Perimenopause Nutrition Foundations

Perimenopause Nutrition Foundations

Many women report mid-life weight gain without changing their dietary habits. It seems to happen spontaneously, along with sleep disturbances, fatigue, PMS, night sweats and other symptoms. But sticking with the way you’ve always eaten could make perimenopause worse.

The truth is that in perimenopause, nutrition becomes even more important than ever before. You can no longer get away with poor eating habits; this is when your lifestyle catches up to you.

The good news is that perimenopause presents an incredible window of opportunity to put healthy eating habits in place to help mitigate perimenopausal symptoms (including weight gain) and make enjoying life easier. Moreover, healthy nutrition patterns also help chronic disease risk that increases into menopause.

Nutrition is essential for perimenopause health, and today’s article will walk you through a holistic approach. It’s not always easy to change habits, but it’s worth it, and by the end of the article, you’ll see why. We’ll explore:

• Why nutrition needs to be a foundational part of perimenopausal and menopausal care
• A holistic nutrition view and philosophy
• Key nutrients to keep an eye on
• Action steps you can start taking today

Why Is Nutrition Foundational for Peri/Menopausal Care

During perimenopause, the transition to menopause, estrogen and progesterone levels decline. These hormones do more than support reproduction; they play crucial roles in all body systems. A recent review on the importance of nutrition in perimenopause describes estradiol, the primary estrogen during the reproductive years, as having “extensive metabolic effects.”

Declining estrogen is associated with:

• Increased insulin resistance
• Increased hunger
• Decreased basal metabolic rate (calorie burning potential decreases by 250-300 calories daily)

A slower metabolism, less insulin sensitivity, and increased hunger can promote weight gain. These metabolic changes due to hormone decline explain why you can eat the same diet you always did and still gain weight in perimenopause.

Sixty to 70% of women gain weight through perimenopause and early menopause. Women worldwide gain an average 10 kilograms (22 pounds) between the ages of 40 and 60.

Weight gain during perimenopause is only the tip of the iceberg with metabolic changes. Body composition changes as lean body mass (muscle) declines and visceral (belly) fat increases. The changes in fat cells can increase inflammation, which can lead to chronic diseases.

With menopause, the one-year mark without a menstrual cycle, comes an increased risk of chronic disease because of the loss of estrogen and progesterone. Aging accelerates without the protective benefits of these hormones. Women’s risks increase for:

• Metabolic syndrome and type 2 diabetes
• Heart disease
• Breast cancer
• Osteoporosis

Interestingly, diet can also be a risk factor for weight gain and chronic disease. By optimizing dietary patterns, you can help mitigate the adverse effects of hormonal changes.

Nutrition Patterns and Philosophy for Perimenopause

Nutrition is tricky in perimenopause because you still need to meet your daily nutrient needs, but your body might begin to need less energy. Because of stress, metabolic changes, aging digestion, and other factors, there might be nutrients you need more of, making what you get in every bite more meaningful. In other words, the diet has less room for nutrient-poor foods.

At a foundational level, you can think of food as medicine, providing what your body needs to sustain good health.

There’s been some research on the optimal perimenopause diet and many authors point to the Mediterranean eating pattern as an example. This approach focuses on:

• Whole, fresh foods (while minimizing sugary beverages and ultra-processed foods)
• Healthy fats like olive oil and nuts
• High-fiber foods, including legumes, fruits, vegetables, and whole grains
• High-quality protein

There’s no doubt that diet quality and balance are essential for perimenopause. Yet, there isn’t a single way to achieve optimal nutrition. When you shift the diet towards whole foods, many strategies can work, and there is much room for personalization.

Critical Nutrients for Perimenopause

The benefits of whole foods are often greater than the sum of their parts, so start there. Then, pay attention these specific nutrients to ensure you’re getting enough.

Protein

Eating enough protein is critical for sustaining and improving lean body mass for all the metabolic and longevity benefits. (Along with protein, you’ll need strength training too).

Get a minimum of 1 to 1.2 grams of protein per kilogram body weight per day. Many women will benefit from going higher than this, up to 1.6 grams of protein per kilogram of body weight daily. Your TārāMD nutritionist can help you calculate your protein needs based on your body size, activity level, and goals.

Both animal and plant proteins fit. Some good sources include:

• Pastured eggs
• Grass-fed yogurt and cottage cheese
• Organic chicken and turkey
• Grass-fed beef and wild game
• Cold water fish, like wild salmon and sardines
• Organic tofu and tempeh
• Nuts, seeds, and beans

Fiber

All whole plant foods contain fiber; it’s the carbohydrates we don’t digest (but the microbiome does). High-fiber diets are associated with better metabolic health. Fiber helps slow digestion, manage hunger, feed beneficial microbes in the colon (which influence metabolism and weight), balance lipids, nourish the gut-brain axis, and more.

