Menopause is a natural process of ageing which usually occurs between the ages of 45 and 55. It’s estimated that around a third of the entire female population in the UK are either currently going through the menopause transition or have been through it. (LGA, 2021)
As menopause is a time where nutrition needs and health risks change, it is a good time to consider whether your diet and lifestyle is supporting your health and quality of life.
You may be aware that a woman’s risk of osteoporosis increases after menopause, but the same is also true for a woman’s risk of heart disease. A woman’s risk of heart attack is five times higher post-menopause than before. (Boardman et al. 2015)
World Menopause Day – focuses on heart health
It’s great to see that this year’s theme for World Menopause Day (18th October) is cardiovascular health. Heart disease is often thought of as a man’s disease, but it’s actually the leading cause of death in women in Scotland.
Heart disease and fatty liver
There is a linked between heart disease and fatty liver. Liver function and cholesterol are closely linked. People with high blood cholesterol are more likely to develop non-alcoholic fatty liver disease (NAFLD), and liver problems increase the likelihood of high cholesterol.
Data from the Health Survey for England in 2019 (NHD Digital, 2020) shows that up until around age 45 years, more men than women have raised cholesterol. The average age women reach menopause is 51 years, and there’s often a sharp rise in cholesterol around this age for women. Oestrogen helps control cholesterol levels and so reduces the risk of fatty plaques building up inside artery walls. Two in three women (66%) aged 55-65y have raised cholesterol. As there’s no notable signs of high cholesterol, getting a test every few years, especially around or just after reaching menopause is useful.
Women have lower rates of NAFLD compared with men. However, this protection is lost after menopause and the prevalence of NAFLD in post-menopausal women increases. (DiStefano, 2020) The risk of non-alcoholic fatty liver disease is 2.4 times higher in women post-menopause than pre-menopause. (Jaroenlapnopparat, 2023)
How your diet can support your heart and liver health
A Mediterranean diet has many benefits for health and wellbeing including supporting heart and liver health. This type of diet includes plenty of plant-based foods such as fruits and vegetables, wholegrains, beans, pulses and nuts as well as moderate amounts of dairy and fish, and some meat. The main type of fats in this diet are unsaturated fats (found in olive or rapeseed oil, vegetable spreads, nuts and seeds), as opposed to saturated fats (found in pastries, fried foods, cakes and biscuits). The Mediterranean diet can also help alleviate a number of menopausal symptoms women may experience – something that is covered in the Eating Well for Menopause book. (Wyness & Burns, 2023)
Heart and liver health dietary tips for menopausal women
- Include fibre-providing plant foodsOpting for wholegrains where possible will help increase your fibre as well as provide a variety of B-vitamins and minerals such as magnesium, iron and zinc that are beneficial for heart health. Eating a wide range of plant foods will help support a healthy and diverse gut microbiome. It’s thought that a healthy gut microbiota plays an important role in reducing the risk of fatty liver and heart disease.
- Include two portions of fish a weekOily fish are a great source of healthy unsaturated fats, particularly omega-3 fatty acids which help maintain normal cholesterol levels and normal heart function. Oily fish are one of the few dietary sources of vitamin D which, as well as supporting bone health, may have a role in heart health. (Wyness and Burns, 2023) Omega-3 fatty acids also seem to be beneficial for liver health and for those who have NAFLD (Wenxia et al. 2016)
- Hydrate wellKeeping well hydrated helps the body manage changes in temperature, so may help manage menopausal hot flushes. Staying well hydrated helps muscles work more efficiently – remember the heart is a muscle so hydration is important to help the heart function well. Water is great choice, but other drinks also help with hydration. Coffee seems to have a protective effect relating to liver disease, possibly due to its antioxidants or plant compounds. Menopausal women may find decaf coffee a better option for managing menopausal symptoms though, as caffeine may trigger hot flushes for some women.
Dr Laura Wyness has been supporting individuals with dietary advice for several years. She is Head of Nutrition at Zoë Rose Fitness, the Edinburgh–based health and well-being coaching company that specialises in helping women achieve their fitness and health goals. Check out Laura’s book: Eating Well for Menopause for more information and tailored recipes.
Boardman et al (2015) Hormone therapy for preventing cardiovascular disease in post-menopausal women. The Cochrane database of systematic reviews. doi: 10.1002/14651858.CD002229.pub4.
DiStefano (2020) NAFLD and NASH in postmenopausal women: Implications for diagnosis and treatment. Endocrinology 161(10): 1-12 doi: 10.1210/endocr/bqaa134
LGA (2021) Local Government Association. Menopause factfile, 2021, https://www.local.gov.uk/our-support/workforce-and-hr-support/wellbeing/menopause/menopause-factfile
NHD Digital, 2020 Health Survey for England 2019: Adults health report Health Survey for England 2019 [NS] – NHS Digital
Jaroenlapnopparat et al (2023) Menopause is associated with increased prevalence of non-alcoholic fatty liver disease: a systematic review and meta-analysis. Journal of The North American Menopause Society 30(3): 348-54 doi: 10.1097/GME.0000000000002133
Wenxia et al (2016) Effects of omega-3 fatty acid in Non-alcoholic fatty liver disease: a meta-analysis. Gastroenterol Res Pract doi: 10.1155/2016/1459790
Wyness and Burns (2023) Eating Well for Menopause: Advice and recipes to improve your health and well-being.