Nutrition, changement hormonaux et vieillissement
Note: In this article, the acronym AFAB will be used to refer to individuals Assigned Female At Birth. The processes described affect AFAB individuals, those who have a uterus and have experienced menstrual cycles. We acknowledge that, even without necessarily going through menopause, some people identifying as women may experience symptoms related to hormonal changes and could also benefit from the interventions mentioned in this article.
The human body has an incredible capacity to adapt and function, ranging from our most basic needs to more individualized ones. When we change our external environment—whether by performing daily tasks, starting a new hobby, or trying certain foods for the first time—our body can process and maintain a stable internal environment, allowing us to stay healthy and function at our best.
As part of the natural aging process, the way our body responds to the external environment gradually changes. With age, body composition shifts, and we progressively lose some muscle mass and bone density. We also begin to experience changes in hormonal balance—molecules that affect metabolism, sleep, mood, and stress levels, among other functions.
For individuals Assigned Female At Birth (AFAB) in particular, there is a drastic decline in estrogen and progesterone hormones that occurs at the end of the reproductive phase of life. This decline is known as menopause, and the years leading up to it are called perimenopause.
Perimenopause: To mark the end of the reproductive years, the body begins its transition to menopause, known as perimenopause. This period involves fluctuating estrogen levels and variations in menstrual flow and cycle length. AFAB individuals may experience the following to varying degrees: menstrual changes, hormonal symptoms, cognitive symptoms, and other effects. Periods often become more irregular and change in length, and the intervals between menstrual flows may increase. Individuals may also experience hot flashes, mood swings, vaginal dryness, difficulty sleeping, short-term memory problems, weight gain, and more.
Perimenopause can begin as early as the mid-30s for some people and continue into the mid-50s. After the onset of the first symptoms, perimenopause typically lasts around 4 years, though symptoms may persist for shorter or longer periods depending on individual factors.
Menopause: Menopause is defined as the biological phase in a person’s life when the ovaries stop releasing eggs, at which point the individual has not had a menstrual period for at least 12 months. In many cases, this marks the resolution of most symptoms experienced during perimenopause. Most individuals reach menopause between the ages of 45 and 55, although it can occur earlier or later for some. The decrease in symptoms and the timeline for their resolution can also vary.
The Importance of Nutrition with Age
A Balanced Diet: Throughout our lives, a balanced diet is recommended to support growth, development, and the maintenance of bodily functions. General guidelines for all adults are the same: we should aim for a diet that includes foods from all food groups. One way to follow these recommendations is by using Canada’s “Healthy Plate” as a reference: half of the plate should be filled with vegetables and fruits, one-quarter with a source of protein, and one-quarter with grains.
Eating a variety of foods helps meet nutrient needs and provides the energy necessary to continue doing the activities we enjoy. Furthermore, due to changes in the body with age, certain nutrients become more important during menopause, as the body begins to use and store them less efficiently over time.
Calcium: Around the age of 50, bone resorption—the process by which older bone tissue is broken down—occurs more rapidly than the formation of new bone. This means that over time, our bones are likely to become weaker. During perimenopause, the decline in estrogen also reduces our protection against fragile bones, increasing the risk of osteoporosis and fractures.
Calcium is an essential mineral for building and maintaining bone density, as it combines with other minerals to form the crystalline structure of bones. In fact, 99% of the calcium in our body is stored in the bones due to this vital role. Consuming adequate dietary calcium helps maintain these necessary reserves to keep our bones strong and healthy.
For individuals going through menopause and over the age of 50, Health Canada recommends a daily intake of 1,200 mg of calcium. Good sources of calcium include dairy products, calcium-fortified foods and beverages, canned fish with bones, leafy green vegetables, as well as nuts and seeds.
Vitamin D: This vitamin helps the body absorb calcium from food into the bloodstream. It therefore plays an important role in maintaining bone density, as calcium cannot perform its necessary functions without the help of vitamin D. Due to the increased risk of osteoporosis, it becomes especially important to ensure an adequate daily intake once we reach menopause.
Vitamin D is naturally found in only a few foods, such as fatty fish (salmon, herring, sardines, mackerel), egg yolks, and certain red meats. It is also present in fortified products, such as milk, some plant-based beverages, and cereals. In addition, the body can produce vitamin D when exposed to sufficient UV rays from sunlight.
During the summer months, it is recommended to get approximately 2–3 hours of sun exposure per week (in shorts and a T-shirt) to meet vitamin D needs, which can provide between 800–1,600 IU of vitamin D. However, in winter, UV levels and sun exposure are often insufficient to meet requirements. Health Canada recommends a daily intake of 600–800 IU of vitamin D for individuals experiencing menopause after the age of 50.
Fats: Changes in hormonal balance with age can lead to a natural decline in organ function and a redistribution of body fat toward visceral areas. This means that more fat is stored in the abdominal cavity surrounding the organs. A combination of these changes can increase the risk of cardiovascular disease, especially when combined with other factors such as low physical activity, family history of the disease, and so on.
One way to reduce the risk of developing cardiovascular disease is to include plenty of sources of unsaturated fats in our diet. Monounsaturated and polyunsaturated fatty acids help lower blood cholesterol, reduce triglycerides, and improve blood sugar control, contributing to a properly functioning heart. Including a wide variety of foods in our meals and snacks helps provide all the essential nutrients the body needs.
Some examples of good sources of unsaturated fats include vegetable oils (olive, canola, sesame), nuts and seeds, eggs, avocados, fatty fish (salmon, sardines, mackerel, anchovies), tofu, and soybeans.
Consulting a registered dietitian can help you choose the best plan of action to maintain a balanced diet while meeting your nutrient needs and maintaining a healthy relationship with food. Your dietitian can guide you through your dietary and health goals, review appropriate educational tools, and provide the resources and support needed to eat the foods you enjoy without the guilt or restriction that can accompany traditional diets.
Mélissa Mcallister, Nutritionist, RD
