Guide to a healthy diet during menopause

Menopause (including peri- and post-menopause) is a natural stage of life that affects all women as part of the ageing process.

Specifically, it refers to a time when periods stop because the ovaries stop producing eggs. As part of the process, the levels of sex hormones they produce also fall. Officially, menopause is diagnosed 12 months after the final period.

Menopause is linked to over 30 physical & psychological symptoms, many of which can be uncomfortable. And while menopausal changes can’t be reversed, lifestyle approaches, a healthy diet and medical treatment can help to alleviate or reduce these symptoms.

Today, our in-house nutritionist, Barbara Usak (ANutr, BSc Human nutrition and PGDip Clinical & Public Health Nutrition) discusses all things menopause diet, healthy eating and weight gain.

Does diet play a role in the menopause?

Whilst food and nutrition can certainly play a role in managing many of the symptoms of menopause – and even potentially alleviate some of the symptoms – it’s important to know that it’s not a magic bullet.

Healthy diet and lifestyle changes are very complimentary to HRT or other personalised treatments, which should be prescribed by an expert medical professional.

That being said, following a healthy, balanced diet is the best anyone, at any life stage, can do to make sure that they look after their health and wellbeing now and in the future!

Does the menopause lead to weight gain?

Although not an official symptom of menopause, weight gain can be a side effect of menopause for many women. There is evidence that proposes that resting metabolic rate decreases in postmenopausal women by about 10%, meaning you may burn fewer calories at rest.

But weight gain during or after the menopause can also be due to:

1. Hormonal changes

Hormonal changes during peri/menopause contribute to increased central abdominal fat and abdominal obesity. Decreasing oestrogen levels are associated with an increase of fat mass and the loss of lean body mass. Typically, there is also a redistribution of fat to the abdomen and an increase in total body fat.

2. Sleep disruption

Hot flushes, night sweats, a disruption to melatonin due to oestrogen deficiency, as well as the rise in the stress hormone cortisol, could disrupt your sleep quality. In turn, poorer quality (or less) sleep can negatively affect the balance of appetite regulating hormones.

In fact, research suggests that sleep-deprived individuals tend to choose foods that are high in calories and carbohydrates. And studies show that regularly sleeping for less than 5 hours, compared with sleeping 7–8 hours, increases the likelihood of developing obesity by 40%.

3. Stress

Increased cortisol levels, as well as the experience of other disruptive menopause symptoms, may increase your stress levels – and increased stress levels can result in increased appetite and weight gain.

Research suggests that those with a higher cortisol response typically have more body fat. This is likely because cortisol directly influences NPY (neuropeptide Y), which is an appetite stimulating hormone. 

Healthy diet tips for the menopause

Let’s have a look at what specific dietary changes you can make to not only help manage symptoms, but to ensure that you are well nourished and remain healthy through menopause and beyond.

1. Choose whole foods

Choose minimally processed and unprocessed whole foods over ultra-processed foods as best as you can. That’s foods like unprocessed meat, fish, full-fat plain dairy, non-starchy vegetables nuts, seeds, legumes, healthy oils and some whole grains, rather than pizza, ready meals, white bread and crisps.

A healthy, balanced diet mainly based on whole foods will provide the right quality and balance of macro- and micronutrients and will support your overall health, as well as help to manage menopause symptoms.

If you need some help getting started, try Purition for breakfast and a Daily Feed meal in the evening. It’s quick, it’s easy and it instantly means 66% of your diet will come from whole foods!

2. Focus on protein

During (peri)menopause, decreasing oestrogen levels can lead to an increase of fat mass and the loss of lean body mass. To counteract this, it’s super important to eat enough quality protein.

It’s recommended that women over the age of 50 consume approximately 1-1.2g per kg body weight daily (alongside regular exercise 3-5 times/week) to offset age-related muscle mass loss. And for those over 65 who are regularly exercising or have an acute/chronic disease, a 1.2-1.5g/kg body weight intake is recommended. 

To ensure that you easily meet your daily needs, try to include 1-2 serving of quality protein with each meal or snack, such as:

• Poultry
• Red meat
• Fish
• Eggs
• Dairy or vegan alternatives
• Tofu
• Tempeh
• Edamame/soy beans
• Legumes
• Nuts & seeds
• Good quality protein powders

Just aim to include one or two (palm sized) serving at each meal. For nuts, the serving size is approximately 25g, which is a small handful.

3. Don’t fear fat

Healthy omega 3 fats can help to manage the symptoms of menopause:

• Evidence suggests that omega 3 fat is beneficial for managing menopause symptoms such as night sweats and low mood.
• Diets that include omega 3 fats have also been shown to help reduce the risk of developing symptoms of stress, anxiety and depression.
• Omega 3 fats can help to lower the risk of cardiovascular disease and improve metabolic health, which are especially important during the menopause.

