Nutritional guidance on the journey through menopause
Categories Advice, Food, Health, Hormones

Nutritional guidance on the journey through menopause

Read this article published on the Daily Times. Nutritional guidance on the journey through menopause.

Over the course of Jennifer Lawrence’s  10-year career as a registered dietitian, she has seen many women nearing their 50s spend years with their body feeling different as they journey through menopause and experience a host of different signs and symptoms.

According to the AARP, while menopause is defined as the point in time 12 months after a woman’s last period, perimenopause (the transition to menopause) most often begins between the ages of 45 and 55 and lasts an average of seven years, but can be as long as 14 years.

While hot flashes, night sweats, moodiness and irritability are some of the more common physical signs, others might surprise you once you get your blood labs back after your annual check-up.

“It’s common to see lab results start to change,” Lawrence said. “There can be a change to cholesterol numbers and fasting glucose.”

Lawrence, the co-author of Prevention Magazine’s 28-Day Get-Lean Diet for Women Over 40, which includes tips on tackling the major obstacles that happen during perimenopause and menopause, further explained that our risk of insulin resistance increases when estrogen levels start to decline, which can lead to pre-diabetes or other negative health outcomes.

Your diet can serve as a tool in your toolbox to help manage the transition to menopause. (Pexels)
Your diet can serve as a tool in your toolbox to help manage the transition to menopause.

Quality of diet

When it comes to cholesterol, Lawrence usually takes an overall look at the quality of one’s diet. She highlighted two factors, fiber and unsaturated fats, that can contribute to healthier cholesterol levels, so it’s important to be mindful of them.

javascript:false

High cholesterol can increase our risk of cardiovascular disease, and when our estrogen and progesterone levels are altered during menopause, our body doesn’t have the same support for  managing cholesterol.

Dietarily, she said that fiber, especially soluble, is really important for managing cholesterol, which is an important compound of the body.

“There are a lot of really good sources,” she said. “Oats are one of the highest in soluble fiber.”

Other good sources Lawrence recommended are sweet potatoes, beans, avocados and Brussels sprouts.

Mono and polyunsaturated fats

In terms of fats, Lawrence said one should consume a higher percentage of mono and polyunsaturated fats in your diet over saturated fats.

“Unsaturated fats can help raise your HDL, which is your good cholesterol,” she said. “What they have found through studies is that HDL is more anti-inflammatory and LDL is more inflammatory, which is more linked to heart disease.”

Lawrence isn’t saying you have to omit saturated fats, found in things such as marbled red meat, butter or ghee, but suggests eating them in moderation with a higher focus on consuming unsaturated fats, such as those found in avocado oil, olive oil, nuts, seeds, avocados and olives.

In addition to keeping your cholesterol in check, Lawrence emphasized the importance of being mindful of your bone health.

“It is absolutely essential for women at this stage to be aware of their bone health since they are at a higher risk for bone density loss,” she said.

Top four nutrients for bone health

According to Lawrence, the top four nutrients to be aware of for bone health are vitamin D, calcium, vitamin K2 and magnesium, which lowers inflammatory response and is good for digestion and our heart.

“You can get magnesium from dark, leafy greens, pumpkin seeds, which are one of the highest forms, spinach, almonds, avocado and black beans,” she said. “You can get calcium from dairy products, dark leafy greens and sesame seeds.”

While your calcium and magnesium needs can be met through food, Lawrence said that since an adequate amount of vitamin D and K2 may be harder to obtain through diet, it’s important to discuss with your doctor whether or not supplements may be necessary. K2 is essential for your body to properly get vitamin D and calcium to the bones.

“It’s important to go to the doctor to get your bloodwork,” she said.

Phytoestrogens

To help manage symptoms related to menopause, Lawrence educates her clients on foods that are high in phytoestrogens, such as natural forms of soy, like edamame, tempeh and tofu, as well as other foods, such as apples, lentils, chickpeas, ground flax seeds and yams.

“These are all plant-based foods that have estrogen-like characteristics,” she said. In studies, women who consume these report less symptoms related to menopause.”

She suggests adding more of these foods to your diet, so it gets more variety.

