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Tips for healthy living

There's a lot out there about how to be healthy - it can be overwhelming! We're going to summarise the most important parts of healthy living during menopause.

Diet

As with most diet advice - it's important to get enough fruit, vegetables and fibre. For fruit and veg - aim for 5 a day (more veg than fruit). Wholegrains are a great healthy source of fibre (e.g. rice, barley, quinoa, oats and wholemeal bread). It's recommended that you get at least 25g per day of fibre as a woman - but more than that is good too!

Protein is another important part of the diet for menopausal women. As you age, you're less able to build muscle mass from the food you eat so to keep your muscles strong you need to eat enough. Good sources of protein are lean meat, eggs, fish, beans and lentils. A bit of red meat is fine - but try to avoid processed forms like cheap sausages and bacon because these are linked to higher mortality rates.

Sugar and carbohydrates are getting a lot of bad press right now. But everything in moderation! Rice, pasta and potatoes are 'high glycaemic index' carbohydrates - which means the body breaks them down quickly. This process releases sugar (or glucose) in the blood. Too much of these, and too much sugar in the blood, increases your risk of type 2 diabetes and heart disease. So try not to eat too many of these carbs - replace them with carbs that are broken down slowly. These 'low glycaemic index' carbs include fruit, vegetables, beans and nuts.

Calcium and vitamin D are important for bone health during menopause. For calcium - dairy products are a good source. If you're vegetarian or vegan you can get calcium from leafy green vegetables too - such as broccoli, cabbage and okra. Soya beans are a good source of calcium for vegetarians. Some women also like to eat soy during menopause as it contains natural estrogens (called phytoestrogens) [1].

To get enough vitamin D it's important to spend enough time outside. In the UK you can get enough Vitamin D from being outside during the summer - but it's difficult in the winter. So it's recommended to take a supplement during the winter [2].

In summary, a balanced diet with lots of fruit and veg is important during the menopause. Avoid highly processed foods which tend to contain unhealthy fats, sugars and excess salt. Ideally you'd have some fish - as they are high in protein and good fats called omega-3s. If you don't eat fish you may also want to consider supplementing omegas. With all supplements you should consult a medical professional before taking them.

Exercise

Regular exercise is a good thing - there's no doubt about it! It decreases your risk of many cancers, heart disease and diabetes. Exercise also helps with maintaining bone strength - which is very important for menopausal women.

Even if your weight stays the same through menopause, you tend to lose muscle and increase fat. Resistance training to build muscle can help with this. It's really important to maintain muscle with age - as it helps with staying active and mobile.

Exercise is also great for mental health symptoms - like anxiety and depression. Even taking a brisk walk can make you feel better. The current exercise recommendation from the World Health Organinsation is 150 minutes of moderate exercise; or 75 minutes of vigorous exercise per week [3].

Moderate exercises raise the heart rate, and require some effort. They include:

  • Brisk walking
  • Dancing
  • Gardening
  • General housework.

Vigorous exercises will raise the heart rate significantly, and require a lot of effort. They include:

  • Running
  • Aerobics
  • Cycling (quite fast)
  • Swimming
  • Fast walking uphill or hiking.

Smoking and alcohol

It's almost boring advice by now - but try to quit or cut down on smoking. With alcohol - a moderate amount is fine (no more than 2 units per day).
If you're worried about breast cancer risk though - there's evidence that not having any alcohol may be best. Also, if you are on HRT drinking might increase the risk more - as the Nurses Health Study found an that the risk of breast cancer was doubled for women on HRT who drank.

Keeping your pelvic floor healthy

Pelvic floor exercises can help you to maintain a healthy bladder, uterus and support the whole area to stay strong. If you're suffering from urinary incontinence pelvic floor exercises will be the first thing to try.

Squeezy is an amazing low cost app that reminds us to do pelvic floor exercises. You can find it on the NHS app store. The Elvie trainer is another great tool to help you strengthen your pelvic floor.

Pelvic floor exercises can also help with sexual function (and prevent vaginal prolapse). Pregnancy weakens the pelvic floor the most - so it's wise to start pelvic floor exercises then (and keep them up)!

Preventative screening for diseases

There are some screening programmes which are important take up as you age:

  • Cardiovascular screening (CVD)
  • Cervical screening
  • Breast cancer screening
  • Ovarian cancer screening
  • Colorectal cancer screening
    Your GP will offer you these when you visit for a routine appointment, or about more specific problems. If you think you should be offered screening programmes - don't be afraid to ask your GP about them. They'll often appreciate the reminder!

References:

1 Hillard T., et al. (2017). Management of the menopause. 6th edn. British Menopause Society. UK.

2 National Health Services Website (2017). *Vitamin D -Vitamins and minerals * Retrieved 8 October 2019 from [https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/]

3 National Health Services (2018). *Physical activity guidelines for adults * Retrieved 8 October 2019 from [https://www.nhs.uk/live-well/exercise/]