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熱潮紅（潮熱）需要的營養：飲食有幫助嗎？
是否有支持健康體重管理的特定營養素？
June 18, 2021
十字花科蔬菜有助於排毒嗎？
June 18, 2021
更年期是女性生命中重大的生理和心理轉變，可以代表女性進入更深刻智慧和自由的時代。但是，如果您正在與不良症狀作鬥爭，這種轉變可能會讓人感覺不那麼美好。
根據定義，更年期是女性在前 12 個月沒有月經週期的時間點。然而，伴隨轉變而來的症狀可以在前後持續很多年。 [1]
雖然女性對更年期的生理反應各不相同，但熱潮紅（潮熱）和盜汗等症狀往往是最常見的。 [2]一項研究發現潮熱平均可持續約十年，因此解決它們對於確保您的生活質量不會受到負面影響至關重要。 [3]
由於女性在尋求更複雜的干預措施之前通常會採用自然方法來讓自己感覺更好，因此營養可能是第一步。更年期還與慢性健康問題的風險增加有關，因此飲食可以提供一種非侵入性的方法，在改善整體健康的同時針對潮熱。 [4]
為什麼女性更年期會出現熱潮和盜汗？
如前所述，潮熱和盜汗等血管舒縮症狀是女性在更年期最常見的症狀。它們可以持續數秒或更長時間，中斷日常活動並顯著影響睡眠。有些女性只有輕微的、偶爾的潮熱。相比之下，其他人的掙扎頻率更高，甚至一天多達 20次[5]
雖然潮熱的原因尚未完全清楚，但研究人員一致認為它們源於身體熱中性區的變化。熱中性區是你的體溫舒適的地方，即出汗和顫抖之間的細線。 [6]隨著更年期雌激素水平下降，該區域變得更小，因此最輕微的溫度變化或刺激都會導致過度反應。
雌激素還支持大腦中去甲腎上腺素活性的調節。去甲腎上腺素作為一種興奮性神經遞質和激素參與壓力反應，包括增加心率和血流量。 [7]升高的去甲腎上腺素與潮熱有關，因為它也可能影響熱中性區。
營養在潮熱管理中起什麼作用？
有幾種重要的方法可以從飲食和營養上支持你度過更年期過渡期：
保持健康的體重
飲食可以提供幫助的一個基本方法是通過體重管理支持。 這種關係尚不清楚，但其影響可能是因為脂肪（或體脂）組織會破壞正常體溫或激素調節。 [8]
幾項研究指出，身體質量指數 (BMI) 較高或體脂百分比較高的女性更常出現嚴重的潮熱。 [9] 體重增加也可能會增加潮熱的發生率，但隨著女性達到健康的體重，潮熱的發生率也會降低。 [10]
遵循抗炎飲食模式
研究指出，在絕經後的幾年裡，炎症標誌物會增加，這可能是由於雌激素失去了抗炎作用。 [11]由於炎症會加劇症狀，因此提出具有較高炎症標記的女性也會出現更多潮熱。
因此，多攝取低加工食品和水果、蔬菜、堅果和種子等抗炎飲食可能是有益的。一項研究發現，遵循抗炎飲食模式的女性不太可能出現更年期症狀，包括身心問題。相反，在飲食上攝取精製油、加工肉類和糖等被認為具有炎症的食物會引致更多與更年期症狀有關的報告，包括盜汗和潮熱。 [12] [13]
有趣的是，這些研究中對抗炎飲食的描述與地中海飲食相似。地中海飲食富含抗氧化劑和植物化學物質，因其對許多健康狀況（包括潮熱）的抗炎作用而受到研究。[14]研究人員發現，隨著水果攝取量的增加，地中海飲食模式與潮熱呈負相關。 [15]
地中海飲食也富含來自定期魚類攝取的 奧米加-3 脂肪酸。 奧米加-3 脂肪酸支持減少體內炎症。 [16]雖然 奧米加-3 脂肪酸和潮熱之間的直接聯繫並非非黑即白，但額外的抗炎功效可能會有所幫助。 [17]由於許多人沒有吃足夠的魚，補充 奧米加-3 可以幫助滿足預計的需求。
多吃植物
多吃水果、蔬菜和全穀物有助於顯著減少潮熱，正如一項針對一年遵從多吃植物飲食的女性的研究所見。本研究中的女性也比對照組減輕了更多的體重，因為健康飲食的改變。
