Dr. Anni Tripathi gives her top tips on how best to deal with the effects of the perimenopause with a plant-based diet.
According to the Local Government Association, it has been estimated there are over 13 million perimenopausal or menopausal women in the UK1. This equates to one-third of the entire female population.
What is perimenopause?
Perimenopause is the natural transition towards menopause and is normally expected between the age of 45-55. This change happens over a number of years before the periods have completely stopped, during which the oestrogen hormone slowly reduces.
The depletion of oestrogen causes a woman’s body to behave differently, both emotionally and physically. It is important to know that oestrogen plays several important roles, some of which include supporting bone, cardiac and brain health during the reproductive years.
Menopause is defined as the part of life once the periods have stopped for over a year. In the UK, the average age of menopause is 51.
Symptoms to expect with the perimenopause
It is common for up to 80 per cent of women to experience symptoms related to perimenopause. A quarter describe them as severe and life debilitating.
Most common symptoms include hot flushes and night sweats, but there are others, including sleep disturbance, insomnia, fatigue, joint pain, mood changes, low libido, vaginal dryness, urinary tract infections, urinary frequency, weight gain, palpitation, impaired memory and concentration.
Most common symptoms include of perimenopause include hot flushes and night sweats, as well as fatigue, joint pain, and mood change. Photo © digitalskillet1 via Adobe Stock
Lifestyle and diet changes to ease perimenopause symptoms
As a GP, I totally support the use of hormone replacement therapy (HRT) when perimenopausal symptoms are affecting quality of life. However, I am mindful that medication does come with its side effects. Not everyone will respond to HRT in the same way.
With the increase in longevity, women live for around 30 years after menopause and it is vital that this part of life is enjoyed as much as the earlier years. One has to remember that good perimenopause care is more than just reaching for medication.
As a Lifestyle Medicine Physician, I often advise on the growing evidence of how simple lifestyle changes can make a huge difference during perimenopause2. Research into various diets shows that a whole food plant-based diet (WFPBD) is possibly one of the best options to support wellbeing during perimenopause3.
Research shows that a whole food plant-based diet (WFPBD) is possibly one of the best options to support wellbeing during perimenopause. Photo © InsideCreativeHouse via Adobe Stock
What is Whole Food Plant Based Diet?
Wholefoods are foods that are in their natural form with no, or minimal, processing involved. A plant-based diet would include food items like wholegrains, legumes, beans, vegetables, fruits, nuts and seeds, which are only sourced from plants.
No animal products, eggs, meat or dairy are included. By eating a WFPBD one also limits the processed chemicals, which are known to cause hormone disruption4. Low glycaemic index food is beneficial during perimenopause5 and a WFPBD provides easy swaps for white refined carbs, which are high glycaemic index food items.
This helps maintain blood glucose and increase satiety, which in turn helps avoid weight gain and mood swings. Both big concerns during this time.
Effects of processed food during the perimenopause
Most processed food items have ingredients added to improve taste, texture and shelf life. These include emulsifiers, stabilisers, trans fats as well as high levels of sugar and salt.
These chemicals cause inflammation in the body at cellular level6, leading to symptoms like aches and pains, mood disorders and fatigue. Too much salt can have an impact on cardiovascular health7 as well as quality of sleep, both of which are affected during perimenopause.
Xenoestrogens present in processed food, are chemicals that behave like oestrogen molecules. Due to their structural similarity, xenoestrogens are able to attach to the oestrogen receptors, causing disruption in the hormones8. Sources of xenoestrogens include plastics, pesticides, chemicals, metals, additives, food contaminants, personal care products and water systems.
So it’s best to avoid processed food and try to use organically sourced vegetables and fruits when possible. Avoiding plasticware for cooking or heating food will also reduce the exposure to xenoestrogens.
Processed foods contain chemicals that cause inflammation and lead to symptoms like aches and pains, mood disorders and fatigue. Photo © Wayhome Studio via Adobe Stock
Top tips for managing perimenopause symptoms
- Unprocess the diet. Following a WFPBD makes this part easier.
