Change of Life, Change of Diet -- Elaine Magee, MPH, RD

WebMD Live Events Transcript; Event Date: Wednesday, June 30, 2004

By Elaine Magee, MPH, RD
WebMD Weight Loss Clinic - Live Events Transcript

Menopause is a time of big changes in your life. WebMD Weight Loss Clinic's "Recipe Doctor," Elaine Magee, RD, says you should include how and what you eat in those changes. She's written about it in her new book, The Change of Life Diet and Cookbook. In this live event, Elaine shares her tips on cooking, eating, and enjoying yourself on your journey from pre- to post-menopause.

If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Welcome back to WebMD Live, Elaine. Please explain the basic premise of The Change of Life Diet and Cookbook.

When some of the studies came out showing the benefits of showing the risks outweigh benefits for many women with hormone replacement therapy, it behooved me to write a book helping women get through this time in their life without hormone replacement therapy (HRT). I wanted women to have some options to HRT. I wanted to have some options to HRT as well.

I had already written a book called Eat Well for Healthy Menopause quite a few years ago, but I wanted this book to focus on the specific symptoms and how to eat your way around them, and I wanted this book to have a sense of humor, because at this point in many women's lives that's what they need. So I literally took the top seven symptoms of menopause and I researched each one individually to come up with some practical food or diet-related steps that women could take to ease that particular symptom.

The other thing we did in the book was I looked at the two things that they could say was definitely beneficial to HRT, which was basically decreasing osteoporosis risk and decreasing colon cancer risk. We know HRT has those benefits for women.

So I looked at those two things as well and helped women reduce their risk through diet and lifestyle changes. So those are the other two chapters of the book besides the seven symptoms. My favorite chapter is "Aphrodisiac for Menopausal Women Only."

I love the chapter "I'm Not Moody -- I'm Cranky All the Time!" I think it's exciting. What I like most about this book is that it's organized by symptom, so that you can literally just turn to the chapters that are your priority at that time. Let's start with "Is It Me, or Is It Hot in Here?"

Are there certain kinds of food that can cut down the hot flashes?

With diet and hot flashes it's a bit of trial and error. Something may work for some women, so either you have to throw them all up in the air and see what helps you.

  • Avoiding spicy foods around your prime hot-flash time can help.
  • Eating smaller-sized meals, because large meals can increase your body temperature.
  • Chewing on ice chips or sipping on some ice-cold, no-calorie beverages at a time when you tend to have hot flashes can help decrease your body temperature.
  • If it's convenient, taking a colder shower before you tend to get hot flashes, or swimming, if that's practical, actually decreases your body temperature for hours afterwards.
  • Try a daily serving or two of a phytoestrogen-rich food, like soymilk, tofu, or edamame.
  • You could try some other phytoestrogen rich foods, like papaya, peas, and beans.
  • Then there's ground flax seed. Flax seed is the most potent food source of the phytoestrogen called lignin. You need it to be ground and a general sort of amount is 1 tablespoon a day.

Now, the foods to lose for hot flashes would be the hot and spicy type foods, foods with caffeine as beverages, and alcohol.

Some recent research suggests that soy, for hot flashes, works better for women who work out and exercise. So that might explain why it works better in some women than others.

Here is one of Elaine's great recipes for dealing with hot flashes and night sweats.

Hot Flash Mochaccino
from The Change of Life Diet and Cookbook
by Elaine Magee, MPH, RD

1/2 cup double-strength decaf coffee, chilled
3/4 cup chocolate soy milk
1 1/2 cup ice cubes
1 tablespoon ground flaxseeds (optional)
1 tablespoon chocolate syrup (optional)

  • Add coffee, chocolate soymilk, ice cubes, and flaxseeds (if desired) into the blender and blend until the mixture has a nice, smooth texture (like a milkshake).
  • Taste the drink. If you would like a stronger chocolate flavor, add a tablespoon of chocolate syrup. Blend the mixture, pour into a tall glass, and enjoy!

Makes 1 drink * Serving size: About 2 cups

This particular recipe has three things going for it here. It's got decaf coffee, since we're avoiding caffeine; it uses soymilk; it has ground flax seed also as an option. Also, it's cold and it's going to help decrease your body temperature.

Can you substitute soy milk in recipes that call for milk to get soy into your diet?

That works most of the time. There are certain things it may not work as well in where it has to do with the milk protein. Pudding is an example. You can get away with using half milk and half soy milk and it will still mostly gel, but if you use all soy milk it won't gel. So in certain cases you may run into trouble, but in most recipes it works. Making oatmeal you can use soy milk instead of milk, and in muffin or bread recipes.

Choose a good tasting one, though. Some brands taste better than others. My personal favorite is Silk brand, made in Colorado.

With night sweats, is the idea to cool off before you get in bed?

That's one strategy, definitely. The other strategy is to follow the same rules for the hot flashes so that you're increasing phytoestrogen over time in your body so your body is less likely to go through those shifts in temperature. You want to look at long-range ways of decreasing night sweats and short range, which would be to sleep cool, maybe take a cold shower before you go to bed, maybe have a light night snack that is cold, as well, which is mainly what we did in the recipes in this chapter.

