5 Questions to Include in Your Menopause Nutrition Assessment (That Go Beyond Diet)

In this episode, we explore five essential, but often overlooked, areas to include in your nutrition assessment for menopause: sleep, brain fog and mood, exercise, family dynamics, and long-term health vision. These insights will help you go beyond food and build a more holistic, personalized care plan for your midlife clients.

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Transcript

0:01

Hi, and welcome to the Femme Health Nutrition Podcast. I'm Milu de LaMi, a registered dietician and founder of the Women's Health Nutrition Learning Hub, a platform where dieticians and nutrition professionals can learn about all things related to female health and nutrition. If you haven't already, you can check out the website, atn learning hub.com and you can find the link for that in the episode description. On the website, you can find many blog posts on women's health across the lifecycle, as well as some free resources you can download. You can also join my newsletter where I send biweekly research updates on various topics, as well as share new courses and new learning opportunities. Now I do have a free webinar that is coming up on July 16th, and the topic will be on female hormones and metabolic health. I will put the link for that in the description of this episode, but you can also get the link at the w hn learning hub.com website. And if you're not able to attend live, that's okay. You can sign up anyway and I will be sending. The recording as well as the references to everybody who registers. A couple of other things I wanted to share. The first is that this podcast will go on a little break in July. And I will be back with more episodes in August. So if you've been listening to this podcast or if this is the first time you tune in to listen to this specific episode and you feel that it gives you value and that it's helping you learn, then please feel free to subscribe and you will get notified. Whenever new podcast episodes are uploaded, As I've mentioned in some of the previous episodes, I absolutely love recording these episodes and sharing this knowledge with you. All the challenges that when it's not a live audience, you don't have that direct engagement with your audience. So things like ratings and followers, and seeing that the podcast is being shared with others really gives me the signal that there's interest in this podcast and to continue with this work. So don't forget to take a moment to subscribe, rate, and share with others. So let's get into the content for this episode. You'll notice it's a little bit different than some of the previous episodes I've had in that it's much more practical and it's these tips that you can use in your everyday practice. While you're speaking to your clients and during your assessments, so what we're going to talk about is five non-food areas to include in your assessment when you're working with clients who are in midlife around the time of perimenopause or menopause. So we'll cover sleep, brain fog and mood, exercise, family dynamics, and their long-term vision for health. And if you want a bit more of a tangible tool, you can actually download a free menopause assessment form that I have on the WHN Learning Hub website. So if you think that would be helpful, you can just go to the website, go to free resources and download that resource. So first we'll talk about sleep. And sleep is one of the first things to start to shift during the menopause transition. And sometimes it's easy to overlook it in a nutrition focused session. But what happens is that during perimenopause. Those fluctuating hormone levels, specifically estrogen and progesterone, can affect sleep latency. Which is basically the time it takes for a person to fall asleep. Sleep duration and also quality. And this can a lot of the times be related to night sweats which are hot flashes that people have during sleep. It can be related to changes in mood, and it can be just an independent symptom of perimenopause. And why we really care about sleep is that poor sleep can affect eating behaviors, so it can lead to increased production of the hormone ghrelin, which stimulates appetite. It can impact cravings. It can impact the motivation for the individual to prepare meals because they're just so tired they haven't slept the night before. Poor sleep, can also have metabolic consequences, so it could impact insulin resistance, it could impact hypertension, so lots of things can be affected when there is poor sleep. So this is one of the main questions to ask clients who are in midlife. You want to check in to see how many hours of sleep they're getting each night? Are they feeling well rested when they wake up? And if they're having issues with sleep, have they talked to their primary care providers about it? Because there are strategies that can be used to help with sleep. For example, there may be need for hormone therapy if it's related to vasomotor symptoms. Insomnia. CBT is another very effective treatment for poor sleep. From a diet perspective, we might look at caffeine intake, alcohol intake. We may look at the timing of the last meal. We may also look at whether people are doing high intensity exercises right before sleep. So there's a lot that can be done from a lifestyle perspective to improve sleep, but sometimes we would need to refer that client back to their care provider to get support because that sleep will have a