When the transition to menopause starts, women can be plagued by uncomfortable symptoms such as hot flashes, night sweats, sleep problems, mood swings, weight gain, and vaginal dryness. The pharmacological approach to controlling menopausal symptoms (which occur when levels of estrogen, progesterone, and testosterone drop off in midlife) is hormone therapy (HT), medications with female hormones that replace the ones the body no longer produces. Lifestyle changes such as diet, exercise, layered clothing, smoking cessation, and vaginal moisturizers and lubricants have also been shown to be effective in coping with symptoms related to menopause.

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Which Fruits and Veggies Are the Most Helpful?

Many studies have looked at the positive effects of the Mediterranean diet (a diet rich in fruit, vegetables, whole grains, nuts and healthy fats) on these symptoms, especially hot flashes and weight gain. An Iranian study published in the journal of the North American Menopause Society (NAMS), Menopause, on February 19, 2020, looked at subgroups of fruits and vegetables to find which provide the biggest benefits. The study recruited 393 post-menopausal women between ages 40 and 76 years. Possible participants were excluded if they were overweight, smoked, had a medical history of cancer, diabetes, stroke, multiple sclerosis, dementia, hyper- or hypothyroidism, or had undergone hormone therapy in the previous six months.

The More Fruits and Veg You Eat, the Better You Feel

Overall, participants who self-reported a higher intake of fruits and vegetables combined, total vegetables, or total fruits “had more energy and physical activity compared with individuals who reported a lower intake.” A previous study, published in June 2018 in Maturitas, looked at vegans, who do not eat animal products, and found that they “report less bothersome vasomotor and physical menopausal symptoms than omnivores.”

“These results are consistent with other studies. The mechanism by which it works is not entirely clear, but we are assuming it is related to the antioxidant effects of the vitamin C, beta-carotene, and lycopene contained in the fruits and vegetables,” said Neal Barnard, MD, author of Your Body in Balance.

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One More Reason to Eat Your Spinach and Kale

The researchers also looked at specific subgroups of fruits and vegetables, including cruciferous vegetables, green leafy vegetables, dark yellow vegetables, berries, and citrus fruits.

In the results, the researchers found that in the vegetable groups, higher consumption of leafy greens and cruciferous vegetables led to a significant reduction in overall menopausal symptoms and specifically in physical symptoms.

Leafy green vegetables Kale, collard greens, spinach, cabbage, beet greens, watercress, romaine lettuce, Swiss chard, arugula, endive, and bok choy

Kale, collard greens, spinach, cabbage, beet greens, watercress, romaine lettuce, Swiss chard, arugula, endive, and bok choy Cruciferous vegetables Cauliflower, broccoli, cabbage, kale, garden cress, bok choy, Brussels sprouts

Does Eating Meat and Dairy Mean More Hot Flashes?

Dr. Barnard, who is also the president of the Physicians Committee for Responsible Medicine, says, “This study also fits a longer-term observation from years ago in Japan, when the diet was much lower in animal products and higher in rice and vegetables, and women rarely complained of menopausal symptoms. When the diet become more Westernized with more meat and dairy, menopausal symptoms were much more frequently reported.”

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Fruits May Help You Find Your Smile

A higher intake of fruits across the board was found to have a slight impact on the psychological front, with high consumption respondents reporting somewhat less moodiness. Citrus fruits (oranges, limes, lemons, citrons, grapefruit, kumquats, ugli fruit) were also reported to help reduce overall menopause symptoms.

Will Eating More Fruits and Veggies Lead to More UTIs and Urinary Tract Problems?

Acidic tomatoes and citrus fruits are known to act as bladder irritants. One concerning result from the study was that higher intakes of fruits and vegetable combined, total vegetables, green leafy vegetables, dark yellow vegetables, and citrus fruits were associated with higher urogenital issues, such as urinary tract infections (UTIs). “However, further investigation is warranted to confirm the findings,” wrote the researchers in the published papers.

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Limitations of Iranian Study Due to Population Sample

The researchers caution that the nature of Iranian society and characteristics of diet and food preparation there may limit the ability to generalize results to women worldwide. For example, frying as a method for vegetable preparation in Iran is very popular. Therefore, confirming the findings of the present study in different sociocultural and dietary behavior contexts will better illuminate the relationship between fruit and vegetable consumption and menopausal symptoms, wrote the researchers.

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Study Lights the Way for Further Research

“This small cross-sectional study provides some preliminary evidence regarding the influence of fruit and vegetable intake on menopause symptoms. There is ample evidence that a healthy diet rich in fruits and vegetables has a beneficial effect on health in a myriad of ways, but additional study is needed to determine whether various menopause symptoms may be affected by dietary choices,” said Stephanie Faubion, MD, the medical director of NAMS, and the Penny and Bill George Director at the Mayo Clinic Center for Women’s Health in Rochester, Minnesota, in a news release about the study.

Barnard adds, “This was not a randomized trial — this was self-reported food intake, which makes it more likely that there was a [confounding factor]. However, the study does seem to be rigorously done. It suggests that the next step is to conduct a randomized trial in which people would be given a certain amount of food or asked to consume a certain diet, and [which would include] the presence of a control group.”