Menopause can bring increased cholesterol levels and other heart risks. Here’s why and what to do about it
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Menopause is a natural biological process that marks the end of a woman’s reproductive years, typically between 45 and 55. As women approach or experience menopause, common “change of life” concerns include hot flushes, sweats and mood swings, brain fog and fatigue.
But many women may not be aware of the long-term effects of menopause on the heart and blood vessels that make up the cardiovascular system. Heart disease accounts for 35% of deaths in women each year – more than all cancers combined.
What should women – and their doctors – know about these risks?
Hormones protect hearts – until they don’t
As early as 1976, the Framingham Heart Study reported more than twice the rates of cardiovascular events in postmenopausal than pre-menopausal women of the same age. Early menopause (younger than age 40) also increases heart risk.
Before menopause, women tend to be protected by their circulating hormones: oestrogen, to a lesser extent progesterone and low levels of testosterone.
These sex hormones help to relax and dilate blood vessels, reduce inflammation and improve lipid (cholesterol) levels. From the mid-40s, a decline in these hormone levels can contribute to unfavourable changes in cholesterol levels, blood pressure and weight gain – all risk factors for heart disease.
4 ways hormone changes impact heart risk
1. Dyslipidaemia– Menopause often involves atherogenic changes – an unhealthy imbalance of lipids in the blood, with higher levels of total cholesterol, triglycerides, and low-density lipoprotein (LDL-C), dubbed the “bad” cholesterol. There are also reduced levels of high-density lipoprotein (HDL-C) – the “good” cholesterol that helps remove LDL-C from blood. These changes are a major risk factor for heart attack or stroke.
2. Hypertension – Declines in oestrogen and progesterone levels during menopause contribute to narrowing of the large blood vessels on the heart’s surface, arterial stiffness and raise blood pressure.
3. Weight gain – Females are born with one to two million eggs, which develop in follicles. By the time they stop ovulating in midlife, fewer than 1,000 remain. This depletion progressively changes fat distribution and storage, from the hips to the waist and abdomen. Increased waist circumference (greater than 80–88 cm) has been reported to contribute to heart risk – though it is not the only factor to consider.
4. Comorbidities – Changes in body composition, sex hormone decline, increased food consumption, weight gain and sedentary lifestyles impair the body’s ability to effectively use insulin. This increases the risk of developing metabolic syndromes such as type 2 diabetes.
While risk factors apply to both genders, hypertension, smoking, obesity and type 2 diabetes confer a greater relative risk for heart disease in women.
So, what can women do?
Every woman has a different level of baseline cardiovascular and metabolic risk pre-menopause. This is based on their genetics and family history, diet, and lifestyle. But all women can reduce their post-menopause heart risk with:
- regular moderate intensity exercise such as brisk walking, pushing a lawn mower, riding a bike or water aerobics for 30 minutes, four or five times every week
- a healthy heart diet with smaller portion sizes (try using a smaller plate or bowl) and more low-calorie, nutrient-rich foods such as vegetables, fruit and whole grains
- plant sterols (unrefined vegetable oil spreads, nuts, seeds and grains) each day. A review of 14 clinical trials found plant sterols, at doses of at least 2 grams a day, produced an average reduction in serum LDL-C (bad cholesterol) of about 9–14%. This could reduce the risk of heart disease by 25% in two years
- less unhealthy (saturated or trans) fats and more low-fat protein sources (lean meat, poultry, fish – especially oily fish high in omega-3 fatty acids), legumes and low-fat dairy
- less high-calorie, high-sodium foods such as processed or fast foods
- a reduction or cessation of smoking (nicotine or cannabis) and alcohol
- weight-gain management or prevention.
What about hormone therapy medications?
Hormone therapy remains the most effective means of managing hot flushes and night sweats and is beneficial for slowing the loss of bone mineral density.
The decision to recommend oestrogen alone or a combination of oestrogen plus progesterone hormone therapy depends on whether a woman has had a hysterectomy or not. The choice also depends on whether the hormone therapy benefit outweighs the woman’s disease risks. Where symptoms are bothersome, hormone therapy has favourable or neutral effects on coronary heart disease risk and medication risks are low for healthy women younger than 60 or within ten years of menopause.
Depending on the level of stroke or heart risk and the response to lifestyle strategies, some women may also require medication management to control high blood pressure or elevated cholesterol levels. Up until the early 2000s, women were underrepresented in most outcome trials with lipid-lowering medicines.
The Cholesterol Treatment Trialists’ Collaboration analysed 27 clinical trials of statins (medications commonly prescribed to lower cholesterol) with a total of 174,000 participants, of whom 27% were women. Statins were about as effective in women and men who had similar risk of heart disease in preventing events such as stroke and heart attack.
Every woman approaching menopause should ask their GP for a 20-minute Heart Health Check to help better understand their risk of a heart attack or stroke and get tailored strategies to reduce it.