People are often afraid of fat, but health authorities (BDA/BNF/NHS) recommend that around a third of your daily intake should come from fat. Women should eat about ~70g of fat per day, with around ~20g coming from saturated sources.

To meet your daily needs, aim to include a serving of healthy fat per meal:

• Oily fish (salmon, mackerel, sardines)
• Extra virgin olive oil
• Avocado & avocado oil
• Nuts & seeds
• Nut butters
• Olives

Find out more about essential fats in our omega 3 guide.

4. Concentrate on calcium

Oestrogen has an important role in bone health. As levels decline through the menopause, the risk of osteoporosis increases. Osteoporosis is a health condition that weakens bones, which means they’re more fragile and more likely to break.

Calcium is particularly important for optimising bone health through the menopause. To keep your bones healthy and reduce the risk of osteoporosis through the menopause, make sure you’re eating at least 2-3 portions of calcium-rich food per day.

The best dietary sources of calcium include:

• Milk, cheese & yoghurt
• Oily fish
• Soybeans
• Green leafy vegetables (such as spinach, kale and okra)
• Dairy-free alternatives fortified with calcium

5. Support your vitamin D intake

Vitamin D is vital for maintaining normal bone and muscle function, but also helps to regulate calcium levels. That's why getting enough of it can help to reduce the risk of osteoporosis during menopause. 

Vitamin D is a fat-soluble vitamin that can be produced in the skin as a response to exposure to sunlight/UVB light. However, during October-April in the UK, most adults do not get exposed to enough daylight to obtain enough vitamin D.

Try to incorporate plenty of vitamin D-rich foods into your daily diet:

• Oily fish
• Red meat
• Eggs
• Mushrooms (look for the ones that state they are a source of Vitamin D, as those grown in the dark won’t be)
• Fortified foods

It can be difficult for anyone to get an adequate amount of daily vitamin D during October-April from food alone, so recommendations to supplement with 10μg/day during autumn and winter have been emerging. If you're looking for a good supplement, try Purition's Multi Nutrient.

6. Maximise magnesium

Magnesium is a mineral that is especially important during the menopause.

It contributes to the reduction of tiredness and fatigue, the normal functioning of the nervous system, normal muscle function and for the maintenance of normal bones and teeth.

Getting enough magnesium is also essential for a good night’s sleep, which many women struggle with during the menopause. In fact, studies show that not having enough magnesium in your system can cause troubled sleep and even insomnia.

However, there's very little evidence to support any benefit from magnesium supplements. It’s easy to obtain enough magnesium from a healthy, balanced diet.

Try to include a variety of the following magnesium-rich foods in your daily meals:

• Green leafy vegetables
• Legumes (soya beans, lentils, beans, chickpeas)
• Nuts & seeds
• Fortified dairy & dairy-free products
• Fish, such as halibut, mackerel, and salmon
• Dark (80%+) chocolate

7. Get plenty of vitamin C

You probably already know that vitamin C helps to maintain a healthy immune system, but did you know that its role in skin, heart and bone health make it extra important for the menopause?

During the menopause, oestrogen levels decline, which can lead to an increase in fine lines and wrinkles. This is perfectly naturally and nothing to be concerned about. But vitamin C plays an important role in collagen formation, so it can help to keep skin healthy.

Vitamin C’s role in collagen formation also make it an important nutrient for maintaining bone health and further reducing the risk of osteoperosis during menopause.

It’s easy to get enough vitamin C from a healthy, balanced diet by simply eating a wide variety of fruits and vegetables, particularly berries, citrus fruits, broccoli, Brussel sprouts and peppers. 

8. Drink more water

It’s always important to stay hydrated. But throughout the menopause, thirst sensitivity may decrease due to hormonal changes. This means it’s even more important to include enough fluids to avoid dehydration.

Opt for water, unflavoured sparkling water, unsweetened (herbal) tea and coffee (or decaffeinated coffee if you are sensitive) with or without (nut) milk – at least 6 to 8 cups per day.

Staying well hydrated can also help reduce headaches, hot flushes and bloating during menopause.

9. Know your phytoestrogens

Plant oestrogens/phytoestrogens can be your nutritional ally though menopause. As well as helping to reduce hot flushes, they even support heart and bone health.

Phytoestrogens are compounds that naturally occur in plants and have similar structure to oestrogen, but only display weak oestrogen activity. The best sources are:

• Soybeans/edamame beans
• Flax seeds
• Sesame seeds
• Garlic
• Chickpeas
• Cruciferous vegetables (broccoli, cauliflower, Brussel spouts…)
• Berries
• Barley
• Apricots
• Tea (both green and black)

It may take a few months to notice the effects, so try to make them a part of your daily routine for the long-term.

You might be wondering if it’s better to take a phytoestrogen supplement. Current evidence relates to the beneficial effects dietary phytestrogens – i.e. phytoestrogens from real, whole foods. For example, studies show that approximately 2 portions of soy per day can reduce hot flushes by 50%.

