Nutrition and Diet During Menopause

When you’re going through perimenopause or menopause, your body needs a rich and varied diet, full of nutrition provided by all of the food groups.

Eating well is about so much more than maintaining a healthy weight. Good nutrition is about feeling good from the inside out. Your diet has a huge impact on how you feel now and on your long-term risk factors for a wide range of diseases.

Making good choices now may not only improve your menopausal symptoms, but also significantly reduce your risk of diabetes, heart disease, osteoporosis, cancer and dementia. Eating well is an essential part of the toolkit to help you stay strong and healthy in the decades ahead of you.

You can’t run at full speed without regular top ups of fuel. That means eating a nutritious breakfast, lunch and dinner. A lot of people like to plan a mid-morning snack and a mid-afternoon snack, too.

Planned snacking can be really helpful at managing mealtime portion control. If you know you tend to overeat at dinner, leaving you feeling bloated before bed, it’s worth trying a healthy mid-afternoon snack.

Foods for perimenopause

Menopause is a transitional period and although menopause itself is defined as the moment when you’ve gone 12 consecutive months without a period, the time leading up to menopause, perimenopause, can last for several years. During this time, your hormones fluctuate drastically, triggering many changes within the body and giving rise to different symptoms.

With these changes, it’s likely that what your body needs, how it responds to food and your health goals will change too. For example, when younger, women typically experience less severe spikes in blood sugar levels after they eat than men. However, as they age, their post-meal blood sugar levels increase. These peaks and troughs in blood sugar levels can leave you feeling hungry, even just after eating, and lead to fatigue. Eating a perimenopause diet that keeps blood sugar balanced throughout the day can help combat these effects.

As women get older, they also tend to lose lean muscle and experience a decrease in basal metabolic rate, which increases the risk of weight gain (1). Therefore, focusing on protein intake alongside resistance training can help maintain muscle strength.

Conscious food choices made with an awareness of their benefits alongside an understanding of hormonal and bodily changes is key to healthy eating for perimenopause well-being.

Meals

When planning your meals (breakfast, lunch and dinner) try to fill most of the plate with fibre-rich vegetables or fruit. Opt for smaller portions of protein and starchy carbohydrates like:

· Bread

· Wholegrains

· Potatoes

· Rice

· Pasta

· Cereals

Aim to include at least four servings of pulses and legumes in your diet across the week, for optimal gut and cardiovascular health. Examples include:

· Soya (edamame) beans

· Chickpeas

· Lentils

· Kidney beans

· Black beans

Snacks

Ideally, snacks should be made up of two food groups e.g. carbohydrate + protein. Ideal combinations include:

· A slice of cheese with two oat cakes

· Apple and unsweetened peanut butter

· Dried fruit and unsalted nuts

· Banana on a slice of wholegrain toast

Protein

The key to achieving a good balance here is variety. Plan your meals according to your dietary preferences (omnivorous, pescetarian, vegetarian or vegan), and include a mixture of different proteins across the week. If you do not already do so, aim to have at least two meat-free days a week.

When choosing your proteins, think about the following:

Red meat – choose lean cuts and extra lean mince. Dry fry when you can. Limit your overall intake to no more than once or twice a week, and avoid processed meats such as bacon, salami and ham.
Fish – aim to have at least one serving of oily fish like salmon, sardines, trout, mackerel or pilchards a week. If you do not eat fish, consider taking an algae-based EPA/DHA supplement and/or include regular plant-based omega-3 sources in your diet such as ground flaxseed, chia seeds and walnuts.
Plant-based sources - these include tofu, tempeh, nuts, beans and pulses. Soya is particularly beneficial during menopause and is a complete plant-based protein that can be consumed daily. Quorn and plant-based meat alternatives can also be included, but limit your intake to no more than twice weekly as they can be high in salt.

Carbohydrates

Forget no carbs, it’s all about slow carbs. Avoiding carbohydrates is one of the worst nutrition mistakes you can make if you want to fuel your body.

Wholegrain and low glycaemic (complex) carbohydrates are your best choices, so try to have some of these at each meal:

· Bread - granary, rye, wholemeal seeded bread.

· Potatoes - sweet potatoes, baby new potatoes.

· Pasta - dried wholegrain pasta (cooked al dente, with a bite).

· Cereals - oats, no added sugar muesli.

· Grains - brown basmati rice, red rice, couscous, bulgur wheat, quinoa, barley.

Nutrition for bone health

Menopause leads to lower levels of oestrogen in the body, and this can result in bone loss, increasing the risk of osteoporosis. Now, more than ever, your body needs the necessary nutrients to support good bone health and maintain bone density.

Calcium is a mineral that is important for maintaining bone strength, and vitamin D is needed to help you absorb the calcium in your diet.

