Menopause and nutrition for students....

Detail about menopause and nutrition to be taken

1. MENOPAUSE A ND NUTRITION Shifa Kumpariya Roll no: 116 Mentor: Dr. Vasudha Agrawal Ma’am Slide:1

2. What is Menopause? Menopause is a natural biological process, marking the end of women's reproductive years (menstrual cycle). It typically occurs between the ages of 45 and 55 but can vary widely. Menopause is diagnosed after 12 month without a menstrual period. Slide:2 https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397

3. The transition period leading up to menopause. Mid-30s or mid-50s The stage when a woman has not had a menstrual period for 12 consecutive months. Occurs at the age of 45 and 55 The stage after a woman has gone 12 months without menstrual period. Around the age of 51 Slide:3

4. Hormonal Changes Associated with Menopause Testosterone levels may decline Testosterone Slide:4

5. Signs and Symptoms Slide:5 https://images.app.goo.gl/Vy8DEL3E8RinpzBm6

6. Age: Most significant risk factor. Smoking: Leads to experience menopause earlier Chemo and radiation therapy: Can damage the ovaries leading to earlier menopause Ovarian surgery: Causes immediate menopause Autoimmune disorders: Can influence the timing of menopause BMI: Lower BMI can be associated with earlier menopause Diet and nutrition: Poor diet can influence the onset of menopause Chronic diseases: Can affect the timing and severity of menopausal symptoms Factors Affecting Menopause Slide:6

7. Balanced diet Regular exercise Adequate sleep Stress management Avoiding triggers Hormone replacement therapy Non-Hormonal medications: 1. Antidepressants 2. Gabapentin 3. Clonidine Acupuncture Herbal supplements Phytoestrogen Slide:7

8. Slide:8 Types Of Phytoestrogen Lignans Containing Food: Anethole Containing Food: Soybeans(raw): 103mg/100g Flaxseed: 85.5mg/28.35g Anise seed: 8.5/100g Tofu: 27mg/100g Sesame seeds: 11.2mg/28.35g Star Anise: 8g/110g Soy Milk: 10mg/100ml Broccoli: 0.6mg/half cup, chopped Fennel seed: 6g/100g Miso: 43mg/100g Apricots: 0.4mg/half cup, sliced Basil(essential oil): 30g/100g Edamame:18mg/100g Cabbage: 0.3mg/half cup, chopped Tarragon(essential oil): 60g/100g Soy yogurt: 10mg/100g Strawberries: 0.2mg/half cup - Soy protein isolate: 91mg/100g Curly Kale: 0.8mg/half cup, chopped - Isoflavones Containing Food:

9. Nutrients Values Energy 377 Protein 37.8 Carbohydrates 10.16 Fats 19.42 Beta-Carotene 2.82 Thiamin 0.61 Niacin 2.28 Riboflavin 0.23 Calcium 195 Iron 8.22 Dietary Fiber 22.63 Soybean Nutrients Values Energy 333 Protein 10 Carbohydrates 13.3 Fats 26.6 Beta-Carotene 1.05 Thiamin 0.28 Niacin 1.09 Riboflavin 0.05 Calcium 257 Iron 5.44 Dietary Fiber 26.17 Flaxseed Nutrients Values Energy 337 Protein 17.6 Carbohydrates 50 Fats 0.3 Beta-Carotene - Thiamin 0.34 Niacin 3.06 Riboflavin 0.29 Calcium 646 Iron 37 Dietary Fiber 14.6 Anise seed Nutrient Composition Slide:9 Recommended:20-60g per day Recommended:1-2 tbsp per day Recommended:5g per day

10. Nutrients Values Energy 377 Protein 37.8 Carbohydrates 10.16 Fats 19.42 Beta-Carotene 2.82 Thiamin 0.61 Niacin 2.28 Riboflavin 0.23 Calcium 195 Iron 8.22 Dietary Fiber 22.63 Isoflavones : It is a class of phytoestrogens- plant derived compound with estrogenic activity. They are type of flavonoid, which are polyphenolic compounds known for their antioxidant properties. High Source of Isoflavones: Soybean Other sources: Tofu, Soy Milk, Soy flour.

