Citrus fruits have been present in the diet of people living in Asia and the Mediterranean basin since the time of the Roman Empire. Not only do these fruits play an important role in the landscape but also in the diet of these populations. [Duarte et al, 2016; Naureen, 2013].
It is well known in many of these countries around the Mediterranean, that these beautiful, colourful fruits help to improve inflammatory markers as well as our immune health (Miles & Calder, 2021).
So, with the menopause transition now recognised as an inflammatory event, why aren’t we having citrus fruits in our diet?
As we move through mid-life, inflammatory changes occurring around the body, including in the lungs, means that changing our diet to accommodate these changes matters. We need a robust immune system to reduce the inflammation that builds up in menopause.
That’s why, when I arrived in London, I was heartened that my daughter bought me her small hand-juicer and a bag of citrus fruits.
I already knew the powerful effect of citrus on our immune and cardiovascular health as we age, which is why I’m heartened by newer research (Miles & Calder, 2021), confirming my actions, even when travelling, that citrus juice is part of my daily routine.
When my mid-life menopausal body hobbled along to various specialists with sore joints, aching muscles, sore heels, heart palpitations and feelings of fatigue, not one of them mentioned my new ‘heroine’ of menopause health – Vitamin C – and to be fair to these wonderful specialists, nor did I give this vital vitamin a thought either.
But I should have – and I also needed to take note that the reason there was a lemon tree in my garden at the time, was that I needed to embrace this beautiful fruit during menopause.
Of all the nutrients we’re most familiar with, but possibly have in our diet the least, due to all the confusing dietary messages, Vitamin C is perhaps the most impressive.
Even more-so now that we need optimal immune health following the pandemic. If you are experiencing fatigue and changing immune health from long-covid, then you know what I mean.
Citrus fruit juices are a particularly good source of both Vitamin C and folate. Both of these nutrients have roles in sustaining the integrity of immunological barriers and reducing the inflammatory response.
Furthermore, with a known connection between low intake folate and depression in older women (Reynolds, 2002) and the connection between low folate and hot flushes (Bani at al., 2013), midlife is the time to take this nutrient seriously.
Positioning our menopause and post-menopause transition in ageing and longevity science changed my life and I want to bring this to your attention now too.
By doing this, I realised that most roads to turning around symptoms of menopause, including worsening anxiety, heart health, weight gain and immune health, led to better understanding of the impact of inflammatory changes that are all part and parcel of biological ageing in the female body.
Peri-menopause is now known as an inflammatory event, especially for our brain, nervous system and our muscles and liver. (McCarthy- & Raval, 2020).
There’s a new term in ageing and longevity science and this is the term ‘Inflammaging’. It refers to the process of ageing as setting up pockets of inflammation around the body.
I talk about this in the MyMT™ programmes and in my coaching groups, and reassure women that the starting point to begin to REDUCE inflammation is to focus on anti-inflammatory foods, especially Vitamin C and other anti-inflammatory lifestyle changes.
That’s the purpose of MyMT™ – to teach you how to do this.
Sleeping all night, restoring optimal cardiac health, improving blood pressure, reducing the build up of fats and inflammation in our liver and helping our joints to heal, are important issues to address as part of an anti-inflammatory strategy.
Once we achieve these changes, then we can move more freely and have the energy to get through whatever it is we must do in our day.
As we’ve all lived through some of the most profound changes to food and alcohol production over our lifetime and many women, now in their post-menopause years have been regular exercisers and have been following the high-intensity mantra, it’s important to also note that if women aren’t sleeping or are overweight, then higher intensity exercise may contribute to worsening inflammation in muscles and joints too.
One of the ways to help reduce the chronic inflammation that arrives as we move through menopause is to have a renewed focus on your Vitamin C intake.
Vitamin C is one of the most powerful anti-inflammatory nutrients available … and no, you don’t need expensive supplements, you just need lemons and oranges in your life instead. If you can’t tolerate these, then have apples.
The Quercetin in apples is a known immune-system enhancer. And yes, sleeping all night is crucial as well. This is because our cardiovascular and immune healing occurs overnight between the hours of 2-4am. This is so important for women if they are doing lots of exercise and therefore, stressing their heart, joints and muscles.
All too often, we have seen our mother’s generation experience changing joint health, arthritis and become more sedentary because their muscles and joints go into age-related decline.
When I began to look at menopause through the biological lens of ageing research and my own joints and muscles were aching during the day and giving me grief at night, I began to understand that my ageing heart, immune system and joints were craving Vitamin C. Not only does your skin need it because Vitamin C is a requirement in the collagen-repair pathway, but your immune system needs this powerful vitamin too.