Treasure McGuire, Assistant Director of Pharmacy, Mater Health SEQ in conjoint appointment as Associate Professor of Pharmacology, Bond University and as Associate Professor (Clinical), The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Longevity Project – by Dr. Howard Friedman & Dr. Leslie Martin
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Most books on the topic of longevity focus on such things as diet and exercise, and indeed, those are of course important things. But what of psychological and sociological factors?
Dr. Friedman and Dr. Martin look at a landmark longitudinal study, following a large group of subjects from childhood into old age. Looking at many lifestyle factors and life events, they crunched the numbers to see what things really made the biggest impact on healthy longevity.
A strength of the book is that this study had a huge amount of data—a limitation of the book is that it often avoids giving that concrete data, preferring to say “many”, “a majority”, “a large minority”, “some”, and so forth.
However, the conclusions from the data seem clear, and include many observations such as:
- conscientiousness is a characteristic that not only promotes healthy long life, but also can be acquired as time goes by (some “carefree” children became “conscientious” adults)
- resilience is a characteristic that promotes healthy long life—but tends to only be “unlocked” by adversity
- men tend to live longer if married—women, not so much
- religion and spirituality are not big factors in healthy longevity—but social connections (that may or may not come with such) do make a big difference
Bottom line: if you’d like to know which of your decisions are affecting your healthy longevity (beyond the obvious diet, exercise, etc), this is a great book for collating that information and presenting, in essence, a guideline for a long healthy life.
Click here to check out The Longevity Project and see how it applies to your life!
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Peaceful Kitchen – by Catherine Perez
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The author, a keen cook and Registered Dietician with a Master’s in same, covers the basics of the science of nutrition as relevant to her recipes, but first and foremost this is not a science textbook—it’s a cookbook, and its pages contain more love for the art than citations for the (perfectly respectable) science.
Mexican and Dominican cuisine are the main influences in this book, but there are dishes from around the world too.
The recipes themselves are… Comparable in difficulty to the things we often feature in our recipes section here at 10almonds. They’re probably not winning any restaurants Michelin stars, but they’re not exactly student survival recipes either. They’re made from mostly non-obscure whole foods, nutritionally-dense ingredients at that, with minimal processed foods involved.
That said, she does take a “add, don’t subtract” approach to nutrition, i.e. focussing more on adding in diversity of plants than on “don’t eat this; don’t eat that” mandates.
If there’s any criticism to be levelled at the book, it’s that in most cases we’d multiply the spices severalfold, but that’s not a big problem as readers can always judge that individually; she’s given the basic information of which spices in which proportions, which is the key knowledge.
Bottom line: if you’re looking to expand your plant-based cooking repertoire, this one is a fine choice.
Click here to check out Peaceful Kitchen, and try some new things!
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Hawthorn For The Heart (& More)
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Hawthorn, The Heart-Healthy Helper
Hawthorn, a berry of the genus Crataegus (there are many species, but they seem to give more or less the same benefits), has been enjoyed for hundreds of years, if not thousands, as a herbal remedy for many ailments, mostly of the cardiovascular, digestive, and/or endocrine systems:
Crataegus pinnatifida: Chemical Constituents, Pharmacology, and Potential Applications
Antioxidant & Anti-inflammatory
Like most berries, it’s full of helpful polyphenols, with antioxidant and anti-inflammatory properties. Indeed, as Dr. Nabavi et al. wrote,
❝Crataegus monogyna Jacq. (hawthorn) is one of the most important edible plants of the Rosaceae family and is also used in traditional medicine.
Growing evidence has shown that this plant has various interesting physiological and pharmacological activities due to the presence of different bioactive natural compounds.
In addition, scientific evidence suggests that the toxicity of hawthorn is negligible. ❞
Read in full: Polyphenolic Composition of Crataegus monogyna Jacq.: From Chemistry to Medical Applications
While “the toxicity of hawthorn is negligible” may be reasonably considered a baseline for recommending an edible plant, it’s still important as just that: a baseline. It’s good to know that berries are safe, after all!
More positively, about those antioxidant and anti-inflammatory properties:
This one was a mouse study, but it’s important as it about modulating liver injury after being fed a high fructose diet.
In other words: it a) helps undo the biggest cause of non-alcoholic fatty liver disease, b) logically, likely guards against diabetes also (by the same mechanism)
Anti-Diabetes Potential
Curious about that latter point, we looked for studies, and found, for example:
- Hypoglycemic effect of hawthorn in type II diabetes mellitus rat model
- Molecular Mechanisms of Hawthorn Extracts in Multiple Organs Disorders in Underlying of Diabetes: A Review
- Modulation of GPC-4 and GPLD1 serum levels by improving glycemic indices in type 2 diabetes: Resistance training and hawthorn extract intervention
Noteworthily, those studies are from the past couple of years, which is probably why we’re not seeing many human trials for this yet—everything has to be done in order, and there’s a lengthy process between each.
We did find some human trials with hawthorn in diabetes patients, for example:
…but as you see, that’s testing not its antidiabetic potential, so far demonstrated only in mice and rats (so far as we could find), but rather its blood pressure lowering effects, using diabetic patients as a sample.
