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2. About your speakerAbout your speaker
• Founder of Foods for Life and The Life Consultancy
2
• Clinical Nutritional Therapist - clinics in Harley
Street and the New Forest
• Member of BANT and CNHC
• Media voice

3. AgendaAgenda
• Nutritious aging
• A time for change
• Symptoms of menopause
• Effects on health
– Temperature regulation
– Cardiovascular
– Hair and skin
– Weight
• Optimising health
3

4. When does aging start?When does aging start?
4

5. Life begins at …Life begins at …
5
60

6. Sandwich generationSandwich generation
6

7. 7
How are we aging?How are we aging?

8. • The fine detail of the way our bodies function changes
with age
• Nutrient needs change too
– Malnutrition risk is 1 in 7 older people, especially if living in residential care
(BNF)
• Key areas to focus on:
• Calorie need
– BMR reduces, lowering calorie need
– Activity level also tends to reduce
8
What do our bodies need?What do our bodies need?
• Protein
– Over the age of 65 our need for
protein may increase as muscle
mass and efficiency reduces.
Adult recommendation is 0.80
grams of protein per kilogram of
body weight (48g per day for
60kg woman). 1.5g per kg body
weight may be more
appropriate

9. • Omega 3 fatty acids
– We need these from the very beginning, as we age they support:
• Help protect against heart disease, especially in those who have already
had a heart attack
• Anti-inflammatory helping prevent and reduce ‘itis’
• Support eye health
• Help reduce cognitive decline
• Improve immune function
(BNF)
– Older population eat more than the recommended amount of saturated
fat which hinders the essential fats
– Can’t get enough of these fats from fish due to the pollutants
– Have the parent fats: flax, chia and hemp seeds, walnuts
– Take an algae oil supplement (check no meds)
9
What do our bodies need?What do our bodies need?

10. • Vitamins and minerals
– Ability to digest, absorb and utilise nutrients changes with age, so assume
higher intake is needed
– Variety may reduce as mobility and access to foods reduces
– Financial constraints may reduce quality and variety of foods
– Dental health issues may reduce variety
– Changes to sense of smell and taste affecting enjoyment and appetite
• Vitamin D
– Over 65 yrs 6% of free living men and 38% in residential care have low vit D
status, women 10% and 37%
– Associated with increase in fall risk
– Aging skin is less efficient at producing vitamin D from sunlight
– Older people may be outdoors less
– Recommendation is over 65 years should take a supplement of 10mcg a
day
10
What do our bodies need?What do our bodies need?

11. • Vitamin B12
– B12 absorption decreases with age as intrinsic factor declines
– B12 supplement likely to be needed
• Vitamins B6,B9 and B12
– Low status of these B vitamins is associated with elevated homocysteine, stroke
and dementia
– Over 65 yrs 5-10% of people have low B12
– Folate is low in 16% of people in residential care
– Food sources of B6 and B9 include nuts, seeds, soya, wholegrains and some
vegetables. B12 should be supplemented
• Bone minerals
– Need for bone minerals starts young but increases with risk of osteoporosis
– Calcium, magnesium, vitamin K, beta-carotene (not high vit A)
• Potassium
– Can help reduce blood pressure. Fruits and vegetables are great sources
11
What do our bodies need?What do our bodies need?

12. • Fibre
– Not a nutrient but still vital for digestive health, cholesterol levels and supports
diabetes prevention
– Older adults eat less than the rest of the population
12
What do our bodies need?What do our bodies need?

13. Even more change for womenEven more change for women
On top of middle age pressures women have life-
changing physiological changes to deal with
13

14. Shh?Shh?
An embarrassing secret or a time to celebrate the start of
the freedom or wisdom years?
14
Menopause

15. Hormonal havocHormonal havoc
15
Oxytocin
•Bonding hormone from childbirth to
mothering to orgasm to bones
•Secreted from pituitary
•The effects of this natural “love
hormone” are amplified by estrogen
A daily dose of oxytocin
reversed osteopenia and
visceral fat gain in a mouse
model of menopause
It partially restored
osteoclast number and
totally normalized osteoblast
numberhttp://www.medpagetoday.com/Endocrinolog
y/GeneralEndocrinology/44346

