Following a Mediterranean diet may play a role in improving women's wellbeing during their menopausal years. By Jennifer Bowden
Can the food she eats and what she drinks affect a woman's experience of menopause?
Most women feel unprepared for menopause, according to a 2018 study in the journal Maturitas. Perhaps not a surprising finding, due to the lack of clear guidance given to women on how to manage the barrage of symptoms that arrive in midlife – from hot flashes to night sweats, disturbed sleep, mood swings, anxiety, irregular periods, decreased fertility, increased abdominal fat, thinning hair and more. Menopause may be a natural biological change in a woman's life cycle – the end of menstruation and fertility – but it's not often a recipe for quality of life in the short term.
Add to that the increased risk of cardiovascular disease and osteoporosis that accompanies menopause. Heart disease is the leading cause of death in New Zealand women. An estimated one in three women over 50 will suffer an osteoporotic fracture, according to the International Osteoporosis Foundation. So, is there something we could, and should, do to improve our wellbeing during the perimenopause 9the transition to menopause) and to boost our long-term health?
There is increasing recognition that diet can help improve women's health at menopause, as well as reducing the risk of diseases such as cardiovascular disease, osteoporosis, dementia and cognitive decline. Moreover, there is evidence to suggest that certain dietary patterns, in particular the Mediterranean diet, may reduce the particularly unpleasant side effects of perimenopause, such as vasomotor symptoms like hot flashes and night sweats.
There is no one exact Mediterranean diet; rather it is a group of dietary patterns characteristic of people traditionally living in the Mediterranean region. The most notable characteristics include: a high intake of olive oil, nuts, vegetables, fruits, and wholegrain cereals; moderate intake of fish and poultry; low intake of dairy products, red meat, processed meats and sweets; and wine in moderation, consumed with meals.
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In one study following more than 6000 Australian women, those whose diet more closely adhered to a Mediterranean diet had a 20 per cent lower risk of experiencing hot flashes and night sweats. Still, that doesn't prove it caused the lower risk, just that it is associated with it.
The Women's Health Initiative, however, was a large randomised controlled trial involving 6104 post-menopausal women that delivered intensive education and counselling to encourage the women to alter their dietary pattern and shift to a higher plant intake similar to a Mediterranean diet.
Among women with mild vasomotor symptoms, shifting to a plant-based diet increased their chances (by 14 per cent) of eliminating their vasomotor symptoms entirely within 12 months. However, there was no improvement among women with moderate to severe vasomotor symptoms.
Studies have also found compelling evidence that following a Mediterranean diet reduces the risk of depression. In one randomised controlled trial, participants with major depression, who were mostly women in early perimenopause, found that sticking to this type of diet for three months significantly improved their depressive symptoms and increased the chances of their depression moving into remission.
Given what is known about the positive long-term health benefits of a Mediterranean diet, and its impact on symptoms associated with menopause, it has been recommended by the European Menopause and Andropause Society, which released a position statement in 2020. It noted that long-term high adherence to a Mediterranean diet may reduce the risk of diseases such as cardiovascular disease, cancer, osteoporosis and more. In the short term, it may improve vasomotor symptoms associated with menopause, cardiovascular risk factors such as blood pressure, cholesterol and blood glucose levels, and mood and symptoms of depression.
So, while there is no miracle dietary cure, there is hope. Either way, a Mediterranean dietary pattern is going to benefit long-term health in a plethora of ways, and potentially may also mitigate many of the unpleasant side effects of menopause. Bear in mind, too, that your GP or a specialist endocrinologist will have more information on options to help you through this transition.