# Post Menopause: Staying Healthy Through Good Nutrition
## Post Menopause and Nutrition
### Menopause

Menopause refers to the permanent end to a women’s menstrual cycle. A women is considered to reach menopause when she has not experienced a period for 12 months, at 12 months and 1 day, she is then considered to be post-menopausal. The time leading up to menopause is referred to as peri-menopause and this is when women experience most of the typical symptoms of menopause. The symptoms of menopause are caused by a gradual decline in the hormone oestrogen.

### How Does Menopause Effect a Women’s Health?

The health consequences of menopause are mostly due to the loss of oestrogen, hormonal imbalances and changes in body composition. These changes lead to alterations in energy levels, memory, bone health, hormones, urinary and heart health. As a result, post menopausal women are at an increased risk of a number of diseases/conditions. Osteoporosis, cardiovascular disease and being overweight are of particular concern for women at this stage of their life.

### Why is Nutrition Important?

Some risk factors for diseases and conditions cannot be reduced, for example a family history of disease cannot be changed. However a healthy diet along with physical activity is the easiest and most effective way to reduce some risk factors that can have a significant impact on health, including high blood pressure, overweight, obesity and high waist circumference, high blood glucose levels and poor bone density. Healthy eating and exercise have been shown to significantly improve how women feel and aids them in achieving overall good health.

### What Does a Healthy Diet Look Like

All Australians, including those in post menopause, are encouraged to follow the Australian Guide to Healthy Eating which can be found at http://www.eatforhealth.gov.au/guidelines/australian-guide-healthy-eating. The Australian Dietary Guidelines provide the most up to date evidence based advice around the types and amounts of foods that should be eaten for optimal health and wellbeing. Within these guidelines are gender and age based dietary recommendations based on the 5 food groups:
* Vegetables and legumes/beans
* Fruit
* Grain (cereal) foods
* Lean meats and poultry, fish, eggs, tofu, nuts and seeds and legumes/beans
* Milk, yoghurt cheese and/or alternatives
For women:
| | Recommended Serves Per Day for Women | Recommended Serves Per Day for Women | Recommended Serves Per Day for Women |
| | 19-50 yrs. | 51-70 yrs. | >70 yrs. |
| Vegetables & Legumes | 5 | 5 | 5 |
| Fruit | 2 | 2 | 2 |
| Grain (cereal foods) | 6 | 4 | 3 |
| Meat, fish & alternatives | 2.5 | 2 | 2 |
| Dairy & alternatives | 2.5 | 4 | 4 |
Adapted from the NHMRC's Australian Guide to Healthy Eating (2013)
NOTE: Once a women moves into the years of menopause (~50 years +), there is a decrease in the number of recommended serves of grain foods and meat and alternatives and an increase in the recommended serves of dairy and alternatives.

## Nutrition and Bone Health

After menopause, women experience greater bone loss due to reduced oestrogen levels and there is a decrease in their bodies ability to absorb calcium. This puts post-menopausal women at greater risk of osteoporosis. As a result of this, calcium requirement increases from 1000mg to 1300mg and the recommended number of serves per day of dairy and alternatives increases from 2.5 to 4. This recommendation is poorly met by Australian women, 90% of women over 50 do not meet the recommendation for calcium and the average intake is less than 1 serve of dairy per day.

### Sources of calcium to meet the requirement:

* Reduced fat dairy (milk, yoghurt, cheese)
* Fortified soy products (eg: milk, tofu)
* Fish with edible bones (eg: sardines, salmon)
* Fortified cereals
* Leafy greens
* Almonds

## Nutrition and Heart Health

Cardiovascular disease (CVD) is the number one cause of death in not only post menopausal women but in Australia nationally. In 2011, 31% of all deaths in Australia were attributed to cardiovascular diseases. Oestrogen plays an important role in keeping arteries healthy. The drop in oestrogen during menopause therefore decreases this protection. In addition, as we age LDL cholesterol and triglycerides naturally increase (LDL cholesterol and triglycerides increase CVD risk). As a result of these changes, post menopausal women are at an increased risk of cardiovascular disease and heart health is particularly important.

### Tips to improve your heart health through nutrition

* Make plant based foods the main part of each meal (vegetables, fruit, legumes, cereals, wholegrain bread, pasta and rice) - these foods contain soluble fiber which has been shown to lower cholesterol
* Limit salt in processed foods and in cooking and at the table
* Eat foods containing unsaturated fats (reduce LDL cholesterol) and reduce intake of foods containing saturated fat (increase LDL cholesterol)
Unsaturated fat sources: Oily fish (e.g. salmon, sardines, mackerel), plant based oils (e.g. olive oil), avocado, nuts and seeds.
Saturated fat sources: Red meat (untrimmed or highly marbled), full fat dairy, baked/fried products (e.g. cakes, pastries & other snack foods), butter.

## Nutrition and Weight Maintenance

Naturally as we age we gradually lose muscle mass, this means we require less energy to fuel our bodies . So for a women moving through menopause her energy requirement is decreasing, but it is common for women to be unaware of this and continue on eating as normal, or possibly in excess, therefore gaining weight. In general, women post menopause tend to gain weight around the abdomen, more so than their thighs or hips. This is of particular concern in regards to increasing risk for diseases such as cardiovascular disease and diabetes.

### Tips for weight maintenance

* Follow the Australian Guide to Healthy Eating
* Choose wholegrain/high fibre varieties of cereals and breads to increase feelings of fullness
* Opt for low fat dairy products
* Control portion sizes
* Limit alcohol intake
* Grill, steam, poach, stir fry, bake and roast over frying in oil or butter

## For More Information

* General menopause and nutrition http://www.managingmenopause.org.au/
* The Australian Guide to Healthy Eating http://www.eatforhealth.gov.au
* Heart health http://www.heartfoundation.org.au
* Bone health http://www.healthybonesaustralia.org.au

## References

* ↑ Women to Women. (2011). Understanding what menopause is. Retrieved from http://www.womentowomen.com/menopause/postmenopausal.aspx/
* 1 2 Women's Health Concern. (2009).Focus on… Diet, nutrition and the menopause. Retrieved from http://www.womens-health-concern.org/help/focuson/focus_dietmenopause.html/
* 1 2 3 4 5 Jean Hailes for Women's Health. (2012). Understanding what menopause is. Retrieved from http://www.managingmenopause.org.au/images/stories/Education/Documents/info/nutritional_tips.pdf/
* 1 2 National Health and Medical Research Council. (2013). Australian Dietary Guidelines Summary. Retrieved from Australian Government Department of Health and Ageing : http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/n55a_australian_dietary_guidelines_summary_book_0.pdf
* ↑ Healthy Bones Australia. (2012). Calcium. Retrieved from http://www.healthybonesaustralia.org.au/how/calcium/
* 1 2 The Heart Foundation. (2012). Data and Statistics. Retrieved from http://www.heartfoundation.org.au/information-for-professionals/data-and-statistics/Pages/default.aspx