Menopause: Nutrition & Bone Health

Menopause is a natural process experienced by all women at some point during their lifespan. It is a time when menstrual cycles cease and hormone levels, most importantly oestrogen decline which can cause a wide spectrum of symptoms to occur during this transitional phase.

For some women symptoms will be mild and perhaps hardly noticeable and for others menopause can be a really tricky phase and impact many aspects of daily life. Whether you experience symptoms or not a drop in oestrogen levels that occur during this time impacts bone health, heart health and brain health therefore it’s important not to neglect good nutrition through the menopause.

In this blog we’re going to deep dive into ways your nutrition can support bone health through menopause and also focus on some practical tips to tweak your diet and optimise bone density.

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Bone health & Nutrition

Osteoporosis risk increase is higher in women during all stages of life but this risk increases further post menopause due to declining levels of oestrogen. Bone density loss combined with accelerated reduction in muscle tissue (if not proactive) increases risks of fractures, falls and frailty. However this doesn’t have to be the case and being mindful of the following nutrients will help reduce the risk.

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Total calories‍

Under consumption of calories increases the risk of muscle loss and bone density loss. This is due to a combination of factors including insufficient energy available for muscle growth and repair and insufficient nutrients available for bone maintenance and laying down of new bone tissue.

Low calorie diets are often lower in nutritional value too. This is because its hard to obtain all the nutrients we need when overall food intake is too low. For example if we removed dairy produce from the diet to reduce calories then by default calcium intakes will reduce too.

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Calcium‍

It is essential to meet the minimum recommended intakes of calcium (700mg/day) post menopause and if you are specifically at risk of developing osteoporosis or have been diagnosed with osteoporosis then this should be increased to 1000-1200mg per day.

The best sources of calcium:
Dairy products; cheese, milk, yoghurt etc
Tinned fish with bones
Tofu
Fortified products such as plant based milks.

Small amounts of calcium can be found in leafy green veg and some fruits such as dried apricots and figs however this is not as well absorbed as dairy sources.

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Vitamin D‍

In the UK we can synthesise vitamin D from the sun between April & October. It is however recommended that we supplement all year round or at the very least between October & April. Food sources can provide small amounts of vitamin D but they shouldn’t be the main source.

Food sources:
Egg yolk
Oily fish
Liver
Mushrooms grown under UV
Fortified foods.

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Protein
Similarly to sufficient calories, a regular intake of protein is essential for maintenance and repair of both bone and muscle. Eating regularly, not skipping meals and fueling exercise is really important to ensure adequate protein. A good approach would be including a source of protein in each meal and if you also snack then try and make one snack per day high in protein too.

Sources of protein:
All meat - try to choose lean meat such as chicken & turkey more often than red meat or pork
All fish - try to include white fish and oily fish
Eggs
Dairy
Lentils
Beans & pulses
Soy including tofu, soy yoghurt & milk, edamame beans
Nuts & seeds

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Magnesium, Vitamin k, phosphorus, potassium
These nutrients are needed in much smaller quantities but are essential for bone formation, bone density and reduction of bone loss.

Foods sources:
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Magnesium
Spinach
Soy beans
Almonds, cashews, Brazil nuts
Chia, pumpkin & sunflower seeds
Potatoes
Wholegrain
Dark chocolate

Vitamin K
Spinach, chard, kale
Soy beans
Broccoli
Turnip

Phosphorous
Meat
Fish
Dairy
Nuts
Beans
Whole Grains

Potassium
Bananas
Brussel sprouts
Fish
Shellfish
Meat


Three take home messages:

1. Try not to heavily restrict calorie intake even if working towards a weight loss goal. Reducing calories by 20 - 25% under maintenance is more than enough to lose weight whilst still allowing for a nutrient dense diet. No 800kcal diets please.
2. Don’t fear dairy. Unless you are following a vegan diet or allergic/intolerant dairy is a really positive nutrient group to include in the diet. Some dairy products such as cheese or heavy cream are calorie dense but options such as greek yoghurt, feta cheese, cottage cheese and semi-skimmed milk are great options to include in the diet.
3. Aim for 80 - 90% of your diet to be whole foods. There is a lot of crossover between the nutrient groups above and as you can probably tell, eating a variety of foods which are minimally processed will allow you to cover most bases.

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