25. Hall, W. L., et al. (2005). Soy-isoflavone-enriched foods and inflammatory biomarkers of cardiovascular disease risk in postmenopausal women: Interactions with genotype and equol production. Am J Clin Nutr, 82 (6), 1260–1268.
26. Desrochesm, S., et al. (2004). Soy protein favorably affects LDL size independently of isoflavones in hypercholesterolemic men and women. J Nutr, 134 (3), 574–579; Nagata, C., et al. (2003). Soy product intake is inversely associated with serum homocysteine level in premenopausal Japanese women. J Nutr, 133 (3), 797–800.
27. Food & Drug Administration, U.S. Department of Health and Human Services (1999). FDA talk paper: FDA approves new health claim for soy protein and coronary heart disease (T99-48).
28. William, K. (Nov. 1997). Interactive effects of soy protein and estradiol on arterial pathobiology. American Heart Association annual scientific sessions, Orlando, FL.
29. Shao-Hua, L., et al. (2010). Effect of oral isoflavone supplementation on vascular endothelial function in postmenopausal women: A meta-analysis of randomized placebo-controlled trials. Am J Clin Nutr, 91 (2), 480–486.
30. Alexandersen, P., et al. (2001). Ipriflavone in the treatment of postmenopausal osteoporosis: A randomized controlled trial. JAMA, 285 (11), 1482–1488.
31. Roudsari, A. H., et al. (2005). Assessment of soy phytoestrogens’ effects on bone turnover indicators in menopausal women with osteopenia in Iran: A before and after clinical trial. J Nutr, 4, 30.
32. Cotterchio, M., et al. (2006). Dietary phytoestrogens intake is associated with reduced colorectal cancer risk. J Nutr, 136 (12), 3046–3053.
33. Bennink, M. R., Thiagarajan, L. D., et al. (Sept. 1999). Dietary soy is associated with decreased cell proliferation rate and zone in the colon mucosa of subjects at risk for colon cancer. Presented at the American Institute for Cancer Research Meeting, as reported on Reuters Health News Service.
34. Ward, H. A., et al. (2010). Breast, colorectal, and prostate cancer risk in the European Prospective Investigation into Cancer and Nutrition—Norfolk in relation to phytoestrogen intake derived from an improved database. Am J Clin Nutr, 91 (2), 440–448.
35. Bruce, B., Spiller, G. A., & Holloway, L. (Apr. 15–18, 2000). Soy isoflavones do not have an anti-thyroid effect in postmenopausal women over 64 years of age. Experimental Biology, San Diego, CA. Health Research and Studies Center, Los Altos, CA 94022; Palo Alto VA Health Care System, Palo Alto, CA 94034; Duncan, A. M., et al. (1999). Soy isoflavones exert modest hormonal effects in premenopausal women. J Clin Endocrinol Metab, 84 (1), 192–197; Duncan, A. M., et al. (1999). Modest hormonal effects of soy isoflavones in postmenopausal women. J Clin Endocrinol Metab, 84 (10), 3479–3484.
36. Albertazzi, P., et al. (1998). The effect of dietary soy supplementation on hot flashes. Obstet Gynecol, 91, 6–11.
37. Doerge, D. R., & Sheehan, D. M. (2002). Goitrogenic and estrogenic activity of soy isoflavones. Environ Health Perspect, 110 (suppl.), 349–353; Bruce, B., Messina, M., & Spiller, G. A. (2003). Isoflavone supplements do not affect thyroid function in iodine-replete postmenopausal women. J Med Food, 6, 309–316; Messina, M., & Redmond, G. (2006). Effects of soy protein and soybean isoflavones on thyroid function in healthy adults and hypothyroid patients: A review of the relevant literature, Thyroid, 16, 249–258.
38. Council for Responsible Nutrition (June 17, 2009). International researchers convene meeting on isoflavones. Press release, available online at www.npicenter.com/anm/anmviewer.asp?a=24304&print=yes.
39. Margaret Ritchie, Ph.D. (June 2009). Personal communication.
40. Albertazzi, P., et al (1998). Op. cit.
41. Basaria, S., et al. (2009). Effect of high-dose isoflavones on cognition, quality of life, androgens, and lipoprotein in post-menopausal women. J Endocrinol Invest, 32 (2), 150–155.
42. Handayani, R., et al. (2006). Soy isoflavones alter expression of genes associated with cancer progression, including interleukin-8, in androgenindependent pc-3 human prostate cancer cells. J Nutr, 136 (1), 75–82; Thelen, P., et al. (Oct. 20, 2005). Pharmacological potential of phytoestrogens in the treatment of prostate cancer. Urologe A [epub ahead of print; German]; Sonn, G. A., Aronson, W., & Litwin, M. S. (2005). Impact of diet on prostate cancer: A review. Prostate Cancer Prostatic Dis, 8 (4), 304–310.
