30 Mar 2022

Nutrition for heart health through menopause and beyond

Viridian Nutrition’s Jenny Carson explains how nutrition and lifestyle changes can help support heart health through menopause and beyond.

Did you know that the hormone oestrogen is associated with heart health? 

You might be surprised  to know that before menopause women enjoy the cardio-protective benefits of oestrogen.  

And that’s perhaps a factor for why prior to the menopause women have half the risk that men do for cardiovascular health conditions.  

Reassuringly, once you’re post-menopause and oestrogen has declined it doesn’t necessarily mean that you will develop cardiovascular health conditions.  

But certain risk factors for heart conditions may increase. 

That’s why midlife is the perfect time to take control of your heart health. Regularly check blood pressure, stress levels, cholesterol and body fat percentage while adjusting the diet and lifestyle.

And for good reason: the World Health Organisation considers cardiovascular disease largely preventable.  

Read on for more about how to support your heart health.

How oestrogen and heart health are connected

First, let’s consider why oestrogen plays a role in heart health: 

  • Oestrogen plays a role in producing collagen.  So,  as hormone levels decline so does the production of collagen.  And collagen is important to the heart because it’s a structural protein in all tissues, this includes organs and the skin.  So as our collagen reduces,  the strength and contractability of the heart and arterial tissue can weaken.
  • Oestrogen also regulates cholesterol, which has a protective effect to our heart health. Again, as oestrogen lowers, this can affect cholesterol levels which can be damaging to the body, especially to heart tissue.  
  • And oestrogen helps regulate and dampen down the stress hormone, cortisol.  Generally, oestrogen suppresses excessive cortisol spikes which has a beneficial effect of managing our blood glucose, stress, and heart rate. However, unregulated cortisol can increase the risk of type II diabetes, anxiety, long term stress and palpitations.

The link between heart health and when you go through menopause

Surprisingly, evidence shows that poorer premenopausal heart health may influence the timing of the menopause.  

Analysis has shown that women who had their first heart event under the age of 35 had double the risk of an early menopause.  

The Framingham Heart Study also showed that higher total cholesterol, blood pressure and other cardiovascular risk factors before menopause were associated with an earlier menopause too.

What are the risk factors for heart health through perimenopause and menopause? 

Several risk factors can contribute to an increased risk of cardiovascular outcomes, which may be exacerbated further when oestrogen levels decline.

Diet

Processed foods, heated oils and foods that are high in salt and sugar, are known to disrupt our metabolism. This means they affect how the body uses carbohydrates, fats and proteins.  This can contribute to bringing on type II diabetes and also metabolic syndrome, a health condition that includes higher blood pressure, dysregulated blood lipids and poor blood glucose management.

Caffeine too is thought to be another risk factor. While many of us love our daily cuppas, reliance on large volumes of caffeine can bring on stress, increase blood pressure and heart rate and promote the production of inflammatory forms of oestrogen.  

Alcohol

While we’re all aware that alcohol is not good for health, it can have a particular effect on heart health. 

Firstly, there is evidence that alcohol may affect women to a greater extent than men because we tend to carry proportionally less water to fat in our bodies and because we have less of the enzyme that breaks down alcohol.

In terms of the link to heart health. As our bodies detoxify the ethanol in alcohol we produce a compound called aldehyde which can affect organ tissue including those in our heart and liver. 

Sedentary lifestyle

It is not surprising that regular exercise protects our heart health and the current recommendations advise more than 150 minutes of exercise weekly.  The heart, like any other muscle, benefits from being worked and used. That’s why daily exercise for a minimum of 30 minutes is considered effective.  Evidence shows that more than 8 hours each day of sedentary behaviour, such as prolonged sitting, isreported to increase the risk of death from cardiovascular events.  

Overweight and obesity

Current reports show that obesity is greater in women aged 40-59 years compared to younger women aged 20-39 years.  Plus, post-menopausal women with central fat accumulation and a waist measurement greater than 88cm are at a greater risk of mortality than those with no central fat accumulation. 

Smoking

Interestingly, data analysis shows that the coronary heart disease risk from smoking a cigarette daily in women is far greater than in men.  Women who smoke have a greater risk of coronary heart disease and stroke incidence compared to women who have never smoked.

How to protect your health health

The good news is that changes in lifestyle and diet can support heart health and provide a way tomanage the processes that were previously protected by oestrogen.

Diet 

  • Eat a whole foods diet, rather than a highly processed one.  This includes vegetables, fruit, legumes, cuts of pastured meats, pastured eggs, fish, whole grains and nuts and seeds.  These foods are rich in the nutrients that have a beneficial effect on heart health.
  • Add foods that are naturally phytoestrogen-rich such as organic, fermented soy, red clover, sage, and sprouted seeds.  These foods provide plant-based oestrogen albeit, not at the same levels as human oestrogen.
  • Fresh fruit, berries and salad items are rich in vitamin C, and because they are eaten raw the vitamin C content is preserved (when food is cooked, vitamin C levels reduce).   Vitamin C is key in the production of collagen. Collagen is a structural protein in all types of tissue, especially heart and blood vessel tissues.