“These are all really healthy, wonderful and beautiful foods, and they’re going to help you feel better and more supported through the menopause process,” she said. “We can’t stop the biological change, but we can wake up to our diet and it can be one of the many tools in our toolbox to help us manage the transition.”

Right Balance Integrative Nutrition

Jennifer Laurence, registered dietitian, Integrative and functional nutritionist, is the founder and owner of Right Balance Integrative Nutrition in West Chester and the co-author of Prevention Magazine’s 28-Day Get-Lean Diet for Women Over 40.

For more information, visit www.rightbalancenutrition.com or call 484-401-7837.

Categories Hormones, Exercise, Nutrition, Protein, Weight Loss

Thyroid: Is it to blame for your weight gain and fatigue?

Are you constantly struggling to lose weight even though you eat right, exercise regularly, and get plenty of sleep? If so, the reason could be your thyroid.

The thyroid is a butterfly shaped gland located in the neck. It is a major gland of the endocrine system and affects nearly every organ in the body.

Your thyroid helps to regulate the following:

  • Metabolism (How the body burns and stores carbs, fats, and proteins)
  • Body temperature
  • Calcium Balance
  • Heart rate and cellular oxygenation
  • Hormone balance including depression and anxiety

One of the most common types of thyroid disorder is an underactive thyroid. This is known as hypothyroidism. According to the American Thyroid Association:

Hypothyroidism means that the thyroid gland can’t make enough thyroid hormone to keep the body running normally. People are hypothyroid if they have too little thyroid hormone in the blood. Common causes are autoimmune disease, such as Hashimoto’s thyroiditis, surgical removal of the thyroid, and radiation treatment.”

Since your thyroid helps to regulate your metabolism, an underactive thyroid can cause a slower metabolism and in some cases make it to come to a complete standstill. Individuals with hypothyroidism may find it extremely difficult to lose weight, no matter how healthy they eat and how often they exercise.

In addition to weight gain and difficulty losing weight, other signs of hypothyroidism include:

  • Fatigue
  • Anxiety / depression
  • Intolerance to cold
  • Goiter
  • Elevated cholesterol (LDL)
  • Constipation
  • Food sensitivities
  • Thinning hair
  • Dry brittle nails
  • Low libido
  • Brain fog/memory loss
  • Thinning outer eyebrow
  • Micronutrient deficiencies
  • Impaired methylation
  • Muscle weakness
  • Numbness in the fingers or hands
  • Headaches
  • Menstrual irregularities

Knowing Your Numbers:

Have you had your thyroid tested and been told it’s “normal” even though you are still feeling lousy? How frustrating! While your numbers may be in the normal range according to a lab company, they may not be optimal. Optimal means you are feeling well. Or, more commonly, not all of your thyroid numbers may have even been tested.

One of the most comprehensive ways to determine if your thyroid is functioning at its best, is a have your doctor run a full thyroid panel. A full thyroid panel will look a variety of thyroid numbers, not just your TSH. It will give you a lot more information about your thyroid, including a test for thyroid autoimmune disease such as Hashimoto’s or Grave’s.

A full thyroid panel should include:

  • TSH
  • Free T4
  • Free T3
  • Reverse T3
  • Thyroid Peroxidase Antibodies (TPOAb)
  • Thyroglobulin Antibodies (TgAb)

If you have only had your TSH or T4 tested, and are still experiencing symptoms, it may be time to talk to your doctor or endocrinologist about further testing.

Foods To Include:

To support a healthy thyroid, I recommend a whole foods diet with plenty of lean protein, fruits, vegetables, healthy fats, and complex carbohydrates. Consider organic fruits and vegetables (use the Clean 15/Dirty Dozen list as a guide) meats without antibiotics, dairy without hormones, and non-GMO fermented soy in limited amounts only. Drink plenty of water. Set a goal to drink half of your body weight in ounces each day (For example, a person who weighs 150lbs would drink 75oz in water per day). For weight management, stick to your appropriate calorie range, keep carbs low, and balance with plenty of protein. Aim for 25g of fiber per day minimum.

