What is The Best Diet for Perimenopause

As we reach our mid-thirties, a common time for perimenopause to begin, nutrition needs change. Incorporating the specifics of a perimenopause diet is an effective way to create a healthy body composition, reduce age related disease risk, and enable you to have the energy and health you desire.

In this article we will cover:

• How much protein you need in perimenopause
• How fiber can help with belly fat and body composition
• Best foods for perimenopause
• Why perimenopause diet and nutrition needs change
• Lists of foods to eat and those to avoid
• The Galveston Diet

The frustrating and sometimes life-altering symptoms of difficulty losing weight, heavy irregular periods, insomnia, hot flashes, and impaired sexual function associated with perimenopause are related to declining progesterone and estrogen levels. These symptoms can start as early as your mid-30s and continue for 10 years before you enter menopause — much too long to suffer. Add on an increased risk of osteoporosis and heart disease with declining estrogen, and you’ll see that it’s essential to take preventative steps for your health now.

Let’s take a closer look at how nutrition can help make the perimenopause transition smoother and more manageable.

Best Diet for Perimenopause

There’s no single best diet for perimenopause, but here are the food and nutrient choices that can relieve symptoms and support a healthy weight. In addition, the foods for perimenopause you'll find listed in this article can help minimize inflammation, improve brain health, support insulin and blood sugar, and minimize some of the symptoms that can accompany perimenopause.

High Protein

Protein-rich foods are necessary for perimenopause because they help preserve lean body mass (and more lean mass means a higher metabolism) and help regulate blood sugar. Protein is essential for maintaining a healthy body weight because it can help with satiety between meals (meaning you won’t feel hungry or deprived).

What does high protein mean? Each person’s needs vary depending on body size, activity level, and eating pattern, but generally speaking, aim for 20-30 grams of protein per meal. 

Bumping up protein also doesn’t mean you need to only eat animal-based products. Plant proteins can contribute to your protein intake, too. A mix of lean proteins like fish, poultry, beans, legumes, grass-fed meats, and pastured eggs can top up your protein requirement and keep your meals interesting. 

Keep reading because I have a full list of protein sources to begin including in a diet for perimenopause health.

High Fiber

If you were going to make one single change for perimenopause symptoms and weight management, it should be to focus on eating more fiber-rich foods. Fiber does so many things for our bodies: it helps with digestion, helps to maintain healthy blood sugar, and feeds beneficial microbes in your gut. 

Taking care of your gut is essential for hormone balance. The metabolic byproducts of bacterial fermentation (called short-chain fatty acids or SCFAs) can even help regulate insulin sensitivity and improve your metabolic health. 

Studies suggest that fiber, especially viscous fiber found in fruits, veggies, and legumes, can improve body weight even without caloric restriction. Fiber is also an essential nutrient for cholesterol and a healthy heart. High fiber foods include beans, legumes, vegetables, fruit, nuts, seeds, and whole grains.

I've created a free hormone-balancing starter kit. In it, I break down the most important diet and lifestyle changes you can make to help improve your hormones You can grab it here. 

Nutrient Density

Perimenopause diet and nutrition needs include those foods rich in vitamins, minerals, and antioxidants. Eating a variety of nutrient-rich foods may help calm inflammation and possibly regulate hormones. Foods that contain the following nutrients can be beneficial for perimenopausal women:

• Omega-3s: Omega-3 fatty acids keep inflammation in check by balancing the production of pro-inflammatory compounds. They help protect delicate blood vessels and the brain against inflammation and damage that increases the risk of heart disease and dementia. These fatty acids may also help with mood swings, sleep disturbances, and hot flashes.

You can find omega-3 fatty acids in fatty fish like salmon, flax seeds, chia seeds, and walnuts, but often a supplement can provide higher doses. 

• Calcium: Calcium is an essential nutrient for bone building, but interestingly studies on whether supplementing with calcium prevents fractures later in life show mixed results. This may be because calcium needs other nutrients, like vitamin D and magnesium, to work effectively.  

