaxseed, pulses, broccoli and fennel.
• Fibre, which binds to and eliminates old hormones in the gut, helping to balance oestrogen levels. Wholemeal bread, brown rice, wholegrain pasta and oats will all boost fibre levels. You should also aim to eat five portions of different vegetables each day.
• Many herbs have traditionally been used to relieve hot flushes. Research suggests that the antioxidant compounds in sage leaves help to regulate the mechanisms that manage our body temperature, which in turn helps to relieve menopausal hot flushes.

Foods to avoid:

• Steer clear of anything that causes blood vessels to dilate, as this sends blood to the surface tissues under the skin, causing your skin to flush and possibly making your symptoms worse.
• Typical culprits include alcohol — in particular red wine — and spicy foods such as chillies, cayenne pepper or paprika, as well as caffeine.

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Any woman wanting to embrace the menopause — and experience it as a happy transition rather than a depressing decline — needs to adjust their thinking.

Menopausal symptoms can extend far beyond the hot flushes that people generally associate with this life stage. Women sometimes come to my nutrition clinic looking for help with other physical problems, without necessarily realising they’re connected to the menopause.

Some might talk about experiencing depression, anxiety, brain fog and debilitating exhaustion. Others complain of lank hair, aching joints and brittle nails.

Many women are plagued by headaches. Insomnia, persistent UTIs and lost libido can cause problems, too.

Once I start looking at what they’re typically eating it soon becomes apparent why they are struggling — they aren’t eating the right foods in the right quantities needed for their bodies to function properly.

‘I’m eating the same way I always did,’ is a refrain I often hear. But the menopause puts the body under huge strain. To cope, it needs the right fuel in the tank — and plenty of it.

HRT helps many women suffering with extreme menopausal symptoms. But if your body is poorly nourished, you will still face an uphill battle even with those extra hormones in your system.

Now is the time when your nutrition levels need to be at their absolute optimum. A big problem in achieving that is a general misunderstanding of what we think we should be eating in the first place.

The generation of women now going through the menopause grew up being conditioned to believe that calories are something to restrict and that dietary fat is the enemy. We need to flip that thinking on its head.

It’s a huge mistake to eliminate foods such as nuts, avocado, hummus, oily fish, or meat from grass-fed cattle just because they’re high in fat.

These foods are actually every menopausal woman’s friend, because they contain good levels of mono and polyunsaturated fats which, in the right balance, will speed up your metabolism, support brain and heart health, keep your hormones happy and leave your skin in great shape.

Following an overly restrictive diet or a drastic detox might — if you’re lucky — help you lose a few pounds in the short term, but in my clinical experience this quick fix is soon reversed.

More likely is that you’ll confuse your metabolism and your body will seek to regularise the situation, meaning you may find that you regain or even exceed your original weight a few months later.

Understanding how the body uses the calories from different types of food to achieve varying things helps debunk the idea that they are something you need to count and restrict.

Dietary fats could certainly do with a rebrand when it comes to helping women get through the menopause.

Our bodies use fat to create sex hormones. If ever there’s a time we need to support our bodies in that vital work, it is now, during the menopause. The fact that calories from fat can support heart and brain health, too, makes following a very low-fat diet counterproductive for any woman struggling with brain fog.

Fats also activate what’s called the satiety response, which is when your brain knows to tell your body that you are full, preventing you from over-eating. So, you see, fat really isn’t the enemy at all.

Women also don’t prioritise protein in their diets enough. Yet it aids every bodily function: it helps the body heal wounds; develop and maintain muscle strength (including within the most important muscle of all, your heart); build bones; and replenish your skin, nails and hair.

The body also uses the amino acids found in protein to create vital neurotransmitters that govern mood, memory, motivation and concentration. These are all key factors for women in midlife.