downstream effect on many other health behaviors. Now the next thing I would ask my clients who are on this stage of life is about brain fog and mood, now it is common in perimenopause for people to experience brain fog or changes in their mood, so feeling more symptoms of depression or anxiety, and they may have short-term memory issues, difficulty concentrating. And this can be related to perimenopause and those hormonal shifts that are happening. It can also be related to other factors. So for example, if somebody is having severe hot flashes and night sweats and not sleeping, then that would also likely impact their brain fog. During the day because they're sleep deprived. With these changes, it can have those effects on health behaviors. So if there is brain fog, if there's symptoms of depression, then that might impact eating behaviors.. Physical activity, engagement in social activities. So these symptoms can really have an impact on overall health. Now with brain fog and mood. There are some dietary interventions that you could try. That's outside of the scope of this episode, but I do cover it in detail in my menopause course for dieticians. But sometimes they will need to be referred back to their care providers to get this under control.'cause it can be really hard to make dietary changes when there's this brain fog and low mood happening in the background. The next question I would ask would be about exercise and movement. With perimenopause and aging in general, there are a few things that are happening to body composition. So there's a loss of lean mass that's happening. There's an increase in visceral adiposity, and there's also a loss of bone density. So all of these things. Can be improved with exercise and movement, but it is important to know what kind of movement the client is doing. And we're looking, to whether they're including. Aerobic activity, resistance training, and also weight-bearing exercises. And if they're not doing any exercise, what is the barrier to that? Is it the brain fog or the poor sleep that's stopping them from being able to be active? Is it time, is it not knowing what to do? So with probing and asking. More directed questions, you can help the client remove some of those barriers. The next thing to include in your assessment is family and social dynamics. There have been so many times where a client has come into my office and said. You know what? I can't prepare the meals you're suggesting because my partner won't eat them. Or I have children who are picky eaters, or my mother-in-law is doing the cooking and I can't really tell them what to cook for me. And at this life stage, clients may be supporting their children, their aging parents, their partners. They may have a lot of responsibility at work. It is a really challenging time in terms of just the sheer amount of tasks. These clients have to be juggling. So family dynamics play a huge role in somebody's capacity for change and following recommendations. So figuring out what their life looks like from a family perspective, a social perspective, and also a work perspective can help guide you on what recommendations to make. I will also give you an opening to explore. Topics like setting boundaries and prioritizing self-care and setting realistic nutrition goals. And finally, the last thing that I would suggest including in your assessment, and this is probably something you want to ask in the beginning of your session, is the client's vision for long-term health. Many clients in midlife who seek the support of a dietician are really looking for support with weight loss, and that's valid. But sometimes the fixation on weight loss. It can be so strong that they lose sight of the longer term vision. So this is an opportunity to help them reconnect with that long-term vision that they have for health. So you may want to ask questions like, what do you want your health to look like in 10 or 20 years, and what are you most hoping for physically and emotionally in the years ahead? And what does healthy aging look like to you? This helps shift the focus away from short term weight loss and more toward things like function, vitality, longevity, and healthy aging And generally when people feel connected to a meaningful goal, they are more likely to follow through with those behavior changes long term. So here's a recap. Here are five assessment questions to include in your next session with a client in midlife. So the first is sleep patterns, And you want to focus both on how long an individual is sleeping as well as the quality of the sleep. We want to explore whether they're having issues with brain fog and mood, and how this is impacting their eating behaviors. You want to see what kind of exercise they're including and whether there's anything else they can be doing, like for example, adding resistance training where they can be improving their body composition to support their long-term health and function. It's a good idea to ask about family and caregiving dynamics because midlife can be a time where individuals have many competing roles, and this can impact their ability to take care of themselves, And finally their long-term vision for health and their values. Thank you again for tuning in to this episode. Again, if you enjoyed the content, please feel free to rate, subscribe, or share with others. I hope you have a great start to your summer. I will be back in August with more episodes. Thank you again, and I hope you have a lovely day.