43. Aldercreutz, H., et al. (1986). Determination of urinary lignans and phytoestrogen metabolites, potential antiestrogens and anticarcinogens in urine of women on various habitual diets. J Steroid Biochem, 25 (5B), 791–797.
44. Aldercreutz, H. (1984). Does fiber-rich food containing animal lignan precursors protect against both colon and breast cancer? An extension of the “fiber hypothesis.” Gastroenterology, 86 (4), 761–764; Jenab, M., et al. (1996). The influence of flaxseed and lignans on colon carcinogenesis and beta-glucuronidase activity. Carcinogenesis, 17 (6), 1343–1348; Johnstone, P. V. (1995). Flaxseed oil and cancer: Alpha-linolenic acid and carcinogenesis. In S. C. Cunnane & L. U. Thompson (eds.), Flaxseed in Human Nutrition. Champaign, IL: AOCS Press; Serraino, M., et al. (1991). The effect of flaxseed supplementation on early risk markers for mammary carcinogenesis. Cancer Lett, 60, 135–142; Serraino, M., et al. (1992). The effect of flaxseed supplementation on the initiation and promotional stages of mammary tumorigenesis. Nutr Cancer, 17, 153–159.
45. Lampe, J. W., et al. (1994). Urinary lignan and isoflavonoid excretion in premenopausal women consuming flaxseed powder. Am J Clin Nutr, 60, 122–128; Mousavi, Y., et al. (1992). Enterolactone and estradiol inhibit each other’s proliferative effect on MCF and breast cancer cells in culture. J Steroid Biochem Mol Biol, 41, 615–619.
46. Bierenbaum, M. L., et al. (1993). Reducing atherogenic risk in hyperlipemic humans with flaxseed supplementation: A preliminary report. J Am College Nutr, 12 (5), 501–504.
47. Micallef, M., et al. (2009). Plasma n-3 polyunsaturated fatty acids are negatively associated with obesity. Br J Nutr, 102 (9), 1370–1374.
48. Parra, D., et al. (2008). A diet rich in long chain omega-3 fatty acids modulates satiety in overweight and obese volunteers during weight loss. Appetite, 51 (3), 676–680.
49. Maes, M., et al. (2000). In humans, serum polyunsaturated fatty acid levels predict the response of proinflammatory cytokines to psychologic stress. Biol Psychiatry, 47 (10), 910–920.
50. Bougnoux, P., et al. (2009). Improving outcome of chemotherapy of metastatic breast cancer by docosahexaenoic acid: A phase II trial. Br J Cancer, 101 (12), 1978–1985.
51. Middleton, E., & Kandaswami, C. (Nov. 1994). Potential health-promoting properties of citrus bioflavonoids. Food Technology, 115–119.
52. I am indebted to Maureen Tsao, M.Ac., and her mother, Fern Tsao, for their assistance in preparing this section on Traditional Chinese Medicine and menopause.
53. Vernejoul, P., et al. (1985). Étude des meridiens d’acupuncture par les traceurs radioactifs [The study of acupuncture meridians using radioactive tracers]. Bull Acad Natl Méd, 169 (7), 1071–1075.
Chapter 7: The Menopause Food Plan
1. Fine, J. T., Colditz, G. A., Coakley, E. H., Moseley, G., Manson, J. E., Willett, W. C., & Kawachi, I. (1999). A prospective study of weight change and health-related quality of life in women. JAMA, 282, 2136–2142.
2. Dr. Atkins’ New Diet Revolution was the number-one bestselling diet book of the late 1990s. The research supporting the book is sound, though controversial.
3. A clinical study of the Atkins diet presented at the Southern Society of General Internal Medicine in New Orleans (1999) by lead researcher Dr. Eric Westman, assistant professor of medicine at North Carolina’s Duke University, failed to show any adverse effects on kidney and liver function in the forty-one mildly obese study subjects who limited their carbohydrate intake to less than 20 g per day. They also took a multivitamin-mineral and fish oil supplement and exercised three times per week. The Durham study lasted for four months and test subjects dropped an average of twenty-one pounds each. Cholesterol levels dropped 6.1 percent and trigly
cerides dropped by 40 percent, while protective HDL cholesterol levels increased by about 7 percent. Blood pressure and body composition also underwent favorable changes. The results of the Durham study were supported in a second, larger study of 319 overweight or obese patients conducted over a period of one year at the Atkins Center for Complementary Medicine in New York City. Results were similar, laying to rest any safety concerns. Under many perimenopausal conditions, however, even the Atkins diet may not be as effective as it is during other life stages, nor as it is for men.
