Written by Marygrace Taylor
When it comes to the changes brought on by perimenopause, food can be your friend or your foe. So, what are some things you should consider adding onto your plate to best support your body—and what’s worth leaving out of your perimenopause diet plan?
Let’s start with a few basics regarding perimenopause. Perimenopause, the time leading up to menopause, is a transition from having regular periods, to more irregular cycles, and eventually no periods at all. It’s a gradual change: beginning as early as your late 30s, you might first notice your periods start to become less regular.1 Over time, symptoms like hot flashes, sleep problems, mood changes, vaginal dryness, or less interest in sex become more common. You’ll know you’ve reached menopause, and the end of perimenopause, once you haven’t experienced a period for 12 consecutive months.
Focusing on key nutrients and sticking with an overall healthy diet during perimenopause can help you feel your best and support your changing body. The right foods can even play a role in managing some perimenopause symptoms. And that’s not all: eating well now can also help you get ahead of the game when it comes to managing things like osteoporosis and heart disease risk—both of which tend to increase after menopause.2 Here are some of the foods to consider adding to your perimenopause diet plan, along with foods to avoid.
Helpful Foods for Perimenopause
A healthy diet only becomes more important as we age. But during perimenopause, these three nutrients are particularly essential:
Up to one in two women over 50 will break a bone due to osteoporosis, according to the National Osteoporosis Foundation. The higher fracture risk comes courtesy of declining levels of estrogen, which plays an important role in maintaining bone health.3
The good news? Upping your calcium intake from 1,000 mg to 1,200 mg daily can help keep your skeletal structure sturdy, plus it may help promote healthy blood pressure and cholesterol levels.4
Experts agree that it’s best to get your calcium from foods—think milk, yogurt, cheese, sardines, salmon, and leafy greens.5 But it may also be a good idea to ask your doctor about adding a supplement to your daily diet during perimenopause. When shopping for the right calcium supplement, look for one that includes Vitamin D, which helps the body better absorb the nutrient.
“Vitamin D works with calcium to maintain healthy bones. Recommended daily intake of vitamin D for perimenopausal and menopausal women is 800 IU/day. Dietary sources include fortified cereals and dairy products, salmon and mackerel. As with calcium, vitamin D3 is also readily available over the counter,” says Dr. Alyssa Dweck, MS, MD, FACOG.
Starting during perimenopause, shifting hormone levels can encourage the body to store more fat—particularly around the abdomen, where it can increase the risk for health problems such as cardiovascular disease. But lean protein can help you fight back against this weight gain.6 According to Dr. Susan Hewlings, PhD and Registered Dietician, “As you age your protein needs increase. Intake of about 20-30g (with greater amounts as you age) of protein per meal evenly distributed throughout the day is ideal.”
Getting plenty of lean protein not only helps keep body fat in check—studies demonstrate that it also makes it easier for your body to preserve and build more lean muscle mass.7 Try to include a healthy protein source with each meal or snack, like a palm-sized serving of lean meat, poultry, or fish, a cup of plain yogurt, an egg, or half a cup of cooked beans.
Falling estrogen levels have been shown to cause arteries to become less flexible, leading to a higher risk of heart disease after menopause.8 Be proactive about protecting your heart now by eating at least two servings of omega-3 rich fish (like salmon, mackerel, or tuna) per week. The fatty acid in these foods can keep inflammation in check to protect your blood vessels—and in turn, promote a healthier heart.9
An added bonus? A steady supply of omega-3s may help ease some of the frustrating symptoms that might ramp up during perimenopause, like night sweats or mood swings. And if you’re not a fan of fish, research shows that fish oil supplements may serve to be a helpful addition.10
Foods to Avoid During Perimenopause
This probably isn’t the first time you’ve been encouraged to limit your intake of highly processed, refined, or sugary carbohydrates. But going overboard on foods like white pasta or white bread, refined grains, and baked goods will only exacerbate the symptoms brought on by perimenopause—leaving you feeling lousy and potentially putting your health at risk.
Highly processed carbohydrates and sugar make it easier to gain weight, since they’re high in calories but low in fiber and other nutrients. They can also contribute to blood sugar spikes that zap your energy and trigger cravings for more junk food, setting you up for a vicious snacking cycle. Worst of all? Over time, a diet of junky carbohydrates can increase your triglycerides and the risk for heart disease.11
Try swapping white pasta or bread for their whole grain counterparts. Make brown rice your mainstay instead of white, or try other fiber-rich carbs like quinoa, barley, or sweet potatoes. Try to stick with whole, minimally processed foods over packaged snacks—think fresh fruit instead of crackers or cookies and nuts or seeds instead of chips.
Also check packaged food labels to make sure they’re not sugar bombs in disguise. Packaged sugary cereals, granola bars, whole grain breads, tomato sauces, flavored yogurts, and salad dressings tend to be some of the worst offenders.
According to Dr. Dweck, “When it comes to sweets and treats during perimenopause, a little can go a long way. I recommend moderating intake of sugar and minimizing processed foods to manage weight and optimize energy levels."
All that said, know that you don’t have to swear off sugar and refined carbs completely. (Life without cookies or ice cream wouldn’t be much fun, would it?)
Alcohol and Perimenopause: What to Consider
There’s no denying the pleasures of a glass of wine with dinner or the occasional cocktail on a night out. The downside? Alcohol can pose a bigger risk to your body beginning in perimenopause. So it’s worth being mindful about your intake.
Moderate alcohol consumption—defined as no more than seven drinks per week or three drinks in a single day—may actually be good for your health. Women who drink moderately during and after menopause have been shown to have a lower risk for stroke, heart disease, obesity, dementia, and type 2 diabetes compared to those who abstain.12
On the other hand, some women find that even a single drink can trigger hot flashes and night sweats. More importantly, heavy drinking can negate alcohol’s potential health benefits and even increase the chances for heart disease, osteoporosis, depression, and many types of cancer, including breast cancer.13
If you enjoy an occasional drink and it doesn’t seem to cause or worsen your symptoms, go ahead and raise a glass. Just stick to one drink per day or less (five ounces of wine, 12 ounces of beer, or 1.5 ounces of spirits all count as one drink). But if you notice a drink always seems to leave you feeling worse, it might make sense to steer clear—at least until you’ve made it through perimenopause.
Every woman’s experience of perimenopause and the symptoms that come along with will be unique. Be sure to listen to your body to determine what works for you and what doesn’t. Making some small healthy changes to your diet during perimenopause, such as limiting junk food and incorporating more fruits and veggies, is a great first step. Figure out what nutritional balance looks like for you and build your diet plan from there.