16. Symptoms of menopauseSymptoms of menopause
16

17. Symptoms of menopauseSymptoms of menopause
• Vasomotor - hot flushes and night sweats
• Mood swings and depression
• Insomnia
• Skin thinning and hair loss
• Vaginal dryness and low libido
• Breast size reducing
• Poor memory
• Headaches
• Fatigue
• Muscle pains
• Weight gain,
especially belly
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Reduced hormone level symptoms
Oestrogen Progesterone Testosterone
Headaches
Fatigue
Hot flushes
Joint pains
Mood swings
Reduced memory
Muscle weakness
Irregular heartbeat
Vaginal infections
Mood swings
Anxiety
Headaches
Low libido
Low mood
Low energy

18. Symptoms of menopauseSymptoms of menopause
18

19. Symptoms ofSymptoms of manmanopauseopause
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20. Supporting womenSupporting women
NICE guidelines November 2015
“ The information and support offered to women during and after the
menopause is thought to be variable and, for some, inadequate. A UK-
based survey published in 2007 indicated that most women would
welcome more information about the menopause. To improve the
information provided, and to facilitate women being able to make an
informed choice, some professional groups have suggested that all
women should be invited for a health and lifestyle consultation on
their 50th birthday, which would include a discussion of menopausal
symptoms and possible long-term sequelae of oestrogen depletion”
Suggested support to considerations
– Oestrogen, progesterone and testosterone (oral, transdermal, implant)
medications including bio-identical
– Mood support medications such as SSRI’s
– Phytoestrogens (including Black cohosh and Red clover)
– Acupuncture
– Lifestyle advice, psychological therapies and CBT
20

21. Optimising our healthOptimising our health
• Temperature regulation – turning down the thermostat
• Bone health – strengthening the future
• CV health – protecting the future
• Hair and skin - slowing down the signs of aging
• Weight – preventing the Menopot
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22. Turning down the thermostatTurning down the thermostat
22

23. Turning down the thermostatTurning down the thermostat
Hot flushes
• The hypothalamus releases extra FSH and LH to attempt to stimulate
the ovaries to release oestrogen and develop remaining eggs
• The hypothalamus is also the body’s thermo-regulator. Low oestrogen
may stimulate hypothalamus, dilating blood vessels leading to flushing
and sweating
• Sugar triggers stress hormones and alters vasoconstriction and dilation
confusing the hypothalamus triggering cooling down by releasing
flashes of heat
• Phytoestrogen supplements have been shown to halve incidence and
severity of hot flushes
Actions
• Include phytoestrogen-rich foods
• Soya including tofu, milk, yogurt and ideally fermented products
including miso, natto and tamari
• Consider phytoestrogen supplements: red clover, soya isoflavones
• Keep blood sugar levels balanced
23

24. Hot flush triggersHot flush triggers
24
Common hot flush triggers
 Spicy foods
 Chocolate
 Citrus
 Hot liquids
 Caffeine
 MSG
 Sodium nitrate (cured meats inc. hot dogs, bacon, ham
 Sulphites found in alcoholic drinks and dried fruit
 Tyramine found in aged cheeses and red wine

25. Bone healthBone health
25

26. Bone health - strengthening the futureBone health - strengthening the future
• Declining hormones increase risk of osteoporosis
– Oestrogen helps prevent bone breakdown
– Progesterone stimulates new bone growth
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Osteoporosis risk factors
 White or Asian ethnicity
 Poor diet, excessive alcohol and/ or fizzy drinks
 Gastric/ small bowel resection
 Lack of exercise
 Being underweight, petit stature and small boned
 Long term steroid or anticonvulsant use
 Premature menopause or post-menopausal
 Smoking
 Aging
 Chronic stress
 Hormonal imbalances including hyperparathyroidism and hyperthyroidism
 Family history of osteoporosis
Osteoporosis early warning signs
 High serum calcium or alkaline phosphatase on blood test
 Vitamin D deficiency on blood test
 Difficulty getting up from a chair without using your arms to push
 Joint or muscle aches
 A resting pulse greater than 80 beats per minute
 Height loss
 Increasing stooping (curvature of the spine)
 BMD results of -2.5 or less

27. Bone health – strengthening the futureBone health – strengthening the future
Osteoporosis is known as the silent disease
– Bone loss starts from around 35 yrs
– Don’t know until loss is significant
– Men have reduced risk as they have larger skeletons and bone loss starts
later and progresses more slowly
27

