Hot flashes. Brain fog.
A rollercoaster of moods and emotions.
Wacky, disrupted sleep.
If you’re a woman over 40 experiencing these symptoms, you may be in the menopause transition. Luckily, nutrition can help!
This article delves into how your eating pattern can support the changes that occur to the body during perimenopause and menopause. We’ll explore how diet can help support health, reduce disease risk and improve uncomfortable menopause symptoms.
Let’s go.
Menopause and Disease Risk
For women, the decline in estrogen, progesterone and other hormones, indicating the menopause transition, come with an increased risk for:
- Cardiovascular diseases (e.g., heart disease, stroke)
- Type 2 diabetes
- Depression
- Cognitive changes
- Osteoporosis
- Certain cancers
These changes directly affect our nutritional needs and can be positively impacted by our food and lifestyle choices. Getting adequate sleep, exercise, refraining from smoking and moderating alcohol intake can all impact health positively. Additionally, a balanced, nutrient-dense diet can also have important impacts on heart, brain bone and overall health during menopause.
Need a supportive community in perimenopause or menopause? Learn more about my Menopause Support Group.
Menopause and Diet: Heart Health
Reaching menopausal age can increase women’s risk of various health conditions, one of which is cardiovascular disease. Heart attack, stroke, atherosclerosis (plaque buildup in the arteries/blood vessels), and heart failure are examples of cardiovascular diseases.
Estrogen plays an important part in heart health. Firstly, this hormone helps increase our “good” cholesterol (also known as HDL, high density lipoprotein) and decrease LDL (low density lipoprotein) or our “bad” cholesterol.
As estrogen levels decrease during menopause, heart disease risk increases. Nutrition plays an important role in lowering your risk for cardiovascular disease. Two nutrients that have a positive impact are omega-3 fatty acids and fiber.
Nutrients Important To Heart Health
Omega-3 Fatty Acids
Omega-3 Fatty acids are important for our cardiovascular health. For instance, they help lower inflammation and reduce blood pressure.
Another benefit of Omega-3s is their ability to lower triglyceride levels. Triglycerides, otherwise known as fat that can enter our bloodstream, can lead to cardiovascular disease when levels get too high. However, Omega-3s can help to slow down the buildup of plaque in our arteries, which is a leading cause of cardiovascular disease.
Omega-3s can be found in:
- Oily fish: salmon, tuna, mackerel and sardines
- Plant based sources: walnuts, chia seeds, flax seeds and soy products (tofu, soy milk, etc.)
- Plant oils: flaxseed, soybean, canola
- Fortified foods: yogurt, eggs, and milk (check labels for omega-3 content)
Recommended intake:
1,100mg (1.1g) of Omega-3 Fatty Acids are recommended for adult women.
Menopause Recommendations:
For women in menopause, some providers recommend an increased intake of Omega-3s. Check with your healthcare provider to see if this would be the right decision for you.
How can I meet my daily Omega-3 needs?
One of the following servings of foods provides more than 1.1g of Omega-3:
- 3 ounces cooked Atlantic salmon
- 1 Tbls canola oil or mayonnaise made with canola oil
- 1 Tbls chia seeds
- 1 Tbls flax seeds
- 1 Tbls walnuts
Fiber
As we reach menopause, including fiber in our diet is important for lowering the risks of developing high cholesterol, type 2 diabetes, high blood pressure or other cardiovascular risk factors. With the decreased production of estrogen to help manage cholesterol levels, increasing fiber is key to maintaining a healthy heart.
Fiber is the indigestible part of plant foods that our body cannot break down. As such, it passes through our digestive system and passes on numerous benefits. Fiber is found in fruits, vegetables, legumes, nuts, seeds and whole grains like oats, brown rice and whole grain bread.
Consequently, when we eat plant-based foods, the fiber in these foods helps our body in many ways. Numerous studies have shown heart-related benefits of eating fibrous foods:
- Improved blood pressure
- Improve total cholesterol and reduce LDL cholesterol (the “bad”cholesterol)
- Improve blood sugar control, lowering risk for diabetes
- Improved composition of your gut microbiome, having a positive effect on metabolism, insulin sensitivity, and insulin secretion.
Recommended Intake:
For women, 22g of fiber is recommended for those over 50 and 25g to 28g for women under the age of 50.
Menopause Recommendations:
Occasionally, higher fiber intake may be recommended for women in menopause, so check with your healthcare provider to see what is right for you.