那些體重減輕的人報告的症狀也較少。有趣的是，研究中體重增加的女性的症狀也有所改善，這表明飲食仍然有助於減肥。
減少吃肉也可能有助於支持更年期症狀。在一項研究中，與食用更多肉類的女性相比，遵循純素飲食的女性報告有更少的血管舒縮症狀。對於那些吃更多蔬菜的人來說尤其如此，這表明即使你沒有完全從飲食中去除肉類，增加蔬菜攝入量也會有所幫助。 [18]較高的抗氧化劑攝入量也與減少更年期症狀有關，尤其是潮熱和盜汗。 [19]這是地中海飲食如此有用的另一個原因。
考慮未加工的大豆
大豆在女性健康領域備受爭議，因為它能夠像體內的雌激素一樣發揮作用。 然而，與體內的雌激素相比，這些植物雌激素較弱，可能對某些女性有益。 [20]
大豆可能通過其對激素受體的影響來支持潮熱，有助於彌補可能導致症狀的雌激素水平下降。 [21] 關於補充劑的研究是混合的，所以需要更多的研究，但大豆的飲食攝入量可以成為你膳食的寶貴補充。 食用適量未加工的大豆食品，如毛豆和豆腐，同時遠離假肉和奶酪，可能會通過雌激素樣作用積極支持症狀管理。 [22]
增加葉酸的攝入量
葉酸是一種通常與健康懷孕結果相關的維他命 B，也可能有助於減少血管舒縮性更年期症狀。 一項針對更年期婦女的臨床試驗發現，與服用安慰劑補充劑的對照組相比，服用補充葉酸一個月的人的潮熱嚴重程度、持續時間和頻率都有所降低。 [23]
葉酸是葉酸的合成形式，常見於深綠色蔬菜、豆類、水果和堅果等食物中。 然而，補充葉酸可能會起作用，因為它會影響去甲腎上腺素。 研究表明，它通過減少去甲腎上腺素的分泌而起到類似於體內雌激素的作用，這有助於調節上述熱中性區。 [24]
飲食作為更年期支持的簡單策略
研究表明，在整個更年期過渡期間，感到支持的女性通常會有更好的體驗。 用富含健康抗炎食物的飲食來滋養自己是實現這一目標的一種方法。 [25] 吃得好還可以幫助您整體感覺更好，並更好地控制您的健康。 根據症狀的嚴重程度，飲食可以是解決潮熱和與更年期相關的健康問題的簡單方法。
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參考資料：
[1] National Institute on Aging. “What Is Menopause?” Accessed April 13, 2021. http://www.nia.nih.gov/health/what-menopause.
[2] Avis, Nancy E., Sybil L. Crawford, and Robin Green. “Vasomotor Symptoms Across the Menopause Transition: Differences Among Women.” Obstetrics and Gynecology Clinics of North America 45, no. 4 (December 2018): 629–40. https://doi.org/10.1016/j.ogc.2018.07.005.
[3] Freeman, Ellen W., Mary D. Sammel, Hui Lin, Ziyue Liu, and Clarisa R. Gracia. “Duration of Menopausal Hot Flushes and Associated Risk Factors.” Obstetrics and Gynecology 117, no. 5 (May 2011): 1095–1104. https://doi.org/10.1097/AOG.0b013e318214f0de.
