Heart Health and Menopause: How Hormonal Changes Affect Your Risk of Heart Disease

Understanding the ​​Importance of Heart Health Awareness During Menopause

As previously mentioned, menopause can increase the risk of certain diseases in women. Heart disease is among one these. Once women go through menopause, their risk of heart disease increases to that of men of the same age (1). It has been found that women are 5-7 times more likely to die from a heart attack than breast cancer. This is because there is a reduction in the production of oestrogen hormones in a woman’s body during and after menopause.

The Role of Estrogen in Heart Health: Why Menopause Increases Your Risk of Heart Disease

Oestrogen helps to relax the blood vessels, allowing blood to flow easily throughout the body. During menopause, there is a decline in the levels of oestrogen in the body, which can result in a rise in blood pressure. This also causes a narrowing of the coronary arteries where they were previously protected, reducing the build-up of cholesterol or plaque on the inside of the artery walls. This build-up increases the risk of developing coronary heart disease (CHD) or stroke.

How Nutrition Can Reduce Your Risk of Coronary Heart Disease

Key Nutrients for a Heart-Healthy Diet

Here are some key nutrition points to focus on to help reduce your risk of coronary heart disease:

Salt: The Link Between Sodium Intake and High Blood Pressure

Too much salt consumption can increase your blood pressure (called hypertension) which in turn can increase your risk of heart attack and stroke (2). It is recommended to limit intake to a maximum of 6g salt per day for adults, which is one teaspoon. It is the sodium part of salt which can cause heart disease.

Tips for Reducing Salt Intake

It can take about 6 weeks for your taste buds to get used to a reduced salt diet; however, some useful tips include:

• Avoid adding salt to foods during cooking and at the table.
• Use herbs, spices, lemon and lime juice to flavour foods instead of salt.
• Limit the consumption of processed foods such as sausages, bacon, cured meats, crisps and salted nuts.
• Watch out for hidden salt in the likes of breads and breakfast cereals.

As a guide, the Food Standards Agency of Ireland recommends keeping these figures in mind:

• Low salt = 0.3g or less per 100g
• Medium salt = 0.31g – 1.5g per 100g
• High salt = more than 1.5g salt per 100g

Fat: The Good, the Bad, and the Ugly. Understanding The Different Types of Fat & Tips for Choosing Healthy Fats

There are 4 main types of fat in the diet:

1. Saturated fat comes from animal products and has been shown to increase cholesterol levels. Sources include butter, cream, skin-on chicken and other meats, fat on and in meat and processed meats, i.e., sausages, frozen burgers and rashers, and cakes and biscuits. Aim for low-fat dairy products where possible to reduce your saturated fat intake. Aim for 3 portions of low-fat dairy per day, as it is a good source of calcium which is important for bone health.
2. Trans fat has also been shown to increase cholesterol levels, which can increase your risk of heart disease. Sources include cakes, biscuits and pastries. Limit the consumption of these foods.
3. Polyunsaturated fat can help lower cholesterol levels and reduce your risk of heart disease. These are found in foods such as oily fish, sunflower oil, walnuts and hazelnuts. Aim to increase the consumption of these foods in your diet.
4. Monounsaturated fats are found in olive and rapeseed oils, peanuts, cashews and almonds. Aim to replace the saturated fat in your diet with monounsaturated sources such as olive oil for frying instead of butter.  Extra virgin olive oil is minimally processed and, therefore, better quality than standard olive oil.

Fruit & Vegetables: The Key to a Heart-Healthy Diet

Recommended Daily Servings of Fruits and Vegetables For Heart Health

Aim to eat 5 – 7 portions of fruit and vegetables per day to help increase fibre and potassium, which can help reduce your heart disease risk.  These can be fresh, frozen, tinned or jarred, preferably in spring water.  A nice guide to portions of fruits and vegetables is as follows and try to load up half your dinner plate with vegetables or salad:

Take Home Messages

Simple Changes You Can Make to Reduce Your Risk of Heart Disease

1. Eat a variety of fruit and veg, including the skins, where possible (the more colour, the better!).
2. Opt for wholegrain and high-fibre options such as brown bread instead of white versions.
3. Oats contain a compound called beta-glucan. Consuming at least 3g of beta-glucan daily has shown beneficial effects in reducing cholesterol (3). 40g of porridge oats contain 1g of beta-glucan.
4. Consume oily fish at least once per week, e.g. salmon, mackerel, sardines, herring or trout.
5. Limit salt intake, e.g. from processed meats such as sausages, rashers, bacon and table salt. Use herbs and spices to flavour foods instead.
6. Remove the visible fat from meats and skin from poultry before eating.
7. Limit alcohol consumption to 11 standard drinks or less per week (4).

Dealing with menopause can be a tricky experience for some women. I want to let you know you are not alone in this. Our bodies are constantly changing, so having a chat with a Registered Dietitian in Ireland may be helpful to talk about life after menopause.

References

1. Irish Nutrition and Dietetic Institute (INDI). Women’s health. Nutrition and menopause.  https://www.indi.ie/women-s-health/541-nutrition-and-the-menopause.html.
2. National Institute of Clinical Excellence (2019). Hypertension in adults: diagnosis and management. NICE guidelines. https://www.nice.org.uk/guidance/ng136.
3. The Cholesterol-Lowering Effect of Oats and Oat Beta Glucan: Modes of Action and Potential Role of Bile Acids and the Microbiome. Joyce et al., 2019. https://www-ncbi-nlm-nih-gov.ucc.idm.oclc.org/pmc/articles/PMC6892284/.
4. Health Service Executive (HSE). Wellbeing. https://www2.hse.ie/wellbeing/alcohol/improve-your-health/weekly-low-risk-alcohol-guidelines.html.