Published 31st January 2022

How to eat during perimenopause for your weight and health

Perimenopause is the lead up to menopause. The term is often used interchangeably with menopause, but menopause refers to the specific point in time when a woman has gone 12 consecutive months without a period. 

Everyone experiences perimenopause differently. Hot flashes, irregular periods, and vaginal dryness are common, and many people put on weight.

Changes to your diet may help you to manage your symptoms. 

Altering what you eat and drink could also help your body adapt to other age-related changes and improve your health overall. 

At ZOE, we run the largest nutrition science study in the world, with over 10,000 contributors so far. Our research shows that everyone’s responses to foods are different. 

Understanding your unique biology during perimenopause can help you choose the best foods for your body. 

You can take our free quiz to find out more.

Read on to learn how you might experience perimenopause and how nutrition can help you manage your symptoms.

How does your body change during perimenopause?

During perimenopause, you’ll experience fluctuations in levels of the reproductive hormones estrogen and progesterone.

After your final period, estrogen levels settle at a lower level and your body stops producing progesterone altogether.

The timing, length, and intensity of perimenopause vary, but on average, women start to develop symptoms in their forties. 

Combined with the effects of aging, perimenopause can directly or indirectly contribute to an increased risk of a number of physical and mental health conditions, including osteoporosis, heart disease, depression, and obesity. 

Some of the most common changes and symptoms you may experience include: 

  • temperature changes (hot flashes/night sweats)

  • blood pressure changes and heart palpitations 

  • changes to your metabolism

  • changes to muscle and bone

  • weight gain

  • menstrual changes

  • mood changes

  • brain fog or difficulty concentrating 

  • sleep disturbances 

  • digestive problems 

  • vaginal dryness 

Research by ZOE shows that the way women’s bodies respond to food also changes as they get older.

In earlier life, women tend to experience less severe spikes in blood sugar levels after they eat, compared with men. However, as they get older, their post-meal blood sugar levels increase.

Data collected by ZOE scientists show that, on average, women experience larger post-meal blood sugar spikes as they get older.

These spikes in blood sugar levels and the dips that may follow can make you feel tired and hungry again soon after eating. In the longer term, higher blood sugar can contribute to the risk of heart disease, type 2 diabetes, stroke, and other so-called metabolic diseases

Blood fat levels increase as you get older, too, and some research has found that women’s fat metabolism changes during perimenopause. 

What to eat during perimenopause

What you eat and drink during perimenopause and beyond can not only help to alleviate certain symptoms but also support your long-term health. 

A healthy, varied diet with many plant foods

Researchers have found links between plant-based diets and fewer hot flashes as well as improved quality of life in terms of physical, psychological, and sexual health. 

Even if going fully plant-based is not for you, getting plenty of beneficial nutrients and fiber — as well as adding diversity into your diet — can help you through perimenopause and beyond.

A good way to achieve this is by following a Mediterranean diet that is high in vegetables, fruit, healthy unsaturated fats, fish, and lean meat. 

For personalized recommendations on the best foods for you, during and after perimenopause, take our free quiz

Fiber 

Getting enough fiber is great for your health, but many people don’t eat enough of it. 

Fiber provides fuel for your gut bacteria, which turn it into many different beneficial chemicals. 

Good sources of fiber include vegetables, fruit, whole grains, and legumes. 

Research has found links between fiber and a healthier gut, lower risk of ovarian cancer, better performance in physical tests such as walking and grip strength, and reduced symptoms of depression

Foods containing lots of fiber can also help you feel fuller for longer, improve your cholesterol, and lower your risk of heart disease. 

Protein 

During perimenopause, and as you get older, you may see a decrease in your lean muscle mass and an increase in fat. 

Increasing your daily protein intake can not only help you manage your appetite, but may also reduce body fat, improve cholesterol, help maintain lean muscle mass, and decrease risk factors for heart disease. 

Good sources of protein include tofu, beans, eggs, nuts and seeds, fish, and legumes like chickpeas, soybeans, and lentils. 

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Vitamins and minerals

Your risk of osteoporosis — which can cause weak and brittle bones — increases with age. Perimenopause also makes you particularly susceptible to certain vitamin and mineral deficiencies. 

Foods rich in calcium and vitamin D — like dairy, green leafy vegetables, soybeans, and oily fish — are good for your immune system and improve bone and muscle health. 

Omega-3 fatty acids 

These substances found in fish like salmon, mackerel, and sardines may lower your chance of stroke and heart disease and improve your metabolic health

They may help manage symptoms of perimenopause like night sweats and depression, too. 

Diets high in both fiber and omega-3 fatty acids have also been linked to a lower risk of developing symptoms of depression, anxiety, and stress.

Water

Staying hydrated is important for your health at any time of life, but as people age, their risk of dehydration goes up because their bodies replenish fluids at a slower rate. Hormonal changes during perimenopause can also be a factor in this.

