Food for Menopause: Cutting Through the Noise with Evidence-Based Practice

By Dr Linia Patel (PhD), RD

Menopause is a natural and healthy transition in every woman’s life, yet for more than 80% of women ¹, it is accompanied by a range of disruptive symptoms including fatigue, insomnia, brain fog, joint pain, and hot flushes, that can significantly impact quality of life. Despite growing awareness, women navigating menopause today are often overwhelmed by conflicting nutrition messages, the result of decades of societal taboo, misinformation, and a vulnerable search for relief.

Menopause represents not just a challenge, but a unique and powerful window for implementing long-term preventive strategies that can profoundly shape health outcomes in later life. As clinicians, we have a responsibility to move beyond outdated narratives, dispel misinformation, and deliver grounded, individualised nutrition guidance. This blog aims to cut through the noise, bringing together research evidence and practical clinical insights to help health professionals better support women through this pivotal life stage. The blog explores key topics including protein, soya, bone health and intermittent fasting.

Understanding the menopause ^2,3,4

The term menopause is often used as an umbrella term to describe the entire transition women experience as they approach and cease menstruation. However, menopause itself is just one point within a broader journey involving three distinct phases.

• Perimenopause — meaning “around menopause” refers to the years leading up to menopause when hormonal fluctuations begin. Most women will experience symptoms at some point during this transition, though the intensity and duration are highly individual. Research suggests the menopause transition can last between 2 and 14 years, with an average duration of 4 to 7 years, influenced by factors such as age at symptom onset and overall lifestyle.

• Menopause is officially marked when a woman has not had a menstrual period for 12 consecutive months. The average age of menopause in the UK and USA is around 51, though the timing can vary widely, influenced by genetics, health and lifestyle factors.

• Postmenopause begins the day after those 12 months without a menstrual cycle.

How to adapt to the changing hormones ^2,5,6,7,8

Managing menopause requires a personalised and proactive approach. Every woman’s journey is unique, and it’s important not to wait until symptoms become overwhelming before seeking support. Options may include hormone replacement therapy (HRT), non-hormonal medications, herbal remedies, cognitive behavioural therapy, and alternative therapies like acupuncture or massage, though the evidence for some of these varies. Regardless of the path chosen, lifestyle factors – nutrition, sleep, movement, and stress management – are fundamental. Research increasingly shows that menopause is linked to rising systemic inflammation and shifts in the gut microbiome, both of which influence symptoms and long-term health risks. A balanced diet can help cool chronic inflammation and support gut health, but without attention to all pillars of wellness, optimal health cannot be achieved. In the sections that follow, we’ll explore some of the key nutrition myths that often mislead women during this transition, and what the evidence really says.

Why prioritising protein is important ^9,10,11,12

Prioritising protein intake during the menopause transition is crucial for supporting body composition, mood regulation, appetite control, and the maintenance of healthy bones, hair and skin. Protein, therefore, becomes a foundational nutrient for women during the menopause transition, helping to counteract the natural loss of lean body mass and supporting overall physiological resilience.

As with all aspects of nutrition, protein needs are highly individual, influenced by factors such as age, physical activity level, body composition, health status, and personal goals. In the UK, the reference nutrient intake (RNI) for protein is currently set at 0.75 g/kg of body weight per day, closely mirroring the US recommended dietary allowance (RDA) of 0.8 g/kg. However, it is important to recognise that these recommendations are based on nitrogen balance studies, a method with significant limitations. More recent research utilising the Indicator Amino Acid Oxidation (IAAO) technique suggests that a more appropriate minimum intake lies between 1.0–1.2 g/kg/day, particularly for older adults and individuals seeking to preserve muscle mass and metabolic health.

In my clinical practice, some common patterns emerge that compromise optimal protein intake during the menopause transition. One is the all-or-nothing approach to nutrition – either consuming large amounts of protein irregularly or neglecting it altogether, rather than adopting a consistent and balanced intake throughout the day. Another frequent issue is not eating enough protein early in the morning, when stabilising blood sugar levels and supporting satiety could be particularly beneficial. Furthermore, there is often an overemphasis on the quantity of protein consumed, while ignoring protein quality. Most individuals would benefit from greater attention not only to how much protein they are eating but also to the sources from which it comes such as eggs, lean poultry, fish as well as plant based sources such as legumes, tofu, tempeh, nuts and seeds.

Determining an individual’s optimal protein intake is not black and white. It often requires adjustment over time through careful self-monitoring and professional guidance. Similarly, the best sources of protein can vary based on personal dietary preferences and tolerances.

Understanding soya: evidence-based insights on phytoestrogens ^13,14,15

One persistent myth in menopause nutrition is the belief that soya mimics oestrogen and increases cancer risk. Scientifically, this claim does not hold up under scrutiny. Soya contains isoflavones, plant-derived compounds that can bind weakly to oestrogen receptors; however, their action is far more complex than simple “oestrogen mimicry.” Rather than promoting oestrogen-sensitive cancers, a growing body of research suggests that soya foods may actually offer protective effects, particularly when consumed as part of a whole-food diet.

