On World Menopause Day Irish Heart Foundation Dietitian Orna O Brien suggests ways to protect your heart through menopause by making small changes to your diet

Heart disease and stroke – typically a man’s disease, right? I am afraid not, ladies. One in four women in Ireland dies from heart disease and stroke, that’s six times more than all breast cancer deaths. However, the fact that our risk of heart disease and stroke increases as we approach menopause is still largely unknown. The good news is that 80 per cent of premature heart disease and strokes are preventable through lifestyle changes alone, and we can look after our hearts through the menopause transition by proactively making some changes to what we eat.

Here are some nutrition tips for minding your heart through menopause:

Get into the right mindset for a lifestyle change.  Consider downloading the Irish Heart Foundation’s Self-care and Wellbeing Journal. It is full of tools to help you identify what areas you could most benefit from focusing on to help understand your habits and set goals.

Follow a Mediterranean-style diet. This is based on fruit and vegetables, whole grains, beans and other pulses, nuts and seeds. It includes olive oil, fish, seafood, and poultry, and is low in sugar, salt, processed foods, and red meat. The Mediterranean diet can help to reduce the risk of heart disease and stroke and may help manage some of the menopause symptoms like hot flushes, night sweats, and low mood. Check out our recipe ideas for some inspiration.

Keep meals regular and balanced.

It might sound basic, but having a regular eating pattern and trying not to skip meals really helps support your mood and maintain a healthy weight. Look for balance on your plate – aim to fill half your plate with fruit, vegetables, or salad; a quarter with a source of protein, like salmon or beans; and a quarter with a high-fibre starchy food like brown rice, oats, or unpeeled potatoes.

Try some healthier fat swaps

• Swap butter for low-fat spread, nut butters, avocado, or hummus
• Swap frying in coconut oil or butter for small amounts of olive oil or rapeseed oil, or try cooking without fat – grill, bake or boil
• If you eat meat, choose lean meats, remove skin and fatty parts, limit portions to the size of your palm, consider replacing some or all of the meat with beans or lentils, avoid processed meats like ham and sausages, and include at least two meat-free days a week
• Aim to eat fish twice a week, including one portion of oily fish like salmon or mackerel.
• Switch to lower-fat milk, yogurt, and cheese.

Aim to get 5-7 portions of fruit and vegetables a day

Fruit and vegetables support heart, bone and joint health, so are especially important around menopause. Fresh, frozen, tinned, dried and juice all count. The more colour and variety the better. A portion is about a handful.

Increase your fibre intake

Choose high-fibre foods when you can, for example, wholegrain bread, oats, whole wheat pasta, wholegrain rice, pulses, nuts and seeds. Fibre helps lower cholesterol, maintain a healthy weight, and supports good gut health and mood.

Introduce some soya to your diet.

Research suggests eating 25g of soya protein daily may reduce cholesterol levels by 4% and support bone health. Phyto-oestrogens in soya foods may also reduce hot flushes because they act like a weak version of human oestrogen. However, it can take up to 12 weeks to see an effect, and soya foods seem to work better for some women than others – this might be down to differences in gut bacteria. The greatest benefits are seen when soya foods are spread across the day rather than one large dose. The following foods provide about 8g of soya protein each:

• 100g tofu
• 250ml calcium-fortified soya milk
• 200g calcium-fortified soya yogurt
• 70g fresh or frozen edamame beans

Make water your go-to drink.

Drinking two litres of water or other sugar-free drinks every day helps to keep you hydrated, supports your skin and brain health, and helps prevent tiredness. It may also help manage hot flushes and plays a role in regulating appetite. Beware of caffeine-containing drinks like coffee, cola and tea however as they may contribute to poor sleep and hot flushes. It can be tempting to drink alcohol if you are suffering from poor sleep during menopause however, it significantly reduces sleep quality. Try to limit alcohol to 11 standard drinks a week. Visit AskAboutAlcohol.ie for more information.

Explore your snacking

Snacking on sugary foods may make menopausal symptoms worse and cause weight gain. The same goes for high-fat snacks and our heart health. If you struggle with snacking, map out your habit to address your triggers using our Self-care and Wellbeing Journal, and try nourishing snacks like sliced banana on oat cakes or a low-fat yogurt. A small handful (30g) of unsalted nuts daily can have a positive affect on our heart health.

Include lots of bone-loving foods.

We begin to lose bone mass from the age of 35, but this increases at menopause. For good heart and bone health, try to eat three portions of calcium-rich foods every day such as lower-fat milk, yogurt and cheese. You can also get calcium from calcium-fortified plant alternatives, but sometimes in lower levels. Other ways to keep your bones strong include a balanced diet high in fruit and vegetables, vitamin D (see below), not smoking, maintaining a healthy weight, weight-bearing physical activity, and taking hormone replacement therapy if you choose.

Mind your salt intake

A high salt intake can increase blood pressure. Remember that 80 per cent of the salt we eat is already in our food. To cut down, limit processed foods, make more home-cooked meals, season with herbs and spices instead, and read the food label (low-salt is less than 0.3g per 100g).

Don’t take unnecessary supplements.

A huge number of nutritional and herbal supplements are targeted at women going through menopause, including red clover, black cohosh, evening primrose oil, sage, gingko biloba. They are unregulated, can have significant side-effects, and most have been proven to be no more effective than placebo. Phyto-oestrogen supplements can contain extremely high amounts of phyto-eostrogens and the health risks are unclear. Generally, there is no need to take nutritional supplements if you have a balanced diet and are not vegetarian or vegan.

There are two exceptions Vitamin D and omega-3.

Vitamin D helps prevent brittle bones. In Ireland, we do not get enough from sunshine so all women should consider taking a vitamin D supplement of at least 400IU.

If you don’t eat oily fish, it is difficult to get enough essential fatty acids from other dietary sources, so you should consider taking a good quality omega-3 supplement that contains at least 400-1000mg of EPA/DHA.

If you think you might need to take nutritional supplements, get some advice from doctor, dietitian or pharmacist, especially if you are taking regular medications.

For more information on menopause and your heart please see our Her Heart Matters campaign.