You want to avoid the hot-flash trigger foods and drinks before bedtime, too, because what your body is going to be digesting around bedtime is what you had for dinner.

One quick tip is to definitely make regular exercise part of your life, because it encourages deeper, more productive sleep, which may help you sleep through some of those milder night sweats.

Are there any foods you should avoid; foods that make the hot flashes and night sweats and bad moods worse?

This could be a book in and of itself. It's a very complicated and interesting tie-in between what we eat and our moods. We're basically going to try to eat foods that give us nutrients that elevate our mood. Let me just kind of throw some at you.

  • Working some omega-3 fatty acids from fish and plant sources may be one of the most important ways to decrease depression and elevate mood. It's sort of a mood stabilizer. We're only now learning the extent of the relationship between omega-3s and mood.
  • You want to eat a balanced breakfast . Start your day off without starving. A nice balanced breakfast that has some good fats and some lean and low-fat proteins will last longer and keep your blood sugar more even through the morning.
  • Then we get into sort of "happy foods," or foods that boost serotonin levels in the brain. Believe it or not, this leads us mainly to eating carbohydrates . Perhaps that's why so many comfort foods include some carbohydrates in them. My suggestion is to definitely opt for the smarter carbs when possible, meaning whole grains. Pasta is actually fine in terms of glycemic index as long as it's cooked al dente. Slightly undercooking it makes the body have a harder time breaking it down, which translates into a lower glucose response. Obviously enjoy your pasta with light and healthy pasta sauce.
  • Then there's folic acid , a very, very powerful vitamin with antioxidant types of activity. You basically get your folic acid in foliage: fruits and vegetables.
  • Avoiding alcohol is a great idea. People think that drinking alcohol elevates their mood, but it's short-lived, and if you overdo it, it does the opposite.
  • I don't know about you, but I know what elevates my mood, at least in the short term, is chocolate . I don't let a day go by without a little bit of chocolate. That's the key, the word "little." If you can get to a place where you are happy and satisfied with three Hershey's Kisses or a reduced-fat Fudgesicle, that's a great place to be. You can enjoy chocolate in small amounts. A little goes a long way.
  • Selenium is a mineral that the brain depends on. We're trying to elevate our mood, so we're dealing with brain chemistry here. A few selenium rich foods are:
  • Brazil nuts
  • Oysters
  • Albacore tuna
  • Clams
  • Sardines
  • Pork tenderloin
  • All salt-water fish
  • Whole-wheat pasta
  • Chicken
  • Whole-grain breads
  • Sunflower seeds
  • Brown rice, oatmeal
  • Tofu
  • Pinto beans

Gaining weight seems to be unavoidable during menopause. What's the best thing we can do for ourselves to prevent that dreaded "middle-age spread?"

"Another key is not to diet?"

There's a fun chapter in the book called, "If I'm Sweating So Much, Why Aren't I Losing Weight?" The problem is, there are a few things going on for women during this time. Their metabolism is shifting at the same time their body is changing into an apple shape, if they haven't already been an apple. Your body literally starts shifting towards an apple and metabolism changes.

You don't have to roll over and play dead here. You can fight this by exercising more and doing some strength training for your muscles. This will increase your metabolic rate. You're trying to increase your metabolic rate to counteract the natural decrease that's coming with aging, thereby sort of neutralizing this.

Also, eating smaller meals through the day and eating light at night will help sort of increase your metabolism. Paying more attention to portion size is key here, because some of the women who have not had to pay attention to portion sizes earlier in life (definitely not me) now have to because of the shift, because of the changes. Now is the time to pay attention to eating when you're hungry and stopping when you're comfortable. Many people get away from this. It sounds simple, but it's something we have to re-learn.

Another key is not to diet. No "fad diets," because dieting sort of starts messing around with the eating when you're hungry, stopping when you're comfortable strategy, and I think we all know in our heart of hearts that diets don't work long term. What do make a difference are the permanent changes we make in our food choices and our lifestyle.

Let me just list a few secret weapons I talk about in my book to put the odds in your favor about weight loss and weight maintenance:

  • Secret weapon No. 1: Low-fat, nonfat dairy products . There's something about calcium that seems to help your body lose weight or keep weight off. It falls right in line with getting more calcium as we age. So making a point of having a couple servings a day makes a lot of sense.
  • Secret weapon No. 2: A serving of soy . It looks like soy may mimic many of the weight loss benefits from calcium and dairy. Again, this falls right in line with what we should be doing with some of the other symptoms.
  • Secret weapon No. 3: Don't forget the fiber . We simply don't get enough, and it's an important filler in our meals. It helps give us a feeling of fullness, generally without a lot of calories. It also helps moderate the possible rise in blood glucose when we eat carbohydrates.


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There's a whole lot more in the book. Those are just a few.

