Part 2 – The Intersection of Menopause and Nutrition: A Weight-Inclusive Approach with Val Schonberg

Hola amigos! Welcome back!

Are you chasing a certain body weight? Did you know your body is supposed to change? Menopause may feel like something to fix and yet, “menopause is a process, not a disease.” Val Schonberg sits down with David to discuss the intersection of menopause and nutrition.

Highlights of this episode:

• Menopause and Disordered Eating
• Menopause and Weight Bias
• Intersection of Menopause and Nutrition
• Menopause and Weight Inclusive Approach to Health
• Body image and Menopause
• Cultivating Physical and Emotional Well-Being

Guest Bio: 

Val Schonberg MS, RD, CSSD, LD, NCMP, FAND, was born and raised in Nebraska, Val’s a Cornhusker at heart!  After graduating from the University of Nebraska-Lincoln, she went on to complete both her Master of Science degree in nutrition and dietetic internship at the University of Minnesota.  She is Board Certified as a Specialist in Sports Dietetics, a certified menopause practitioner by the North American Menopause Society, and a Fellow of the Academy of Nutrition and Dietetics.

Val has over fourteen years of experience treating all types of eating disorders while also specializing in sports nutrition, menopause, and women’s health. Prior to establishing her private practice, she worked as a clinical dietitian in the treatment of eating disorders.  In addition to her role as a lead clinical dietitian, she implemented and coordinated The University of Minnesota-The Emily Program Dietetic Internship program, the first ACEND accredited eating disorder dietetic internship in the country.

Although her practice has expanded to provide comprehensive nutrition services to individuals beyond those struggling with eating disorders, Val is passionate about eating disorder prevention and providing nutrition care to populations vulnerable to pathological eating problems, most notably with athletes and midlife women. She has worked as the consulting dietitian for the University of Minnesota Women’s Gymnastics team; and, has provided nutrition consulting and presentations for numerous dance, figure skating, gymnastics, and other sport organizations including the Minnesota Dance Medicine Foundation, the Wisconsin Association of Cheer/Pom Coaches and Just for Kix, a company providing dance programs in fourteen states. Currently, Val serves as the consulting dietitian for Emory Sports Medicine and Orthopedics and The Atlanta Ballet.

Episode Show Notes: 

This is Part 2 of last week’s episode about the Intersection of Menopause and Nutrition – you may want to listen to that too!

[02:52] The Intersection Menopause and Nutrition is Disordered Eating

At the intersection of menopause and nutrition, is disordered eating. Disordered eating steals the joy from eating and from our family and friend connections. Menopause is about change and disorder eating can disrupt this process negatively. At a time when you do not need to compromise your immune system, a restrictive diet is undereating, underfeeding your body. This leads to a poor immune system, which is very harmful for this life phase.

It is not recommended to lose weight after 65 years old. For our eating, we can prioritize nutritious foods without dieting. When women in menopause restrict calories, their body weight can adapt to lower calorie intake and then, body weight does not come down despite the calorie restriction. We don’t know what is happening in the body exactly when calorie restriction takes place in a body in menopause years. Val says that doctors recommending weight loss to anyone can be harmful and short sighted for a person’s health.

Organizations have done little research about menopause and disordered eating. For example, the North American Menopause Society has started to look into psychological disturbances, but they have not examined eating disorders. Eating disorder organizations have not tackled this population either, yet.

There is not data involving survivors of eating disorders being triggered by menopause, a major life change. The hope is that survivors already have tools to work with through this change. However, someone without a prior history, in an older age, may be more at a lost during these new changes.

[11:41] The Intersection Menopause and Nutrition is Weight Bias

At the intersection of menopause and nutrition, is weight preference and weight stigma. One study reported that a large majority of medical students have negative biases of people in large bodies. This bias has consequences for medical patients. For women in menopause, weight loss advice can be misleading because it is a myth that weight loss leads to less menopause symptoms. Maybe certain behaviors, like healthy eating and more exercise play a role in this, which is different than weight loss. This advice is void of trauma informed care, which is missing in most healthcare assessments.

The mammogram equipment does not work for many types of bodies, which can be a harmful experience for women.  Healthcare should be a safe space. Patients can learn how to advocate and speak up for their needs. Usually, providers are understanding and accommodating after they are informed. The harm from weight bias visits includes patient shame, discomfort, embarrassment, etc., resulting in folks is missing on important screenings and health care treatments. These experiences in traditional Western healthcare drives some people to naturopaths. The naturopath is a listening, sympathetic ear with alternative supplement treatments. Then, medical conditions will miss out on important early treatment, causing harm to patients.

[21:46] The Intersection Menopause and Nutrition is Managing Menopausal Symptoms

Hot flashes, night sweats, sleep disturbances—oh my! Val shares that soy foods can be a possible intervention due to the isoflavones within it. All plant foods have natural chemicals that can aid the body functions.

Balance, variety, moderation—is important for our nutrition status. Ethic foods are naturally this way, and the foods work together in a synergy to provide the body what it needs. David and Val discuss the benefit of heritage foods and the pitfalls of restrictive diets.

[33:22] The Intersection of Menopause and Nutrition

Soy has become a feared food due to myths about its role in cancer development. Soy went from the golden child of menopause to the public’s avoidance list. One research study in the mid-90’s was popularized, but was pulled due to inaccuracies. Those cancerous results were in animal models with very high amounts of isoflavones. You can drink soy milk, eat tofu and tempeh, every day, and never reach that level of isoflavones.

Eating soy is not eating estrogen, the body’s mechanisms for estrogen production is complex, and is not as simple as eating foods rich is isoflavones. Val points out that soy is a lean protein source, and there are plenty of ways to enjoy it.

[39:08] One Small Approach to Menopause and Nutrition 

Val says the key take away is to remember menopause is a health milestone. It’s a good time to check in with your health. Val encourages women to embrace this time. Do you really want to be 80 and still chasing weight loss? Or do you want to move into enjoying life?

Also, when men understand menopause, they can be a better partner and supportive friend. They can walk on eggshells less!

Resources: 

• North American Menopause Society
• International Menopause Society
• Red Hot Mama’s
• Hormone Health Network – Menopause Map
• Val’s private practice: EnlightenU
• Val’s previous episode on One Small Bite: Relative Energy Deficiency in Sports

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