28. Bone health – strengthening the futureBone health – strengthening the future
28
Nutrient Food sources Benefits
A rainbow of vegetables and fruits from all colour
groups: green, orange, blue/purple, red, yellow,
white/brown. Especially dark green leafy vegetables,
sea vegetables and culinary herbs.
10 portions a day are recommended
They offer protection due to their
alkalising effects and broad range of
vitamins, minerals and phytonutrients
which help maintain healthy bones
Vitamin A Dark green, yellow and orange coloured
fruit & veg: carrots, sweet potatoes,
squash
Acts as anti-oxidant
Regulates bone remodelling
Vitamin C Citrus fruits, green vegetables, broccoli,
cabbage, cauliflower, kale, peas, berries,
currants, lettuce, red, green & yellow
peppers, potatoes, tomatoes, parsley,
tropical fruits: guavas, mangoes, kiwi fruit,
pineapple. Sprouted alfalfa seeds
Significant positive association
between dietary intake, bone density
and lower risk of hip fractures.
Deficiency impairs collagen formation,
essential for bone elasticity
Vitamin D Fortified foods: soya milk, breakfast
cereals
Daily time outdoors in sunshine
Promotes healthy bones by increasing
calcium absorption from gut and
reducing loss via kidneys . Vitamin D
status is a significant factor in bone
mineral density and fracture risk
Vitamin K1 &
K2
Natto, fermented foods K1 & K2 work synergistically with
vitamin D and bisphosphonates to
reduce risk of fracture and bone loss.
K2 appears to have a stronger effect
Boron Chickpeas, almonds, beans, vegetables,
bananas, walnuts, avocao, broccoli,
prunes, oranges, red grapes, apples,
raisins, pears, and many other beans &
legumes
Improves calcium absorption and
reduces magnesium excretion thereby
increasing bone mineral density

29. Bone health – strengthening the futureBone health – strengthening the future
29
Nutrient Food sources How it may help
Calcium Aim for 1,200 mg of calcium intake every
day which is about 4 servings of calcium-
rich foods a day. Sources include fortified
plant milks. Brazil nuts, chickpeas, dried
seaweeds, figs, green leafy vegetables,
parsley, watercress, broccoli, tofu, soya
beans, okra, blackstrap molasses, sesame
seeds, tahini, swede, almonds, quinoa
Calcium supplementation appears to
be effective in reducing bone loss and
may help prevent osteoporosis.
Too high a dairy intake without
sufficient magnesium may however
reduce bone density so ensure plant-
based sources of calcium which
provide both
Magnesium Almonds, Brazil nuts, brown rice, cashews,
pine nuts, peas, sunflower and sesame
seeds, soya beans, dark green leafy
vegetables, broccoli, wholegrains, wheat
germ, bananas, prunes, millet, quinoa,
blackstrap molasses
Improves bone mineral density. A
critical component of the skeleton,
deficiency has been linked to
osteoporosis
Is needed for vit D
Selenium Brazil nuts, mushrooms, lentils, sesame and
sunflower seeds, walnuts, wholegrains,
potatoes, acorn squash, avocado
Intake has been shown to improve hip
bone mass density
Silicon Wholegrain bread and pasta, oatmeal,
brown rice, oat and wheat bran cereals,
bananas, mangos, green beans and
spinach
Osteoporosis prevention. Improves
bone strength and flexibility
Zinc Dried seaweed, pumpkin, sesame and
sunflower seeds, pine nuts, wholegrains,
wholemeal bread, brown rice, lentils,
almonds, wheat germ, oats
Stimulatory effect on bone formation
and mineralisation

30. Bone health – strengthening the futureBone health – strengthening the future
30
Nutrient Food sources How it may help
Omega-3
Essential Fatty
Acids
Flax, chia and hemp seeds. Walnuts
Algae & algae oil supplements
Studies suggest that diets high in
omega-3 fatty acids may be beneficial
for skeletal health
Good quality
proteins
Plant proteins, choose complete and
combine beans/pulses, grains & seeds
Can stimulate the enzymes that form
collagen and connective tissues in the
bone matrix and hold onto calcium
salts
Catechins from
green Tea
Green tea Prevention of bone loss
Phytoestrogens Soya and soya products especially
fermented sources such as miso,
tempeh, natto and tamari. Flaxseeds,
alfalfa sprouts, mung bean sprouts
Can positively affect bone remodelling
and may be useful for the prevention
and treatment of osteoporosis
Prebiotics &
probiotics
kefir, live plant milk yoghurt and miso.
Prebiotics foods help feed our good
bacteria and include: artichokes, onions,
garlic and unrefined oats
Studies suggest prebiotics increase the
activity of soya isoflavones significantly
increasing soya’s bone sparing effects.
Also beneficial for calcium absorption
and bone mineralisation

