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If you’re of an age where you’ve been googling things like “perimenopause always hungry why?!” and “hot flashes from spicy food,” you’ve probably seen your fair share of nutrition advice come and go throughout the decades—some of it useful and evidence-based, and some of it sheer nonsense.
As with many fields, what we know, believe, and share about nutrition is always evolving thanks to scientific breakthroughs, policy changes, cultural and societal norms, marketing, and the power of trends. Some of this information can help people make life-changing improvements to their health; on the other hand, nutrition misinformation can lead people to waste money, time, and energy on remedies that range from ineffective to downright dangerous.
With social media in the mix, it’s become even more difficult to separate nutrition facts from half-truths (or total fiction) so that you can eat in a way that’s enjoyable, nourishing, and supportive of your health goals. This is especially important during menopause, when bodies start doing unpredictable, unruly things, certain disease risks can rise, and it feels like everyone wants to sell you something to deal with it all.
Now...if you’re curious about perimenopause nutrition, you may be wondering about how much protein to eat, whether intermittent fasting is a good idea, or what foods you can add to round out a healthy diet during menopause, but let us give you one more thing to consider: heart health.
Taking care of your heart in midlife is super important, since heart disease remains the leading cause of death for women in the United States, and the risk of cardiovascular disease rises after menopause. Fortunately, there are ways to lower your risks, including taking medication (yes, statins work for women!), exercising (both cardio and resistance training are recommended), and getting plenty of quality sleep.
By the way: if you’re concerned about the seemingly ever-changing information about hormone therapy for menopause symptoms and cardiovascular disease risks, talk to your doctor! It’s a complex but worthwhile conversation and must account for individual needs and risk factors.
The final piece of the puzzle in a comprehensive approach to a healthy heart is, of course, nutrition. But there are longstanding myths around heart-healthy foods that can be tricky to make sense of, so where do you even start?
That’s where the professionals come in. Menopause nutrition counseling covers an amazing range of symptoms and conditions, and a Registered Dietitian Nutritionist can be one of your best allies when it comes to figuring out what to eat for your specific goals, needs, and preferences. We asked some of Gennev’s RDNs to tackle some of the most persistent myths and questions about nutrition for heart health during and after menopause.
Here’s what they shared:
Cracking the code on eggs and cholesterol
Q: Should you avoid eggs if you have high cholesterol?
A: Like many other animal-based food sources, eggs do contain some saturated fat, which in excess can lead to elevated LDL cholesterol levels for some people. However, there is no need to completely avoid foods with saturated fat. For optimizing health and keeping LDL cholesterol levels within range, the American Heart Association recommends aiming for 6% or less of total calories from saturated fat. For someone following a 2000 calorie diet, this would equal around 13 grams daily. 1 egg, on average, has around just 1.5 grams of saturated fat.
For most people, eating an egg or two a day can be a great option—they contain many key nutrients such as choline, which is an important nutrient for brain health, along with several other vitamins and minerals. However, everyone's needs are different, so talk with a dietitian for individualized recommendations.
Don’t sweat the salty stuff (too much)
Q: If you have high blood pressure, should you cut out sodium altogether?
A: Being mindful of sodium intake can be an important part of blood pressure management. However, sodium should not be cut out altogether, as it is a key nutrient/electrolyte needed for the body to function properly. The American Heart Association recommends aiming for 2300 mg of sodium per day or less for most people, while some may benefit from consuming around 1500 mg daily. Individual needs vary, based on medical history and physical activity level (for example, excess sweating can cause a greater release of sodium), and your healthcare provider can advise what approach would be right for you.
-Katie Linville
Tofu to the rescue?
Q: Can you make up for the loss of estrogen (which has some protective benefits for your cardiovascular system) during menopause by eating more soy products?
A: Unfortunately, no. Phytoestrogens from plants are weaker than those made by the ovaries and are not equivalent to estrogen that the body produces when it comes to their cardioprotective properties. That said, soy products are a good source of plant-based protein in the diet, and for some women, their regular consumption may lead to a reduction in the frequency and/or severity of hot flashes.
Cool it on caffeine if you’re concerned about high blood pressure
Q: Could caffeine be making your hot flashes (and maybe blood pressure) worse?
A: Yes, caffeine can exacerbate hot flashes and it may lead to a brief rise in blood pressure as well. Caffeine has a long half-life and can take up to 12 hours to leave the body, so even an early afternoon cup of joe can negatively impact your sleep—and poor sleep is associated with higher blood pressure.
- Pamela Malo
Almonds and walnuts and cashews, oh my! Go nuts, or slow down?
Q: They say nuts are a heart-healthy food, but aren’t they high in fat? Should you skip those that are higher in saturated fat?
A: Most nuts are high in heart-healthy fat—monounsaturated and polyunsaturated. Heart-healthy fats like these can help improve cholesterol levels and lower the risk of heart disease. There are a few nuts that are higher in saturated fat—including Brazil nuts and macadamia nuts—although these can still be part of a balanced healthy diet if eaten in moderation. Other good reasons to eat nuts: they're also a good source of vitamins and minerals like vitamin E, magnesium, manganese, zinc, and more.
No animal protein, no problem...right?
Q: If saturated fats mostly come from animal-based foods, are vegetarians and vegans in the clear when it comes to heart health?
A: It’s not quite that simple. Heart health is important to everyone whether you choose a plant-based or animal-based eating plan. Genetics is a big determining factor in your overall risk of heart disease. Animal products tend to contain more saturated fat, which can lead to elevated cholesterol levels and therefore increase your risk for heart disease and other chronic diseases. Plant-based foods like fruits and vegetables are low in saturated fat and can help promote heart health and overall lower your chronic disease risk. Overall, physical activity and balanced diet of a variety of foods—lean protein, colorful fruits and veggies, and whole grains—are optimal strategies for decreasing your risk for heart disease.
-Beth Wolfgram
When it comes to heart health, consistency matters!
Q: If you have a family history of high cholesterol or heart disease and risks go up after menopause anyway, will a heart-healthy diet and exercise even help?
Genetics and family history of cardiovascular disease and how it influences your cholesterol varies. Because of this, how much diet and exercise affect cholesterol levels varies too. That doesn't mean lifestyle behaviors don't matter if cardiovascular disease runs in your family. But don't start shaming yourself into doing them or blaming yourself if the lifestyle behaviors don't affect your cholesterol levels like you'd hoped if you have high familial cholesterol.
Overall, diet and exercise have about a 20-30% effect on cholesterol, and consistency matters! Don't go crazy with your fiber intake or exercise routine, thinking that your cholesterol will dramatically change, if you can't sustain those behaviors consistently.
The key to consistency is enjoyment. If you like how the exercise makes you feel during or after, you'll do it more often. The same is true with food. Heart-healthy diets like the Mediterranean, DASH, Plant-based, and MIND diets all follow similar patterns and encourage heart-healthy eating. However, consistency matters more than the specific dietary guidelines you follow.
While these recommendations are a fantastic place to start if you’d like to eat more heart-healthy foods, you may want even more personalized guidance to meet your specific nutritional needs during menopause, especially if you're navigating other health concerns. That’s where our clinicians shine. Learn more about working with a Gennev RDN, or book an appointment today.
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