[4] Cheng, Chao-Chun, Ching-Yun Hsu, and Jen-Fang Liu. “Effects of Dietary and Exercise Intervention on Weight Loss and Body Composition in Obese Postmenopausal Women: A Systematic Review and Meta-Analysis.” Menopause (New York, N.Y.) 25, no. 7 (July 2018): 772–82. https://doi.org/10.1097/GME.0000000000001085.
[5] Thurston, Rebecca C., Joyce T. Bromberger, Hadine Joffe, Nancy E. Avis, Rachel Hess, Carolyn J. Crandall, Yuefang Chang, Robin Green, and Karen A. Matthews. “Beyond Frequency: Who Is Most Bothered by Vasomotor Symptoms?” Menopause (New York, N.Y.) 15, no. 5 (October 2008): 841–47. https://doi.org/10.1097/gme.0b013e318168f09b.
[6] Freedman, Robert R. “MENOPAUSAL HOT FLASHES: MECHANISMS, ENDOCRINOLOGY, TREATMENT.” The Journal of Steroid Biochemistry and Molecular Biology 142 (July 2014): 115–20. https://doi.org/10.1016/j.jsbmb.2013.08.010.
[7] Bylund, D. B., and K. C. Bylund. “Norepinephrine.” In Encyclopedia of the Neurological Sciences (Second Edition), edited by Michael J. Aminoff and Robert B. Daroff, 614–16. Oxford: Academic Press, 2014. https://doi.org/10.1016/B978-0-12-385157-4.00047-6.
[8] Al-Safi, Zain A., and Alex J. Polotsky. “Obesity and Menopause.” Best Practice & Research. Clinical Obstetrics & Gynaecology 29, no. 4 (May 2015): 548–53. https://doi.org/10.1016/j.bpobgyn.2014.12.002.
[9] Kroenke, Candyce H., Bette J. Caan, Marcia L. Stefanick, Garnet Anderson, Robert Brzyski, Karen C. Johnson, Erin LeBlanc, et al. “Effects of a Dietary Intervention and Weight Change on Vasomotor Symptoms in the Women’s Health Initiative.” Menopause (New York, N.Y.) 19, no. 9 (September 2012): 980–88. https://doi.org/10.1097/gme.0b013e31824f606e.
[10] Kapoor, Ekta, Maria L. Collazo-Clavell, and Stephanie S. Faubion. “Weight Gain in Women at Midlife: A Concise Review of the Pathophysiology and Strategies for Management.” Mayo Clinic Proceedings 92, no. 10 (October 2017): 1552–58. https://doi.org/10.1016/j.mayocp.2017.08.004.
[11] Karim, Roksana, Frank Z. Stanczyk, Howard N. Hodis, Mary Cushman, Roger A. Lobo, Juliana Hwang, and Wendy J. Mack. “Associations between Markers of Inflammation and Physiological and Pharmacological Levels of Circulating Sex Hormones in Postmenopausal Women.” Menopause (New York, N.Y.) 17, no. 4 (July 2010): 785–90.
[12] Aslani, Zahra, Maryam Abshirini, Motahar Heidari-Beni, Fereydoun Siassi, Mostafa Qorbani, Nitin Shivappa, James R. Hébert, Mahshid Soleymani, and Gity Sotoudeh. “Dietary Inflammatory Index and Dietary Energy Density Are Associated with Menopausal Symptoms in Postmenopausal Women: A Cross-Sectional Study.” Menopause 27, no. 5 (May 2020): 568–78. https://doi.org/10.1097/GME.0000000000001502.
[13] Soleymani, Mahshid, Fereydoun Siassi, Mostafa Qorbani, Shahla Khosravi, Zahra Aslany, Maryam Abshirini, Ghazal Zolfaghari, and Gity Sotoudeh. “Dietary Patterns and Their Association with Menopausal Symptoms: A Cross-Sectional Study.” Menopause 26, no. 4 (April 2019): 365–72. https://doi.org/10.1097/GME.0000000000001245.
