Should the ‘change of life’ signal the need for a change in your diet & lifestyle? Managing your cholesterol after the menopause Many uncomfortable and sometimes embarrassing changes come with the start of menopause, but far more worrying than reduced libido and hot flushes are the invisible physiological changes such as an increase in cholesterol. Almost four million women in the UK are between the ages of 45 and 55 years of age.1 This is the age at which most women begin the menopause. The good news is that it is never too late to look after your heart and a healthy diet and lifestyle can still make a difference to women’s cholesterol levels Consultant nutritionist Helen Bond offers advice about what you can do to protect yourself from this hidden condition: Getting to the heart of the matter We still tend to associate heart disease as a middle-aged man’s illness, with women being more worried about heart disease affecting their husband’s health rather than themselves. Know your cholesterol levelSurprisingly, 75% of women do not even associate the menopause with raised cholesterol levels.2 Being aware of your cholesterol level is the first step to improving and maintaining your heart health and yet research by The Royal Society of Medicine reveals that around six out of ten people in the UK still don’t know their cholesterol levels or what they should be.3 The guidelines for healthy cholesterol levels are:4 Total cholesterol – Less than 5.0mmol/l Measuring your blood cholesterol level involves a simple blood test, so if you are over 45 years, going through or have gone through the menopause speak with your doctor who will be able to advise you. What is the menopause?The menopause is a natural event in the lives of women and occurs when levels of the female hormones oestrogen and progesterone fall and the body stops producing eggs. The only way to decide if you are menopausal is to have a blood test to check your hormone levels, which your GP can arrange for you.
Proven to actively reduce cholesterol
Why does the menopause affect cholesterol levels? During the menopause, the ovaries stop producing oestrogen and levels start to fall in the body causing a number of important changes. Before the menopause, when a woman gains weight she is likely to carry the excess weight in the hip and thigh area which is referred to as a ‘pear shape’. Then following the menopause women tend to gain weight in and around the abdominal area (central obesity) commonly referred to as an ‘apple’ shape. This shift of body fat distribution is thought to triggers an increase in total cholesterol, an increase in LDL (low density lipoprotein) or ‘bad’ cholesterol and a decrease in HDL (high density lipoprotein) or ‘good’ cholesterol, leaving women at increased risk of developing heart problems.2 This is clearly highlighted by the fact that only 34% of women aged 16-24 have blood cholesterol concentrations that exceed 5.0mmol/l; rising to 88% in those aged 55-64.4 What about treatment?Hormone replacement therapy (HRT) can be a very effective approach to treating menopausal symptoms and your doctor will help you decide if HRT is an appropriate treatment for you. Every woman is unique and will respond differently to treatment. As with any medicine, there are associated risks with HRT including an increased risk of breast cancer,5 blood clots6 and possibly cardiovascular disease.7 For many women, the benefits outweigh the risks, but for some, alternative treatments for either symptom control or heart disease prevention/treatment may be recommended. It is therefore important to discuss your individual needs with your doctor. Prevention is better than cureAs life expectancy continues to increase, women will spend a larger proportion of their lives in the postmenopausal state. For the vast majority of women a healthy balanced diet and an active lifestyle is the best foundation for their long term health and well being: 1. Eat the right fats. We all need to have a small amount of fat in the diet; but what is important is the kind of fat you are eating. Cut back on saturated fat, which can raise your cholesterol (found in fatty meat, full fat dairy products and ‘hidden’ in cakes and pastries). Look for foods with 1g or less saturates per 100g (5g or more per 100g means the product is high in saturates).
2. Check labels for low fat options (3g or less per 100g is low in fat) and cut back on foods containing a lot of fat (20g or 3. Include foods with health promoting benefits over and above the usual nutritional value you might expect. For example foods enriched with plant stanols/sterols, which are clinically proven to lower ‘bad’ LDL cholesterol as part of a healthy diet and lifestyle.
4. Find a physical activity that you enjoy (gardening, walking, and golf) and aim to be physically active for at least half an hour on most days of the week. Start slowly and gradually build it up.
5. Maintain a healthy weight, or aim to lose weight if you are overweight. Avoid faddy/ crash diets which aren’t good for your health and don’t work in the longer term. 6. Osteoporosis is a major health issue for older people, particularly women. It is important to include calcium rich foods which help maintain healthy bones. Good sources are dairy products such as milk, cheese and yogurt. Vitamin D is important for good bone health, which we get mostly from the skin’s exposure to sunlight.
7. People with a healthy heart tend to eat more wholegrain foods. Try to cut down on the amount of fatty foods you eat by filling up with starchy foods such as bread, pasta or rice instead. 8. Improve the nutritional content of your diet by eating more fruit and vegetables. Aim for at least 5 portions of fruit and 9. Eat at least two portions of fish per week, one of which should be oily (Choose from salmon, mackerel, sardines, 1. United Kingdom; Estimated resident population by single year of age and sex; Mid-2006 Population Office for National Statistics, General Register.
2. - an independent, clinician-led website.
3. A Royal Society of Medicine Survey, (December 2005) Digest - the magazine from Heart UK. June/July 2006. 4. National Institute for Health and Clinical Excellence (NICE) and Department of Health cholesterol guidelines.
5. Coronary Heart Disease Statistics. British Heart Foundation Statistics, 2006.
6. Million Women Study Collaborators. Breast cancer and hormone-replacement therapy in the Million Women Study. Lancet 2003; 362: 419-427. The Lancet.
7. Dale E, Vessey M P, Hawkins M M, et al. Risk of venous thromboembolism in users of hormone replacement therapy. Lancet 1996; 348:977-80.
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Proven to actively reduce cholesterol


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