11. Nutrients Values Energy 333 Protein 10 Carbohydrates 13.3 Fats 26.6 Beta-Carotene 1.05 Thiamin 0.28 Niacin 1.09 Riboflavin 0.05 Calcium 257 Iron 5.44 Dietary Fiber 26.17 Lignans: Are a group of polyphenolic compounds found in plants. They are considered phytoestrogens, similar to isoflavones. High source of Lignans: Flaxseeds Other sources of Lignans : Sesame seeds, whole grains, legumes.

12. Nutrients Values Energy 337 Protein 17.6 Carbohydrates 50 Fats 0.3 Beta-Carotene - Thiamin 0.34 Niacin 3.06 Riboflavin 0.29 Calcium 646 Iron 37 Dietary Fiber 14.6 Anethole: It is an organic compound that is widely used for its flavor and aroma. It is a type of phenylpropene, a subclass of aromatic compound. High source of Anethole: Anise seed Other sources of Anethole: Fennel, Basil, Star anise.

13. Soy Products Isoflavones (i.e. a class of phytoestrogens-plant derived compounds with estrogenic activity) Isoflavones ingestion Enters the bloodstream Isoflavones binds to estrogen receptors m imics estrogen activity Reduced estrogen deficiency symptoms and Alleviation of depression, hot flashes and night sweats Improved quality of life symptoms Increased production of serotonin and Beta-endorphins Improved mood Sleep regulation and reduced mood swings, anxiety and Overall reduction in Menopausal symptoms How Do Phytoestrogen Helps In Managing Menopause

14. Flaxseed Lignans Lignans ingestion Enters the bloodstream Conversion to Enterolignans by Gut Microbiota Enterolignans bind to Estrogen receptors Mimic estrogen activity Reduced estrogen deficiency symptoms and Alleviation of depression, hot flashes and night sweats Improved quality of life symptoms Increased production of serotonin and Beta-endorphins Improved mood Sleep regulation and reduced mood swings, anxiety and Overall reduction in Menopausal symptoms (i.e. a class of phytoestrogens-plant derived compounds with estrogenic activity)

15. Phytoestrogen Isoflavones Lignans Isoflavones ingestion Enters the bloodstream Isoflavones binds to estrogen receptors mimics estrogen activity Lignans ingestion Enters the bloodstream Conversion to Enterolignans by Gut Microbiota then binds to estrogen receptor and mimics estrogen activity Reduced estrogen deficiency symptoms Improved mood Improved quality of life Increased production of serotonin and Beta-endorphins Alleviation of depression, hot flashes and night sweats Sleep regulation and reduced mood swings, anxiety Overall reduction in Menopausal symptoms

16. Phytoestrogen Isoflavones Lignans Isoflavones ingestion Enters the bloodstream Isoflavones binds to estrogen receptors Conversion to Enterolignans by Gut Microbiota then binds to estrogen receptor Reduced estrogen deficiency symptoms Alleviation of depression, hot flashes and night sweats Improved quality of life Increased production of serotonin and Beta-endorphins Improved mood Sleep regulation and reduced mood swings, anxiety Overall reduction in Menopausal symptoms Mimics estrogen activity Mechanism Of Action Of Phytoestrogen On Menopause Slide:10

17. Mechanism Of Action Of Anethole On Menopause Ingestion of Anethole Absorption in the digestive system Metabolism in the liver to estragole and other metabolites Modulation of enzymatic pathways Influence on estrogen metabolism and bio-availability Activation of secondary signaling pathways Alleviation of menopausal symptoms Slide:11 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4232798/#:~:text=The%20flavonoid%20anethole%20has%20been,or%20little%20toxic%20side%20effect