- Try to eat a rainbow and aim for at least 30 different vegetables and fruits in a week to make sure there is variety. This adds an abundance of antioxidants, polyphenols, flavonoids, minerals and micronutrients to the diet. The phytochemicals provided from coloured vegetables and plants reduces inflammation as well as oxidative stress at cellular level9.
- Symptoms of aching joints, fatigue and weight gain can be a reflection of inflammation within the body as the oestrogen levels drop.
- Include soya twice a day by adding edamame beans, tofu, tempeh or soya milk as part of a healthy meal plan. Soya is high in protein and combined with leafy greens can be very satiating. The isoflavones found in soya support bone health by improving bone mineral density too10. The WAVS (Women’s study for alleviation of Vasomotor Symptoms) trial found that incorporating soya as part of WFPBD reduced moderate to severe hot flushes by 84%11.
- A WFPBD rich in wholegrains, legumes and pulses is an ideal way to add fibre as well as complex carbohydrates. Fibre supports regular bowel movements, which gets rid of the excess toxins from our body. It also helps maintain healthy weight by increasing satiety and improving hormone balance.
- Use healthy plant-based fat options like nuts, extra-virgin olive oil and avocados. This reduces the saturated fat intake, which is linked with several cardiac health conditions.
- Add vegan omega-3 to the diet in the form of chia seeds, linseeds or walnuts. Omega-3 is protective for brain health and reduces chronic inflammation12.
- Aim for enough calcium to maintain bone health. Plant-based foods rich in calcium include leafy greens, such as rocket, spinach and broccoli, and fortified plant milks, calcium-set tofu, chickpeas and tahini.
Try to eat a rainbow and aim for at least 30 different vegetables and fruits in a week to make sure there is variety. Photo © bongkarn via Adobe Stock
- Reducing salt intake helps with sleep, maintaining healthy blood pressure and also protects the bones.
- Fruits such as bananas, pineapple and mangoes are satisfying sugar alternatives. Dates, raisins, dried figs, berries, grapes and apricots are healthy options for a sweet tooth too.
- Add spices and herbs to make meals taste good as well as include loads of antioxidants.
- Stay hydrated and make water the preferred option.
- Aim for 7-8 hours sleep, which can be difficult during perimenopause.
- Magnesium-rich food helps aid sleep. Pumpkin seeds, amaranth grain and Brazil nuts are rich sources.
- Manage stress levels by including activities. Exercise, being in nature, mindfulness and positive connections are helpful ways to manage stress.
- Exercise and movement of any kind has a positive effect on not just bone health, but helps with mood, sleep improvement and cardiovascular health. I recommend including resistance training and exercises for flexibility, like pilates, yoga or tai chi.
- When following a WFPBD, a good source of vitamin B12 (1000mcg per day) and vitamin D (400-800iu per day) should be included as daily supplements, plus an iodine supplement (150mcg per day).
- Finally, avoid toxins like smoking and alcohol. Limit the use of plastic ware, especially when heating food13.
I have implemented these tips for my own wellbeing while going through perimenopause. It has dramatically improved not only my sleep, night sweats and hot flushes, but I have found new energy levels! The best thing I love about following a WFPBD is I have been able to maintain healthy weight without a need to count calories.
If this article has made you curious, why not give it a try for just a month and experience the difference yourself. It is equally important to ask for support from a health professional if symptoms of perimenopause are affecting your day-to-day living.
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Featured image credit: Monkey Business via Adobe Stock
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Barnard ND, Kahleova H, Holtz DN, Znayenko-Miller T, Sutton M, Holubkov R, Zhao X, Galandi S, Setchell KDR. (2022) A dietary intervention for vasomotor symptoms of menopause: a randomized, controlled trial. Menopause. 2023 Jan 1;30(1):80-87.
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