Sometimes supplements can be necessary to get the recommended daily values, but focusing on a steady supply of calcium-rich foods like almonds, leafy greens, or sardines is a good place to start.

• Vitamin D3: Calcium needs vitamin D to be absorbed properly, and low vitamin D levels can make a person more prone to bone loss. Vitamin D is also critical for blood sugar, immune health, and mood.

How much you need depends on baseline levels, but I usually suggest starting with 2,000 to 4,000 IU of vitamin D3 daily. Food sources of vitamin D are less available, so supplements are often needed, especially if you don’t eat dairy or spend time in the sun. I recommend pairing vitamin D with vitamin K to promote better calcium absorption. 

Foods for Perimenopause

Including foods for the lists below can help you create a nutrient dense diet. If you're looking for recipes to help you get started, you can grab my free guide here.

Incorporate these foods for perimenopause to help support your hormones, mood, and metabolism.

1. Calcium-rich foods: Hormonal changes during perimenopause can increase the risk of bone loss. Incorporating calcium-rich foods like dairy products (milk, yogurt, cheese), leafy greens (kale, spinach), fortified plant-based milks, tofu, and almonds can help support bone health.
2. Foods high in vitamin D: Vitamin D is essential for calcium absorption and bone health. Fatty fish (salmon, mackerel, tuna), egg yolks, fortified foods (milk, orange juice, cereals), and exposure to sunlight are good sources of vitamin D.
3. Healthy fats: Omega-3 fatty acids can help reduce inflammation and support heart health. Include fatty fish (salmon, sardines), flaxseeds, chia seeds, walnuts, and avocados in your diet.
4. Fiber-rich foods: Hormonal fluctuations may lead to digestive issues like constipation. Fiber-rich foods such as fruits, vegetables, whole grains, legumes, nuts, and seeds can promote regularity and support gut health.
5. Phytoestrogenic foods: Phytoestrogens are plant compounds that can mimic estrogen in the body and may help alleviate some symptoms of hormonal fluctuations. Foods rich in phytoestrogens include soy products (tofu, tempeh, edamame), flaxseeds, sesame seeds, lentils, chickpeas, and berries.
6. Antioxidant-rich foods: Antioxidants help combat oxidative stress and inflammation. Include a variety of colorful fruits and vegetables such as berries, oranges, tomatoes, carrots, peppers, and leafy greens in your diet.
7. Iron-rich foods: Some women may experience heavy menstrual bleeding during perimenopause, leading to iron deficiency anemia. Iron-rich foods like lean meats, poultry, fish, beans, lentils, fortified cereals, and dark leafy greens can help prevent or address this issue.
8. Magnesium: Magnesium plays a role in muscle and nerve function and may help alleviate symptoms like muscle cramps and mood swings. Incorporate magnesium-rich foods such as nuts, seeds, whole grains, legumes, leafy greens, and dark chocolate into your diet.
9. Hydration: Staying hydrated is important for overall health, including hormone balance and temperature regulation. Drink plenty of water throughout the day and include hydrating foods like fruits, vegetables, and herbal teas.
10. Probiotic foods: Probiotics can promote gut health and may help alleviate symptoms like bloating and irregular bowel movements. Include fermented foods like yogurt, kefir, sauerkraut, kimchi, and miso in your diet to support your gut microbiota.

Anti-inflammatory foods for perimenopause:

An important aspect of a perimenopause diet and nutrition plan is anti-inflammatory foods. These support the body in reducing pain, improving insulin, decreasing water weight, and support adrenal gland function.