31. Its not just about the calciumIts not just about the calcium
Post menopausally 1,200mg a day of calcium is currently
recommended (700mg for men over 51)
• Throughout life bone is remodelled by bone cells, osteoblasts build
bone, osteoclasts break down bone
• 99% of our calcium is stored in our bones and teeth
• If blood calcium levels are low (not eaten recently) calcium is taken
from the bones
• High calcium intake not associated with reduced osteoporosis or
fracture risk
http://www.hsph.harvard.edu/nutritionsource/calcium-full-story/
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Food Calcium content mg per portion
200ml calcium-enriched almond milk 240mg
130g cooked kale 172mg
100g cooked broccoli 118mg
10 sprigs (30g)watercress 30mg
180g cooked spinach 245mg
100g tofu 350mg
1 sweet potato 43mg
2 tablespoon (18g) sesame seeds 175mg

32. Is dairy the answer?Is dairy the answer?
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Daily Weekly portions
200ml fortified plant milk
1 yogurt
200g lentils, chickpeas, beans
1 slice bread
Cruciferous portion
Leaves portion
One other vegetable portion
30g nuts/ seeds
2 tablespoons houmous
Pasta x 2
Rice x 2
Potatoes x 2
Pitta bread x 2
Muesli x 3
Seaweed x 3
Tofu x 3
Dairy calcium may not be ideal for bones
• While calcium and dairy can lower the risk of osteoporosis and colon
cancer, high intake can increase the risk of prostate cancer and
possibly ovarian cancer
• Synergistic vitamins and minerals are needed to get calcium into the
bones including vit D, beta-carotene (safe vitamin A provider), vit C,
vit K, magnesium
• High saturated fat dairy rich in vitamin A can weaken bones
Example plant-based day
This example gave
1056mg calcium, with only
3 portions of vegetables a
day
Recommendations for
postmenopausal women is
700-1200mg a day, less is
needed with synergistic
nutrients

33. Bone health – strengthening the futureBone health – strengthening the future
33
Bone health actions
• Eat the full range of bone nutrients
• Don’t rely on calcium alone
• Don’t supplement too much pre-formed vitamin A or eat too many
vitamin A foods such as liver and dairy
• Daily time outside for vitamin D
• Regular weight bearing exercise stresses the bones triggering repair
and building: walking, dancing, weight lifting, stair-climbing, racquet
sports
• Other exercises are also important as they improve muscles stress and
coordination reducing fall risk
• Minimise stress as cortisol can inhibit bone formation
• Don’t smoke – biggest osteoporosis risk factor
• Limit alcohol to 1 drink per day. Light alcohol intake of 1 drink per day
is associated with having a positive effect on bone density, moderate
to high consumption has the reverse effect

34. CV healthCV health
34

35. CV healthCV health
CV health
• Being post-menopausal is associated with increased risk of heart
attack and stroke
• Oestrogen is considered to have a positive effect on the inner layer of
artery wall, helping to keep blood vessels flexible
• Around the time of menopause blood pressure starts to increase, LDL
cholesterol increases, HDL remains or reduces, triglycerides increase
Actions (American heart Association)
• Avoid smoking, biggest CV disease risk factor, may also contribute to
early menopause
• Regular exercise - 150 minutes a week
• Healthy diet:
– Rich in: fruit, vegetables, wholegrains, omega-3 fats
– Low in processed and red meat, refined carbs and sugar
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36. Hair and skinHair and skin
36

37. Hair and skinHair and skin
Hair
• Oestrogen keeps hair in the growing phase needed for length
• Post menopausally it can shed before it becomes its previous length
• Relative increase in androgens (male hormones) increase facial and
body hair but thinner scalp hairs reducing volume and strength
37

38. Optimising our healthOptimising our health
Skin aging
• Deep wrinkles and loss of suppleness
– Reduced oestrogen reduces skin’s ability to repair and replace collagen
– UV rays are very destructive to collagen and post menopausal skin is more
prone to sun damage
• Dry, thinning skin
– Blood flow through the skin capillaries is reduced during menopause,
reducing nutrient and oxygen availability. This leads to thinning and
dryness
• Age spots
– Oestrogen helps regulate melanin production. Skin exposed to UV rays is
especially prone to increased melanin and age spots
• Acne and oily skin
– The change in balance between oestrogen and testosterone during
menopause can send skin cells into overdrive
38

