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Perimenopause Diet: Foods to Eat vs. Avoid

By Jill Levy

May 9, 2024

Perimenopause marks the normal transitional phase — typically up to 14 years — leading up to menopause, which specifically refers to the point when a woman has gone 12 consecutive months without a period. Perimenopause most often occurs during a woman’s fourth decade and is a gradual process that involves normal hormonal changes (decrease in sex steroids).

Perimenopause affects everyone differently. Some women may pass through perimenopause without noticing many changes, but for many women, it can bring a whole host of experiences like hot flashes, irregular periods, difficulty sleeping, vaginal dryness and even weight gain. These are all normal and common.

The good news is that making some changes to your diet and lifestyle may help manage this stage in life. After all, your health is directly connected to what you eat and how you live, including when you may be going through perimenopause and menopause.

But beyond simple life stage management, making some of the dietary changes below, including eating more of certain foods while avoiding others, may improve your ability to age healthfully and normally.

Of course, you should always consult your healthcare professional prior to beginning any new dietary or lifestyle regimen.

Normal Body Changes During Perimenopause

While more studies need to be conducted, in one article entitled “The Importance of Nutrition in Menopause and Perimenopause” published in the journal Nutrients in January 2024, the author discusses how the basal metabolism of the female body can decrease significantly during the period of perimenopause and menopause. In fact, the basal metabolic rate (BMR) can lower by up to 250 to 300 calories per day. Without changing one’s diet and lifestyle, an annual weight gain can average 4 to 5 pounds.

Most commonly, there’s an increase in abdominal (visceral) fat while muscle function and mass decreases. In fact, 60 to 70 percent of middle-aged women experience weight gain.

The author concludes that there is “growing evidence that lifestyle factors such as diet, physical activity, smoking, and alcohol consumption have a significant impact on health and menopausal symptoms.”

Nutrition Changes to Make

The above study notes that “achieving and maintaining a healthy nutritional status” can help alleviate both perimenopause and menopause symptoms. For example, in order to lose weight, it’s important to create a negative energy balance, with a combination of calorie reduction and an increase in resistance exercise.

Roughly 20 percent of one’s diet or more should consist of protein, in order to maintain muscle as well as create satiety. Remember that diets with higher protein only result in weight loss if the overall calorie count is also considered. Ideas for reducing calories include removing snacks, eating smaller meals and avoiding alcohol and sugary drinks.

In addition, the study author suggests that the Mediterranean diet is a good option for women entering the perimenopause stage. Characterized by high-antioxidant foods that support healthy inflammation levels, there’s evidence that the Mediterranean diet also supports healthy weight management, healthy blood sugar levels already in the normal range and heart health.

Type of Foods to Eat

As emphasized in the Mediterranean diet, a quality perimenopause diet should be full of nourishing, unprocessed foods that help the body adjust to changing hormones while also assisting in healthy weight management.

Here are a number of key dietary steps to consider taking:

1. Protein

As indicated above, during perimenopause it’s common (and normal) to notice an increase in body weight alongside a decrease in lean muscle mass.

To help counter this all, you can up your daily protein intake. Studies show that consuming more protein than the standard recommendations (so more than 0.8 grams of protein a day per kilogram) can help decrease fat mass while preserving muscle. On top of that, consuming more protein helps you manage your appetite (important when hormones are fluctuating), promote healthy cholesterol levels and support heart health.

See our article on how to eat more protein. Tips include having a protein with each meal, having protein supplements at the ready and selecting leaner cuts of meat.

One such recommended protein is collagen, as it’s the most abundant protein in the body. Ancient Nutrition’s Multi Collagen Protein, among its many benefits, reduces joint discomfort and helps joints recover faster.

2. Fiber

Again, because appetite can affect healthy weight management, even during normal hormonal shifts, it’s helpful to eat more fiber to help slow cravings while making you feel more full. How much fiber per day? Aim for about 25 grams per day for adult women.

With the hormonal changes during perimenopause, occasional constipation may occur. A fiber-rich diet can help alleviate occasional constipation, plus help battle other perimenopause challenges. Some studies have even found that diets higher in fiber might help to promote healthy, normal production of estrogen.

Whole grains, legumes, seeds, certain fruits (pears, apples and bananas), cruciferous vegetables and sweet potatoes are examples of high-fiber foods. Plus cruciferous vegetables contain indole-3-carbinol, which can help to balance estrogen levels.

3. Omega-3 fatty acids

Studies show that fatty acids can help to navigate perimenopause and also promote a healthy mindset and outlook. In general, omega-3 fatty acids support healthy inflammation levels and also help make you feel fuller.

