As women move through perimenopause and menopause, changes in hormones, weight, sleep and muscle health can make nutrition feel more important than ever. But rather than following a special ‘menopause diet’, experts say the focus should be on nourishing the body consistently.
Grace Muteti, a clinical dietitian, would not necessarily call it a menopause diet. It is more about adapting to the changes that come with menopause, maintaining a healthy lifestyle, making good dietary choices, staying active and paying attention to muscle and bone health.
“What a woman eats during her reproductive years, including after having children, and how she looks after her nutrition during these years can help prepare her for later life,” she says.
During perimenopause, hormone levels begin to fluctuate and, over time, oestrogen levels go down. This can affect body composition, where fat is stored, appetite, sleep and muscle mass. Many women notice that foods they used to eat without gaining weight now seem to affect them differently.
“It is often described as having a slower metabolism. Metabolism does change as we age; it is not only about hormones,” says Grace.
She notes that women also gradually lose muscle, may become less active, experience changes in sleep, face increased stress and see their eating habits change.
“Insulin resistance can also become more of a concern as women get older, particularly when there is abdominal fat and little physical activity.”
The basic principles of good nutrition remain the same. However, individual nutritional needs can vary depending on age, health status, activity levels, dietary patterns, medications and whether someone has a nutrient deficiency.
Additionally, there are certain nutrients that deserve more attention during menopausal years. Protein is important because women are trying to preserve muscle as they age. Calcium and vitamin D matter too, along with fibre and other healthy fats.
“I would encourage women to include a variety of protein sources, such as beans, lentils, eggs, fish, yoghurt, poultry and lean meat where appropriate. Seeds such as chia seeds, flax, pumpkin and sesame are easy to add to porridge, yoghurt, salads or other meals."
“Women don’t suddenly begin losing muscle when we reach menopause. It's a gradual process that happens with ageing, so what we do before menopause matters,” she adds.
For women struggling with weight or insulin resistance, Grace discourages cutting out carbohydrates completely.
“It is worth considering the type and portion, as well as what they are eating alongside them.”
If a woman says she is gaining weight because she is menopausal, Grace says she would not simply attribute it to hormones.
“I would want to know what she’s eating, whether she’s getting enough protein and fibre, how active she is, whether she’s doing strength training, how she’s sleeping and what else is happening in her life,” she says.
For a woman in her 40s or 50s going through perimenopause or menopause, half the plate should be vegetables, a quarter protein and a quarter a high-fibre carbohydrate, with healthy fats and calcium-rich foods included depending on the meal.
“It doesn’t have to be complicated or expensive. It could be vegetables with beans, fish, eggs or chicken, along with a reasonable portion of potatoes or whole grains. Seeds can be added to a salad, yoghurt, porridge or cooked meal for extra fibre, minerals and healthy fats.”
“Reaching menopause does not automatically mean that a woman needs several supplements,” she cautions.
“They can be useful where someone has a deficiency, their diet is not meeting a particular need, they have an increased requirement, follow a restrictive diet or have a specific clinical reason for taking one.”
She warns that vitamin D, calcium, B12, iron or omega-3 should not be taken blindly.
“The decision should take into account the individual’s diet, symptoms, medical history, medications and, where appropriate, blood results.”