Research from Otago University in New Zealand, supports the role that Vitamin C plays in our immune defense.
This mighty vitamin supports various cellular functions of the immune system as well as supporting epithelial barrier function against pathogens in your skin (Carr & Maggini, 2017). Don’t forget that your skin is your largest organ and because it is full of oestrogen receptors that lose the role of oestrogen as we move into post-menopause, we need the Vitamin C to help to protect us against environmental oxidative stress.
Every day as part of our normal metabolism, the human body loses approximately 3% of its Vitamin C. If you are exercising intensely, then you can double this loss, assuming that your intake of Vitamin C is low. Vitamin C is a ‘first-line’ anti-oxidant acting as a ‘free radical scavenger’.
In non-technical terms, this means that Vitamin C is an important nutrient that helps to protect cells from the damage caused by harmful substances (called ‘free radicals’). Vitamin C is also important for iron absorption, collagen repair, sleeping all night and it helps to make hormones too.
The highest concentrations of collagen in the human body are found in tendons, skin, artery walls, the cornea in the eyes, the endomysium (this is the sheath which surrounds muscle fibres which gets tight as we lose oestrogen), cartilage and the organic part of bones and teeth.
Can you see where I am going here with your symptoms? Yes, your heart, gut, skin, muscles, tendons and eyes (especially if you are on your cell phone, computer or other technology every day) all need Vitamin C.
But there’s more to the role of Citrus juices specifically. As Miles & Calder (2021) explain,
“In humans, orange juice was shown to limit the post-prandial (after a meal) inflammation inudced by a high-fat-high-carbohydrate meal. Consuming orange juice daily for a period of weeks has been reported to reduce markers of inflammation, including C-reactive Protein (C-rP).”
Citrus fruit juices contain a wide range of micronutrients (vitamins and minerals) and bioactive compounds. Several of these compounds are now known to be important in immune function support. These compounds are called poly-phenols. Oranges, (including blood oranges), lemons, grapefruits, limes, and tangerines also contain different polyphenols that help to reduce inflammation.
In recent years, there has been increasing public interest in plant antioxidants, thanks to the potential anti-carcinogenic (anti-cancer) and cardio-protective (heart protective) actions influenced by their biochemical properties.
Vitamin C is well known as an important anti-oxidant and anti-inflammatory nutrient. The pulp and juice from lemons and limes are rich sources of Vitamin C. So, not only are lemons an important source of Vitamin C, but so too are blood oranges.
I first came across the literature on blood oranges when I read historian and food scientist, Helena Attlee’s book called ‘The Land Where Lemons Grow’. Travelling around Italy, she writes about the cultural and scientific interest in lemons, oranges and mandarins and relates this to numerous health benefits. Blood oranges are grown in Sicily in Italy, Spain and California (I’ve only just recently found them here in New Zealand).
The red (or blood) orange (Citrus sinensis) is a pigmented sweet orange variety typical of eastern Sicily (southern Italy). Research supports their huge contribution to an anti-inflammatory and heart-protective as well as anti-cancer diet. Blood oranges help enzymes to fight harmful free-radicals in the body.
It’s why women on my programmes know that one of the most important kitchen appliances or implements that they need in their kitchen is either a good quality juicer, or a hand-squeezed one instead.
If you look at the symptoms of lowered Vitamin C, you will see a host of issues from low energy, to easy bruising, to painful, swollen joints, to skin problems and more.
All factors that get gathered up as ‘menopause symptoms’ and are then normalised within an ‘age-decline’ paradigm. But when you actually make the time to get the right nutrients into your body (and not necessarily from supplements), then surprisingly, many of these symptoms go away. Funny that.
It was a long time before anyone understood why lemon juice cured diseases such as scurvy. But as nutrition research expanded and the role of all the vitamins were discovered, it was assumed that the scurvy was cured when sailors had enough ascorbic acid (Vitamin C).
The first clinical trials were undertaken on guinea pigs and in 1927, a Hungarian biochemist, isolated a compound called hexuronic acid and the guinea pigs fed this compound thrived, whilst the other group developed scurvy.
The experiment demonstrated that yes indeed that the compound (now called Ascorbic Acid or Vitamin C) in lemon juice was the key ingredient. So began a new understanding about Vitamin C and a Nobel Prize for the Hungarian biochemist for his work in 1937.
"The role of the immune system is to protect the individual against pathogenic organisms including bacteria, viruses, fungi and parasites. Bioactive components that reduce inflammation are present in high amounts in sweet oranges, lemons, limes and tangerines." [Miles & Calder, 2021]
One of the greatest concerns that I have for women going into and through menopause is that we are being subjected to so many supplements that don’t necessarily get to the heart of our symptoms. Don’t even mention the financial cost of these.