• Fatty fish: Salmon, mackerel, sardines, and trout are rich in omega-3 fatty acids, which have anti-inflammatory properties.
• Nuts and seeds: Almonds, walnuts, flaxseeds, and chia seeds are sources of healthy fats and antioxidants that can help reduce inflammation.
• Extra virgin olive oil: Olive oil contains oleocanthal, a compound with anti-inflammatory properties. Use it as a primary source of fat in cooking and salad dressings.
• Berries: Blueberries, strawberries, raspberries, and blackberries are rich in antioxidants called flavonoids, which have anti-inflammatory effects.
• Leafy greens: Spinach, kale, collard greens, and Swiss chard are packed with vitamins, minerals, and antioxidants that help combat inflammation.
• Turmeric: Curcumin, the active compound in turmeric, has potent anti-inflammatory properties. Use turmeric in cooking or consider taking turmeric supplements.
• Ginger: Ginger contains gingerol, a bioactive compound with anti-inflammatory and antioxidant effects. Enjoy ginger in teas, stir-fries, or grated into dishes.
• Tomatoes: Tomatoes are rich in lycopene, a powerful antioxidant with anti-inflammatory properties. Cooked tomatoes (such as in tomato sauce) provide even more lycopene than raw ones.
• Green tea: Green tea is rich in catechins, antioxidants that have anti-inflammatory effects. Enjoy green tea as a refreshing beverage.
• Dark chocolate: Dark chocolate with high cocoa content contains flavonoids that may reduce inflammation. Enjoy in moderation as a treat.

Protein-rich foods for perimenopause:

Protein needs change as we age with research suggesting women should be eating more protein, not less as they enter perimenopause. Use the list below to help you incorporate more protein into your routine and for breakfast ideas (including recipes) please visit this article.

• Lean meats: Skinless poultry, such as chicken and turkey breast, and lean cuts of beef and pork are excellent sources of high-quality protein.
• Fish: Fatty fish like salmon, tuna, trout, and mackerel provide protein along with omega-3 fatty acids.
• Eggs: Eggs are a complete protein source, meaning they contain all essential amino acids. They're also versatile and can be enjoyed in various dishes.
• Legumes: Beans, lentils, chickpeas, and peas are plant-based sources of protein, fiber, and various nutrients.
• Tofu and tempeh: These soy-based products are rich in protein and can be used as meat substitutes in vegetarian and vegan dishes.
• Greek yogurt: Greek yogurt is higher in protein compared to regular yogurt and also provides probiotics for gut health.
• Cottage cheese: Cottage cheese is a good source of protein and can be enjoyed on its own or added to dishes like salads or smoothies.
• Quinoa: Quinoa is a pseudocereal that is a complete protein source, making it an excellent choice for vegetarians and vegans.
• Nuts and seeds: Almonds, peanuts, pumpkin seeds, sunflower seeds, and other nuts and seeds are not only sources of healthy fats but also contain protein.

Perimenopause Diet: Easing Perimenopause Symptoms & Preventing Weight Gain

Now that you understand the best foods for perimenopause and how to structure a perimenopause diet, let's discuss how diet can impact perimenopause symptoms.

Our hormones are closely interconnected with our metabolic health, which means as hormones decline, the way we utilize and store nutrients and energy changes.

Menopause increases the risk of metabolic syndrome, heart disease, and osteoporosis, primarily because of the decline in estrogen. The risk of heart disease jumps for women after menopause, partly because estrogen protects against inflammation, oxidative stress, and blood vessel damage.

Estrogen also protects against osteoporosis, so our bone health is affected once levels drop. As a result, a heart-protective and bone-supporting diet before menopause can help prevent age-related disease, while during perimenopause, it can help mitigate symptoms.

Perimenopause Weight Gain and Body Image 

Weight gain is also a concern for women in the perimenopause transition, so diet also can support weight management. A recent population-based study found that women in menopause experience a higher rate of fat gain and lean mass losses until two years after their final period. At the same time, participants’ weight continued to climb until menopause and then stopped once they hit menopause. 

Part of the reason for the weight gain,lean body mass loss, and perimenopause connection is due to the relationship between sex steroid hormones and metabolism. Estrogen can influence how well your cells can switch from fat burning during fasting (like overnight or between meals) and carb utilization for energy after meals. 