Your sensitivity to thirst may be lower, and so you may need to be mindful of drinking enough water. 

As well as providing essential electrolytes and nutrients, drinking enough water can help relieve hormonal symptoms like bloating, hot flashes, and headaches. 

You can get some water by eating foods like watermelon, cucumber, or lettuce, but experts recommend drinking about two liters (6-8 cups) per day.

Personalized nutrition during perimenopause

The diet changes we suggest above can help to improve your symptoms during perimenopause and beyond, and they are good for your health in general.

However, at ZOE, we know that how a person responds to food can change as they go through different life stages. There is no one-size-fits-all answer to nutrition.

The ZOE at-home test analyzes your blood sugar and blood fat responses in combination with the bacteria that live in your gut.

Based on your unique results, you get personalized nutrition advice to help you find the best foods for your body. 

Unpublished research shows that people who closely followed their personalized ZOE program for 3 months lost an average of 9.4 pounds, while around 80% said they had more energy and didn’t feel hungry.

Find out more about what ZOE can do for you.

What to limit in your diet during perimenopause

At ZOE we don’t believe in restrictive diets. Calories are not your enemy; your body needs them for energy. 

However, there are some foods and drinks that can make perimenopause symptoms worse and can lead to unwanted weight gain. Limit these to the occasional treat to help with your symptoms. 

Alcohol

Some research suggests that low to moderate alcohol intake may be associated with later menopause, and that small amounts of beer could reduce some perimenopausal symptoms

That’s because beer contains small amounts of phytoestrogens, which are chemicals from plants that mimic some of the functions of estrogen. 

But getting phytoestrogens from food may be a better way to reap these benefits because alcohol can contribute to skin flushing and make your hot flashes worse. If you’re prone to these, try switching to alcohol-free alternatives. 

Caffeine 

Perimenopause can make your blood pressure and your body temperature fluctuate, and caffeine can make this worse. It also increases heart palpitations. 

If you’re a caffeine lover, try gradually transitioning to decaf coffee or herbal teas to see if this helps with your symptoms.

Watch out for caffeine-free sodas, though — carbonated drinks can reduce calcium absorption

Spicy food 

Chilis and hot peppers can trigger hot flashes or make them worse. Try limiting these to see if this helps with your symptoms.  

Sugary and ultra-processed foods

Sweets, desserts, and ultra-processed foods like chips and fast food may increase your risk of perimenopausal symptoms. 

Ultra-processed food is also bad for the bacteria that live in your gut. 

Other ways to help with perimenopause symptoms

Improving your health and well-being during perimenopause is not just about your diet. 

As well as eating certain foods, limiting others, and finding out more about your personal responses to foods, you can also make other adjustments to your lifestyle. 

  • Exercise: Increasing your current exercise levels by even a small amount can improve your mood, sleep quality, weight management, and muscle function

  • Quit smoking: Along with major health conditions such as cancer and heart disease, smoking has been linked to worse and more frequent hot flashes

  • Improve your sleep patterns: When it comes to healthier blood sugar responses, ZOE research shows that sleep quality and going to bed earlier are more important than how many hours you get.

Summary

Perimenopause is different for every woman. Symptoms can vary in type, duration, and severity, but there are diet and lifestyle changes you can make to support your mind and body. 

Eating a healthy, diverse, fiber-rich diet — with plenty of vegetables, fruit, whole grains, legumes, nuts and seeds, fish, lean meats, and healthy fats like olive oil — can relieve or prevent some of your symptoms. 

What you don’t eat is as important as what you do. Try limiting alcohol, caffeine, and sugary or ultra-processed foods. 

Exercising, improving your sleep patterns, and quitting smoking can also help your mood, sleep quality, weight, strength, and blood sugar control.

Understanding your body’s responses to different foods can help you find the best ones for your unique biology.

Take our free quiz to find out how the ZOE program can help you.

Sources

Adequate dietary protein is associated with better physical performance among post-menopausal women aged 60–90 years. Journal of Nutrition, Health, and Aging. (2015).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4433492/ 

A review of dietary and microbial connections to depression, anxiety, and stress. Nutritional Neuroscience. (2018).

https://www.tandfonline.com/doi/abs/10.1080/1028415X.2018.1493808 

Association between dietary fiber intake and physical performance in older adults: a nationwide study in Taiwan. PLoS One. (2013).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3823869/ 

Association between dietary fiber intake and risk of ovarian cancer: a meta-analysis of observational studies. Journal of International Medical Research. (2018). 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166337/

Association of alcohol consumption with the onset of natural menopause: a systematic review and meta-analysis. Human Reproduction Update. (2016).

https://academic.oup.com/humupd/article/22/4/516/2573866 

Caffeine and menopausal symptoms: what is the association?. Menopause. (2015).