Women need around 25 grams per day (or more precisely 14 grams per every 1000 calories consumed). But this is just a minimum; going up to 35 grams per day or higher may offer even more benefits.

Some foods particularly high in fiber include:

• Globe artichoke – 10 grams per large artichoke
• Beans and lentils – 7-9 grams per ½ cup cooked navy beans
• Blackberries and raspberries – 8 grams per cup
• Avocado – 7 grams per ½ avocado
• Pear – 7 grams per medium pear
• Oats – 5 grams per ½ cup cooked steel cut oats
• Apple – 5 grams per medium apple with skin
• Pumpkin seeds – 5 grams per ounce
• Blueberries – 4 grams per cup
• Chia seeds – 4 grams per tablespoon

Vitamin D

Vitamin D is essential for gene regulation, bone health, and immunity, yet many women are deficient. The body makes vitamin D out of cholesterol when the skin’s exposed to sunlight but living at high latitudes and sunscreen can hinder the production. One study suggests that optimizing vitamin D (and calcium) levels can help reduce the risk of early menopause.

Natural food sources of vitamin D include pastured eggs, fatty fish, liver, and grass-fed dairy products. Getting enough from food alone is challenging, and supplementation is helpful.

Calcium, Magnesium, and Other Minerals

Minerals act as cofactors to metabolic reactions in the body. Calcium, magnesium, and other minerals also help to build the structure of bones. Mineral deficiencies can contribute to hormone imbalances, perimenopausal symptoms, and declining health. Here are some food sources to consider:

• Leafy green vegetables
• Legumes
• Seaweed
• Nuts and seeds
• Bone broths and mineral broths
• Herbal teas and infusions
• Shellfish
• Cruciferous vegetables (broccoli, kale, collards, cabbage, cauliflower, etc.)
• Cacao and dark chocolate

B Vitamins

B vitamins help turn calories into energy. Without enough, you may feel the impact on metabolic health and energy. These vitamins are widespread in the food supply, with vitamin B12 primarily from animal foods. Some good sources include:

• Leafy green vegetables
• Avocado
• Liver and organ meats
• Eggs
• Fish
• Milk
• Whole grains and legumes
• Nuts and seeds
• Nutritional yeast

Polyphenols and Antioxidants

Although not considered essential, phytonutrients (plant nutrients) offer many benefits. They often act as antioxidants, which can help prevent cells from damage (oxidative stress) and aging. Good sources include:

• Berries
• Green tea
• Herbs and spices
• Coffee
• Cacao
• Pomegranate
• Soy
• Fruits and vegetables

Perimenopause Nutrition Action Steps

Perimenopause is the opportune time to focus on habit building. Put the habits in place that will serve you long-term. Here are some nutrition shifts to begin making today to ease perimenopause symptoms and reduce disease risk.

• Eat balanced meals with protein, fiber-rich carbohydrates, and healthy fats
• Start the day with a high-protein breakfast
• Stay hydrated
• Increase colorful plant foods – shoot for 30-40 unique plants per week (spices count!)
• Let go of fad diets and focus on nourishment
• Limit or eliminate alcohol, refined sugar, and ultra-processed foods
• Practice gentle fasting by not eating between dinner and breakfast the next day for about 12 hours
• Choose organic food as much as possible to reduce toxin exposures
• See your doctor regularly to monitor perimenopause and risk factors
• Use supplemental nutrients to help optimize nutrition, such as quality protein powder, fish oil, fiber, a daily multivitamin/mineral, and vitamin D.

Diet alone might not be enough to prevent all your symptoms and risks, but it’s a step you can’t skip! The more you can put in place now, the more you invest in your future health and quality of life. And you don’t have to walk the path alone. TārāMD is here to support you through your perimenopause journey and beyond with thoughtful, woman-centered, integrative, and holistic medicine.

References

1. Erdélyi, A., Pálfi, E., Tűű, L., Nas, K., Szűcs, Z., Török, M., Jakab, A., & Várbíró, S. (2023). The Importance of Nutrition in Menopause and Perimenopause-A Review. Nutrients, 16(1), 27. https://doi.org/10.3390/nu16010027
2. Silva, T. R., Oppermann, K., Reis, F. M., & Spritzer, P. M. (2021). Nutrition in Menopausal Women: A Narrative Review. Nutrients, 13(7), 2149.
3. Turner, N. D., & Lupton, J. R. (2021). Dietary Fiber. Advances in nutrition (Bethesda, Md.), 12(6), 2553–2555.
4. Purdue-Smithe, A. C., Whitcomb, B. W., Szegda, K. L., Boutot, M. E., Manson, J. E., Hankinson, S. E., Rosner, B. A., Troy, L. M., Michels, K. B., & Bertone-Johnson, E. R. (2017). Vitamin D and calcium intake and risk of early menopause. The American journal of clinical nutrition, 105(6), 1493–1501.