Blood pressure benefits
Hawthorn has been studied specifically for its hypotensive effect, for example:
As an extra bonus, did you notice in the conclusion,
❝Furthermore, a trend towards a reduction in anxiety (p = 0.094) was also observed in those taking hawthorn compared with the other groups.
These findings warrant further study, particularly in view of the low dose of hawthorn extract used.❞
…it seems that not a lot more study has been done yet, but that is promising too!
Other blood metrics
So, it has antidiabetic and antihypertensive benefits, what of blood lipids?
Hawthorn Fruit Extract Elevates Expression of Nrf2/HO-1 and Improves Lipid Profiles
And as for arterial plaque?
here it was tested alongside another herb, and performed well (also against placebo).
In summary…
Hawthorn (Crataegus sp.) is…
- a potent berry containing many polyphenols with good antioxidant and anti-inflammatory effects
- looking promising against diabetes, but research for this is still in early stages
- found to have other cardioprotective effects (antihypertensive, improves lipid profiles), too
- considered to have negligible toxicity
Where can I get it?
As ever, we don’t sell it, but here for your convenience is an example product on Amazon
Enjoy!
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Wholesome Threesome Protein Soup
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This soup has two protein– and fiber-rich pseudo-grains, one real wholegrain, and nutrient-dense cashews for yet even more protein, and all of the above are full of many great vitamins and minerals. All in all, a well-balanced and highly-nutritious light meal!
You will need
- ⅓ cup quinoa
- ⅓ cup green lentils
- ⅓ cup wholegrain rice
- 5 cups low-sodium vegetable stock (ideally you made this yourself from offcuts of vegetables, but failing that, low-sodium stock cubes can be bought in most large supermarkets)
- ¼ cup cashews
- 1 tbsp dried thyme
- 1 tbsp black pepper, coarse ground
- ½ tsp MSG or 1 tsp low-sodium salt
Optional topping:
- ⅓ cup pine nuts
- ⅓ cup finely chopped fresh mint leaves
- 2 tbsp coconut oil
Method
(we suggest you read everything at least once before doing anything)
1) Rinse the quinoa, lentils, and rice.
2) Boil 4 cups of the stock and add the grains and seasonings (MSG/salt, pepper, thyme); simmer for about 25 minutes.
3) Blend the cashews with the other cup of vegetable stock, until smooth. Add the cashew mixture to the soup, stirring it in, and allow to simmer for another 5 minutes.
4) Heat the coconut oil in a skillet and add the pine nuts, stirring until they are golden brown.
5) Serve the soup into bowls, adding the mint and pine nuts to each.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Give Us This Day Our Daily Dozen
- Black Pepper’s Impressive Anti-Cancer Arsenal (And More)
- Why You Should Diversify Your Nuts!
Take care!
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What Happens Every Day When You Quit Sugar For 30 Days
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We all know that sugar isn’t exactly a health food, but it can be hard to quit. How long can cravings be expected to last, and when can we expect to see benefits? Today’s video covers the timeline in a realistic yet inspiring fashion:
What to expect on…
Day 1: expect cravings and withdrawal symptoms including headaches, fatigue, mood swings, and irritability—as well as tiredness, without the crutch of sugar.
Days 2 & 3: more of the same, plus likely objections from the gut, since your Candida albicans content will not be enjoying being starved of its main food source.
Days 4–7: reduction of the above symptoms, better energy levels, improved sleep, and likely the gut will be adapting or have adapted.
Days 8–14: beginning of weight loss, clearer skin, improved complexion; taste buds adapt too, making foods taste sweeter. Continued improvement in energy and focus, as well.
Days 15–21: more of the same improvements, plus the immune system will start getting stronger around now. But watch out, because there may still be some cravings from time to time.
Days 22–30: all of the above positive things, few or no cravings now, and enhanced metabolic health as a whole.
For more specificity on each of these stages, enjoy:
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Want to learn more?
You might also like to read:
The Not-So-Sweet Science Of Sugar Addiction
Take care!
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The Happy Menopause – by Jackie Lynch
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The author, a nutritionist, takes the approach that just as no two menopauses are exactly the same, how it is managed needs to be personalized too.
Thus, rather than simply “do this, do that”, she sets about talking the reader through identifying what things are likely to influence what symptoms, and then then actually testing them to see if a given adjustment is helpful or not. Lest this sound like a lot of work, she does invariably start from a place of “Most women…”, which means that on average, the reader will still get the right thing first try. However, in the cases of not being average, this book has the less common cause-and-effect pairings down as well. To this end, the book is mostly arranged by symptom, so it’s quite easy to find a particular thing one might be looking to fix.
As for HRT, she takes the very respectable position that she is a nutritionist and as such, that matter is not her wheelhouse, and so she restrains herself to her own field of expertise, nutrition. Her intent is that the information in this book should be useful to all, HRT or no HRT.
The style is very light pop science, making this very easily readable and comprehensible to all.
Bottom line: if you have unwanted menopause symptoms, and would like to not be suffering from those, this book offers a natural approach, so give it a try!
Click here to check out The Happy Menopause, and menopause happily!
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