We really ought to be eating protein with every meal. And yet new clients often tell me they eat a bowl of cereal for breakfast and a salad for lunch (because they’re counting calories), only finally getting a portion of protein onto their plate, in the form of chicken or fish perhaps, with their evening meal. That’s nowhere near enough.

Not all carbs are the bad guys

Carbohydrates are another food group that gets demonised. People often seem to think they ought to cut carbs out in pursuit of good health.

It’s true that not all carbs are created equal. An interesting nutritionist-led study published recently made the point that simple carbs, such as white bread, rice and pasta, can increase a menopausal woman’s risk of gaining weight and developing diabetes.

The study of more than 1,000 women found that those who were post-menopausal experienced a bigger blood sugar spike after eating these kinds of foods than pre-menopausal women of the same age.

Take six or seven slow, deep breaths in and out per minute, instead of the usual 13 or 14 breaths.

Over time, high blood sugar can damage organs and lead to serious health conditions such as heart disease and diabetes. Clearly, it’s incredibly important to avoid blood sugar spikes. But you can achieve that without cutting out carbs altogether, as you need these in your daily diet because they are a quick and easy energy source.

Instead, you should swap out simple carbs for complex carbohydrates — such as brown rice, rye bread, wholemeal pasta — which provide a steady release of energy as opposed to a short-lived spike.

If you eat these foods alongside a fat or protein source — or, better still, both — then you slow the blood sugar release yet further.

Vegetables, fruit and pulses also contain complex carbohydrates and, along with the wholegrain foods I just mentioned, they’re packed with fibre, which plays a crucial role in healthy digestion.

Fibre binds to old hormones, making sure that they’re properly excreted rather than reabsorbed into the bloodstream, where they can potentially disrupt the balance of hormones at a time when they’re already fluctuating like crazy.

Eating to beat the menopause is all about having a bit of everything and being sensible about portions, without freaking out over the calories. A great afternoon snack when your energy levels are dipping would be half a dozen raw, unsalted almonds and an apple — a combination of protein and fibre, which is perfect for balancing blood sugar levels.

It’s no good thinking: ‘Oh, but nuts are fattening,’ and deciding to try to hold out until your evening meal.

What happens then is that you get the munchies and end up grabbing a couple of biscuits — and they aren’t going to help you at all.

Keep stress in check

When our ovaries stop producing oestrogen, our adrenal glands — which sit just above the kidneys — take over as the back- up system.

These are a vital player during the menopause, because they make a weak form of oestrogen that helps to keep us fit and well through midlife and into old age.

However, there is a catch: the adrenal glands are also responsible for making our stress hormones, cortisol and adrenaline, and when they are too busy doing that, oestrogen production doesn’t even get a look in.

If you’re struggling with chronic stress, then the chances are your menopausal symptoms will be significantly worse, because your adrenal glands are distracted, depriving your body of the vital oestrogen it needs.

It’s easy to start questioning whether it’s the sign of a serious medical condition, but the chances are it’s all about your hormones.

Try eating:

• Fish is traditionally considered to be ‘brain food’, and this is largely due to the high levels of omega-3 fatty acids found in oily fish, such as salmon, mackerel and sardines.
• Our brain is made mostly of fat, so a very low-fat diet is unhelpful if you want to improve mental clarity.
• Phosphatidylserine and alpha lipoic acid support memory and cognitive function. Phosphatidylserine is typically found in white beans and soya beans, while alpha lipoic acid is present in small amounts in most foods.
• Low levels of iron can lead to memory loss, and anaemia is very common among women who experience flooding (heavy bleeding) during the perimenopause. Red meat, sardines, pulses, spinach and broccoli can all keep you nicely topped up with iron.
• Flavonoids — powerful antioxidants that have an anti-inflammatory effect — are believed to boost cognitive function and memory. Blueberries and spinach are good sources.