Fiber and Hydration
When we increase our fiber intake, it is important to be mindful of hydration. Fiber is important, not only for managing cholesterol and blood glucose levels, but for helping things move through our GI system as well. Soluble fiber absorbs water as it moves through the digestive tract and staying hydrated can help move things through smoothly and prevent constipation. Therefore,iIf you increase fiber intake, increasing hydration will be helpful to make elimination easier.
Menopause and Diet: Bone Health
Osteoporosis, which means “porous bones,” is a condition in which our bones start to become weaker, more brittle and more prone to breaking. This occurs because of changes in bone mineral density.
So why are women more at risk of developing this condition during menopause?
Estrogen is responsible for the upkeep of many functions in our body. It helps to maintain bone health and slow down the natural breakdown of bones as we age. When estrogen levels fluctuate and drop during menopause, our bones can begin to weaken much more rapidly.
The good news? Your nutrition can help.
Nutrients Important to Bone Health
Protein
Protein is increasingly more important for our bone health as we age. A Women’s Health Initiative Study reported that higher protein intake (1.2 g/kg body weight) was associated with a 32% lower risk of frailty and better physical function.
During menopause our muscle mass can also begin to deteriorate. Similar to bone health, estrogen helps to keep our muscles strong and the decline in this hormone causes muscles to weaken and break down in a condition known as sarcopenia. Getting enough protein in our diet is important maintaining muscle mass as we age.
Recommended Intake:
1.1-1.2 grams of protein per kilogram of body weight is recommended for maintenance of both bone health and muscle mass. However some sources report up to 2-2.3g/kg, so checking in with your dietitian on where your needs may fall is critically important. Including a protein source at every meal is a good starting point.
Sources of protein include:
- Poultry (chicken, turkey), fish (salmon, tuna) and red meats (beef, pork, lamb, etc.)
- Tofu, tempeh, soy milk
- Eggs
- Milk, yogurt, cottage cheese
- Legumes, beans, peas, edamame (paired with grains for complete proteins)
- Nuts and nut butters (paired with grains for complete proteins)
- Chia seeds
- Quinoa
Vitamin D
Vitamin D helps our bones to absorb calcium which is extremely important in maintaining bone density and function. It can also be generally beneficial for cardiovascular health, immune health and brain function as well (which we will dive into more shortly.)
Recommended Intake:
15 to 20 mcg (600–800 IU) for adults
Sources of vitamin D
- Egg yolks
- Sardines, salmon and tuna
- Fortified foods like milk, plant milks and cereal
- Vitamin D can also be taken as a supplement, but spending some time outside in the sun is also one of our best sources.
Vitamin D and Sunlight
UVB rays from the sun trigger the skin’s production of vitamin D3 from the cholesterol in our bodies. Even 10-15 minutes spent in the sun can provide most of your body’s daily Vitamin D needs.
Calcium
Calcium is a main component of our bone tissue and helps in its density, strength and ability to heal. Lower estrogen levels can lead to bone density loss, increasing the risk of osteoporosis. Vitamin D helps the body absorb calcium for bone formation, so both nutrients are important for bone and tooth health.
Calcium needs increase around age 50 for women, and vitamin D needs increase at age 70 for all adults.
Recommended Intake:
As bones become more susceptible to weakness during menopause, aiming for 1,200mg of calcium per day is important for maintaining strong bones and avoiding osteoporosis, fracture and breaks. Ideally, spreading out your calcium sources over several meals helps your body absorb this mineral.
Sources of calcium:
- Dairy products (milk, yogurt and cheese)
- Vegetables like leafy greens and broccoli
- Edamame
- Tofu
- Almonds
- Bone broth as well as bone marrow
- Fish with edible bones such as sardines
- Calcium fortified plant-based milks, orange juice and breakfast cereal
Regular physical activity, especially weight-bearing or resistance activity, is also essential to maintaining bone health.
Menopause and Diet: Brain Health
Estrogen, like many other hormones, plays a role in our cognitive (brain) function. In light of reduced estrogen levels in menopause, it is common for women to experience symptoms such as brain fog, memory difficulties and changes in mood. A diet high in vitamin D and Omega-3 fatty acids, however, can mitigate some of these symptoms.
Vitamin D:
Vitamin D has been shown to have a positive impact on preventing cognitive decline as we age. It can help to maintain the brain’s tissue structure and volume and has demonstrated positive effects on memory, attention, decision making and learning. See above for recommended intake.
Omega-3s:
Omega-3 fatty acids are important in the brain’s development and support our cognitive function and memory. Importantly, these fats are essential for the structure of our brain cells, particularly in the hippocampus, the part of the brain we use for memory.
