MyMT™ Blog

MyMT™ Education: Lifestyle evidence to improve menopause anxiety and cognition.

Despite the overwhelming prevalence of anxiety in modern society, medications often fail to achieve complete symptom resolution. We highlight the roles of the microbiome and inflammation as influencers of anxiety, and discuss the evidence base for specific nutritional interventions.’ [Norwitz and Naidoo, 2021]

Most of us know the feelings of anxiety don’t we? The elevated heart rate, holding our breath or breathing more rapidly, and the feeling that there is so much more to do in our day that we hurry from one task to another.

We talked about anxiety levels of women and this new study in my Health Practitioners zoom call in the previous course.

Some of the Practitioners were presenting their case studies and one of them spoke about her client who was stressed and always busy – from early morning to night-time, she was active and busy.

As her client hurried from one task to another, she told the Practitioner she didn’t have time to eat. Her food recall also suggested this as well. There wasn’t much written down. The client mainly lived on soy lattes and cups of tea with sugar, as well as lots of supplements to try and reduce her hot flushes and induce her sleep. 

But here’s the thing.

Those menopause supplements weren’t helping, nor were they giving her the nutrients that her brain and nervous system needed to help reduce her anxiety levels.

Nor was she eating enough omega 3 fats and certain nutrients, such as B-vitamin rich food and calcium-rich food, to not only give her the energy that she needed to get through her day, but to calm her anxiety levels as well as to reduce inflammatory changes that arrive with an over-stimulated gut. 

Many of us forget that the gut bears the brunt of our anxiety and worry. Changes in the gut microbiome (dysbiosis) and inflammation with higher anxiety levels was a leading finding in the study I was sharing with the Practitioners. 

We all have various sources of worry and concern that cause us to become more anxious don’t we?

However, as women arrive in their menopause transition, anxiety is heightened with the ageing of the nervous system and the decline of oestrogen on receptors situated on the outer myelin sheath of the nerves. This also occurs on one of the longest nerves in the body – the vagus nerve. 

The vagus nerve represents the main component of the parasympathetic nervous system.

As such, it oversees a vast array of crucial bodily functions, including control of mood, immune response, digestion, and heart rate. (Breit et al, 2018). If your clients are experiencing increased anxiety and brain-fog or cognition problems, then they cannot ignore the vagus nerve, nor their gut health, nor the accumulation of inflammatory changes on the nerves. 

It was back in the 1950s that those studying human anatomy and ageing changes, noted that ‘starting in the fourth decade of life and continuing into the fifth decade, there is an increase in connective tissue and a reduction in the patency of the blood vessels.

With this gradual reduction in blood supply and increase in connective tissue, there seems to be a gradual alteration and reduction of the nerve fibres, especially the larger ones. Beginning in the fifth decade of life, there is a continual decrease in conduction velocity (speed) in the nervous system.’ [Wilcox, 1956].

If your clients feel that they are a bit wired and their anxiety levels are high, or they feel that they are losing their memory, then reassure them that slowing down helps enormously, as does certain changes to their lifestyle – including nutritional changes and exercise changes. Their nervous system is ageing.

Menopause, is the biological gateway to ageing. 

When I began to explore the ageing research during and after the menopause transition, the evidence indicated that neurological changes in the brain, moved beyond the reproductive hormones. It helped me to move towards better understanding of the relevance of inflammatory changes that arrive in menopause and how we can mitigate these changes, thereby reducing cognitive symptoms.

Chronic inflammation is a feature of numerous disorders and diseases of the neurological system, including anxiety. (Norwitz & Naidoo, 2021]. Hence, reigning in your anxiety levels takes more than pills. It also involves specific nutrients that feed the brain, as well as improving gut health and sleep.  

The brain is part of the nervous system. It is the ‘mother-ship’ for nerve function. Every single nerve originates from the brain.

A typical day for most women is full of anxiety-inducing events. Fort hose in menopause, the decline in oestrogen attaching to receptors in the brain, may compound levels of anxiety, as well as hot flushes. 

Both the brain and the nerves rely on oestrogen to help with nerve conduction. This is also why the addition of HRT helps many women feel calmer and reduces their anxiety levels. 

Some herbs do the same and in new research, turmeric (curcumin) gets a special mention as do other nutritional strategies, including omega 3 fats, which I share with you below.

Stress Management is also Important

Negative emotions can shift the microbial ecosystem in your gut by the release of stress hormones which impact the nerves which control our gut and digestive system.

As such, individuals suffering from anxiety disorders and other stress disorders exhibit elevated levels of inflammatory markers in the circulation, mentions Norwitz and Naidoo  (2021).

Whilst the mechanisms as to how this occurs vary, the authors suggest that modulating and managing inflammatory changes in our gut which contribute to heightened anxiety disorders, require specific changes to the diet.   