18. Phytoestrogen Supplements Available In The Market Red Clover(100 capsules) Recommended: 2 capsules daily Cost: Rs.737 Evening Primrose Oil Supplement (60 capsules) Recommended: 1 capsule daily Cost: Rs.499 Black Cohosh(100 capsules) Recommended: 1 capsule daily Cost: Rs.1.350 Wild Yam(100 capsules) Recommended: 2 capsules daily Cost: Rs.742 Slide:12

19. RESEARCH ARTICLE Slide:13

20. Nutritional Supplement Prepared from Whole Meal Wheat Flour, Soya Bean Flour, Flaxseed and Anise Seeds for Alleviating the Menopausal Symptoms  Authors: Suzanne Fouad, Salwa Mostafa El Shebini, Maha Abdel-Moaty, Nihad Hassan Ahmed, Ahmed Mohamed Saied Hussein, Aliaa El Gendy, Hend Abass Essa and Salwa Tawfic Tapozada    Published: February 22, 2019    Citation: Fouad, S., El, S. M., Abdel-Moat, M., Ahm, N. H., Sa, A. M., Gendy, A. E., Essa, H. A., & Tap, S. T. (2018). Nutritional Supplement Prepared from Whole Meal Wheat Flour, Soya Bean Flour, Flaxseed and Anise Seeds for Alleviating the Menopausal Symptoms. Journal of Biological Sciences, 18(7), 381–388. Journal: Journal of Biological Sciences Slide:14

21. Objecti ve: To help the female’s body to adapt to diminished estrogen hormone around the time of the menopause. To ultimately take control of the symptoms to be relieved by natural safety products. Slide:15

22. Methods 51 Volunteers ( Egyptian Females) With the mean age of 46 years Complaining of menopausal symptoms in the perimenopause stage The participants consumed daily 80g of the supplement made with substituting wheat flour with soy flour and addition of flaxseed and anise seed in the form of cookies Chemical analysis of the supplement was carried out Detailed gynecological, obstetric, drugs intake and dietary history were recorded Menopausal symptoms evaluation was carried out using the Menopause Rating Scale(MRS) for evaluation of somatic, psychological and urogenital symptoms Anthropometric measurements, blood pressure were reported Female sex hormones were evaluated

23. Materials And Method: The study was conducted through a project funded by National Research Centre (NRC) Egypt, 2016-2019: entitled "Dietary therapy and alternative medicine for alleviating the menopausal symptoms".  Subjects: This study was conducted in the nutrition and food science department of NRC from November 2016 to May 2017. Fifty-one women in the perimenopause stage, suffering from symptoms of menopause participated as volunteers in this study, with mean age 46.72±0.62 years, the research was given ethical approval from Ethical Committee of National Research Centre. The participants consumed daily (80 g) of the supplement made with substituting wheat flour with 30% soy flour and addition of Flaxseed and anise seed, in the form of cookies with weekly follow up for 8 weeks. Slide:16 All female participants were subjected to:  Signed written informed consents to participate in the research project after they had been given a full explanation of the study.

24. Full medical history and medical examination, detailed gynecological and obstetric history and blood pressure measurement (it was measured 3 times and the mean was recorded). Abdominal obesity assessment by minimal waist and hip measurements. Menopause Rating Scale (MRS) Evaluation Form 13 : The questionnaire has an option to check the degree of severity of symptoms. The three dimensions (sub-scales) are psychological, somatical and urogenital subscale. The total score is the sum of the three sub-scales scores    All subjects were informed not to consume soya products or to use hormonal replacement therapy and they followed their usual diet throughout the study    Blood sampling and bio chemical analysis : Blood samples were drawn from the patients and were allowed to clot at the room temperature, centrifuged and sera were separated. Biochemical parameters were performed on fasting sera that were stored at -70°C until used. Slide:17

