The new science of eating to...master menopause

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Hormone-replacement therapy, yes. But diet therapy to cool hot flashes and counter the potential health-robbing consequences of menopause? You probably won't find your doctor prescribing it. Yet those in the forefront of menopause research say that eating patterns may explain why women in many Asian cultures are less prone to hot flashes during menopause. Nor do these women appear to suffer the long-term aftereffects associated with dwindling estrogen levels: Asian women are far less prone to heart disease and hip fractures than Western women, for example.

Proof that diet can influence a woman's menopause experience is millions of research dollars away. Some researchers suspect, however, that the traditional Asian diet may hold an important key. Specifically, they have focused their attention on a diet that:

Contains less than 20 percent of calories from fat.
Restricts meat.
Is rich in a variety of fruits, vegetables and whole grains, which are good sources of phytoestrogens.
Includes at least one serving a day of tofu or some other soy food. (See "Resist Cancer" on page 74.)
Wulf Utian, M.D., Ph.D., director of the department of reproductive biology at Case Western Reserve University, Cleveland, and executive director of the North American Menopause Society, describes this as an exciting area of study.

A plant-based diet, especially one that includes soy foods, is abundant in a group of natural chemical compounds called phytoestrogens, he explains. These compounds are converted in the gut to hormonelike substances that the body can mistake for estrogen.

Phytoestrogens come in two general forms: isoflavones and lignans. Isoflavones are found primarily in soy foods like tofu and soy milk; for lignans, the best sources you can use are whole grains and flaxseed. Fruits and vegetables contain lignans but in lesser amounts.

"We're not talking about larged doses of these compounds," says Sherwood Gorbach, M.D., professor of community health at Tufts University Medical School, Boston, and a leading phytoestrogen researcher. The Asian woman's diet averages about 3 to 4 ounces of soy foods a day, for example. That yields about 25 to 40 milligrams of isoflavones. In comparison, the average American woman eats, at most, only a few mg. of isoflavones a day. Dr. Utian cautions, however, that foods containing phytoestrogens can be quite powerful and can have druglike properties. A serving or two a day of a soy food like tofu is a reasonable goat as part of a healthy, well-balanced diet. Because the role of dietary phytoestrogens on health is a new area of study, scientists are analyzing the various amounts of the compounds in various soy foods, as well as the optimal level of intake.

Beyond this unique feature of many Asian diets, researchers point to the fact that, where Asian women age 50-plus enjoy robust good health, their diets contain little to no animal protein and are extremely low in fat, especially saturated fat.

In countries where the intake of protein--particularly animal protein--is low, there is a lower incidence of hip fractures compared with people in Western countries, according to Mark Messina, Ph.D., author of The Simple Soybean and Your Health (Avery Publishing Group, 1994). One reason may be that soy protein causes less calcium to be lost through urine.

After menopause, women no longer require as much iron as they once did. The Recommended Dietary Allowance dips from 15 mg. to 10 mg. after 50, so one of the best reasons for eating meat--its bioavailable iron--is gone. Besides, compared with the leanest red meat, soy foods (which make good meat substitutes) are low in saturated fat. Only about 14 percent of the fat in most tofu is saturated. Low-fat or light versions have even less. Certain brands also provide a decent dose of calcium. That's because some tofu is made by curding cooked, pureed soybeans with calcium compounds.

Of course, at this point the benefits to menopausal women of adopting an Asian diet, as described here, remain largely speculative. Nevertheless, many of the same dietary components have been cited by cancer experts as the key to cancer prevention. Following the "Sample Cancer-Shielding Menu" on page 77 may help keep cancer at bay and perhaps beat menopause's bad rap in the same bite.

A GUIDE TO SOY FOODS
Look for soy products labeled low-fat or fat-free, says Chavanne Hanson. R.D., M.P.H., University Hospitals of Cleveland. Many soy products are high in fat, so be selective. Note also the calcium levels, which can vary widely. Below are some values for the fat and calcium in a half-cup serving of certain soy products. Compare these values with two foods that tofu is often substituted for: a half cup of part-skim ricotta--10 g rams of fat, 337 milligrams of calcium; or three ounces of skinless cooked chicken breast--3 g. of fat, 13 mg. of calcium.

TOFU (1/2 cup; around 4 to 4 1/2 ounces)

Fat Calcium
(grams) (mg.)

Mori-Nu, lite 1.3 26.6
Azumaya, soft 2.5 36.4
Azumaya, regular 3.0 221.0
Azumaya, extra firm 5.0 215.0
Nasoya, soft 4.0 182.0
Nasoya, firm 6.0 189.0
Nasoya, extra firm 7.0 68.0
Note: Soft tofu is lower in fat than the firmer type because it contains more water-less whey has been drained off. OTHER SOY FOODS Fat Calcium (grams) (mg.) 1 cup Solait Instant Soy Beverage 3.0 300 1 ounce Soya Kaas soy cheese 5.0 15 1/2 cup defatted soy flour 0.6 121 1/2 cup cooked soybeans 8.0 68 1 Ken & Robert's Veggie Burger patty 2.0 1 1/2 cup tempeh 6.4 77 Note: Some soy products like vegetarian or soy burgers are made with "soy-protein concentrate," which contains almost no isoflavones. If you see "soy-protein isolate" on the label, however, the isoflavones are largely retained.

For more information about soy foods, write to the Soy Foods Association of America, 1 Sutter St., Suite 300, San Francisco, CA 94104. Include a business-size SASE.

PHOTO: Foods rich in lignans necessary to master menopause.

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by Jan Bresnick with Toby Hanlon

HOT-FLASH TRIGGERS
Sizzling foods--either hot off a flame or fired with chili peppers--are notorious provocateurs. They can jack up your body temperature and send a red rush of heat through your face and chest Alcohol and caffeine can likewise make you flush. Best to avoid coffee, tea, colas and chocolate.

BONE UP ON CALCIUM
Play it safe on the calcium issue. If there's any doubt that your daily diet delivers 1,500 milligrams of calcium, it's prudent to take a supplement (See "Sweet Dreams for Bones," on page 82.) Use either calcium citrate alone or calcium carbonate with some food. And, to get the best absorption, spread your total calcium intake (from food and supplements) over the day so you aren't taking more than 500 to 600 mg. at one time.

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