These changes include the following: 

  • Get your clients off refined sugar, especially high fructose corn syrup. Sugar attaches to molecules throughout the body and can increase neuro-(nerve) inflammation. Compared with glucose, fructose is
    more rapidly converted into triglycerides and causes fatty liver and body weight gain as well, as detrimental cognitive changes in the brain due to inflammation. (Iizuka, 2021).
  • Remove artificial sweeteners. Administration of artificial sweeteners to animals have been known to increase anxiety through increasing the production and secretion of stress hormones. Aspartame in particular gets a mention, as it can block the transformation of dopamine and serotonin precursors in the brain and can increase the levels of excitatory nerve transmitters. This, according to the authors (Norwitz & Naidoo, 2021) may contribute to heightened anxiety. 
  • Help your clients find foods that are low gluten or gluten-free to reduce leaky gut syndrome. When it comes to anxiety and improving the reduction of neurological inflammation, gluten proteins may contribute to leaky-gut syndrome. 
  • Increase Omega 3 fats. The omega 3 fatty acids offer potent anti-inflammatory properties that not only support the microbiome and white adipose tissue that contributes to inflammation, but are known to support cognition and mental health. On the practical side, this includes extra virgin olive oil, fatty fish, such as mackerel, sardines and salmon ( Alaskan sockeye salmon gets a special mention in the research, as does krill oil).
  • Increase intake of Turmeric (Curcumin). Turmeric is one of the most heavily studied spices for brain health with its active ingredient, curcumin, explored in Alzheimer’s Disease, depression, anxiety-related disorders and anxiety itself. Whilst some studies have challenged the relevance of the health benefits of Turmeric due to differences in the bioavailability of this spice in humans when taken as a supplement, on the whole, if consumed in the of food and with black pepper as well as fats, then it may have benefits for those suffering from anxiety, due to changes in brain inflammatory pathways. 
  • Ensure your clients have their Vitamin D and Vitamin B levels  checked. Vitamin D is a neuro-steroid hormone that regulates neurotransmitters and neuro-trophins. It has anti-inflammatory, antioxidant, and neuroprotective properties. In the brain, Vitamin D regulates calcium balance which in turn assists nerve-transmitter levels. It also helps with transmission of mood hormones, dopamine and serotonin. It increases neurotrophic factors such as nerve growth factor which further promotes brain health.

Vitamin D is also known to have benefits to the gut microbiome, because it helps to reduce inflammation. I’m often talking about Vitamin D levels for women in menopause and getting these checked, because if your clients are deficient in this vital hormone (yes, it is now known as a hormone), then these low levels may be contributing to their heightened feelings of anxiety. 

Nutrition regulates brain function and anxiety disorders through not only nutrients passing directly through the gut-brain barrier, but also by influencing the gut microbiome and levels of inflammatory changes.

The gut microbiome and inflammation are inter-related and therefore, work in a two-way relationship with anxiety, brain-fog and depression disorders. Sleep is also important as is exercise, which I’ve talked about in the past.

This is why, for your midlife clients, who may be feeling anxious or forgetful, supporting them with specific nutritional approaches may be helpful and of course, they can also discuss pharmaceutical prescription with their GP too.

On the MyMT™ programmes, I talk a lot about anxiety in my coaching group. I’m always reminding women that menopause per se is not the issue or the problem.

All women go through this life-stage event.

When we stop worrying about our hormones and focus on how our body is ageing and changing as we enter our ‘third age’, then it becomes a game-changer in terms of understanding how to look after ourselves in midlife and beyond. It was for me too. 

I hope you can join me on any of the MyMT™ Education courses sometime to extend your knowledge in the area of menopause and lifestyle science. 

Dr Wendy Sweet (PhD)/ MyMT™ Founder/ Member: Australasian Society of Lifestyle Medicine. 

References: 

Breit S, Kupferberg A, Rogler G, Hasler G. Vagus Nerve as Modulator of the Brain-Gut Axis in Psychiatric and Inflammatory Disorders. Front Psychiatry. 2018 Mar 13;9:44. 

Fadó R, Molins A, Rojas R, Casals N. Feeding the Brain: Effect of Nutrients on Cognition, Synaptic Function, and AMPA Receptors. Nutrients. 2022 Oct 5;14(19):4137. doi: 10.3390/nu14194137. 

Grubić Kezele T, Ćurko-Cofek B. Neuroprotective Panel of Olive Polyphenols: Mechanisms of Action, Anti-Demyelination, and Anti-Stroke Properties. Nutrients. 2022 Oct 28;14(21):4533. 

Norwitz NG, Naidoo U. Nutrition as Metabolic Treatment for Anxiety. Front Psychiatry. 2021 Feb 12;12:598119. doi: 10.3389/fpsyt.2021.

Santiago JA, Potashkin JA. Physical activity and lifestyle modifications in the treatment of neurodegenerative diseases. Front Aging Neurosci. 2023 May 26;15:1185671. doi: 10.3389/fnagi.2023.1185671. 

Stephan, B., Wells, J., Brayne, C., Albanese, E & Siervo, M. Increased Fructose Intake as a Risk Factor For Dementia, The Journals of Gerontology: Series A, Volume 65A, Issue 8, August 2010, Pages 809–814, https://doi.org/10.1093/gerona/glq079

Sultan S, Taimuri U, Basnan SA, Ai-Orabi WK, Awadallah A, Almowald F, Hazazi A. Low Vitamin D and Its Association with Cognitive Impairment and Dementia. J Aging Res. 2020 Apr 30;2020:6097820.

Wilcox HH. Changes in nervous system with age. Public Health Rep (1896). 1956 Dec;71(12):1179-84. 

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