https://pubmed.ncbi.nlm.nih.gov/25051286/ 

Cardiovascular risk in perimenopausal women. Current Vascular Pharmacology. (2019).

https://pubmed.ncbi.nlm.nih.gov/30280667/ 

Changes in hormone levels. (2022).

https://www.menopause.org/for-women/sexual-health-menopause-online/changes-at-midlife/changes-in-hormone-levels 

Dietary fiber, atherosclerosis, and cardiovascular disease. Nutrients. (2019).

https://www.mdpi.com/2072-6643/11/5/1155/htm 

Dietary omega-3 fatty acids aid in the modulation of inflammation and metabolic health. California Agriculture (Berkeley). (2011).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4030645/ 

Dietary patterns and their association with menopausal symptoms: a cross-sectional study. Menopause. (2019).

https://pubmed.ncbi.nlm.nih.gov/30363011/ 

Dietary supplement for relieving menopausal symptoms in Egyptian perimenopausal women. Bulletin of the National Research Centre. (2020).

https://bnrc.springeropen.com/articles/10.1186/s42269-020-00291-2 

Does quitting smoking decrease the risk of midlife hot flashes? A longitudinal analysis. Maturitas. (2015).

https://www.maturitas.org/article/S0378-5122(15)00733-1/fulltext  

Effect of vitamin-containing amino acid supplements on menopausal symptoms and age-related skin changes: a randomised, double-blind, placebo-controlled study. Dermatology and Therapy. (2021). 

https://link.springer.com/article/10.1007/s13555-021-00589-7 

Effect of omega-3 supplements on vasomotor symptoms in menopausal women: a systematic review and meta-analysis. European Journal of Obstetrics & Gynecology and Reproductive Biology. (2018).

https://pubmed.ncbi.nlm.nih.gov/30056356/ 

Fluid (water and drinks): Food fact sheet. (n.d).

https://www.bda.uk.com/resource/fluid-water-drinks.html

Hormonal changes during menopause and the impact on fluid regulation. Reproductive Sciences. (2014).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3984489/ 

Hot flashes: What can I do? (n.d.).

https://www.nia.nih.gov/health/hot-flashes-what-can-i-do

Impact of insufficient sleep on dysregulated blood glucose control under standardised meal conditions. Diabetologia. (2022).

https://link.springer.com/article/10.1007/s00125-021-05608-y 

Inverse association between dietary fiber intake and depression in premenopausal women: a nationwide population-based survey. Menopause. (2021).

https://journals.lww.com/menopausejournal/Abstract/2021/02000/Inverse_association_between_dietary_fiber_intake.8.aspx 

Life habits of postmenopausal women: Association of menopause symptom intensity and food consumption by degree of food processing. Maturitas. (2022).

https://pubmed.ncbi.nlm.nih.gov/35033227/

Menopausal hot flashes: a concise review. Journal of Midlife Health. (2019).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459071/ 

Menopause-associated lipid metabolic disorders and foods beneficial for postmenopausal women. Nutrients. (2020).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7019719/

Moderate consumption of beer (with and without ethanol) and menopausal symptoms: results from a parallel clinical trial in postmenopausal women. Nutrients. (2021).

https://www.mdpi.com/2072-6643/13/7/2278/htm 

Nutrition in menopausal women: a narrative review. Nutrients: Nutrition in Gynecologic Disease. (2021).

https://www.mdpi.com/2072-6643/13/7/2149/htm

Omega-3 fatty acids: an essential contribution. (n.d.).

https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fats-and-cholesterol/types-of-fat/omega-3-fats/

Physical activity and health during the menopausal transition. Obstetrics and Gynecology Clinics of North America. (2011).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3270074/ 

Physical performance in relation to menopause status and physical activity. Menopause. (2018).

https://journals.lww.com/menopausejournal/fulltext/2018/12000/physical_performance_in_relation_to_menopause.7.aspx 

Postprandial glycaemic dips predict appetite and energy intake in healthy individuals. Nature Metabolism. (2021).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7610681/

The anti-inflammatory role of omega-3 polyunsaturated fatty acids metabolites in pre-clinical models of psychiatric, neurodegenerative, and neurological disorders. Frontiers in Psychiatry. (2020).

https://www.frontiersin.org/articles/10.3389/fpsyt.2020.00122/full 

The women's study for the alleviation of vasomotor symptoms (WAVS): a randomized, controlled trial of a plant-based diet and whole soybeans for postmenopausal women. Menopause. (2021).

https://journals.lww.com/menopausejournal/Fulltext/2021/10000/The_Women_s_Study_for_the_Alleviation_of_Vasomotor.12.aspx 

Weight management module for perimenopausal women: a practical guide for gynecologists. Journal of Midlife Health. (2019).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947726/ 

What is the Mediterranean diet. (n.d.).

https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/mediterranean-diet