In addition, be sure to include thyroid supportive foods that are rich in Vitamin D, iron, selenium, iodine, zinc, Omega 3 fatty acids, B12, and anti-inflammatories such as:

  • Lentils
  • Spinach
  • Sardines
  • Tuna
  • Crab
  • Lobster
  • Oysters
  • Eggs
  • Sea salt / Kelp /iodized salt
  • Brazil Nuts – about 2 per day
  • Beans (if tolerated)
  • Dark chocolate (in moderation)
  • Olive oil
  • Almonds
  • Cashews
  • Avocado
  • Sweet potatoes
  • Oats
  • Grass fed beef
  • Poultry
  • Flax seed
  • Pumpkin seed
  • Sesame seed
  • Tumeric

It is also important to include fermented foods to heal the gut such as kefir, sauerkraut, miso, yogurt, fermented vegetables, and Kombucha

Foods to modify:

  • Cruciferous vegetables – Foods such as broccoli, cauliflower, kale, Bok Choy, Brussels sprouts, cabbage, collards, watercress, radishes, arugula, and mustard greens contain goitrogens. In a person with hypothyroid disease, goitrogens can attack the thyroid and produce what is known as a goiter. Let me be clear, you do not need to avoid these foods! You just need to cook them first. Cooking will break down the goitrogenic properties and make them safer for your thyroid.

Foods to limit/avoid:

  • Gluten*
  • Dairy*
  • Millet
  • Soy (in some cases)
  • Coffee – Limit, consume 1-2 hrs after taking medication
  • Added sugars
  • Trans fats
  • Fast food
  • Common food sensitivities should be ruled out
  • Halogens including chlorine and fluoride (can inhibit iodine update)
  • Environmental toxins (Plastics, synthetics, pesticides, xenoestrogens)

*It is important to note that celiac disease, gluten sensitivity, and dairy intolerance should all be ruled out. There is evidence that supports a correlation to thyroid disease and celiac disease. If autoimmune disease is present, there is evidence to support a GFDF diet can help.

Supplements to consider (Not all of these supplements may be needed. Certain supplements should only be considered if you are deficient. I recommend micronutrient testing to determine your needs)

  • Daily Multivitamin
  • Vitamin D3
  • Fish Oil
  • Iron
  • Selenium
  • Vitamin A
  • Vitamin E
  • Zinc
  • Certain Antioxidants

Supplements that may interfere with thyroid medication:

  • Calcium, fiber – If taking, space apart from your thyroid medication
  • Biotin – Can interfere with thyroid tests

Finally, be sure to get plenty of exercise and manage stress. Here are some additional treatment therapies to consider:

http://www.thyroid.org/thyroid-disease-cam/

Resources:

Gaby, Alan R., MD. Nutritional Medicine. Alan R. Gaby, M.D., 01/2011. VitalBook file.

Murray, M. T., & Pizzorno, J. (2012). The Encyclopedia of Natural Medicine, 3rd Edition. New York, New York: Atria paperback.

http://www.umm.edu/health/medical/altmed/condition/hypothyroidism

https://my.clevelandclinic.org/health/diseases/8541-thyroid-disease

https://www.thyroid.org/hypothyroidism/

http://www.todaysdietitian.com/newarchives/070112p40.shtml

https://www.eatright.org/food/vitamins-and-supplements/nutrient-rich-foods/the-beginners-guide-to-cruciferous-vegetables

https://www.amymyersmd.com/thethyroidconnection/

Categories Weight Loss, Exercise, Health, Hormones, Sleep, Stress

Menopause and Weight Gain

Menopause. That notorious phase of life where one is prone to mood changes, fluctuating stress levels, anxiety, hot flashes, insomnia, food cravings and weight gain.

I counsel women about this topic all of the time. What I typically see is someone who is restricting calories, engaging in high intensity cardio multiple times per week, and not losing one pound. One of the most important things I want women to know is that there is A LOT going on behind the scenes during this time that is causing that stubborn weight gain, and much of that may not be your fault. And while a healthy diet and exercise are important, it may take more then that to handle the major fluctuation in hormone levels that can occur.