For most adults over 19, the UK recommended daily amount (RDA) is 700 mg, but it is 1000-1250 mg if you are postmenopausal and/or have osteoporosis, coeliac disease or inflammatory bowel disease. You can calculate your own calcium intake via an online calcium calculator.

When most people think of dietary calcium, they tend to think of dairy products. While dairy is a convenient source of calcium and other nutrients, it is not the only source. Many people are unable to tolerate lactose (with dairy intake leading to uncomfortable gastrointestinal symptoms), and others choose to exclude dairy from their diet for both ethical and environmental reasons.

Whatever your dietary needs or preferences, there are plenty of calcium rich foods, including:

· Dairy-products, such as yoghurt and cheese

· Calcium-set tofu and other soya-based foods

· Beans and lentils, especially chickpeas and edamame beans

· Leafy greens/cruciferous veg, e.g. watercress, rocket, kale, broccoli, cabbage, cauliflower, spring greens and bok choy

· Small fish with bones, e.g. sardines, whitebait, pilchards

· Nuts and seed, including nut butters (almond butter and unhulled tahini are particularly calcium-rich)

· Oranges, dried (uncooked) figs and apricots

· Teff and amaranth (ancient grains)

In addition to including calcium rich food in your diet, it is important to be mindful of “calcium thieves” by avoiding smoking, high caffeine consumption (more than three cups of coffee daily), regular sweetened fizzy drinks (especially cola) and excess salt. If you drink alcohol, be moderate with your intake - daily drinking and/or binge-drinking is damaging to your bones.

Fruits and vegetables

The recommended intake of '5 a day' for fruits and vegetables is the minimum you should aim for to get all the vitamins and minerals your body needs to be healthy. There’s nothing wrong with having more than five a day – in fact, it’s actively encouraged. Recent research suggests that we should actually be aiming to include 30 different plant-based foods in our meals and snacks over the course of a week! Ultimately this just means having variety in your diet.

One serving is 80g of fresh, frozen or canned fruit or veg (not including potatoes or other starchy foods) or 30g of dried fruit. 150 ml of fruit juice, vegetable juice or a smoothie can count as a serving but these should only be counted once a day as higher intake can lead to teeth damage). 80g of beans and pulses also count as one serving daily.

Eat a rainbow of different coloured fruit and veg, as the different colours indicate different vitamins and minerals and provide different benefits. Diversity is key to a healthy gut microbiome, and good hormonal and emotional health.

Fresh, frozen, dried or (unsweetened and unsalted) canned fruits and vegetables all count towards your daily count. Budget ranges or wonky veg contain just as many vitamins and minerals as premium range fruits and vegetables.

Drinks and fluids

Maintaining good hydration is just as important as eating well. Most fluids count towards your intake, so you don’t just have to drink water. The only drinks that don’t count towards your fluid intake are alcohol, fruit juices and smoothies, but aim to minimise your intake of sweetened drinks (whether that is sugar in your tea or fruit squash).

You can check if you’re hydrated by having a look at your urine when you go to the bathroom. If your urine is a very pale - , white wine colour - , you are well hydrated. If it’s darker than that, try to drink a little more.

Other beneficial foods and supplements

During perimenopause and postmenopause, a daily vitamin D supplement (containing 400 IU or 10 ug) is recommended to protect your bone health. If you are over 50, Government recommendations are to also take a regular vitamin B12 supplement (10 mcg daily, or 2000 mcg once weekly) as this is not absorbed as well from food sources as we get older. If you are vegetarian or vegan then, whatever your age, you should also take a vitamin B12 supplement daily.

There are a wide range of supplements targeted at menopausal women, but there is very limited evidence to support their effectiveness, and many women spend vast amounts of money for very little benefit. Other supplements e.g. omega-3, iodine and magnesium may be recommended on an individual basis, but not routinely.

Some women find including more plant oestrogens, or phytoestrogens, in their diet (not supplements) helps to reduce the frequency and severity of hot flushes. You may need to eat 2-3 servings of phytoestrogen rich food, such as like soya, every day for a few months to see the full potential symptomatic benefits. However, these foods also play a role in improving bone, cardiovascular and breast health benefits. If you have been diagnosed with, or have a family history of, breast cancer, you do not need to avoid these foods. In fact, current research suggests it is beneficial to include these in your diet.

Food to avoid during perimenopause

Just as certain foods can support your body during perimenopause, others may exacerbate symptoms, contribute to fluctuations in energy levels, and leave you feeling sluggish. While you don’t have to eliminate these foods entirely, being mindful of their impact and moderating your intake can help you feel more balanced and in control of your well-being.

Caffeine

Caffeine can disrupt sleep, which is already a challenge for many women during perimenopause due to fluctuating hormones. It can also contribute to feelings of anxiety, increase heart palpitations, and worsen hot flushes in some women. If you find that caffeine affects your sleep or heightens symptoms, consider switching to herbal teas or decaffeinated options, especially in the afternoon and evening.