[14] Barrea, Luigi, Gabriella Pugliese, Daniela Laudisio, Annamaria Colao, Silvia Savastano, and Giovanna Muscogiuri. “Mediterranean Diet as Medical Prescription in Menopausal Women with Obesity: A Practical Guide for Nutritionists.” Critical Reviews in Food Science and Nutrition 61, no. 7 (April 12, 2021): 1201–11. https://doi.org/10.1080/10408398.2020.1755220.
[15] Herber-Gast, Gerrie-Cor M, and Gita D Mishra. “Fruit, Mediterranean-Style, and High-Fat and -Sugar Diets Are Associated with the Risk of Night Sweats and Hot Flushes in Midlife: Results from a Prospective Cohort Study.” The American Journal of Clinical Nutrition 97, no. 5 (May 1, 2013): 1092–99. https://doi.org/10.3945/ajcn.112.049965.
[16] Calder, Philip C. “Omega-3 Fatty Acids and Inflammatory Processes: From Molecules to Man.” Biochemical Society Transactions 45, no. 5 (October 15, 2017): 1105–15. https://doi.org/10.1042/BST20160474.
[17] Mohammady, Mina, Leila Janani, Shayesteh Jahanfar, and Mahsa Sadat Mousavi. “Effect of Omega-3 Supplements on Vasomotor Symptoms in Menopausal Women: A Systematic Review and Meta-Analysis.” European Journal of Obstetrics, Gynecology, and Reproductive Biology 228 (September 2018): 295–302. https://doi.org/10.1016/j.ejogrb.2018.07.008.
[18] Beezhold, Bonnie, Cynthia Radnitz, Robert E. McGrath, and Arielle Feldman. “Vegans Report Less Bothersome Vasomotor and Physical Menopausal Symptoms than Omnivores.” Maturitas 112 (June 2018): 12–17. https://doi.org/10.1016/j.maturitas.2018.03.009.
[19] Abshirini, Maryam, Fereydoun Siassi, Fariba Koohdani, Mostafa Qorbani, Shahla Khosravi, Mehdi Hedayati, Zahra Aslani, Mahshid Soleymani, and Gity Sotoudeh. “Dietary Total Antioxidant Capacity Is Inversely Related to Menopausal Symptoms: A Cross-Sectional Study among Iranian Postmenopausal Women.” Nutrition (Burbank, Los Angeles County, Calif.) 55–56 (November 2018): 161–67. https://doi.org/10.1016/j.nut.2018.04.014.
[20] Taku, Kyoko, Melissa K. Melby, Fredi Kronenberg, Mindy S. Kurzer, and Mark Messina. “Extracted or Synthesized Soybean Isoflavones Reduce Menopausal Hot Flash Frequency and Severity: Systematic Review and Meta-Analysis of Randomized Controlled Trials.” Menopause (New York, N.Y.) 19, no. 7 (July 2012): 776–90. https://doi.org/10.1097/gme.0b013e3182410159.
[21] Zaheer, Khalid, and M. Humayoun Akhtar. “An Updated Review of Dietary Isoflavones: Nutrition, Processing, Bioavailability and Impacts on Human Health.” Critical Reviews in Food Science and Nutrition 57, no. 6 (April 13, 2017): 1280–93. https://doi.org/10.1080/10408398.2014.989958.
[22] Borrelli, Francesca, and Edzard Ernst. “Alternative and Complementary Therapies for the Menopause.” Maturitas 66, no. 4 (August 2010): 333–43. https://doi.org/10.1016/j.maturitas.2010.05.010.
[23] Bani, Soheila, Shirin Hasanpour, Leila Farzad Rik, Hadi Hasankhani, and Seiedeh Hajar Sharami. “The Effect of Folic Acid on Menopausal Hot Flashes: A Randomized Clinical Trial.” Journal of Caring Sciences 2, no. 2 (June 1, 2013): 131–40. https://doi.org/10.5681/jcs.2013.016.
[24] Ewies, Ayman AA. “Folic Acid Supplementation: The New Dawn for Postmenopausal Women with Hot Flushes.” World Journal of Obstetrics and Gynecology 2, no. 4 (November 10, 2013): 87–93. https://doi.org/10.5317/wjog.v2.i4.87.
