I like to think of myself as an "inclusive" nutritionist rather than one that tells you to exclude foods. I often suggest including more variety of foods, more fruits and vegetables, and wholesome natural foods and that an occasional treat or so is ok.
However, I think one food ingredient is particularly dangerous for perimenopausal women: sugar. I'm talking about added sugars, not natural ones from fruits and vegetables. There is a big difference in how the body processes natural versus added sugars, and I'll add more details about this later in this post.
The reality is that Americans consume about 17 teaspoons of added sugar a day or about 270 calories. Most of this added sugar comes from processed and prepared foods, not from the honey that we add to our tea.
The leading sources of added sugar in the US are sweetened beverages like soda desserts and cookies and also sugary breakfast cereals, and to a lesser extent, sweetened yogurt.
These are some foods and their added sugars amount:
The Dietary Guidelines for Americans 2020-2025 recommends limiting added sugars and the diet to less than 10% of total calories. A 2000 calorie/day diet equates to 200 calories or 50 grams of sugar, which is about 12 teaspoons of sugar.
The American Heart Association recommends a more drastic limitation to sugars, no more than 100 calories per day or about 24 grams, equivalent to 6 teaspoons for adult women.
Why are added sugars a bigger concern for perimenopausal women?
During perimenopause, as I have explained in several other blog posts, there is a change in hormonal Physiology. Progesterone and estrogen production starts to decrease to new low levels, which occur when we reach menopause. There are consequences to this decrease in hormones, especially estrogen.
Some of the changes that the consumption of extra sugars can aggravate are:
Beginning at perimenopause, women start to become more resistant to insulin, meaning we don't metabolize carbohydrates and sugars as efficiently as we did in the past. This can increase our risk for conditions like diabetes, heart disease, and obesity.
Abdominal fat storage
With the decrease in estrogen, our body shape changes, and there is an increased ability for the body to store fat in the abdominal area. Since our carbohydrate metabolism is compromised now, we deposit glucose at a much higher rate as belly fat. Added sugars, especially in liquid form as found in sodas or sugary drinks, are particularly fast to be stored as fat.
Lack of sleep and fatigue
According to the sleep foundation, up to 47% of perimenopausal women have sleep issues. Lack of sleep induces fatigue during the day and increases cravings for sugary foods to increase alertness. The problem is that when we rely on sugary foods to counteract our fatigue, we induce a sugar crash which will keep the cycle going.
Decreased serotonin levels
Estrogen promotes serotonin production (the feel-good hormone). Without estrogen, we experience less serotonin which sometimes can promote depression, anxiety, and low mood. This also increases cravings for carbohydrates and highly sugary foods to increase serotonin.
During perimenopause, there is an increased systemic inflammation due to hormone changes. Sugar is a known pro-inflammatory food. So perimenopausal women who consume a lot of sugar will likely increase inflammation in their bodies. This is particularly concerning after menopause when our risk for cardiovascular disease increases, and inflammation can promote further damage to our blood vessels.
perimenopause can increase the risk of depression, anxiety, and mood swings. High-sugary foods can create a temporary feeling of excitement with the follow-up feeling of a sugar crash, leading to increased irritability and mood swings.
The bottom line
The body does not need added sugars to function. In fact, since most added sugars come in the form of processed foods, a good rule of thumb is to avoid these products as much as possible. Reading the labels of foods is particularly helpful in trying to limit the consumption of added sugars.
Although sweeteners like maple syrup and honey are considered a "healthier" alternative to sugar, they are still chemically similar to sugar and are processed the same way in the body so it's wise to limit those as well.
Sugars naturally existent in fruit and vegetables are not absorbed the same way as added sugars in processed foods, mostly because of fiber and other components of those natural sources that prevent them from being absorbed as fast as a soda drink, for example. So no, you should not limit your consumption of fruits, especially in their raw state. Juices, however, are mostly deprived of fiber and can have added sugar which is not recommended, at least daily.
Tips for reducing added sugar intake
Swap sodas and sugary drinks to water or seltzer with no added sugar. Add a slice of cucumber, orange, lemon, or lime to boost flavor.
Choose plain yogurt instead of flavored yogurt and stir fresh fruit or unsweetened applesauce and A dash of cinnamon.
Look for cereals with 5% of the daily value or less of added sugars, and add sliced ripe bananas or berries.
If you are craving sweets, try one of these first: 1-ounce square of 70% or higher dark chocolate, 1/4 cup of unsweetened dried fruit, 1 cup of frozen grapes, 1/4 cup of trail mix with raisins or dried cranberries but no chocolate bites.
When baking, decrease the amount of added sugar by 1/4 or 1/3 cup. You can reduce the sugar by substituting half the amount with unsweetened applesauce or mashed ripe banana. For example, instead of 1 cup of sugar, use half a cup of sugar and half cup of mashed bananas.
If you choose to have a dessert or ice cream doing it on a full stomach is better than on an empty stomach to avoid a sugar crash.
Another recommendation is to use a calorie tracking app to see the amount of added sugars you're eating daily to have a sense of your need to change your dietary patterns and habits. In this case, the support of a nutritionist might come handy.
Our taste buds can adjust to sweetness levels (both ways). As you are consistent with reducing your total sugar intake and sweetened foods, you will notice that your sweet cravings will decrease, and certain foods will start to taste too sweet.
Consistency is the key! :)