Menopause is a time of change, and unfortunately that change includes a few increased risk factors. One of these risk factors is an increased risk of cardiovascular disease (disease of the heart and blood vessels).
An observational study of almost 2000 mature aged women found that 49% of postmenopausal women, compared to only 21% of premenopausal women had hypertension (high blood pressure). These figures alone suggest that once you go through menopause your risk of developing high blood pressure more than doubles. With menopause considered the tipping point, it is not surprising that hormones are believed to play a large role in cardiovascular health in women.
However, internal hormone levels and the process of menopause is largely out of our control – yes, we can supplement with bio-identical hormones, and we can complete dietary and lifestyle changes to support our hormones during menopause, however the process of menopause is not escapable. Nor is ageing.
As we start the menopause transition, it is important to be aware of the changes, and the effects of those changes. Being aware of the risk factors puts you in a place to be proactive.
Let’s be proactive and talk about diet. Your diet is one of the biggest things you can control.
Unfortunately, the odds are that you are not eating enough vegetables. If you honestly believe you are eating enough vegetables, I suspect that you could be, but I am sure you could also benefit from eating a few more vegetables.
Eating enough vegetables doesn’t mean that you have some vegetables at dinner. It doesn’t even mean that you have a predominantly vegetable based dinner. It means that you are eating vegetables at breakfast, lunch and dinner. It means that you are eating a variety of vegetables, and that you are eating about 30 different kinds of vegetables each week. A mixture of raw and cooked is ideal and a diet that is predominantly vegetables (or vegetable based) is a good standard to aim for.
Vegetarian diets have gained significant popularity lately. Vegan diets too. However, how does that impact your risk factors after menopause, and more specifically, how does that impact your heart health?
In 2017 a team of researchers explored this. They located all available studies investigating the association between vegetarian and vegan diets, and chronic health conditions. Ninety-six studies were located, observing over 130,000 vegetarians and over 15,000 vegans. The comprehensive meta-analysis reported a significant protective effect of a vegetarian and vegan diet. They found significantly lower levels of body mass index, lipid variables and fasting glucose, when compared to nonvegetarians and nonvegans. These markers are common risk factors for developing numerous chronic diseases including cardiovascular diseases. More specifically, if we go back to the heart, the researchers found that those following a vegetarian diet had a 25% reduced incidence and/or mortality from ischemic heart disease.
As mentioned above, ninety-six studies were completed with an overwhelming consistency towards a vegetarian diet resulting in numerous positive health benefits, including cardiovascular benefits.
Have you ever wondered why a vegetarian diet is a healthy diet?
It’s because of the vegetables of course!
I spoke with a vegetarian last week who was having three pieces of fruit and a coffee for breakfast, the same for lunch, a plate of veggies and some rice for dinner, and one piece of fruit for dessert. Technically, she is eating a vegetarian diet. I was not surprised that she is not feeling so great.
I want you to think of a vegetarian diet as a vegetable-laden diet, not a no-meat-diet.
A vegetarian diet, done well, is considered significantly healthy. In a study of 56,000 subjects, it was found responsible for significantly lower BMIs, total cholesterol, LDL-cholesterol, triglycerides and blood glucose levels2. It is also believed to reduce the risk of developing metabolic syndrome and type 2 diabetes by about a half.
The positive effect of the vegetarian diet is suggested to be mainly due to the greater variety and amount of plant foods. Abundant consumption of vegetables, fruits, legumes, unrefined grains and nuts provides the body with a complex mixture of vitamins, minerals and phytochemicals. This reduces the chance of nutrient deficiencies, often providing the body what it needs to adapt and thrive. In addition to the nutrient boosting benefits, positive health results, particularly regarding the cholesterol markers, may be due to the large consumption of foods known to decrease cholesterol parameters, such as soybeans, legumes and nuts.
A well-rounded vegetarian diet can be healthy and nutritious. An incorrectly designed or slap-hazard vegetarian diet can harmful.
Another example of a common unhealthy vegetarian diet is toast for breakfast, chips as snacks, spinach and feta roll for lunch, pasta for dinner and chocolate for dessert. Again, technically a vegetarian diet, however significantly lacking the vegetables, protein and good fats.
While a vegetable-laden vegetarian diet is high in vitamins and minerals, it can also increase your risk of certain nutritional deficiencies. A healthy vegetarian diet (and therefore successful vegetarian diet) requires some extra care, paying particular attention to protein, iron, calcium, vitamin D, vitamin B12 and omega-3 fatty acids. This means that if you are eating a vegetarian diet, you need to be aware, or you need to seek professional advice.
A vegetarian diet needs a lot of thought, planning, calculating and reassessing. Supplements or protein powders may be needed to ensure adequate intake of nutrients, and the ideal vegetarian (or even non-vegetarian) diet will avoid refined, processed and man-made foods.
As a general overview, a vegetarian diet will include:
- Vegetables – a variety, and a lot (3 heaped handfuls per meal, with a variety of 30 different veggies over a week)
- Complex carbohydrates – brown or basmati rice, quinoa, oats, sweet potato, pumpkin etc.
- Legumes – chickpeas, lentils, black beans, butter beans, etc. (all pulses and beans)
- Protein – tofu, tempeh, eggs, yoghurt, nuts, hummus and nut butters
- Good fats – nuts, olive oil, chia seeds, avocado, flaxseed/linseed, hemp seed oil, etc.
If you are not ready to break up with meat, that’s OK, just eat more vegetables.
A meat serve should only be the length, width and thickness of your palm (palm, not hand). Your plate should be largely full of vegetables (full!).
If you are not ready to be vegetarian, no problem. Consider going to a predominantly plant-based diet. This means only a ‘normal’ size of meat (palm sized), lots of veggies, unrefined grains and nuts/seeds.
This style of eating means that you are getting the variety of vegetables and all of the vitamins, minerals and phytochemicals that come in those vegetables. It means you are getting plenty of fibre, meaning a well-functioning bowel, and potentially a very happy microbiome. It also means you don’t need to worry about the protein, iron, calcium, vitamin D, vitamin B12 and omega-3 fatty acids that strict vegetarians need to keep an eye on.
Are you concerned about the increased risks that come with post-menopause?
Stack your plate full of vegetables and saturate your cells in the goodness that comes from them.
 Fang, S. H., et al. (2013). “[Relationship between female menopause and hypertension/isolated systolic hypertension in rural districts of Hanzhong in Shaanxi province].” Zhongguo Yi Xue Ke Xue Yuan Xue Bao 35(4): 422-426.
 Dinu, M., et al. (2017). “Vegetarian, vegan diets and multiple health outcomes: A systematic review with meta-analysis of observational studies.” Crit Rev Food Sci Nutr 57(17): 3640-3649.