Alterations in fat metabolism affect cholesterol levels and even increase inflammation and free radicals in the body. As estrogen declines, blood sugar spikes may increase as insulin regulation is also impacted, which means the body is less efficient at utilizing and storing energy—resulting in more fat storage. 

A lot of women struggle with body image and weight concerns in this period. 

In fact, some research suggests that women may be especially vulnerable to developing an eating disorder during perimenopause because of these hormonal changes and challenges associated with mood and body.

Making diet changes within this perimenopause window may help, but this doesn’t mean restricting calories or spending countless hours in the gym

Instead, focus on foods that nourish you and eating patterns that highlight essential nutrients for hormones, bone health, and metabolic regulation. For example, one study found that consuming more antioxidants is linked to fewer perimenopausal symptoms like hot flashes, sleep problems, and difficulty concentrating.

Related: How to Lose Weight During Perimenopause

What Should You Limit in Your Diet?

Alcohol

That glass (or two or three) of wine after a long day probably isn’t doing you any favors. I’m not here to judge anyone’s choices about alcohol, but I’m here to give you the facts about alcohol and perimenopause. 

While some research suggests that drinking could help with hot flashes, alcohol can worsen insomnia, increase anxiety and depression, and impact your sex drive. Plus, it adds extra calories that aren’t metabolized as efficiently by the body as food, making it even harder to lose weight during perimenopause.

Sugar

Sweets may feel like comfort or a treat, but they probably aren’t helping you feel better. Women who eat more sugar during perimenopause are more likely to have hot flashes. Plus, with blood sugar dysregulation and the increased risk of insulin resistance, eating more sugar can actually make you crave it even more, creating a cycle that’s hard to break. 

Caffeine

Caffeine has a lot of benefits, including improved memory, alertness, and mood, but some people don’t tolerate it well. It can worsen anxiety, hot flashes, and sleep disturbances—all things you don’t need more of during perimenopause. 

If you love your coffee or matcha in the morning, try switching to decaf or experimenting with cutting down on how much you have and see if it helps. Or, try an alternative like an herbal coffee or tea with adaptogens. 

Highly-Processed Foods

Processed foods aren’t great for us at any age, but if you struggle with symptoms of perimenopause, you’ll definitely want to limit them. Studies suggest that higher intakes of processed foods are linked to more symptoms, while eating more fruits and veggies may help you feel better. 

Processed foods include packaged white bread, frozen dinners, packaged chips and cookies, fast food meals, microwave-ready foods, candy, and others. Not only are these foods nutritionally void, but they are also linked to heart and blood sugar issues.

What About the Galveston Diet?

The Galveston Diet is an anti-inflammatory, whole foods diet program designed by Dr. Mary Claire Haver, a board certified OB-Gyn, for those in perimenopause and menopause. It emphasizes an eating pattern of 16/8 intermittent fasting and focuses on what to eat, rather than calorie counting.

As a nutrition scientist with over two decades in the field, I agree that both an anti-inflammatory and whole foods focused diet is an effective way to not only increase nutrient density in the diet, but also support hormone health in this unique period of a woman's life.

The Galveston Diet was developed with weight loss in mind, an area where many perimenopause and menopausal women struggle due to their shifting hormones. In my clinical experience, a calories in/ calories out model has served very few women struggling with their hormone related weight issues. This is one reason the Galveston Diet is an effective weight loss plan—it focuses on quality food and limits foods which are known to contribute to metabolic issues, like added sugar and alcohol.

The Bottom Line on Perimenopause and Your Diet

Eating whole foods packed with nutrients and limiting highly-processed items is vital for promoting overall health during perimenopause. Focus on healthy fats, lean protein, and fiber while ensuring you eat enough calcium and other essential vitamins and minerals for bone and heart health.
It can take time to feel like yourself again, and self-compassion goes a long way. With a balanced diet and healthy lifestyle, it’s possible to manage the physical and emotional symptoms of perimenopause naturally.

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