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Mediterranean diet - what is it and how can it help peri-post menopausal women?

A typical Mediterranean diet is one that is high in vegetables, fruit, legumes (like chickpeas, lentils and beans) and healthy fats like omega 3 fatty acids from fish, avocadoes, nuts and seeds. Nothing on the diet is actively off limits, but processed foods or ones that are high in sugar are rarely part of the plan and meat and alcohol tend to be kept to a minimum.

The range of foods included are typically nutrient-dense and packed with vitamins and minerals, plus the high fibre and protein content is likely to help you stay fuller for longer. The diet is low in trans fat (known to raise levels of 'bad' cholestoerol), and because you typically cook from scratch there are no hidden preservatives or added sugar or salt.

A Mediterranean-inspired diet could help balance your hormones, minimise your perimenopause and menopause symptoms, keep your weight down, reduce your belly fat (aka meno-belly) and protect your heart and cognitive and bone health. Here is a bit more detail on how and why:

1. The diet can help minimise many typical menopause symptoms such as hot flushes, night sweats and depression. Research has shown that the high intake of legumes (like kidney beans, peas, lentils, chickpeas) and extra virgin olive oil typical of the diet led to less severe, or fewer, menopause symptoms. The women who stuck to the Med diet also reported sleeping better. Legumes are a potent source of vitamins, antioxidants, fibre, protein and also phyto-oestrogens (plant based substances that mimic the role of oestrogen in the body), and low oestrogen can be the cause of some of the typical menopausal symptoms.

2. It is an anti-inflammatory diet. An anti-inflammatory diet is particularly important during perimenopause and menopause because oestrogen acts as an anti-inflammatory and diminishing levels of it can trigger inflammation in the body, potentially leading to symptoms like joint pain and possibly even neurodegenerative conditions in later life. Certain foods like ultra-processed ones, refined white carbohydrates, deep-fried foods, processed and cured meats, sugary and very salty ones are known to drive inflammation whereas food staples on a typical Mediterranean diet like fruit and vegetables, fresh fish, nuts, pulses (including chickpeas and lentils), garlic, herbs (like turmeric and rosemary), unsalted nuts and seeds protect against it.

3. The diet can help reduce weight and belly fat. The Mediterranean diet isn’t a specific weight loss or restrictive diet, but is has been shown to be significant in helping to maintain a healthy weight - something that is an issue for many women during perimenopause and menopause. It may also reduce potentially harmful belly fat – which raises your risk of type 2 diabetes and heart disease. Studies have found that those who followed a Mediterranean diet reported less weight gain and abdominal fat than those not following this pattern of eating. Of course, the Med diet is not going to wave a magic wand and make you three stone lighter over night – you still have to watch your portion sizes and the amount of sugar and simple carbohydrates you are eating, but it remains one of the healthiest ways to keep your weight under control.

4. The diet increases bone health. Declining levels of oestrogen as you go through perimenopause and menopause put you at an increased risk of reduced bone density and osteoporosis (weakened, fragile bones). There is evidence to show having a good intake of calcium-rich foods (like natural yogurt, almonds, leafy greens like spinach, oily fish) with vitamin D (synthesised in the body on exposure to sunshine and found in foods like oily fish, eggs, cheese and mushrooms) as part of a Mediterranean pattern of eating can help you to maintain good bone health and reduce the risk of osteoporosis. Vitamin D helps you to better absorb calcium and research also suggests low levels of vitamin D may lead to lower levels of oestrogen. Research shows it may prevent osteoporosis and the risk of fractures by increasing bone density and muscle mass in post-menopausal women.

5. The diet contributes to a healthy heart. This is a diet renowned for its heart-healthy benefits after it was noticed heart disease was not as prevalent in Mediterranean countries as in other Western ones like the US and UK. The drop in oestrogen during perimenopause and menopause puts women at an increased risk of higher blood pressure, cholesterol levels and cardiovascular disease. One of the key factors in helping keep your heart healthy on a Mediterranean diet is the use of olive oil as the primary source of added fat. Olive oil is a source of monounsaturated fat which helps lower LDL (’bad’) cholesterol levels. Nuts and seeds also contain a complex of essential fats such as omega 3 (particularly walnuts, flax and chia seeds) and omega 6 (pine nuts and sunflower seeds) as well as monosaturated (macadamia and hazelnut) fats. Avocadoes are also known to contain heart-healthy fats and fibre and eating them regularly has also been linked to lower levels of LDL cholesterol and less visceral fat. Omega 3 fatty acids found in oily fish like salmon, mackerel and sardines also help to fight inflammation in the body and are known to help reduce triglycerides (a type of fat found in the blood), the risk of blood clots and lower your risk of stroke and heart failure.

6. Better cognitive health. Research suggests eating the Mediterranean way is associated with better cognitive function and may lower the risk of cognitive decline and neurodegenerative conditions like Alzeimer's. In particular, regularly eating omega 3-rich oily fish as part of this diet is linked to a reduced risk of cognitive impairment. Alzheimer’s disproportionately affects women, and is linked to declining levels of oestrogen during menopause – so anything that potentially helps reduce, prevent or delay that risk is beneficial.

7. Improved mood. Research has shown that people who eat more fruit and vegetables have a lower incidence of depression, better mood and more positive mental health. This is particularly significant during perimenopause and menopause when low mood is cited as one of the most common symptoms of both.

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