Some evidence for example, points to modest improvements in vasomotor symptoms, such as hot flushes, as well as favourable changes in lipid profiles, contributing to cardiovascular health. For phytoestrogens to be clinically effective in reducing hot flushes, research suggests an intake of approximately 50-100 mg of isoflavones per day is beneficial. It is important to note that the efficacy of phytoestrogens is also mediated by the individual’s gut microbiome health, as certain gut bacteria are necessary to metabolise isoflavones into their most active forms.

In clinical practice, it is advisable to encourage the inclusion of whole soy foods, such as edamame, tofu, tempeh, soya milk for example, within a balanced diet, while providing accurate education about the minimal oestrogenic impact of dietary phytoestrogens. Avoiding fear-based messaging around soy can empower women to make informed, health-promoting food choices during the menopause transition, while optimising outcomes through attention to gut health.

However, it’s worth knowing the following:

• Consuming plant oestrogens several times a day appears to be more effective compared to one larger dose
• It can take two or three months for benefits of plant oestrogens to be seen
• They seem to work better for some women than others which maybe down to differences in gut bacteria
• Whole food sources are better than supplements
• Not all soya foods contain isoflavones. Processing removes 80-90% of isoflavones (i.e. isolated soya protein)

Soya Nutrition, Health and Sustainability – MyNutriWeb Report

Protecting bone health in menopause: it takes more than just calcium ^11,15,16,17

Around 10% of a woman’s bone mass is lost within the first five years of menopause, significantly increasing the risk of developing osteoporosis, a condition where bones become fragile and more prone to fractures. The decline in oestrogen levels during the menopause transition is a major driver of this change, as oestrogen plays a critical role in maintaining bone strength and health. Furthermore, the simultaneous reduction in testosterone and oestrogen levels also places women at heightened risk of losing muscle mass, further compounding frailty and fall risk.

A common misconception is that simply taking a calcium supplement is sufficient to protect bone health. However, the science clearly shows that while calcium is important, it is only one piece of the puzzle. Bone health requires a synergistic approach involving multiple nutrients and lifestyle factors. Vitamin D is essential for effective calcium absorption, and resistance training is critical to stimulate bone remodelling and maintain skeletal integrity. Moreover, excessive calcium supplementation, particularly without the appropriate cofactors, has been associated with an increased risk of cardiovascular events.

In clinical practice, a multifactorial approach is key. For strong and healthy bones, practical strategies include maintaining optimal vitamin D levels, consuming multiple calcium-rich foods daily (with attention to bioavailable sources in plant-based diets), seeking professional guidance before supplementing, maintaining a healthy body weight through moderate, sustainable approaches, including lean protein at each meal, eating colourful, nutrient-dense fruits and vegetables rich in flavonoids and phytonutrients, drinking alcohol in moderation, and regularly engaging in weight-loading activities such as lifting weights or walking with a load. Bone health is best preserved through an integrated lifestyle strategy, not a single supplement.

Intermittent fasting in midlife: a helpful tool or overhyped trend ^18,19,20

Intermittent fasting (IF) has gained significant popularity in recent years, with “intermittent fasting” being the most searched diet term on Google in 2019 (Google, 2020). IF is an eating pattern that alternates between periods of eating and fasting, shifting the focus from what you eat to when you eat.

While there is some scientific evidence supporting intermittent fasting, it is important to highlight that the majority of research has been conducted primarily on men, with relatively low numbers of women included in trials, and often over short-term durations rather than long-term assessments. Researchers are still working to piece together how different forms of intermittent fasting may affect men and women differently, which likely contributes to the continued mixed, and often strongly polarised, opinions about IF among healthcare professionals. Some existing studies suggest that intermittent fasting may support weight loss, improve insulin sensitivity, benefit cardiometabolic health, and positively influence gut health.

However, practical considerations must be kept in mind. Intermittent fasting tends to work best for individuals who already maintain a stable, balanced, and adequate eating pattern, as it is not intended to become a cycle of restriction and overindulgence; the goal is not famine followed by feast. Although IF may be useful as a weight loss strategy, it has not been shown to be superior to traditional approaches such as portion control or balanced calorie reduction.

Furthermore, moderation particularly in the menopause transition remains critical – excessive or prolonged fasting carries the risk of losing valuable muscle mass, which is particularly concerning for women during the menopause transition when muscle preservation is vital. When approached mindfully and in the appropriate context, intermittent fasting can serve as a useful tool for increasing body awareness, helping individuals reconnect with physical hunger cues and develop better insights into appropriate portion sizes. However, it should always be individualised and used as one possible strategy among many, not as a blanket solution.

Take home message

As you’ve seen, what we eat, and how we live, plays a powerful role in navigating menopause. But just as important is how we approach it. My book ‘Food for Menopause’ isn’t about rigid rules or restrictive plans; it’s about finding joy, flexibility, and confidence in a way of eating that supports your body and fits your life. With 80 delicious, research-backed recipes and a holistic lifestyle toolkit, this guide helps you connect the dots between food, hormones, and wellbeing – so you can thrive, not just survive, through midlife and beyond.

For more information on Food for Menopause – HERE

Watch MyNutriWeb’s full day e-symposium on Menopause, Nutrition and Lifestyle here

References

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