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INFLAMMATION AT THE MENOPAUSE

Inflammation occurs when your body tries to protect itself from infection by foreign organisms, including bacteria and viruses. It involves several processes, including action by your white blood cells. The whole process is called an immune response. A short sharp immune reaction, such as a bee sting, is called an acute inflammatory response. Other immune responses can go on for some time and are called chronic inflammation.

This article was included in issue 91 (winter 2021-22) of The Menopause Exchange newsletter.

Chronic inflammation is caused by a number of factors, such as carrying extra weight, pollution in the environment and also by poor diet and lifestyle. In the long-term, it can lead to diseases such as heart disease, cancers, Alzheimer’s, arthritis and even depression. Inflammation is also linked to metabolic changes and metabolic disorders, such as diabetes.

Inflammation at the menopause
Oestrogen and progesterone can help to reduce inflammation, so, as their levels fall at the menopause, you may begin to notice new or worsening aches and pains. The tendency to gain weight around the middle during the menopause can make this worse, increasing the risk of conditions such as diabetes and heart disease.

Inflammation can also make general menopausal symptoms such as hot flushes worse. Recent evidence now points to falling cognitive ability and depression being caused, at least in part, to rising levels of inflammation in the body. A poor diet and lifestyle (such as a lack of exercise, poor sleep, stress) during this time will increase inflammation even more.

Reducing inflammation
General diet:
A Mediterranean-type diet includes olive oil**, fish, nuts, a little red wine**, wholegrains, tomatoes, fresh fruit and vegetables**. The DASH (Dietary Approaches to Stop Hypertension) diet is low in salt and high in fruit and vegetables.
Types of fats:
Long chain omega-3 oils such as from oily fish (e.g. salmon, mackerel, sardines). Use olive oil** in cooking. An omega-3 supplement may reduce depression due to its anti-inflammatory effect.
Carbs and sugars:
Low glycaemic index/load (slow-release) carbs, such as wholegrain foods (three helpings a day is recommended). Minimally processed carbs are best.
Calories:
Being at the right weight for your height.
Vegetables:
All vegetables are good but, in particular, eat green leafy vegetables and tomatoes**.
Fruits:
All fruits are good but especially colourful berries and oranges**.
Vitamin D:
Foods containing plenty of vitamin D, e.g. eggs, oily fish, fortified lower saturated fat margarines and spreads.
Protein sources:
A diet based on plant-based proteins such as beans, soya and lentils.
Snack:
Dark chocolate** (but not too much), nuts and seeds, unsalted popcorn, oatcakes, wholegrain crackers.
Hot beverages: Tea, especially green, coffee, cocoa**.
Alcohol:
Drink alcohol in moderation, especially red wine**. Red wine contains an antioxidant called resveratrol.
Herbs and spices:
Many spices are rich in polyphenols, such as turmeric. Use these in cooking other than salt.
Activity:
Keeping active can help to keep inflammation at bay.
**These foods contain polyphenols, which are natural substances made by plants to protect themselves from bugs.

Increasing inflammation
The following lifestyle factors may increase inflammation in the body:

  • A fast-food diet/highly processed diet.
  • A high fat diet, especially one high in saturated fats and trans fats (now not used much in the UK)*. A diet high in linoleic acid (an omega-6 fat) may give rise to migraines due to its inflammatory effect.
  • Sugary foods, refined carbohydrates (white bread, rice etc.), sugary drinks.
  • A low fibre diet.
  • Diets that encourage a lot of weight gain.
  • Over-processed veg or veg with added full fat mayonnaise, butter etc.
  • Over-processed fruit or fruit with added sugar/syrups.
  • A low vitamin D diet, especially if you’re not getting much sun.
  • Fatty meat, too much red meat (pork, beef and lamb), and processed meat such as sausage and ham.
  • Certain snacks, such as sweets and chocolates, biscuits, crisps, salted or coated nuts and seeds, sweet popcorn.
  • Hot chocolate, sweetened fatty beverages, e.g. coffees with extra cream and syrups.
  • Excessive alcohol and/or salt.
  • Not being active enough.
    *Trans fats were used a lot by the shortening industry (margarines and spreads) to allow plant-derived oils, normally liquid at room temperature, to be harder. These fats are now hardened using a different process that doesn’t carry the risk of harm to health. But trans fats are still used in some processed foods, pies and pastries.

What about supplements?
You shouldn’t need supplements if your diet’s adequate (except for vitamin D and a fish oil supplement if you don’t eat oily fish). Taking antioxidant supplements may actually increase inflammation.

There’s increasing evidence that having a healthy gut with a diverse and plentiful colony of good bacteria can bring down inflammation in the body, as well as controlling digestion. The gut microbiome is made up of trillions of different bacteria, fungi and other tiny microbes. A balanced microbiome keeps bad microbes in check using the so called ‘good’ ones. So eating some probiotic foods, such as yogurts and/or taking a probiotic supplement every day may be a good idea. Probiotics need to be taken daily as they don’t survive for long in the gut. Some foods feed the good bacteria (prebiotics) such as veg from the onion family, oats, sauerkraut and other fermented veg and drinks such as kefir and kombucha. You can also take a combined pro- and pre-biotic supplement.

About the author
Gaynor Bussell is a freelance dietitian and nutritionist. She sees private patients and also writes articles about diet and nutrition.

Created Winter 2021-2022
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