Foods to avoid:

• Limit your intake of refined sugars found in chocolate, confectionery, baked products and sugary drinks. These will disrupt your blood sugar balance, which will affect your concentration and focus.
• Keep alcohol to a minimum. Regular alcohol consumption will play havoc with cognitive function, and drinking to excess can cause memory loss.
• Alcohol also impairs sleep by disrupting sleep cycles. Consistent lack of sleep makes it very difficult to concentrate and process information effectively.

It’s fairly safe to say that the years around the perimenopause and the menopause are among the most stressful in a woman’s life: juggling the pressures of work with the needs of a growing family and the clash of hormones if puberty coincides with menopause in your household.

Midlife is also often a time when women are reassessing their relationships, which can be painful. We are also the sandwich generation, caught between caring for our elderly relatives and our children.

So, there’s plenty of stress going on, which sidetracks the adrenal glands at the very time when we need them to be focusing on producing oestrogen.

That’s why taking a nutritional approach to reducing levels of stress hormones in the body, so that your adrenal glands have the time and the space to get on with that job, is so important.

Keeping your blood sugar balanced is crucial for getting your stress hormone levels in check.

When your blood sugar is low, you feel tired, irritable, anxious, shaky, headachy, dizzy and absolutely desperate for a pick-me-up.

Sugar is the body’s primary source of energy, so a blood sugar crash is bad news, which is why the stress hormones cortisol and adrenaline are released to redress the balance.

They will send a message to the liver, instructing it to release sugar stores into the blood.

Cortisol also generates powerful cravings for sugary foods and refined carbohydrates — or possibly a cup of coffee or a glass of wine, depending on what time of day it is. Your body instinctively knows that this will give you that quick fix.

It’s a double whammy — the liver releases the sugar stores, you’ll grab a sugary snack and, instead of settling back within the required range, your blood sugar will spike and the whole process starts all over again.

You can see how easy it is for blood sugar levels to end up on a rollercoaster ride over the course of the day, which means that your adrenal glands are continually releasing stress hormones, and that puts oestrogen production very much on the backburner. Typical symptoms of a blood sugar imbalance include fatigue, low energy, cravings for sugar or carbs, PMS, mood swings, insomnia, irritability, low mood, anxiety, headaches, dizziness, difficulty getting going in the morning, palpitations, reliance on caffeine or alcohol for a quick boost, and weight gain.

You need two key nutrients to balance your blood sugar. The first are complex carbohydrates, which are high in fibre and will release sugar into the body more slowly than refined carbs.

The second is protein, which is hard to digest and slows down the release of the carbohydrate, keeping you going for longer and maintaining that blood sugar balance.

The trick is to eat a combination of protein and complex carbohydrates with every meal and snack.

In parallel to this, you need to avoid sugary foods and refined carbohydrates, such as cakes, cookies and chocolate.

This might seem like a gargantuan task, but if you keep your blood sugar stable, you’ll be far less prone to the sugar cravings that drive you during a blood sugar crash and this will make things easier fairly quickly. In essence, your brain will determine your food choices, rather than your hormones.

Be smart about your snacking

Smart snacking is crucial to maintaining blood sugar levels, because no matter how balanced your meal is, if you then don’t eat again for five or more hours, your blood sugar will drop, and out will come the stress hormones.

On average, most people will need to eat something roughly every four hours to keep their blood sugar on track.

If there’s a long gap between lunch and dinner, it’s no surprise that the dreaded afternoon slump kicks in at around 4pm.

This is the time for a carefully balanced snack, and here are a few ideas:

• 6–7 raw unsalted nuts with an apple, plum or satsuma.
• 1–2 oatcakes with unsweetened nut butter or cottage cheese.
• Carrot sticks, cherry tomatoes or other chopped vegetables with hummus.
• Slices of apple dipped in unsweetened peanut butter.
• A cereal bar containing at least 8g of protein and 4g of fibre.
• A mini pot of plain yoghurt with blueberries and a tablespoonful of sunflower         seeds.
• A hard-boiled egg with a handful of spinach leaves.