Nutrition Considerations for Perimenopause and Menopause
Menopause marks a phase of life every female who reaches post-reproductive years will experience. There are many changes happening in the body which impact various aspects of our health. These changes begin in perimenopause, which is the transitional time leading up to menopause that is less commonly discussed but quite significant. This phase can last 2-8 years on average and is marked by changes in the body, such as irregular periods, heavier or lighter flow, sleep challenges, hot flashes, mood changes, and other hormone-related symptoms. When a woman has gone one full year without a menstrual period, this is considered having entered menopause. This season of a woman’s life requires extra consideration for long-term health and disease prevention.
Nutrition is one essential way to support our bodies and provide them with the energy and nutrients needed to navigate these changes most effectively. At the foundation, consuming adequate energy (aka calories) from nutrient-dense foods is the best starting point. Data shows that close to 40% of women actively engage in diet practices, and a portion of the population unintentionally undereats. These practices put added stress on the body, which can negatively impact our health and put our body in a compromised state during a time when proper nutrition is vitally important.
A framework like the Plate Method ensures we balance our meals to include adequate protein, carbohydrates, vegetables, healthy fats, vitamins, and minerals. This concept incorporates all the food groups and doesn’t need to be overly complicated. Let’s look into the specifics of why and how these nutrients play such an essential role in health, especially in this season of life.
Protein
Starting with protein, data shows women are either falling short of the recommended amount or aren’t properly balancing their intake throughout the day. This often leads to dips in energy, increased hunger, and cravings in the second half of the day. Since protein is a key player in balancing blood sugar and keeping us satisfied between meals, not eating enough or not balancing amounts adequately between meals is a driver of these common symptoms women face.
What else does protein do? Protein is a building block for our cells and tissues, and an essential element for maintaining lean body mass. As we age, lean body mass (including muscle tissue) breaks down, especially if we are less active and not eating adequate protein. To achieve adequate intake in this stage of life, women should be aiming for around 30 grams of protein per meal. Ideally, this comes from a variety of sources – eggs, fish, seafood, lean meats, soy, beans, legumes, nuts, and seeds. Snacks are a chance to fill gaps between meals, if needed, to boost our intake if we fell a bit short at the past meal (such as only getting 15-20 grams of protein).
As a final point, remaining physically active throughout our life ensures that the protein building blocks aid in maintaining lean body mass, which supports our metabolism, our mobility and ultimately our longevity.
Starch
The next nutrient and section of the plate to outline is starches or carbohydrates. Often demonized and restricted, during this season of life, carbohydrates are still very important as the primary fuel source for the brain and a key component of many nourishing foods. Whole grains, starchy vegetables, beans, and fruits should be the focus for the 1/4 of our plate that is reserved for starches. Because the female body and brain are undergoing significant changes during perimenopause, common symptoms women experience include fatigue, low energy, brain fog, and low mood. Carbohydrates have been shown to support the body in each of these areas. While they may not be the only solution, ensuring adequate nourishment is an essential first step.
During perimenopause, we see fluctuating levels of estrogen, and once into menopause, estrogen levels are much lower than our bodies have been used to for several decades. Why are we referencing estrogen when talking about carbohydrates? Because there is an important connection between estrogen and blood sugar management. Lower levels of circulating estrogen mean our cells are less insulin sensitive, another way of saying they are insulin resistant (a phrase you may have heard before). Insulin is a hormone released from the pancreas, and its main job is to allow our cells to take in glucose from the bloodstream for energy. So when our cells are not as responsive to the presence of insulin as they should be, they aren’t able to take in as much glucose from the bloodstream.
What happens when more glucose (aka blood sugar) stays in the bloodstream? Our blood sugar level tends to remain higher, and the body may keep trying to lower our blood sugar by releasing more insulin, creating a vicious cycle. If we are eating imbalanced meals or higher amounts of refined carbohydrates, this may be problematic for individuals who are more susceptible to insulin resistance. Luckily, we can do a lot to support the body in optimizing its insulin response and management of blood sugar by incorporating adequate protein, healthy fats, and fiber into our meals. For those who feel their body is more sensitive to carbohydrates, a session with a dietitian is a great way to explore which sources and amounts feel best to your body.
Non-starchy vegetables
Filling half our plates with non-starchy veggies is another key aspect of blood sugar support.
Using the Plate Method as your guide at lunch and dinner ensures you’re well on your way to meeting that recommendation and supporting total body health. The research regarding a diet rich in fruits and vegetables, at least five servings per day, shows a reduction in the risk of cardiovascular disease, cancer, and all-cause mortality. Since cardiovascular disease is the leading cause of death in women, accounting for 35% of deaths in women each year, every action we can take may help. Strive to consume an array of colors, which represent a variety of micronutrients, especially those with disease-fighting antioxidants, to prevent cell damage and provide anti-inflammatory protection. Think of deep red cherries, dark blueberries, bright orange peppers, carrots, dark leafy greens, and so many others!
The fiber-rich nature of these plant foods is another reason we want to be eating several servings in a day. Fiber feeds the healthy bacteria that live in our digestive tract and supports regular bowel movements. It is beneficial for overall health, especially for hormone health. Focusing on cruciferous veggies supports detoxification, a process by the liver that can help reduce some symptoms of hormone imbalances. Examples of these veggies include broccoli, cauliflower, Brussels sprouts, kale, arugula, cabbage, collards, watercress, radish greens, and Bok choy.
Fats
Lastly, fats are an essential component of proper nutrition. Much like carbohydrates, they’ve had their time on the chopping block that is the realm of fad diets, but eating too few can be harmful to our health. We need fats to support our cellular structure, produce important hormones, protect our organs, and absorb certain nutrients.
Much like proteins, fats are beneficial for satiety and blood sugar balance. They often make their way into meals and onto our plate through cooking methods (butter and oil) or when they are naturally found in foods (meat, seafood, sauces/dressings, nuts and seeds). A focus on unsaturated sources like nuts, seeds, avocadoes, fish and fish oil, olives, and olive oil is recommended, with smaller amounts of saturated fat coming from sources like meat, high fat dairy and coconut oil.
Food first… but supplements when necessary
Depending on individual health status, genetic risk, and other factors that may increase our nutrient needs, there are particular vitamins and minerals to consider when it comes to supplementation. This list is simply for reference during this phase of life; please discuss the most appropriate options for you with your provider/s.
Nutrients of focus/concern to fully support at-risk body systems:
- Bone health: vitamin D3, vitamin K2, calcium, magnesium, and phosphorus
- Heart and brain health – omega-3 fatty acids, B vitamins, and minerals (such as magnesium, zinc)
- Digestive health, energy and memory – fiber, vitamin B12, and iron (perimenopause)
- Lean muscle/body mass – sufficient and varied sources of protein
Our health is a dynamic aspect of our life. When we enter perimenopause, big changes happen throughout the body on the cellular level. Nutrition is one key aspect we can and should prioritize to ensure the body is fully supported. If you’d like more customized support on this topic or with implementing some of the guidelines shared above, please reach out to us and we’ll connect you with one of our dietitians who can meet you where you are today and guide you on the journey to becoming the healthy person you envision!