What gives women the best chance of breezing through menopause with few or even no symptoms? Eating more plant food and less highly processed food at mid-life is a good start, as evidence grows that the kind of diet that helps cool the planet could help tame hot flushes too.

Earlier this year, a Brazilian study of menopause symptoms and lifestyle factors found that women eating the most ultra-processed food – a major contributor to greenhouse gases – had the worst hot flushes, while those eating the most vegetables had milder symptoms. It followed a 2021 US study of the effects of a vegan diet that included half a cup of cooked soybeans daily in women having hot flushes. After 12 weeks, the hot flushes had dropped by 79 per cent and most women had no moderate to severe hot flushes at all.

A new study shows that a plant-based diet might be the solution to combatting symptoms such as hot flushes.Credit:iStock

“The interest in plant-based diets and menopause is growing,” says advanced accredited dietitian Dr Sue Radd, author of Food as Medicine: Cooking for Your Best Health. ”In 2020 the European Menopause and Andropause Society issued a position statement saying that a plant dominant Mediterranean diet has benefits, not just for menopause symptoms in the short term, but for long-term health too, helping reduce the risk of problems like heart disease and breast cancer that increase after menopause.”

It reflects what she sees in her Sydney practice.

“I often see women who want to lose weight or reduce cholesterol, and once they’ve adopted a more plant-based diet, they’ll say, ‘by the way, my hot flushes are better too’. I see a big difference in their wellbeing once women start eating more vegetables, nuts, seeds, legumes and wholegrains – and that doesn’t necessarily mean becoming vegetarian or vegan,” she adds.

It’s no secret that healthier eating helps prevent problems like heart disease and some cancers but how can plants cool hot flushes?

The reason the vegan diet with soybeans worked well in the US trial is thought to lie in the interaction between isoflavones from soy food and microbes in the gut, says Radd.

“Isoflavones belong to a category of food compounds called phytoestrogens. Phytoestrogens are in most unrefined plant foods, generally in small amounts, but soy is a particularly good source. They can act like weak oestrogens, especially if isoflavones are converted by certain gut microbes into equol – a more bioactive compound that’s been found to reduce hot flushes,” she explains. “There’s still more to learn about equol, including why not everyone has the right gut bacteria to produce it, but the evidence that it helps hot flushes is strengthening.”

“We already know that when you eat more whole plant foods like vegetables, fruit, grains and legumes you grow more of the gut microbes that help prevent disease, and fewer of those that promote it. Some emerging research has also linked a higher fibre diet from these foods to a greater chance of being able to make equol in your gut.”

More plant food also makes it easier to maintain a healthy weight – a good thing when you’re on the brink of menopause.

“Too much extra weight provides more insulation and that can increase hot flushes,” explains Dr Sonia Davison, an endocrinologist with Jean Hailes for Women’s Health and research fellow at Monash University’s Women’s Health Research Program. “In the lead up to menopause, one strategy for reducing the risk of symptoms is to stay at a healthy weight. Less alcohol may help too – alcohol makes blood vessels dilate which increases heat.”

Like Sue Radd, Sandra Villella, a naturopath with Jean Hailes, recommends a plant rich diet with foods that provide phytoestrogens – besides isoflavones from whole soyfoods and other legumes, there are coumestans (in sprouted foods like alfalfa and mung beans), and lignans (in linseed, grains and vegetables).

“If the rest of the family aren’t keen on these foods, there are ways around it. You can marinate cubes of firm tofu in fresh ginger and tamari and add them to a chicken and vegetable stir-fry, and make sure your serving has the tofu,” she says. “Ground linseed is a great breakfast sprinkle for muesli – I use a coffee grinder and add a couple of cardamom seeds for extra flavour. Grinding releases the phytoestrogens in linseed but it must be freshly ground – it keeps in the fridge for two weeks in an airtight jar.”

What about fears that soy can cause cancer or provoke a recurrence in breast cancer survivors?

According to the Cancer Council, the evidence so far doesn’t suggest any need to avoid soy foods – and that goes for women who have had breast cancer. A 2014 review of the evidence by the World Cancer Research Fund found that breast cancer survivors who ate more soy foods after diagnosis may have a lower risk of dying, although there was insufficient evidence to make a recommendation. However, there are concerns around the safety of supplements such as soy protein isolates or isoflavone capsules – the Cancer Council does not recommend their use.

*Got a few minutes? Jean Hailes for Women’s Health is asking women to take part in this national (anonymous) survey to learn more about women’s health during the pandemic.

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