4. Fukagawa, N. K., et al. (1990). Effect of age on body composition and resting metabolic rate. Am J Physiol, 259, E233; Ganesan, R. (1995). Aversive and hypophagic effects of estradiol. Physiol Behav, 55 (2), 279–285.
5. Sieri, S., et al. (2010). Dietary glycemic load and index and risk of coronary heart disease in a large Italian cohort: The EPICOR study. Arch Intern Med, 170, 640–647.
6. Welsh, J. A., et al. (2010). Caloric sweetener consumption and dyslipidemia among US adults. JAMA, 303, 1490–1497.
7. Groff, J. L., & Gropper, S. (2000). Advanced Nutrition and Human Metabolism, 147, 252, 447. Belmont, CA: Wadsworth.
8. Reaven, G. M. (2000). Syndrome X: Overcoming the Silent Killer That Can Give You a Heart Attack. New York: Simon & Schuster.
9. Eriksson, J., et al. (1989). Early metabolic defects in persons at increased risk for non-insulin-dependent diabetes mellitus. N Engl J Med, 321, 337–343; Lillioja, S., et al. (1993). Insulin resistance and insulin secretory dysfunction as precursors of non-insulin-dependent diabetes mellitus: Prospective studies of the Pima Indians. N Engl J Med, 329, 1988–1992.
10. Reaven, G. M. (1988). Role of insulin resistance in human disease. Diabetes, 37, 1595–1607; Zavaroni, I., et al. (1989). Risk factors for coronary artery disease in healthy persons with hyperinsulinemia and normal glucose tolerance. N Engl J Med, 320, 702–706.
11. Fuh, M. M., et al. (1987). Abnormalities of carbohydrate and lipid metabolism in patients with hypertension. Arch Intern Med, 147, 1035–1038; Zavaroni, I., et al. (1987). Evidence that multiple risk factors for coronary artery disease exist in persons with abnormal glucose tolerance. Am J Med, 83, 609–612.
12. Nestler, J., et al. (1999). Ovulatory and metabolic effects of D-chiroinositol in the polycystic ovary syndrome. N Engl J Med, 340, 1314–1320.
13. Kazer, R. (1995). Insulin resistance, insulin-like growth factor 1 and breast cancer: A hypothesis. Int J Cancer, 62 (4), 403–406.
14. Bruning, P. F., Bonfrer, J. M., van Noord, P. A., Hart, A. A., de Jong-Bakker, M., & Nooijen, W. J. (1992). Insulin resistance and breast-cancer risk. Int J Cancer, 52 (4), 511–516; Seely, S. (1983). Diet and breast cancer: The possible connection with sugar consumption. Med Hypotheses, 11, 319–327.
15. Bruning, P. F., et al. (1992). Op. cit.
16. Kazer, R. (1995). Op. cit.
17. Micha, R., et al. (2010). Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: A systematic review and meta-analysis. Circulation, 121, 2271–2283.
18. Huang, Z., Willett, W. C., Colditz, G. A., Hunter, D. J., Manson, J. E., Rosner, B., Speizer, F. E., & Hankinson, S. E. (1999). Waist circumference, waist:hip ratio, and risk of breast cancer in the Nurses’ Health Study. Am J Epidemiol, 150 (12), 1316–1324. Dr. Zhi-ping Huang from the Harvard School of Public Health and his colleagues examined the association between waist circumference and waist-to-hip ratio with subsequent risk for breast cancer. Those with a waist circumference between 32 and 35.9 inches had a breast cancer risk 1.5 times greater than normal, while those with a waist circumference between 36 and 55 inches had a risk that was almost twice that of women whose waists were between 15 and 27.9 inches. Abdominal adiposity is associated with an excess of androgen and increased conversion of androgen to estrogen in fatty tissue. The research also concluded that “all postmenopausal hormone users were at increased risk of breast cancer regardless of central obesity.”
19. Wild, R. D., et al. (1985). Lipoprotein lipid concentrations and cardiovascular risk in women with polycystic ovarian syndrome. J Clin Endocrinol Metab, 61, 946; Rexrode, K., et al. (1998). Abdominal adiposity and coronary heart disease in women. JAMA, 280, 1843–1848; Gillespie, L. (1999). The Menopause Diet: Lose Weight and Boost Your Energy, 18. Beverly Hills, CA: Healthy Life Publications.
20. Adams, K. F., et al. (2006). Overweight, obesity, and mortality in a large prospective cohort of persons age 50 to 71 years old. N Engl J Med, 355 (8), 763–778.
21. Jia, H., & Lubetkin, E. I. (2010). Trends in quality-adjusted life-years lost contributed by smoking and obesity. Am J Prev Med, 38, 138–144.