There is currently limited evidence to say that supplements have the same effect. Plus, there may be risk of side effects.

10. Try Purition

Purition is a blend of whole foods that you can make into a shake, yoghurt bowl or instant porridge. It’s quick, easy and super nutritious – think protein, healthy fats (including omega 3s), fibre and loads of naturally-occurring nutrients to fuel your day.

Even better? Purition is a great natural source of vitamins & minerals, including many of the micronutrients highlighted for their menopause benefits, including calcium and magnesium.

Plus, two of the main ingredients in Purition, flax seeds and sesame seeds, are a great source of phytoestrogens to help with the reduction of hot flashes!

It’s such an easy way to support your health during the menopause. Get started with any 7 sachets for £16.80!

Can eating soy impact menopause symptoms? 

Absolutely! Soy is also a great source of isoflavones, which are a type phytoestrogen.

A study has shown that a plant-based diet that includes soy is beneficial for not only improving hot flushes, but overall can help improve well-being. Even if going vegan isn’t for you, you can still reap the benefits by including plenty of plants and some soy sources in your diet.

There are some outdated myths out there that propose that soy products are endocrine disruptors and can cause cancer. The studies referred to are outdated (from the 90s) and were done on animals, not humans. Since then, many meta-analyses of human studies have shown that soy phytoestrogens are not harmful.

Soy and products do not place women at a higher risk of breast cancer. This is backed up by all of the major cancer organisations.

Are there any foods to avoid during menopause?

1. Ultra-processed foods

It’s best to avoid ultra-processed foods during the menopausal transition, as studies show that they can increase the risk of menopausal symptoms. 

A higher intake of ultra-processed foods is associated with more intense symptoms, including hot flushes, memory and concentration problems. On the contrary, a diet rich in vegetables is associated with better quality of life and lower menopause symptom intensity!

Ultra-processed foods are high in salt and/or sugar and unhealthy fats but extremely low in fibre. They’re also known to negatively effect the diversity of the gut microbiome – and a healthy gut microbiome is so important throughout life, including during the menopause.

2. Alcohol

Alcohol can cause skin flushing and may worsen hot flashes. Although there is a variation between how individuals react to this, it’s best to follow the official guidelines and not exceed more than 2 units per day. If you find that it worsens your symptoms, you may consider stopping alcohol altogether.

Reducing alcohol also has an endless list of health benefits, such as a lower risk of liver disease, heart disease, osteoporosis, type 2 diabetes and certain types of cancer.

3. Caffeine (in some cases)

If you find that you’re sensitive to caffeine, it may be worth cutting down.

(Peri) menopause can causes fluctuations in both blood pressure and body temperature. For some women, caffeine can worsen these symptoms. 

Some women may also experience that spicy foods can make hot flushes worse. If you’ve experienced this, it may be a good idea to limit these and see if the flushes improve.

Extra lifestyle tips for a healthy menopause

1. Try stress-reducing activities

From hot flushes to low mood, hormonal changes can lead to a number of uncomfortable symptoms. Understandably, many women find these symptoms stressful. To help reduce stress, Menopause.org suggests:

• Exercise: Walk with a friend, join a yoga class, bike, hike – whatever you enjoy, exercise is a great way to reduce stress and stay healthy.
• Talk: Share your concerns with a family member, good friend, healthcare professional or counselor.
• Relax. Practice deep breathing, positive thinking and meditation. The app ‘Headspace’ is a great starting point!
• Pamper: Treat yourself to a massage, manicure or bath. Enjoy a good book, music or a favourite hobby. 

And, most importantly, if you feel that the stress of the menopause is affecting your quality of life, don’t be ashamed to reach out to your doctor or healthcare provider for advice.

2. Get plenty of rest

Hot flushes, night sweats and the rise in the stress hormone cortisol can disrupt sleep patterns during menopause. If you can relate, the following tips might help you to fall (and stay) asleep:

• Avoid screens for an hour before bed – try reading instead
• Go to bed and wake up at the same time each day
• Moderate caffeine and ditch it entirely after 2 pm
• Avoid eating 2–3 hours before bed

Find out more in our tips for better sleep blog.

If establishing a healthy sleep routine doesn’t improve your sleep quality, please make sure to visit your doctor or healthcare professional for further advice.

Exercise, if you can

Regular exercise is not only good for your general health, but it could also help to relieve some of symptoms of the perimenopause and menopause. It helps to strengthen your muscles, boost your mood and may even help you to maintain a healthy weight.

Aim for at least 150 minutes of moderate activity (that could be as simple as a brisk daily walk after work or a relaxing swim 2 or 3 times per week) or 75 minutes of vigorous activity (this could be as simple as 2 gym classes per week!).

To maintain muscle and bone health, it's a good idea to incorporate strengthening activities into your routine. Yoga is a great option – as well as teaching mindfulness and meditation to decrease stress, it strengthens your bones and muscles.

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