Omega-3s have been shown to help prevent inflammation in our brains that is associated with neurodegenerative disorders and cognitive decline such as Alzheimer’s and Parkinson’s Disease.
Adequate intake has demonstrated the potential to decrease depression and anxiety, both of which can become more common during menopause. See above for recommended intake.
Menopause and Diet: Mood
Overall, food impacts our brain and our moods much more than we are usually aware.
We all know how it feels to get grumpy or irritated when we’re hungry and this is a very real phenomenon. What we eat and if we’re eating enough has a very real impact on our brains and our mood.
Adequate and balanced nutrient intake helps us to maintain our brain function and neurotransmitter production. Dopamine, serotonin and norepinephrine are chemicals in our brain that help regulate our moods. Micronutrients (vitamins and minerals) are essential for the production of these chemicals and stabilizing our moods.
Eating enough throughout the day also helps us to balance blood sugar levels. Blood sugar crashes can cause us to experience drops in energy levels and mood changes such as irritability, low energy and even sadness. Making sure you’re eating enough throughout the day and maintaining a balanced, diverse diet can have positive effects on mood stability, energy levels and brain function.
If you are unsure whether you’re eating enough, a registered dietitian can evaluate your needs and advise whether changes are necessary.
Menopause and Diet: Hydration
Hydration also plays an interesting role in our bodies during menopause. As our hormones fluctuate, this can cause changes in our fluid and electrolyte levels as well. The hormone shifts during menopause can cause women to be more susceptible to dehydration. Symptoms such as hot flashes, sweating and frequent urination can lead to loss of fluids.
To add on to this, research has highlighted a decline in the thirst mechanism as we age. Which means we are simply less in tune with when we need water, making dehydration more common.
Staying hydrated can help to combat the fluid shifts and losses caused by hormone fluctuations leading to:
- Mood and Brain Function: Dehydration negatively impacts things like mood, memory and decision making.
- Urinary tract health: Staying hydrated can help to prevent urinary tract infections, which can be more common during menopause, by flushing out harmful bacteria.
- Joint Health: Remaining hydrated allows for better lubrication of joints; dehydration can lead to joint pain and stiffness
Try to hydrate throughout the day, being mindful of water intake to avoid dehydration!
Recommended Intake:
2.7 liters of fluid intake (from food and drinks) is recommended for adult women (around 7-9 cups per day). Foods such as fruits and vegetables provide hydration and should be included in the total intake. For best results, hydrate throughout the day, not all at once.
Menopause and the Mediterranean Eating Pattern
The Mediterranean diet emphasizes diverse food intake with fruits, vegetables, legumes, olive oil and lean proteins at the center of the diet. Also central to Mediterranean food culture is sharing meals communally, eating with others and savoring food slowly.
Focusing on foods from the Mediterranean eating pattern may be beneficial to women entering menopause due to their benefits to cardiovascular health, blood sugar management, muscle mass and bone density as well as links to improved mood.
Foods in the Mediterranean eating pattern include lean protein sources such as fish and poultry, unsaturated fats such as olive oil, and diverse fruits and vegetables providing fiber and ample vitamins and minerals. This diet is rich in Omega-3s, vitamins and minerals, and protein all of which, as we have discussed, are important during menopause.
It is important to remember that this is more a style of eating or a pattern, rather than a weight loss diet. The focus on including more of certain nutrients can help establish a more diverse or balanced pattern of eating, emphasizing mindful choices rather than “perfect eating.”
Menopause and Diet Wrap Up
While we cannot control the loss of estrogen and progesterone during menopause, we can lower our disease risk with changes to our nutrition and lifestyle.
Eating a balanced diet which focuses on foods high in fiber, protein, vitamin D, calcium and omega-3s can do a lot to mitigate the disease risks and symptoms of menopause. Seeking balance in our diet, movement and stress management can all help with symptoms of menopause and reduce disease risk.
Changes to your body may feel scary. Remember that the changes women experience in perimenopause and menopause are NORMAL! Our bodies change as we age and it is important to recognize this and give ourselves grace.
Need a supportive community in perimenopause or menopause? Learn more about my Menopause Support Group.
Written by Cate Thiery; Edited and reviewed by Britt Richardson, RDN
Hello there! I’m Britt, a Registered Dietitian Nutritionist and Certified Intuitive Eating Counselor. I can help you find freedom from life-long dieting, disordered eating and eating disorders. When I’m not writing about ditching diet culture, joyful movement or improving body image, you can find me hiking in Vermont’s Green Mountains, eating pizza, making modern quilts or sipping a hot cup of tea. Let’s connect!