22. Huang, Z., et al. (1999). Op. cit.
23. Moriyama, C. K., et al. (2008). A randomized, placebo-controlled trial of the effects of physical exercises and estrogen therapy on health-related quality of life in postmenopausal women. Menopause, 15, 613–618.
24. Physical Activity Guidelines Advisory Committee (2008). Physical Activity Guidelines Advisory Committee Report, 2008. Washington, D.C.: U.S. Department of Health and Human Services, 2008. Available online at www.health.gov/paguidelines/Report/pdf/CommitteeReport.pdf.
25. Lee, I. M., et al. (2010). Physical activity and weight gain prevention. JAMA, 303, 1173–1179.
26. P. T. Campbell et al. (2009). A yearlong exercise intervention decreases CRP among obese postmenopausal women. Med Sci Sports Exerc, 41 (8), 1533–1539.
27. Hackney, M. E., et al. (2007). Effects of tango on functional mobility in Parkinson’s disease: A preliminary study. J Neurol Phys Ther, 31, 173–179.
28. Hackney, M. E., et al. (2009). Health-related quality of life and alternative forms of exercise in Parkinson disease. Parkinsonism Relat Disord, 15, 644–648.
29. Belluscio, D. O., & Ripamonte, L. E. (2004). Utility of an oral formulation of hCG for obesity treatment: A double-blind study. Oral hCG Research Clinic; available online at www.indexmedico.com/obesity/hcg.htm; Belluscio, D. O., Ripamonte, L. E., & Wolansky, M. (2009). Utility of an oral presentation of hCG (human choriogonadotropin) for the management of obesity: A double-blind study. Oral hCG Research Clinic; available online at http://hcgobesity.org/hcg_obesity_study.htm.
30. Gillespie, L. (1999). The Menopause Diet Mini Meal Cookbook, 3. Beverly Hills, CA: Healthy Life Productions.
31. Michnobicz, J. (1987). Environmental modulation of estrogen metabolism in humans. Int Clin Nutr Rev, 7, 169–173; Anderson, K. E. (1984). The influence of dietary protein and carbohydrate on the principal oxidative biotranformations of estradiol in normal subjects. J Clin Endocrinol Metab, 59 (1) 103–107.
32. Larsen, T. M., et al. (2010). Diets with high or low protein content and glycemic index for weight-loss maintenance. N Engl J Med, 363, 2101–2113.
33. Ludvigsson, J. F., et al. (2009). Small-intestinal histopathology and mortality risk in celiac disease, JAMA, 302, 1171–1178.
34. Cutler, R. G. (1984). Carotenoids and retinol: Their possible importance in determining longevity of primate species. Proc Natl Acad Sci, 81, 7627–7631.
35. Murakoshi, M., et al. (1992). Potent preventive action of alpha-carotene against carcinogenesis. Cancer Res, 52, 6583–6587.
36. Franceschi, S., et al. (1994). Tomatoes and risk of digestive-tract cancers. Int J Cancer, 59, 181–184.
37. Opara, E. C., et al. (1996). L-glutamine supplementation of a high fat diet reduces body weight and attenuates hyperglycemia and hyperinsulinemia in C57BL/6J mice. J Nutr, 126 (1), 273–279; Rogers, L. L., et al. (1955). Voluntary alcohol consumption by rats following administration of glutamine. J Biol Chem, 214, 503–507.
38. Park, J. E., et al. (2010). Stevia rebaudiana Bertoni extract supplementation improves lipid and carnitine profiles in C57BL/6J mice fed a high-fat diet. J Sci Food Agric, 90, 1099–1105.
39. Mozaffarian, D., et al. (2010). Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: A systematic review and meta-analysis of ran
domized controlled trials. PLos Med, 7, e1000252.
40. Hornstra, G. (2000). Essential fatty acids in mothers and their neonates. Am J Clin Nutr, 71 (suppl.), 1262S–1269S.
41. I was introduced to this concept by Drs. Mary Dan Eades and Michael Eades, authors of Protein Power (New York: Bantam, 1996), and have found it to be true. Remember, however, that it is possible to produce too much insulin from overeating anything and also during times of stress—even when there aren’t any carbohydrates around.
42. Christie, D. R., et al. (Apr. 30, 2010; epub ahead of print). Metabolic effects of soy supplementation in postmenopausal Caucasian and African American women: A randomized, placebo-controlled trial. Am J Obstet Gynecol.
43. Strand, R. (2005). Healthy for Life: Developing Healthy Lifestyles That Have a Side Effect of Permanent Fat Loss, 228–229. Rapid City, SD: Real Life Press.
44. Hwang, J. H., et al. (2010). Dietary supplements reduce the risk of cervical intraepithelial neoplasia. Int J Gynecol Cancer, 20, 398–403.
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