When you’re going through perimenopause or menopause, your body needs a rich and varied diet, full of nutrition provided by all of the food groups.
Eating well is about so much more than maintaining a healthy weight. Good nutrition is about feeling good from the inside out. Your diet has a huge impact on how you feel now and on your long term risk factors for a wide range of diseases.
Making good choices now may not only improve your menopausal symptoms, but also significantly reduce your risk of diabetes, heart disease, osteoporosis, cancer and dementia. Eating well is an essential part of the toolkit to help you stay strong and healthy in the decades ahead of you.
You can’t run at full speed without regular top ups of fuel. That means eating a nutritious breakfast, lunch and dinner. A lot of people like to plan a mid-morning snack and a mid-afternoon snack, too.
Planned snacking can be really helpful at managing mealtime portion control. If you know you tend to overeat at dinner, leaving you feeling bloated before bed, it’s worth trying a healthy mid-afternoon snack.
Meals
When planning your meals (breakfast, lunch and dinner) try to fill most of the plate with fibre-rich vegetables or fruit. Opt for smaller portions of protein and starchy carbohydrates like bread, wholegrains, potatoes, rice, pasta and cereals. Aim to include at least four servings of pulses and legumes in your diet across the week, for optimal gut and cardiovascular health. Examples include: soya (edamame) beans, chickpeas, lentils, kidney beans and black beans.
Snacks
Ideally, snacks should be made up of two food groups eg. carbohydrate + protein. Ideal combinations include a slice of cheese with two oat cakes; apple and unsweetened peanut butter; dried fruit and unsalted nuts; banana on a slice of wholegrain toast.
Protein
The key to achieving a good balance here is variety. Plan your meals according to your dietary preferences (omnivorous, pescetarian, vegetarian or vegan), and include a mixture of different proteins across the week. If you do not already do so, aim to have at least two meat-free days a week.
When choosing your proteins, think about the following:
- Red meat – choose lean cuts and extra lean mince. Dry fry when you can. Limit your overall intake to no more than once or twice a week, and avoid processed meats such as bacon, salami and ham.
- Fish – aim to have at least one serving of oily fish like salmon, sardines, trout, mackerel or pilchards a week. If you do not eat fish, consider taking an algae-based EPA/DHA supplement and/or include regular plant-based omega-3 sources in your diet such as ground flaxseed, chia seeds and walnuts.
- Plant-based sources - these include tofu, tempeh, nuts, beans and pulses. Soya is particularly beneficial during menopause and is a complete plant-based protein that can be consumed daily. Quorn and plant-based meat alternatives can also be included, but limit your intake to no more than twice weekly as they can be high in salt.
Carbohydrates
Forget no carbs, it’s all about slow carbs. Avoiding carbohydrates is one of the worst nutrition mistakes you can make if you want to fuel your body.
Wholegrain and low glycaemic (complex) carbohydrates are your best choices, so try to have some of these at each meal:
- Bread - granary, rye, wholemeal seeded bread.
- Potatoes - sweet potatoes, baby new potatoes.
- Pasta - dried wholegrain pasta (cooked al dente, with a bite).
- Cereals - oats, no added sugar muesli.
- Grains - brown basmati rice, red rice, couscous, bulgur wheat, quinoa, barley.
Nutrition for bone health
Menopause leads to lower levels of oestrogen in the body and this can result in bone loss, increasing the risk of osteoporosis. Now, more than ever, your body needs the necessary nutrients to support good bone health and maintain bone density.
Calcium is a mineral that is important for maintaining bone strength, and vitamin D is needed to help you absorb the calcium in your diet.
For most adults over 19, the UK recommended daily amount (RDA) is 700 mg, but it is 1000-1250 mg if you are postmenopausal and/or have osteoporosis, coeliac disease or inflammatory bowel disease. You can calculate your own calcium intake via an online calcium calculator.
When most people think of dietary calcium, they tend to think of dairy products. While dairy is a convenient source of calcium and other nutrients, it is not the only source. Many people are unable to tolerate lactose (with dairy intake leading to uncomfortable gastrointestinal symptoms), and others choose to exclude dairy from their diet for both ethical and environmental reasons.