Omega-3 foods include fish like sardines, salmon and herring, as well as flaxseeds, walnuts and natto. If you find it difficult to get enough omega-3s into your diet, consider an omega-3 supplement. Ancient Nutrition’s Ancient Omegas Whole Body formula provides 1,000 milligrams of omega-3s (including ALA, DHA, ETA and EPA) and features a special combination of organic plant and wild ocean omega fatty acids.

4. Calcium

Calcium is important for maintaining a healthy skeletal structure, bones and teeth. It also helps muscles relax and contract.

During perimenopause, women should make sure they get enough nutrients, including calcium. It’s especially important for postmenopausal women to make sure their calcium levels are optimal in order to support their healthy bones.

Therefore, it’s important to add more calcium-rich and vitamin D foods into one’s diet in order to support bone health. Food sources include dairy (yogurt, kefir, milk, cheese), fortified plant-based milks, canned sardines, leafy greens, broccoli, cashews, almonds and legumes.

Supplement-wise, it’s best to use a body-ready, food-sourced form of calcium that’s made without dairy. Ancient Nutrients Calcium also features vitamin D3, which, in general, is a preferred form of vitamin D and acts as a supporting role in the body’s absorption of calcium.

5. Magnesium

Magnesium helps to support bone health, heart health, muscle function and even a positive mindset and ability to sleep more restfully — all important benefits for anyone going through perimenopause.

Coming up short on magnesium is one of the leading nutrient shortfalls affecting women. Although we only need small amounts of magnesium relative to other nutrients, we must regularly replenish our stores, either from foods or magnesium supplements.

Make sure to get enough by consuming magnesium-rich foods, such as leafy green veggies, sea vegetables/algae, beans, nuts and seeds, as only low levels of magnesium are typically included in multivitamins.

6. Probiotic Foods

Perimenopause and menopause are often times to focus on gut health, too. Probiotic foods and supplements help balance the gut, including strengthening the gut lining, as well as promoting overall heart health and relieving common perimenopause symptoms like occasional constipation.

Probiotics are “friendly” microbes that live in your gut and assist in healthy digestion and nutrient absorption. Eating probiotic-rich foods like yogurt, kefir, sauerkraut and kimchi can help fill your gut with more good bacteria, as can taking a quality probiotic supplement each day.

Ancient Nutrition’s SBO Probiotics Women’s support healthy digestive function, and it features clinically studied Bacillus coagulans to support women's overall vaginal and urogenital health as well as healthy yeast balance — including before, during and after menopause.

7. Fruits and vegetables

Have you heard the nutrition advice to “eat the rainbow”? Well, it’s true. Aim to eat a variety of colors with your fruit and vegetable consumption. Indulge in the seasonal offerings at your local farmer’s market and grocery store.

Why? A 2020 study demonstrated that women who consumed more vegetables and fruits had an easier time with normal menopause compared to women who ate fewer of these foods. These foods are loaded with vitamins, minerals, fiber and antioxidants.

8. More Fluids

Hormonal change during perimenopause can even impact thirst, which can result in consuming less fluid. But it is important to have at least eight glasses of water per day to help stay hydrated and to keep digestion running smoothly.

Foods to Avoid

• Ultra-processed packaged foods: Most of these foods contain added sugar, chemical preservatives, high amounts of sodium, toxins and synthetic additives. These can negatively impact hormones.

• Conventional meat: Choose hormone-free, grass-fed, cage-free or pasture-raised animal proteins whenever possible to support healthy inflammation levels, as factory farm meat can do the opposite.

• Added sugar: High levels of sugar can cause weight gain, digestive issues, negatively impact hormones and cause hot flashes.

• Refined oils and fried foods: Foods cooked in highly-processed vegetable oils are high in omega-6 fats that can contribute to unhealthy inflammation levels, while negatively impacting the heart and weight.

• Carbonated drinks: Carbonated soda or other drinks may rob the body of calcium and negatively impact bone and teeth health.

• Alcohol: Alcohol can aggravate hot flashes and contribute to weight gain.

Ancient Nutrition’s Women’s Hormones: Hormone Balance

Designed to support balanced hormones, this Women’s Hormones supplement brings you time-tested superfoods that are optimized for absorption.

• Features vitex (chaste tree berry) to help promote women's overall hormonal health and balance plus back cohosh to support women's reproductive health, including during menopause and postmenopause

• Supports female reproductive health

• Supports healthy energy and reduces fatigue

• Helps reduce stress and promotes a positive mindset

• Helps promote mental clarity and concentration

• Promotes restful sleep

• Supports immune system modulation

• Supports the body’s ability to adapt to stress