25. Slide:18

26. Table 1: Composition of the supplement (g/100g) Slide:19

27. Chemical Composition Of The Supplement Analytical Analysis: Formula was prepared by mixing the ingredients according to the table 1 and the suitable amount of water were added . These formulas were baked in an electrical oven at 200 °C for about 20 mins. Weight, volume, diameter, specific volume, diameter, thickness, and spread ration of the cookies were recorded. Moisture, ash, crude protein, fat and crude fiber contents were determined in raw materials [whole meal wheat flour (WWF), defatted soybean flour (DSF), skim milk (SM), Flaxseed and anise] and the cookies. Carbohydrates were calculated: Carbohydrates = 100-Protein %+Fat %+Ash %+Crude fiber %  Statistical analysis: Data were analyzed using the Statistical Package for the Social Sciences version 16 (SPSS Inc., Chicago, IL). The categorical variables were expressed as rates (in percentage and frequency); while numerical data were expressed as Mean±SD and SE. Two tailed student t-test was used to compare the results before and after intervention. p-values less than 0.05 were considered statistically significant.  Slide:20

28. Soya Supplement Slide:21

29. Results Table 2: Chemical Composition of raw materials and cookies Samples Moisture(%) Ash(%) Protein(%) Fat(%) Fiber(%) Total Carbohydrate Whole meal wheat flour 12.88±0.135 1.74±0.151 11.71±0.189 2.66±0.03 3.29±0.11 80.60±1.04 Defatted soybean flour 7.33±0.08 7.46±0.06 42.40±0.17 5.39±0.09 2.82±0.06 41.93±1.16 Skim milk 2.69±0.02 4.55±0.09 22.11±0.19 3.02±0.07 - 70.32±0.83 Flaxseed 6.46±0.07 3.12±0.05 20.17±0.13 37.54±0.22 6.37±0.09 32.80±0.26 Anise seed 7.84±0.09 6.83±0.10 19.92±0.10 7.34±0.09 13.35±0.15 52.56±0.33 Soy cookies 20.52±0.13 2.88±0.02 15.98±0.11 6.16±0.03 3.21±0.03 71.77±0.96 Slide:22

30. Table 3: Minerals and phenols content in dry tested samples Samples P (mg/100g) K (mg/100g) Ca (mg/100g) Mg (mg/100g) Na (mg/100g) Fe (mg/100g) Total Phenol (as Tannin) Soybean flour 327 200 423 561 147 102 5796.98 Soy cookies 299 196 461 582 169 148 7321.68 Slide:23

31. Table 4: Frequency and percentage of menopausal symptoms score before and after intervention Menopausal evaluation questionnaires Score Frequency basal Frequency after intervention Percentage basal Percentage after intervention MRS 1 2 3 4 - 9 9 33 6 6 15 24 - 17.60 17.60 64.70 11.8 11.8 29.4 47.1 Somatic Subscale 1 2 3 4 3 3 15 30 6 12 24 9 5.90 5.90 29.40 58.80 17.6 11.8 17.6 29.4 Psychological Subscale 1 2 3 4 3 6 9 33 6 9 15 21 5.90 11.80 17.60 64.70 11.8 17.6 29.4 41.2 Urogenital Subscale 1 2 3 4 6 - 18 27 9 3 15 24 11.80 - 35.30 52.90 17.6 5.9 29.4 47.1 Slide:24

32. Table 5: Mean ± SD and p-value of menopausal symptoms score before and after intervention Mean±5E t.test p.value MRS1 20.65±1.34 11.95 0.00 MRS2 14.4±1.10 Somatic1 8.59±0.460 13.436 0.00 Somatic2 5.47±0.379 Psych1 7.76±0.601 8.863 0.00 Psych2 5.41±0.455 Urogenital1 4.53±0.440 6.103 0.00 Urogenital2 3.65±0.394 1: Menopausal symptoms score before intervention 2: Menopausal symptoms score after intervention, significant at p≤0.05 Slide:25