The Zimmerman File, October 2009, by Marcia Zimmerman. Visit Marcia’s website at www.thenutritionsolution.com

“Am I salami, turkey or cucumbers with goat cheese? All I know is that I am in the company of 44% of American women who care for both aging parents and children under the age of 21. I live with my 84-year-old mother, my husband, two daughters, aged 16 and 12, and two dogs, one puppy and one geriatric. We are the Sandwich Generation.”

By Susan Ito, Literary Mama Magazine

The term “sandwich generation” describes Americans between the ages of 45 and 55 – most are baby boomers. – at least half are menopausal to boot. According to a 2001 survey prepared for the American Association for Retired Persons (AARP), boomers are a unique generation that find themselves sandwiched between parenting children born late in life and providing for parents who are living longer.1 In the September issue of the Zimmerman File, I presented the arguments for and against hormone replacement therapy for severe menopausal symptoms. This month I will focus on natural remedies for the three classes of menopausal concerns: menopausal complaints, physical changes, and aging conditions.

After the Change

It is widely understood that healthy eating throughout life helps prevent chronic illnesses, but it’s critical during the menopausal transition. That’s because a healthy diet addresses all three classes of menopausal concerns. The Mediterranean diet, a composite of foods common to the sixteen countries that border the Mediterranean Sea, is considered by most experts to be the most health-promoting. The diet has specific characteristics, according to the American Heart Association:2

- High consumption of fruits, vegetables, bread, cereals, potatoes, beans, nuts and seeds.
- Olive oil, an important monounsaturated fat source
- Dairy products, fish and poultry, consumed in low to moderate amounts, and little red meat.
- Eggs – if eaten at all – not more than four times a week
- Red wine; low to moderate amounts, one to two glasses per day for women

Fruits, vegetables, olive oil, nuts and seeds all contain higher levels of heart-friendly omega 3 fatty acids. They also help keep weight normal, reduce inflammation and pain, and are needed for bone health. Fruits and vegetables contain high levels of minerals that help maintain optimum pH, plus vitamins and antioxidants that help prevent aging conditions. Eating fish and fish oils helps reduce mood swings and counter loss of cognitive function.3,4 Keeping your weight and total cholesterol in check helps keep you mentally sharp as well as protecting your heart.5,6,7

In a Flash

During a hot flash, there is an increased blood flow to the head and extremities. Fingers, toes and noses may become bright red. It can be very embarrassing to be suddenly clawing at one’s collar to get more air to the neck and chest, while fanning the upper body with whatever is handy. Male colleagues may look at you like you’re nuts. But don’t laugh, guys, men get flushes too!

Hot flashes have been associated with a transient increase in blood pressure that may indicate an upward trend for systolic pressure (the top number) over time.8 L-arginine is an amino acid that may help keep blood pressure under control. It does this through the release of nitric oxide, which relaxes the blood vessel walls.9

Concern over use of hormone therapy has driven many women to seek alternative sources of estrogen, including herbal remedies. A study at the University of California, San Diego found estrogen-like compounds (estradiol equivalents) in hops, licorice, soy, red clover, Fo-Ti and soy isoflavones. Chaste Tree berry, dong quai and black cohosh did not contain these compounds, although they have been useful for other menopausal complaints.10,11,12 The researchers reported that the potency of estradiol equivalents – a comparison of binding capability to that of to human estradiol – is greatest for Fo-Ti (1/300) and soy (1/330) However, an extract of soy (soy aglycone) that’s found in fermented soy foods, was by far the most potent (1/80).13

A 2007 study published in the journal Menopause reported that 190 women aged 38 – 60 years who experienced four to fourteen hot flashes per day, experienced a 50 percent reduction in flash frequency and intensity when taking either 40 mg or 60 mg of a soy aglycone (free isoflavones) extract per day for twelve weeks.14 Intestinal bacteria convert soy isoflavones into S-equol, the active form that binds to estrogen receptors.

Approximately one third of Caucasian and over half of Asian women efficiently convert isoflavones into the active metabolite equol. This helps explain the scientific conundrum over whether soy isoflavones are really effective and partly explains why Asian woman do not experience the same rates of bone loss 15,16 Dr. Kenneth Setchell, lead author of this study, and his colleagues suggest that a healthy balance of prebiotics and probiotics might enhance the conversion of isoflavones to equol.17

There are many excellent soy isoflavone products to choose from. These come in soy isoflavone capsules, soy protein isolate powder, fermented soy powder, soy milk, and dry-roasted soybeans to snack on or sprinkle on salad.

References

Belden, Russenello & Stewart; “In the Middle: A Report on Multicultural Boomers Coping with Family and Aging Issues” AARP; July 2001.
2 American Heart Association www.americanheart.org.
3 Albanese, E.; et al.; “Dietary Fish and Meat Intake and Dementia in Latin America, China, and India: a 10/66 Dementia Research Group Population-Based Study” Am J Clin Nutr 2009;90:392-400.
4 Lucas, M.; et al.; “Ethyl-Eicosapentaenoic Acid for the Treatment of Psychological Distress and Depressive Symptoms in Middle-Aged Women: a Double-Blind, Placebo-Controlled, Randomized Clinical Trial” Am J Clin Nutr. 2009;89:641-51.
5 Solomon A.; et al.; “Midlife Serum Cholesterol and Increased Risk of Alzheimer’s and Vascular Dementia Three Decades Later” Dement Geriatr Cogen Disord. 2009;28:75-80.
6 Whitmer, R.A.; et. al. “Body Mass Index in Midlife and Risk of Alzheimer Disease and Vascular Dementia” Curr Alzheimer Res. 2007;4:103-9.
7 Fizpatrick, A.L.; et al.; “Midlife and Late-Life Obesity and the Risk of Dementia: Cardiovascular Health Study” Arch Neurol. 2009;66:336-42.
8 Gerber, L.M.; et al.; “Hot Flashes are Associated with Increased Ambulatory Systolic Blood Pressure” Menopause 2007;14:308-315.
9 “L-Arginine Monograph” Altern Med Rev. 2005;10:139-147.
10 Cimicifuga racemosa Monograph Altern Med Rev 2003 8:186-189.
11 Angelica sinensis Monograph Altern Med Rev 2004;9:429-432.
12 Liu, J.; et al.; “Isolation of Linoleic Acid as an Estrogenic Compound From the Fruits of Vitex agnus-castus L. (chaste-berry)” Phytomed. 2004;11:18-23.
13 Klein, K.O.; et al.; “Estrogen Bioactivity in Fo-Ti and Other Herbs Used for Their Estrogen-Like Effects as Determined by a Recombinant Cell Bioassay” J Clin Endocrine Metabol. 2003;88:4077-4079.
14 Khaodhiar, L.; et al.; “Daidzein-Rich Isoflavone Aglycones are Potentially Effective in Reducing Hot Flashes in Menopausal Women” Menopause 2008; 15:125-134.
15 Setchell, K.D.R.; et al.; “S-Equol, a Potent Ligand for Estrogen Receptor B, is the Exclusive Enantiomeric Form of the Soy Isoflavone Metabolite Produced by Human Intestinal Bacterial Flora” Am J Clin Nutr. 2005; 81:1072-9.
16 Ma, D.F.; et al.; Soy Isoflavone Intake Inhibits Bone Resorption and Stimulates Bone Formation in Menopausal women: Meta-Analysis of Randomized Controlled Trials” Eur J Clin Nutr. 2008;62:155-161.
17 Ibid. p. 1078.