Heart Disease during Perimenopause and Menopause: An Omega-3 rich diet can reduce your risk

Key Takeaways:

- Heart disease is the leading cause of death in women globally, and cardiovascular risk rises significantly during the menopause transition.

- Declining estrogen affects cholesterol, blood vessels, inflammation, and blood clotting, increasing cardiovascular risk.

- Lifestyle patterns during midlife; sedentary lifestyle, poor diet, low protein intake, lack of resistance training and abdominal fat gain, compound this risk.

- Omega-3 fatty acids help protect heart health by lowering triglycerides, reducing inflammation, improving blood vessel function, and supporting healthy blood pressure.

- A Mediterranean-style diet rich in omega-3 foods, lean protein, fibre, and regular exercise can dramatically reduce cardiovascular risk during midlife.

Perimenopause and Menopause are a time of great change for a woman’s body and mind. Changing eating habits, patterns and goals becomes a necessity to meet the specific nutrients that are required during this life-stage. Heart disease remains the number one killer of women in the world, even when you combine mortality rates from cancer and trauma. This isn’t talked about enough, and many women put heart health on the backburner as they deal with compound symptoms, fatigue and frustration.

Heart Health & Inflammation:

Estrogen helps support healthy cholesterol levels and blood vessel function—so when it declines, cardiovascular risk increases. This makes cardiovascular risk a real concern as women enter menopause and estrogen levels drop, inflammatory markers increase and so does risk of heart attack and stroke. Drops in estrogen and progesterone negatively affect blood vessels because they begin to constrict more. Coagulation proteins in the blood increase because the liver compensates, which increases the chance of developing a clot.

Cholesterol and blood sugar levels can spike, as can inflammation in the architecture of the cardiovascular system. All of this can be compounded by smoking, poor fitness, and larger waist circumference (meaning high adipose fat) around the belly and insulin resistance, creating a deadly metabolic storm.

Poor Diet Planning:

So many women in Perimenopause are also mothers, and / or deep into the height of career responsibilities. Combine that with possible care giving to elders and spouses, there is often a lack of proper nutrient-rich eating happening daily. Ultra-processed foods, high in calories but devoid of nutrition increase inflammatory responses and fat around the abdomen. Lack of protein in the diet causes muscles to whittle away! And low fibre creates a perfect storm for unwanted debris and metabolites to be left hanging around in the gut affecting mood and digestion.

Lack of Exercise:

The heart is a muscle like any, and if it is not properly exercised, it will not work optimally. Lack of exercise (beyond commuter walking), meaning that which elevates the hart rate up into Zone 4 and 5 of training, even in tiny bursts, is often sorely lacking among women in general. Societal and cultural notions, family expectations of care, a lack of time and resources (many women feel guilt and shame about exercise!) Without exercise, and especially stimulating muscle growth through resistance training, women lose lean tissue at a rapid rate, creating a cycle of increased abdominal fat gain and muscle loss.

How Omega-3s help reduce Cardiovascular Risk:

- Lower triglycerides (sometimes supplements are even prescribed by MDs at higher levels to combat this).
- Support healthy blood pressure through patent blood vessels and arteries, reduced arterial inflammatory damage.
- Reduce systemic inflammation, including in the brain and gut.
- Improve endothelial (blood vessel) function, meaning better efficiency of blood flow and nitric oxide for improved exercise tolerance, and less arterial calcification.
- Improve exercise-performance and muscle protein synthesis when eaten with protein-rich foods.

Bottom Line:

Protecting your heart may not be top-of-mind as a woman in perimenopause, but it must be the top priority for a resilient strong mid-life; here are 5 ways to start the process:

1. Reduce or remove as much Ultra-processed food as possible.

2. Eat a diet that follows the pillars of the Mediterranean Diet. Lean proteins are a key pillar, and eggs are an excellent source of highly-biologically valuable protein, with a low saturated fats-to-protein ratio, a perfect choice within the Mediterranean eating plan. Liquid egg whites can add a boost of saturated-fat free protein to any dish!

3. Increase your Omega-3 fats daily.

4. Build meals and snacks with protein as the foundation.

5. Increase Moderate to Intense Cardio (short bursts) and resistance training; no gym required (use validated free online resources at home or work with a professional).

The information outlined in this article is supported by the following research and publications .


*** For additional information about menopause and perimenopause read our insightful articles on the importance of protein as well as the benefits of incorporating Omega-3 Fatty Acids into your diet. ***

Nishta Saxena

MSc, Registered Dietitian

@nishtasaxenard