[25] Hoga, Luiza, Juliana Rodolpho, Bruna Gonçalves, and Bruna Quirino. “Women’s Experience of Menopause: A Systematic Review of Qualitative Evidence.” JBI Evidence Synthesis 13, no. 8 (August 2015): 250–337.
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Menopause, the significant biological and psychological shift in a woman’s life, can represent the entrance into an age of more profound wisdom and freedom for a woman. But this transition can feel less than idyllic if you are struggling with undesirable symptoms.
By definition, menopause is the point when a woman has not had her menstrual cycle for the twelve prior months. However, symptoms that accompany the transition can last for many years before and after.[1]
While physiological responses to menopause vary from woman to woman, symptoms like hot flashes and night sweats tend to be the most common.[2] One study found that hot flashes can last about ten years on average, so addressing them is vital to ensure your quality of life isn’t negatively affected.[3]
As women often turn to natural approaches to feel better before seeking out more complicated interventions, nutrition can be the first step. Menopause is also related to an increased risk of chronic health concerns, so diet can provide a non-invasive approach that targets hot flashes while improving overall health.[4]
Why do women experience hot flashes and night sweats with menopause?
As mentioned, vasomotor symptoms like hot flashes and night sweats are the most common symptoms women experience in the menopause years. They can last seconds or much longer, interrupting daily activities and significantly impacting sleep. Some women have only mild, occasional hot flashes. In contrast, others struggle with more frequency, even up to twenty times a day[5].
While the causes of hot flashes are not entirely understood, researchers agree that they stem from a change in the body’s thermoneutral zone. The thermoneutral zone is where your body temperature is comfortable, the fine line between sweating and shivering.[6] As estrogen levels drop during the menopause years, this zone becomes smaller, so the slightest temp changes or stimuli can cause an overreaction.
Estrogen also supports the regulation of norepinephrine activity in the brain. Norepinephrine acts as an excitatory neurotransmitter and hormone involved in the stress response, including increasing heart rate and blood flow.[7] Elevated norepinephrine is associated with hot flashes as it may also impact the thermoneutral zone. 6
What role does nutrition play in hot flash management?
There are several important ways you can use diet and nutrition to support you through the menopause transition:
1. Maintain a healthy weight
A foundational way that diet can help is through weight management support. This relationship is not well understood, but the effects may be because adipose (or body fat) tissue can disrupt normal temperature or hormone regulation.[8]
Several studies suggest that women with a higher body mass index (BMI) or greater percent body fat have severe hot flashes more often.[9] Weight gain may also increase the incidence of hot flashes, but they are also reduced as a women reach a healthy weight.[10]
2. Follow an anti-inflammatory diet pattern
Studies show that inflammatory markers increase in the years following menopause, likely due to the loss of the anti-inflammatory benefits of estrogen.[11] As inflammation can exacerbate symptoms, it’s suggested that women with higher markers also experience more hot flashes.5
As a result, an anti-inflammatory diet low in processed foods and high in fruits, vegetables, nuts, and seeds may be beneficial. One study found that women who follow anti-inflammatory diet patterns are less likely to have menopause symptoms, including physical and mental concerns. Oppositely, diets high in foods considered inflammatory like refined oils, processed meats, and sugar are linked to more reports of menopause symptoms, including night sweats and hot flashes.[12] [13]
Interestingly, the description of an anti-inflammatory diet in these studies is similar to the Mediterranean diet. High in antioxidants and phytochemicals, the Mediterranean diet has been studied for its anti-inflammatory effect on many health conditions, including hot flashes.[14] Researchers found that, along with increased fruit intake, the Mediterranean diet pattern is inversely associated with hot flashes. [15]
The Mediterranean diet is also high in omega-3 fatty acids from regular fish intake. Omega-3 fatty acids support reductions in inflammation in the body.[16] While the direct connection between omega-3 fatty acids and hot flashes is not black and white, the additional anti-inflammatory benefits may help.[17] As many people don’t eat enough fish, supplemental omega-3 can help meet estimated needs.