39. Hair and skinHair and skin
Skin and hair health actions
• Maximise nutrients for skin health including omega-3 fats, antioxidants,
vitamins and minerals (see handout)
• Ensure sufficient protein
• Minimise your intake of sugar and sugary foods or drinks
• Reduce your intake of non-organic animal fats – milk, cheese, cream
• Limit your alcohol intake to no more than one drink a day, ideally
choose red wine and have two days off alcohol a week, and have
some weeks completely alcohol-free
• Ensure proper hydration: drink at least 1.5L of filtered water a day
(ideally alkalised)
• Choose natural face, hair and body products without detrimental
chemicals
• Minimise UV exposure whilst ensuing vitamin D activation
39

40. WeightWeight
40

41. 4141
The MenopotThe Menopot
• As we age, we naturally lose lean muscle mass, an important
calorie burner
• Same calorie intake leads to more fat on arms, hips, thighs and
especially the middle
• Fat weighs less than muscle so we don’t realise it’s increasing
• The belly fat sends hormone ghrelin to brain increasing appetite
• The belly fat is a sign of insulin resistance meaning less
efficient carb metabolism

42. Weight lossWeight loss
42

43. Weight lossWeight loss
• A plan for life not an event
– Practical and easy to follow
– Finding places to eat out when no time to prepare
• Glycaemic load and insulin balance
– The right proteins, carbs and fats in the right proportions
• Nutrient-dense eating plan which satisfies the body
– Knowing which foods to eat and which deplete
• Finding out what your body needs
– Biochemical individuality
• Right amount of food for your activity
level
43

44. Nutrient-dense dietNutrient-dense diet
4444
Eat whole-foods rather than half-foods
• Proteins – body structure, mood, and
correct bodyweight
– Beans, pulses, nuts and seeds
combined
– Soya
• Fats – brain and nervous system, energy,
mood, skin and anti-inflammatory
– Hemp, flax and chia seeds
– Walnuts
– Algae and algae oil
Picture source - IVU

45. Nutrient-dense dietNutrient-dense diet
4545
Eat whole-foods rather than half-foods
• Starchy carbs – energy, fibre and daily cleansing, vitamins and
minerals
– Wholegrain
– Variety
– Lower gluten
• Vegetables and fruits – vitamins, minerals, antioxidants, phyto-
nutrients
– 10 not 5
– Focus on veg
• Water – nutrient transport,
concentration and mood
– Avoid caffeine, alcohol,
high sugar

46. SupplementsSupplements
4646
Supplements to consider
• B12
• Vitamin D
• Omega-3
• Bone minerals

47. Putting it all togetherPutting it all together
4747
Put your food groups together in the right plate ratio for
good blood sugar balance
• Day-long energy
• Reduced hot flushes and night sweats
• Better sleep for revitalisation
• Better mood
• Reduced cravings for sugar and stimulants
• Ideal weight
• Reduced inflammatory risk and
degenerative disease

48. Balancing blood sugar levelsBalancing blood sugar levels
48
Your day
Bloodglucoselevel
Your day
Bloodglucoselevel
Helpers
• The nutrition basics
 Eat 5 times a day
 Have protein with every
meal
 Have complex carbs
 Include mono and poly
unsaturated fats
Hinderers
• Avoid sugar and ‘white’ carbs
• Avoid stimulants
 Caffeine
 Alcohol
 Nicotine
 Artificial sweeteners
 Stress
Tired Cravings Store fat Headaches

49. Your balanced plateYour balanced plate
49
Dinner
Lunch
Graphic from “Becoming Vegan: Comprehensive Edition” (2014) and from "Becoming Vegan: Express Edition” (2013), both by Registered Dietitians Brenda Davis
and Vesanto Melina, Book Publishing Co

50. 50
The 80:20 ruleThe 80:20 rule

51. 51

52. In summaryIn summary
• Choose nutrient-dense proteins, carbs and fats
• Have 10-a-day veg and fruit
• Have 1.5 litres of water a day
• Consider phyto-oestrogens
• Avoid foods which trigger symptoms
• Protect your bones with minerals and exercise
• Get the plate ratio right
• Keep an eye on calories
• Relaxation strategies
• Bespoke your plan if this isn't
enough
52

53. Getting in touch
53

54. Questions ?Questions ?