As your ovaries begin to decline in estrogen production, your body will try to compensate by producing estrogen in other ways. One way is through your fat cells. This is why it is so common for women to gain weight (especially in their abdomen) during menopause. Those fat cells are trying to produce and hold on to estrogen. Your body will make it much harder to lose fat then it will to gain it.

In addition, your adrenal glands (which regulate the stress hormone cortisol) will also try to support your declining sex hormones, essentially working overtime to help your body regulate itself. This is a problem because cortisol can then become out of balance, and run high or low at the wrong times. Normally, cortisol should be highest in the morning upon waking, giving us energy to start our day. Throughout the course of the day, cortisol should gradually decline and be at its lowest as we prepare for sleep. When cortisol becomes imbalanced, it can end up running high at night (causing insomnia) or low in the morning (causing fatigue). Or sometimes, cortisol will run high all day long. When this happens, it can cause your blood sugar to chronically run high, which can lead to increased appetite, food cravings, weight gain, and insulin resistance. Cortisol also plays a role in causing symptoms like hot flashes and night sweats.

So what’s a woman to do?

The following strategies can help…

Balance your plate

The first thing I typically recommend is to balance your blood sugar with plenty of high fiber non-starchy vegetables, complex carbs, lean protein, and healthy fats. Complex carbs include fruit, starchy vegetables, beans, legumes, and high fiber grains such as quinoa. For protein, I like to recommend wild caught fish, free range chicken or turkey, and grass fed beef. Healthy fats would include olive oil, grass fed butter, ghee, coconut oil, nuts and nut butters, seeds, and avocado.

Do not deprive yourself of calories

It’s important to note that while we are normally inclined to limit calories in order to lose weight, in times of stress we actually want to be cautious about going too low. When this happens, it can actually cause additional stress on your body. That’s why it’s important to fuel your body with the right amount of calories to support its needs. Calorie needs differ for each individual. Know your minimal calorie range (I can help you with that) and stick to it. Do not over restrict yourself.

Stick to a meal schedule

Eat small meals throughout the day, and avoid going long stretches of time without eating. I usually recommend fueling your body every 3-4 hours. This will help to stabilize blood sugar and optimize your energy levels.

Limit or avoid caffeine and alcohol

Caffeine and alcohol can raise cortisol, increase hot flashes and night sweats, and impair sleep. Many women report a reduction in symptoms when they reduce or eliminate these from their diet.

Exercise

Exercise on the regular, and include strength training. Strength training will help burn fat and build muscle, which is known to decline as we age. It will also help to slow down the onset of osteoporosis, which women are at risk of during menopause because of the direct relationship between estrogen and bone health. Avoid frequent amounts of intense exercise. This can actually raise cortisol levels which will make it harder to lose weight. Have variety in your workouts, such as strength training 2-3x per week, cardio 2-3x per week, and low impact exercise such as walking or yoga 1-2x per week to really balance things out.

Focus on Stress Reduction

Manage your stress! Deep breathing, yoga, laughing, being outdoors, and simply taking time for yourself are all things that can help support your adrenals and lower cortisol levels. You can also incorporate supplements such as Vitamin C or B vitamins to help reduce stress. Adaptogenic herbs such as Ashwaganda, Holy Basil, Rhodiola, Lemon Balm, or Valerian can be especially helpful, but I recommend starting with these in the form of a tea versus a supplement, unless you’ve taken a cortisol hormone test and know what your specific levels are throughout the day. Work with a qualified health practitioner to learn more.

Prioritize your sleep

Adapt a healthy sleep routine and stick to it. Turn off electronic devices after 10pm, keep your bedroom cool and dark, and practice healthy sleep habits such as reading or meditating to help clear your mind and prepare you for restful sleep. The ultimate goal is 7-9 hours of uninterrupted sleep per night.

Acupuncture

Consider complementary therapies such as acupuncture to help with stress and hormone balance.

Hormone Replacement

Talk to your doctor about hormone replacement therapies such as compounded bio-identical hormones. Your doctor will be able to discuss options and help you determine if this is something right for you.

Finally, recognize that this is a journey and that it may take time to see your body respond to some of these changes. Set goals, stay consistent, and be patient.

For more ideas on how you can manage menopause and weight gain, contact me here

Photo by Jennifer Burk on Unsplash