Advice from a menopause specialist: why healthy fats are a must in a menopause diet

When it comes to diet, fats get a bad rap. This isn’t justified: certain types of fat help keep hormones balanced and reduce menopausal symptoms, while eating foods that are high in carbohydrates can make these symptoms worse. It's time to embrace fats and learn new ways to look at our diet.

In this article, our menopause specialist Suzanne Rouhard takes a deep dive into the world of fats and explains why instead of fat free, it’s better to go with full fat. Did you know that full-fat Greek yoghurt is one of the healthiest varieties of yoghurt you could possibly buy?

But aren’t fats bad for you?

The answer to that question is ‘no’. In the 1990s, our perception of fats shifted dramatically. Then scientific research showed that trans fats had a direct impact on our health. As a result, all types of dietary fat were demonised and replaced by carbohydrates. More and more low-fat products were created and put into the market. For years, we believed that fat was bad and zero fat was healthier.  

I come across many people who avoid fats for fear of gaining weight. They are shocked when I advise them to eat more fat to lose weight. This cannot be good, surely? I go on to explain that our body needs cholesterol (fat) to make sex hormones, and that these hormones play an important role in weight management. It's then that the penny drops. 

Despite the common misconception that all fats are ‘bad’, more recent studies have revealed that excess carbohydrates are more detrimental than fats. Consuming carbohydrates increases blood sugar levels, which stimulates the pancreas to secrete insulin. When we eat too much carbohydrates the pancreas secretes too much insulin, reducing our cells’ sensitivity to insulin. Over time, this can lead to insulin resistance and the development of diabetes. As a Western lifestyle is becoming more widespread around the world, more and more people are developing diabetes. Insulin resistance also lurks beneath many symptoms women experience during menopause. 

The relationship between carbohydrates and fats

Understanding the balance between fats and carbohydrates is essential for a healthy diet. It is OK to eat fats and carbohydrates, as long as the right proportions are maintained, and your diet includes the right fats and carbs. 

What types of fats do we need?

What type of fats do we want for our bodies? My rule is: all fats are OK, as long as you avoid trans fats. So you can eat saturated fat? Sure! But remember, it’s all about balance. It is vital to maintain a good balance between saturated and unsaturated fats. 

The right ratio of saturated and unsaturated fats

First, let’s look at unsaturated fatty acids: omega-3, omega-6 and omega-9 fatty acids. Consuming the right ratio of omega-3 and omega-6 fatty acids is especially important for hormonal balance and the permeability of your cells.  

People following a Western diet are typically eating too much omega-6s relative to omega-3s. This is because vegetable oil, such as sunflower oil, is commonly used for cooking and frying.  

If omega-6s are ingested in high quantities, the cells lose flexibility. This can affect the way they work, reducing your body's ability to absorb nutrients and detoxify naturally (which is very important for removing used hormones).  

Imbalance in dietary omega-3/omega-6 fatty acid ratio is also associated with lower immune cell function. Suppose you cut your finger while chopping vegetables. Omega-6 acts as your body's soldiers, attacking and destroying bacteria that enter the wound. When omega-6 has done its job, energy allocation to your immune system needs to be switched off. This is where omega-3 comes in. 

It is very important to balance the ratio between these two unsaturated fatty acids for your immune system and your cells (and thus your hormones) to function optimally. The optimal ratio of omega-3 to omega-6 fats​​ is a dietary ratio of 1:3. 

How do you test for fatty acid composition?

You can check your ratio of omega-3 to omega-6 fatty acids by doing a finger-prick test. The test measures the amounts of essential fatty acids in your blood and how your body used them. These results are a good starting point for getting them back in balance. 

I take multiple finger-prick tests on a daily basis and I’m often shocked by the results. Many women have omega-3 to omega-6 ratios that are way too high, from 1:15 up to 1:80. The good news is that it is relatively easy to rebalance fatty acid levels. You’ll notice the effects fairly quickly: you’ll lose weight more easily, your memory will improve, you’ll be better able to control your temper and your mood will improve. 

Your body's cells are constantly replicating themselves. Red blood cells take between four months to completely replace, so that’s when we retest. All tests come back good, which is great. With levels in a healthier range, the health benefits will be evident, which gives an extra incentive to maintain a healthy lifestyle and diet. 

What lifestyle and dietary changes are we talking about? More on this below. 

How do you ensure your meals containa balanced ratio of healthy fats?

Understanding the key parts of a balanced diet is the first step. So, mind what you eat and make sure your diet include unsaturated fats in the right ratio: 

• Omega-3 (alpha-linolenic acid) is found in walnuts, flaxseed oil, chia seeds and leafy green vegetables.
• Omega-6 (linoleic acid) is found in walnuts, sunflower seeds, Brazil nuts, sesame seeds, flax seeds and cashew nuts. Sources such as sunflower oil, maize oil, soy oil, margarine and low-fat margarine, and concentrated margarine for frying purposes also contain omega-6, but are best avoided. We tend to get enough omega-6 oils in our diet, so we don't need to include these sources. 

Metabolism of omega-3 and omega-6

Your body must first convert omega-3s and omega-6s from food into energy to fuel various functions. During this process, called metabolism, so-called prostaglandins are formed, which also play an important role in hormonal balance. Vitamins and minerals (from fruit and vegetables) are used to drive metabolic processes in every cell of your body.  

During this process, omega-3 often loses out. In order for it to be useable, the body converts omega-3 into DHA and EPA. The conversion rate depends on adequate levels of vitamins and minerals as well as on a specific enzyme. This is where the crux of the problem lies: our body's natural production of this enzyme has declined.  

Why? Hundreds of years ago, humans started eating more fish. Fish and seafood tend to be high in DHA and EPA, which are vital for overall health. Since we were getting DHA and EPA in adequate amounts, our body adapted to these levels (‘use it or lose it’).  

There are also other factors that affect omega-3 and omega-6 conversion efficiency. These include: 

• Deficiency of certain vitamins, such as B6, C, E, biotin, and minerals such as chromium, magnesium and zinc.
• Trans fats from, for example, cookies, sweets, crackers and dairy products.
• Excessive saturated fat. We need saturated fats, but in the right proportions.
• Excessive sugars and fast carbohydrates.
• Insulin resistance.
• Certain medications. 

What can you do?

• Make sure your diet contains plenty of vitamins and minerals. Eat 300-500 grams of vegetables and fruit a day. 
• Replace vegetable oils with extra virgin olive oil, organic butter and ghee (alternate between them). 
• Make sure you get adequate amounts of omega-3s. Although conversion efficiency may not be optimal, every little bit helps. 
• Eat oily fish, such as herring, mackerel or sardines twice a week (opt for smaller fish as they contain less contaminants, such as dioxins, PCBs, pesticides and heavy metals). 
• Do you eat beef? If yes, opt for grass-fed meat. 
• If you don't eat fish, then you should take an algae supplement to complement your diet.  

Balancing fatty acids is important for hormonal balance, but it is also vital for keeping your heart and blood vessels healthy. You can do a lot to improve your health by following the above diet tips.