Alcohol

Alcohol can have a stronger effect on the body during perimenopause, worsening symptoms. It can also contribute to weight gain and affect liver function, which plays a key role in hormone regulation (2). Try to keep your alcohol consumption occasional and moderate (no more than 14 units per week with 2-3 consecutive alcohol-free days per week) and opt for lower-sugar options like dry wines or clear spirits with mixers.

Saturated fats

Diets high in saturated fats, found in fried foods, processed meats, and full-fat dairy products, may contribute to increased cholesterol levels and a higher risk of cardiovascular disease, which becomes a greater concern as oestrogen levels decline (3).

Replacing saturated fats with healthier fats from sources like avocados, nuts, seeds, and olive oil can support heart health and overall well-being.

Refined carbohydrates

White bread, pasta, pastries, and other refined carbohydrates can cause spikes and crashes in blood sugar levels, leading to energy fluctuations, increased hunger, and cravings. These foods also contribute to insulin resistance, which can make weight management more challenging during perimenopause.

Spicy food

Spicy foods can worsen hot flashes and night sweats for some women, as they can temporarily raise body temperature and increase blood circulation. If you notice that spicy meals trigger symptoms, try reducing your intake or choosing milder spices that add flavour without excessive heat.

Ultra-processed foods

Highly processed foods often contain additives, preservatives, excess salt and sugar, and unhealthy fats that may exacerbate perimenopausal symptoms (4). They also tend to be low in essential nutrients needed to support your body during perimenopause.

Prioritising whole, minimally processed foods will help provide the necessary vitamins and minerals to keep you feeling your best.

Is there a best diet for perimenopause?

There is no single perimenopause diet plan that will work for every woman. Each person’s needs, symptoms, medical history and goals are unique, meaning their dietary choices should be too. However, some well-known dietary approaches may be beneficial for certain individuals during perimenopause.

Vegan diet for perimenopause

A vegan diet eliminates all animal products and focuses on plant-based foods such as fruits, vegetables, legumes, nuts, and whole grains. This diet can provide plenty of fibre, antioxidants, and phytoestrogens that may help balance hormones and reduce physical and vasomotor symptoms (5).

If following a vegan diet, you need to be mindful of getting enough protein, vitamin B12, iron, and zinc, as these are often lower in plant-based diets.

Keto for perimenopause

The ketogenic diet is high in fats, moderate in protein, and very low in carbohydrates. Some women find it helps reduce cravings and support weight management (6,7).

However, the diet can be restrictive, and its long-term effects on health are still being researched, with some studies suggesting certain risks including:

An increased risk of kidney stones
Increasing low-density lipoprotein (LDL) cholesterol
A loss of bone density (8,9,10)

Anti-inflammatory diet for perimenopause

This approach emphasises whole, nutrient-dense foods that help reduce inflammation, such as:

Leafy greens
Berries
Apples
Citrus fruits
Fatty fish
Tomatoes
Nuts
Olive oil

Since inflammation is linked to many perimenopause symptoms, following an anti-inflammatory diet may help with joint pain, mood swings, and fatigue. It does, however, mean a commitment to avoiding processed and inflammatory foods like refined sugars and trans fats.

Mediterranean diet for perimenopause

The Mediterranean diet focuses on whole foods, including fruits, vegetables, whole grains, healthy fats, and lean proteins like fish and poultry.

Studies have found that adhering to a Mediterranean diet during menopause can have beneficial impacts on health by reducing:

Weight
Blood pressure
Triglycerides
Total cholesterol
LDL cholesterol (11)

It’s also a flexible and sustainable way of eating, though some may need to adjust portions to meet specific health goals.

A calorie deficit for perimenopause

For women experiencing weight gain, a calorie deficit (consuming fewer calories than the body burns) can help with weight loss in perimenopause. However, it’s essential to prioritise nutrient-dense foods and avoid extreme calorie restriction, which can lead to muscle loss and further metabolic slowdown.

The British Menopause Society states that safe, maintainable weight loss needs a daily calorie deficit of 500 calories per day, combined with strength and cardio training (12).

Perimenopause meal plan example

With so much information, it’s understandable if you feel a little daunted about the thought of putting it all into practice. To give you a helping hand, we’ve created a meal plan which includes a week of perimenopause-friendly meals and snacks.

If you’d like to learn more about nutrition and staying healthy during menopause, book a consultation with our Menopause Care dietitian.

DisclaimerAt Menopause Care, we ensure that everything you read in our blog is medically reviewed and approved. However, the information provided is not meant to replace professional medical advice, diagnosis, or treatment. It should not be relied upon for specific medical advice.

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