3. Eat more plants
Eating more fruits, vegetables, and whole grains can help significantly reduce hot flashes, as seen in a study on women who followed a plant-heavy diet for a year.9 Women in this study also lost more weight than the control group because of the healthy diet changes.
Those who lost weight also reported fewer symptoms. Interestingly, women in the study who gained weight also experienced improvements in symptoms, suggesting that diet still helped independently from weight loss.
Eating less meat may also aid in menopause symptom support. In one study, women who followed a vegan diet reported fewer vasomotor symptoms than women who consumed more meat. This was especially true for those who ate more vegetables, suggesting that increasing vegetable intake can help even if you don’t completely remove meat from your diet.[18] Higher intake of antioxidants is also associated with reduced menopause symptoms, especially hot flashes and night sweats.[19] This is another reason why the Mediterranean diet may be so helpful
4. Consider unprocessed soy
Soy is controversial in the women’s health world because of its ability to act like estrogen in the body. However, these phytoestrogens are weak compared to estrogen in the body and may benefit some women.[20]
Soy may support hot flashes through its influence on hormone receptors, helping to make up for the drop in estrogen levels that can lead to symptoms.[21] Studies on supplementation are mixed, so more research is needed, but dietary intake of soy can be a valuable addition to your meals. Eating moderate amounts of unprocessed soy foods like edamame and tofu while staying away from fake meats and cheese may positively support symptom management through the estrogen-like effects.[22]
5. Bump up folic acid intake
Folic acid, the B vitamin usually associated with healthy pregnancy outcomes, may also support the reduction of vasomotor menopause symptoms. A clinical trial focused on menopausal women found that those who took supplemental folic acid for a month saw reductions in severity, duration, and frequency of hot flashes compared to the control group who took a placebo supplement.[23]
Folic acid is the synthetic form of folate, which is found in foods like dark green vegetables, beans, fruit, and nuts. However, supplementation with folic acid may work because of its influence on norepinephrine. Studies suggest that it acts similar to estrogen in the body by supporting reductions in the secretion of norepinephrine, which helps regulate the thermoneutral zone as mentioned above.[24]
Diet as a simple strategy for menopause support
Studies suggest that women who feel supported generally have a better experience throughout the menopause transition. Nourishing yourself with a diet rich in healthy, anti-inflammatory foods is one way to accomplish this.[25] Eating well also helps you feel better overall and more in control of your health. Depending on the severity of symptoms, diet can be a simple way to address hot flashes and the health concerns associated with menopause.
Disclaimer: The information is for general education purposes only. These therapies are not substitutions for standard medical care and are not meant to be used by a patient alone. The Company assumes no liability for the author’s information, whether conveyed verbally or in these materials. All presentations represent the opinions of the author and do not represent the position or the opinion of the Company. Reference by the author to any specific product, process or service by trade name, trademark, or manufacturer does not constitute or imply endorsement or recommendation by the Company.
Reference
[1] National Institute on Aging. “What Is Menopause?” Accessed April 13, 2021. http://www.nia.nih.gov/health/what-menopause.
[2] Avis, Nancy E., Sybil L. Crawford, and Robin Green. “Vasomotor Symptoms Across the Menopause Transition: Differences Among Women.” Obstetrics and Gynecology Clinics of North America 45, no. 4 (December 2018): 629–40. https://doi.org/10.1016/j.ogc.2018.07.005.
[3] Freeman, Ellen W., Mary D. Sammel, Hui Lin, Ziyue Liu, and Clarisa R. Gracia. “Duration of Menopausal Hot Flushes and Associated Risk Factors.” Obstetrics and Gynecology 117, no. 5 (May 2011): 1095–1104. https://doi.org/10.1097/AOG.0b013e318214f0de.
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