Whatever your dietary needs or preferences, there are plenty of calcium rich foods, including:
- dairy-products, such as yoghurt and cheese,
- calcium-set tofu and other soya-based foods,
- beans and lentils, especially chickpeas and edamame beans,
- leafy greens/cruciferous veg, e.g. watercress, rocket, kale, broccoli, cabbage, cauliflower, spring greens and bok choy,
- small fish with bones, e.g. sardines, whitebait, pilchards,
- nuts and seed, including nut butters (almond butter and unhulled tahini are particularly calcium-rich),
- oranges, dried (uncooked) figs and apricots,
- teff and amaranth (ancient grains).
In addition to including calcium rich food in your diet, it is important to be mindful of “calcium thieves” by avoiding smoking, high caffeine consumption (more than three cups of coffee daily), regular sweetened fizzy drinks (especially cola) and excess salt. If you drink alcohol, be moderate with your intake - daily drinking and/or binge-drinking is damaging to your bones.
Fruits and vegetables
The recommended intake of '5 a day' for fruits and vegetables is the minimum you should aim for to get all the vitamins and minerals your body needs to be healthy. There’s nothing wrong with having more than five a day – in fact, it’s actively encouraged. Recent research suggests that we should actually be aiming to include 30 different plant-based foods in our meals and snacks over the course of a week!
One serving is 80g of fresh, frozen or canned fruit or veg (not including potatoes or other starchy foods) or 30g of dried fruit. 150 ml of fruit juice, vegetable juice or a smoothie can count as a serving but these should only be counted once a day as higher intake can lead to teeth damage). 80g of beans and pulses also count as one serving daily.
Eat a rainbow of different coloured fruit and veg, as the different colours indicate different vitamins and minerals and provide different benefits. Diversity is key to a healthy gut microbiome, and good hormonal and emotional health.
Fresh, frozen, dried or (unsweetened and unsalted) canned fruits and vegetables all count towards your daily count. Budget ranges or wonky veg contain just as many vitamins and minerals as premium range fruits and vegetables.
Drinks and fluids
Maintaining good hydration is just as important as eating well. Most fluids count towards your intake, so you don’t just have to drink water. The only drinks that don’t count towards your fluid intake are alcohol, fruit juices and smoothies, but aim to minimise your intake of sweetened drinks (whether that is sugar in your tea or fruit squash).
You can check if you’re hydrated by having a look at your urine when you go to the bathroom. If your urine is a very pale - , white wine colour - , you are well hydrated. If it’s darker than that, try to drink a little more.
There is some evidence that caffeine and alcohol can make hot fluahes worse. If you’re bothered by hot flushes, consider limiting tea and coffee to one or two cups per day or use decaffeinated varieties. Make sure you keep your alcohol intake within safe limits - no more than 2-3 units per day and a maximum of 14 per week. Ideally, you should not consume more than 7 units a week for optimum brain health. and you may benefit from cutting it out altogether.
Other beneficial foods and supplements
During perimenopause and postmenopause, a daily vitamin D supplement (containing 400 IU or 10 ug) is recommended to protect your bone health. If you are over 50, Government recommendations are to also take a regular vitamin B12 supplement (10 mcg daily, or 2000 mcg once weekly) as this is not absorbed as well from food sources as we get older. If you are vegetarian or vegan then, whatever your age, you should also take a vitamin B12 supplement daily. mcg
There are a wide range of supplements targeted at menopausal women, but there is very limited evidence to support their effectiveness and many women spend vast amounts of money for very little benefit. Other supplements e.g. omega-3, iodine and magnesium may be recommended on an individual basis, but not routinely.
Some women find including more plant oestrogens, or phytoestrogens, in their diet (not supplements) helps to reduce the frequency and severity of hot flushes. You may need to eat 2-3 servings of phytooestrogen. rich food, such as like soya, every day for a few months to see the full potential symptomatic benefits. However, these foods also play a role in improving bone, cardiovascular and breast health benefits. If you have been diagnosed with, or have a family history of, breast cancer, you do not need to avoid these foods. In fact, current research suggests it is beneficial to include these in your diet. For more information on the health benefits of soya, see here.
If you’d like to learn more about nutrition and staying healthy during menopause, book a consultation with Menopause Care dietitian Marcela Fiuza.
