Nutrition After Menopause – Be Your Best at Every Age

Bruce Young, MD

Health care professionals are often asked by their female patients, friends and family members if nutrition needs change with aging, and especially after menopause. For women, every stage of life brings different nutritional needs. To be your best at any age, good nutrition and physical activity are foundational.  For example, as a girl grows into a woman, her nutritional needs change to support growth and development. If she becomes pregnant her nutritional needs undergo enormous shifts. And in menopause, they change yet again. These changes are governed by her hormones, level of physical activity, and her diet.

For everyone, the brain and body require the right nutrients, in the right amounts, at the right time.

  • A woman needs carbohydrates as the energy source for the chemical processes of metabolism.  Carbs are the primary fuel to carry out the tasks that keep her functioning. Without the recommended amount of carbohydrates, the body can use protein for energy, potentially making protein less available for muscles, supporting tissues and bones.  Fat also provides energy, but the body needs carbohydrates as a more efficient fuel. All carbohydrates are a first-rate energy source.  Excellent sources of carbohydrate are grain foods like bread, cereals and pasta, as well as fruits and vegetables.
  • A woman also needs protein to support growth, muscle and tissue development and maintenance.  Meat, fish, eggs, nuts, beans, and dairy foods (like milk, cheese, and yogurt) are examples of excellent sources of protein.
  • The third major group of nutrients is fat. Fat is nature’s way of storing energy, so a well-nourished person needs less of it than other nutrients, and too much of it is predisposing to health problems.  Fatty fish like salmon, nuts and nut butters, seeds, and vegetable oils (olive oil, safflower oil, canola oil, and soybean oil) are examples of healthy fats.

These basic nutritional needs are consistent throughout life, but things shift with menopause. Menopause means menstruation has stopped for at least one year, and the time after that is called “postmenopause.”  In developed countries, where life expectancies are long, women can live in postmenopause for one-third to one-half of their lives. To make the best of those years, women should know that during menopause weight tends to increase and calorie needs tend to decrease.  With more quality carbs (i.e., more grain foods and less sugar), weight control is easier. In a study with older adults aged 60-80 years, whole grain and cereal fiber intake was associated with lower total percent of body fat, and lower abdominal fat mass (“belly fat”).

Proper nutrition is somewhat different after menopause because there tends to be loss of bone, connective tissue and muscle mass. Regular exercise is very important to maintain wellbeing. In the postmenopausal period, aging may be accompanied by joint and muscle changes and some loss of strength, limiting exercise and vigorous physical activity.

The hormones that cause the menstrual cycle, estrogen and progesterone, are only minimally detectable after menopause. These hormonal changes may result in easy fatigability and decreased feeling of energy.  Many clinicians believe that this can result in a woman’s body responding by making her crave carbohydrates, usually as bread.  Energy is usually increased with appropriate carbohydrates, including refined as well as whole grains, so yes, eating bread is just fine.  Women also need more fiber, for proper digestive health. Cereals, whole grains and high-fiber breads, fruits, and vegetables are important contributors for meeting fiber needs.  Milk and cheese and leafy vegetables are great for calcium, needed for strong bones.  Eating nutrient-rich foods, like whole and enriched grains, provides vitamins and minerals required for good health.

Proper nutrition is strongly associated with preserving mental function as a woman enters menopause. The Mediterranean diet – emphasizing vegetables and complex carbohydrates such as whole grain breads, cereals and pasta, olive oil and fish oils low in saturated fats – has been associated with improving brain function as well lowering the risk of heart disease in older women. After menopause, the decreased hormone levels associated with aging may affect cognition. This can be combated with mental activities that challenge the mind, such as reading, working crossword puzzles, or learning a new language. Maintaining social relationships and remaining physically active also help keep the mind sharp.

More than a third of the American population is over 50 years old and the number of women entering menopause is increasing. They spend billions of dollars and considerable effort trying to stave off the aging process. It is a myth that menopause is always associated with decline.  The women you care for need to know that a healthy diet, physical activity, and mental and social stimulation are the keys to enjoying the postmenopausal years and a long vigorous life.