RELATED ARTICLE: Top 5 nutrients to support you through menopause and perimenopause

Supplements

  • Turmeric and its bioactive constituents curcuminoids protect cardiovascular tissue and mildly thin the blood which may reduce blood pressure.  Blood pressure reduction has also been reported for pine bark extract, Black Seed (Nigella sativa) and boswellia (Frankincense resin).
  • A good intake of B vitamins, especially B3 and vitamin C alongside a wholefoods diet can improve cholesterol status.  Similarly, the compound octacosanol from rice bran is considered effective for this too.
  • The heart muscle is a rich source of Co-enzyme Q10 and taurine, which declines as we age .  Both of these can be found in food supplements..
  • Calcium absorption into bone depends on vitamin K2. Without vitamin K2, calcium may be deposited in the blood vessels and contribute to hardening of the arteries. Research shows that post menopausal women who had the greatest intake of vitamin K2 had a reduced risk of blood vessel calcification.
  • Traditional European medicine recognises garlic as a beneficial herb. Studies show that garlic can reduce blood pressure, total cholesterol and inflammatory markers - each of which support heart health.
  • The Mediterranean fruit pomegranate is rich in ellagic acid and is considered beneficial for heart health.  Research reports that pomegranate can induce a significant reduction in blood pressure, and inflammatory markers.

RELATED ARTICLE: Demystifying supplements for your 40s, 50s and beyond

Lifestyle tips

  • Aim for 30 minutes of exercise daily, this could be a brisk walk, jogging, swimming, gym or yoga and Pilates.
  • Maintain a healthy caloric intake, there are several food tracking apps that make logging dietary intake easy.  This will help to monitor intake and regulate the amount eaten to support a heart healthy outcome.
  • Reduce and quit smoking.  There are several programmes on offer at health centres.
  • Reduce alcohol intake.

Conclusion

It is no surprise that heart health is an important consideration both during and after menopause.  

Our hormone oestrogen plays a regulatory role in several processes that affect the heart, such as collagen, cholesterol, stress and calcium uptake.

And although phytoestrogen foods are weaker than human oestrogen, they can play a valuable role supporting menopause and heart health.  

Ultimately the World Health Organisation considers heart disease largely preventable when dietary changes are combined with lifestyle modification.

For further information on dietary, supplement and lifestyle support for heart health and menopause, visit your local health store at: www.findahealthstore.com

About the author: 

Jenny Carson, MRes, BSc (Hons) is a Senior Nutritionist at ethical vitamin company Viridian Nutrition. She has over 7 years’ experience supporting people with nutritional health advice. She recently completed a Master of Research(MRes) in Public Health, giving her a wide understanding of public health nutrition. Her other focus areas include ageing, dealing with stress, peri and post-menopause, detox and mood. For more information visit www.viridian-nutrition.com

References

Beulens JW, Bots ML, Atsma F, Bartelink ML, Prokop M, Geleijnse JM, Witteman JC, Grobbee DE, van der Schouw YT. High dietary menaquinone intake is associated with reduced coronary calcification. Atherosclerosis. 2009 Apr;203(2):489-93. 

El Khoudary SR, Greendale G, Crawford SL, Avis NE, Brooks MM, Thurston RC, Karvonen-Gutierrez C, Waetjen LE, Matthews K. The menopause transition and women’s health at midlife: a progress report from the Study of Women’s Health Across the Nation (SWAN). Menopause. 2019; 26:1213–1227.

Kok HS, van Asselt KM, van der Schouw YT, van der Tweel I, Peeters PH, Wilson PW, Pearson PL, Grobbee DE. Heart disease risk determines menopausal age rather than the reverse. J Am Coll Cardiol. 2006; 47:1976–1983.

Patterson R, McNamara E, Tainio M, de Sá TH, Smith AD, Sharp SJ, Edwards P, Woodcock J, Brage S, Wijndaele K. Sedentary behaviour and risk of all-cause, cardiovascular and cancer mortality, and incident type 2 diabetes: a systematic review and dose response meta-analysis. Eur J Epidemiol. 2018; 33:811–829. 

Razani Z, Dastani M, Kazerani HR. Cardioprotective Effects of Pomegranate (Punica granatum) Juice in Patients with Ischemic Heart Disease. Phytother Res. 2017 Nov;31(11):1731-1738. 

Sahebkar A, Ferri C, Giorgini P, Bo S, Nachtigal P, Grassi D. Effects of pomegranate juice on blood pressure: A systematic review and meta-analysis of randomized controlled trials. Pharmacol Res. 2017 Jan; 115: 149-161. 

Sun Y, Liu B, Snetselaar LG, Wallace RB, Caan BJ, Rohan TE, Neuhouser ML, Shadyab AH, Chlebowski RT, Manson JE, et al.  Association of normal-weight central obesity with all-cause and cause-specific mortality among postmenopausal women. JAMA Netw Open. 2019; 2: e197337.

Varshney R, Budoff MJ. Garlic and Heart Disease. J Nutr. 2016 Feb;146(2):416S-421S.

Zhu D, Chung HF, Pandeya N, Dobson AJ, Hardy R, Kuh D, Brunner EJ, Bruinsma F, Giles GG, Demakakos P, et al.  Premenopausal cardiovascular disease and age at natural menopause: a pooled analysis of over 170,000 women. Eur J Epidemiol. 2019; 34:235–246.

This article is for information purposes and does not refer to any individual products. The information contained in this article is not intended to treat, diagnose or replace the advice of a health practitioner. Please consult a qualified health practitioner if you have a pre-existing health condition or are currently taking medication. Food supplements should not be used as a substitute for a varied and balanced diet.

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