"What Was I Saying? I Must Be Having One of Those Menopause Moments" was written for me. I have notes everywhere because I can't remember anything anymore; but half the time I can't remember where I put the notes! Midafternoon is a special challenge. What can we eat to help with memory?

Just only recently have we seen some really good research showing the association between certain foods and nutrients and brainpower. Most of us know that after 40 we're sort of in a decline. Our eyes are getting worse; we get injured more easily exercising; and our brain isn't quite as sharp as we remember it being in our earlier years.

There are a few really great things we can do, again, to put our brain's best foot forward:

  • Lots of fruits , particularly blueberries. There are some great recipes in the book. Cranberries and boysenberries are also good sources of the particular phytochemicals that have been linked to slowing the brain from aging.
  • Vegetables . The antioxidants in vegetables can be helpful. Generally you want the rich colored ones; the brighter the green, the deeper the orange, the more antioxidants they have.
  • There are two other brain-worthy vitamins to mention: folic acid , again, and B-12 . B-12 is the vitamin we can only get generally from animal foods, so if you're getting those two servings of reduced-fat dairy products, you'll be getting some B-12. Particularly high B-12 foods are:
  • Clams
  • Oysters
  • Shrimp
  • Herring
  • Crab
  • Trout
  • Salmon
  • Tuna in water
  • Lean beef
  • Lean lamb
  • Low-fat yogurt
  • Nonfat milk
  • Low-fat cottage cheese

Those are just some of them. Also soy has been linked to helping our brain function. There's that soy again. Experts suspect that the isoflavins in soy are working together with other antioxidants.

There are some very helpful charts in the back of the book listing food sources for various nutrients. It makes it easy to find sources of folic acid, calcium, selenium, etc.

I want to point out that there are also smart fats for the brain, so to speak. Again, we're getting back to omega-3 fatty acids from fish and plants, and a lot of new research has just come out linking these smart fats to helping reduce Alzheimer's. More needs to be done, but it looks very encouraging.

It seems like I need more sleep/rest these days than I used to. I always thought as we got older we need less sleep. Why am I so tired?

Your body's going through some changes. Not sleeping as well is because of the night sweats, mainly. It disrupts your sleep. You're more moody because you are not getting enough sleep. A lot of the suggestions we've talked about can really help you. Hang in there for many weeks. It takes time for all this to kick in.

Let me give you five quick tips to fight fatigue with food:

  • No. 1: Give your body a well-balanced, healthy diet, because your body needs fuel for energy, and drink plenty of water.
  • No. 2: Start your day with a lower-fat, higher-fiber breakfast. And lower sugar. What we're trying to do is eat smart carbs and smart fat. You want to give your body high-quality food to run its best. Garbage in, garbage out. Staying away from foods that offer calories without a lot of nutritional benefit is key at this time of your life and after. It's not that you can't have cookies or cake or pie; it's just they need to be smaller portions and less often. So the majority of your food choices should hopefully be higher-fiber, nutrient-rich healthy foods.
  • Tip No. 3: Eat smaller amounts of food more frequently during the day instead of eating just two large meals, because large meals zap you of your energy, and so does going hungry when you have large gaps between meals.
  • Tip No. 4: Include fresh fruits and vegetables, whole grains, lean meats (or vegetable protein if you're a vegetarian), and fish and low-fat dairy in your diet to make sure your diet is balanced and you're getting all the nutrients you need.
  • Tip No. 5: Don't fill up on high-fat or high-sugar foods, because they tend to leave you feeling sluggish, if not right away then shortly thereafter.

I've found that indulging in carbs makes me sleepy and increases my hot flashes. Is this just my imagination or is there merit to it?

There could be a couple things going on there. Carbs do have a calming effect, which ties into the happy foods I was talking about earlier. You may say it makes you sleepy, but another way of saying it is it makes you calm. You can moderate this effect by having smaller-sized meals. Any time we fill our stomach it tends to make us sleepy, because our body is diverting blood from the general circulation into the digestive tract to help with digesting. That's another benefit to having the smaller meals through the day. It's a little less practical when you're working out, but shifting to this way of eating is something to keep in mind.

Choose smart carbohydrates whenever possible. These would be carb-rich foods that offer nutrients and fiber along with its calories. This may also help decrease the sleepiness. Steer away from carbs that don't have a lot of nutritional value and tend to have a higher glycemic index and move more toward the carbs that have what I call a lower glycemic load on the body. That would be your whole fruits and vegetables, dairy, all those things we've been talking about. It really all fits together nicely when you look at the big picture.

Elaine, any final words for us?

I'm approaching menopause myself. Try to keep your sense of humor through this. We can get through this. As women, there are a lot of great things about this time of life we can focus on at the same time, and use as your motivation to make really healthy changes in your life that we should have been doing anyway. And that make us healthier people down the line at the same time.

If you want more information and recipes on flaxseed beyond menopause, check out my cookbook, The Flax Cookbook, on It's always a pleasure to be here.

Thanks to Elaine Magee, MPH, RD, for sharing her expertise with us today. For more information, please read The Change of Life Diet and Cookbook .

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