I used to take a variety of supplements too. But what I know better now is that all of these supplements were not getting to the heart of the issues with our symptoms.
We experience many of our symptoms because we aren’t sleeping and because, as we transition through menopause, our joints, tendons, muscles and other organs are ageing. This sets up inflammatory changes in our body, making our body feel stressed.
That’s why we need to work with our body so that we resist the acceleration of inflammation and ageing. One of these things is having Vitamin C – and no, we don’t necessarily need it in a supplement, because an ageing gut doesn’t recognise supplements. Our gut recognises real food and natural juices from fruit.
There are long traditions of healthy ageing in Mediterranean countries including the Blue Zone’s countries where some of the worlds healthiest and longest-living men and women live.
I’ve based most of the information in the MyMT™ programmes in women’s healthy ageing research.
In many countries where women live to a long age, and experience less cardiac, joint and immune health problems, there is a focus on growing citrus fruits such as lemon and orange trees. As such, research on citrus fruits has gathered momentum over the decades.
It’s now well evidenced that Bergamot oil has antiseptic and anti-bacterial qualities and is also used as an anti-depressant.
Lemons are also well evidenced as being great for heart and liver health. I find it interesting that poor liver health, cardiac health, immune system concerns and depression are all recognised symptoms in menopause.
It’s really important that we all understand how to look after ourselves as we transition through this important life-stage. For many of us, it’s also time to turn-back-the clock and get our body feeling healthy again.
The information you need is in the powerful MyMT™ online coaching programmes – my passion is to help women understand what to change with regard to their lifestyle habits and routines to match our changing hormonal environment in menopause. When you’re ready, I hope you can join me. And yes, you will be encouraged to increase your Vitamin C intake!
If you aren’t quite ready to join me on either of my 12 week programmes, then start with my 2 hour Masterclass on Menopause webinar … and yes, you can ‘pause’ me anytime you like and you have access for 3 months. I tell you about it in the video below.
References:
Attlee, H. (2014). The land where lemons grow. Penguin Books: London, UK
Bani S, Hasanpour S, Farzad Rik L, Hasankhani H, Sharami SH. The effect of folic Acid on menopausal hot flashes: a randomized clinical trial. J Caring Sci. 2013 Jun 1;2(2):131-40. doi: 10.5681/jcs.2013.016.
Carr, A. C., & Maggini, S. (2017). Vitamin C and Immune Function. Nutrients, 9(11), 1211. https://doi.org/10.3390/nu9111211
Duarte, Amílcar & Fernandes, Jacinta & Bernardes, João & Miguel, Graça, 2016. “Citrus As A Component Of The Mediterranean Diet. Journal of Tourism, Sustainability and Well-being, vol. 4(4), 289-304.
Kato, Y., Domoto, T., Hiramitsu, M. et.al (2014). Effect of blood pressure on daily lemon ingestion and walking. Journal of Nutrition and Metabolism, Article ID 912684, 1-6
Mann, J. & Trusswell, S. (2007). Essentials of Human Nutrition. Oxford University Press: London, UK
McCarthy M. & Raval A. (2020). The peri-menopause in a woman’s life: a systemic inflammatory phase that enables later neurodegenerative disease. J Neuroinflammation, 23;17(1):317. doi: 10.1186/s12974-020-01998-9. PMID: 33097048; PMCID: PMC7585188.
Miles E. & Calder P. (2021). Effects of citrus fruit juices and their bioactive components on inflammation and immunity: A narrative review. Front Immunol. 12:712608. doi: 10.3389/fimmu.2021.712608. PMID: 34249019; PMCID: PMC8264544.
Naureen Z, Dhuli K, Donato K, Aquilanti B, Velluti V, Matera G, Iaconelli A, Bertelli M. Foods of the Mediterranean diet: citrus, cucumber and grape. J Prev Med Hyg. 2022 Oct 17;63(2 Suppl 3):E21-E27. doi: 10.15167/2421-4248/jpmh2022.63.2S3.2743.
Pullar, J., Carr, A. & Vissers, M. (2017). The roles of Vitamin C in skin health. Nutrients (9), 866, 1-27.
Reynolds EH. Folic acid, ageing, depression, and dementia. BMJ. 2002 Jun 22;324(7352):1512-5. doi: 10.1136/bmj.324.7352.1512.
Schwingshackl L, Morze J, Hoffmann G. Mediterranean diet and health status: Active ingredients and pharmacological mechanisms. Br J Pharmacol. 2020 Mar;177(6):1241-1257.
