What To Eat And Avoid During Menopause, According To A Dietitian

We reach menopause when we don't have a period for 12 consecutive months. However, the years leading up to this – known as perimenopause – are when we feel a variety of symptoms that prepare us for this big hormonal change. These include hot flushes, brain fog, mood swings and insomnia.  

Did you know that you should be paying more attention to your diet while going through this phase? Grace Quek, Principal Dietitian, Nutrition and Dietetics Department at KK Women’s and Children’s Hospital, says that although diet does not affect menopause directly, dietary interventions can help manage symptoms of menopause such as hot flushes, night sweats, mood swings, weight gain and changes in bone density. 

She lists the following examples:

• Eating foods rich in carbohydrates can help to raise the levels of serotonin, improving mood
• Taking more lean proteins and plant-based foods can help with muscle maintenance and alleviate menopausal symptoms respectively
• Ensuring adequate calcium and vitamin D intake can help with calcium absorption to prevent further bone loss
• Consuming healthy sources of fats help promote heart health and stabilise mood
• Certain foods and beverages can trigger hot flushes and night sweats in some women, so it is important to identify and avoid these triggers. Common triggers include alcohol, caffeine, spicy foods and hot beverages
• Staying hydrated is also important, but it is advisable to opt for water or herbal teas rather than caffeinated beverages
• Avoiding high-sugar, high-fat and high-sodium foods all help to maintain good overall health

Dealing with weight gain

If you're in the perimenopausal or menopausal phase of your life, you might have noticed that you have put on weight. This is due to your decreasing metabolic rate so you should be careful with your diet to prevent excessive weight gain. 

“Women may find that they are putting on weight despite consuming the same amount of energy as before,” Grace explains. “Excessive weight gain also increases the risk of high blood pressure, diabetes, heart disease and certain cancers (e.g. breast cancer). Essentially, a well-balanced diet rich in fruits, vegetables, lean proteins and whole grains can help control weight by providing essential nutrients and fibre while limiting excess calories.”

Your weight gain could be more prominent around the abdominal area due to hormonal changes and a shift in fat distribution, says Grace. She stresses how vital it is for women to adopt healthy lifestyle habits such as eating well, exercising regularly and having good quality sleep, to prevent weight gain and minimise abdominal fat accumulation. 

Exercise is also essential as it will both improve your fitness level and manage your weight.

“Having a healthy weight helps reduce the severity of hot flushes and support bone health,” says Grace. “Exercise or physical activities improve mood, reduce stress, prevent weight gain and promote heart and bone health.”

What should I eat? 

A good way to decide what you should be eating is by using the Health Promotion Board's My Healthy Plate as a guide. Follow a healthy and balanced diet as recommended. If you're overweight, Grace suggests limiting portions from different food groups, especially foods that are higher in fat and calories. Also, be mindful of the amount and type of fats consumed. 

“Reduce intake of saturated fat and trans fats to help prevent the unwanted weight gain that occurs due to slower metabolism during menopause,” Grace advises. “Instead, select healthier oils that contain monounsaturated or polyunsaturated fats, such as olive oil, canola oil or flaxseed oil, as they can also reduce the risk of developing heart disease. Increasing water intake can also help to lose any water being retained in the body, as well as help to increase metabolism.”

Here's what My Healthy Plate recommends:

• Fill 1⁄2 of your plate with fruits and leafy greens/non-starchy vegetables 
• Fill 1⁄4 of your plate with whole grains carbohydrates or starchy vegetables
• Fill 1⁄4 of your plate with meat and other alternatives (ie. tofu, eggs, beans)

Other healthy eating habits include:

• Use healthier fats and oils, and limit fried foods to twice a week or less
• Replace saturated fats (coconut oil, palm oil, animal fats) and trans fats (e.g. those found in frozen foods, commercial baked goods and fast foods) with healthier fats like canola and olive oil, nuts (e.g. almonds, walnuts) and cold-water fatty fish (e.g. salmon, tuna)
• Substitute animal sources of protein (e.g. meat, chicken) with plant sources of protein (e.g. tofu, lentils, beans) twice a week
• Make water the drink of choice, limit sugar-sweetened beverages

Looking after your bones

It's not just weight gain you have to worry about during menopause, your risk of osteoporosis increases too. To reduce this risk, Grace says that menopausal women should ensure an adequate intake of calcium (1,000 mg/day) and vitamin D (2.5mcg or 100 IU/day), as well as engage in regular weight-bearing exercises. 

“Vitamin D requirements for adults can vary based on factors such as age, gender, genetics and individual health conditions. Some experts suggest that older adults may benefit from a higher intake of vitamin D at around 600 to 800 international units (IU) per day,” she adds.

You can increase your vitamin D intake from the food you eat too. Such dietary sources include salmon, eggs and fortified foods like low-fat and non-fat milk. Our bodies also produce vitamin D in the presence of sunlight; Grace suggests 15 minutes of daily sunlight exposure to aid in the prevention of osteoporosis. 

For more calcium, eat more good dietary sources such as low-fat and non-fat dairy products (e.g. milk, cheese, yoghurt), fish with edible bones (e.g. ikan bilis and sardines) and calcium-fortified products (e.g. soymilk and bread). Other calcium-rich foods include prunes, figs and leafy green vegetables. 

Some examples of how much calcium you'll get from food: 

• 1 cup of low-fat milk – 300mg 
• 3 heaped tablespoons of high-calcium milk – 500mg
• 1 slice of cheese – 140mg 
• 3 heaped tablespoons of anchovies – 150mg
• Half cup spinach – 80mg
• 15 almonds – 50mg

Eating the Mediterranean way 

Some experts recommend the Mediterranean diet for women going through menopause. It has often been cited as a heart-healthy way to eat and is more of a lifestyle than a diet. It's based on the traditional cuisine of countries bordering the Mediterranean Sea and is high in vegetables, fruits, whole grains, beans, olive oil, nuts and seeds, with herbs and spices used to season foods. 

“The Mediterranean diet emphasises eating whole, minimally-processed foods, including plenty of whole grains, fruits and vegetables, use of healthy fats (unsaturated fats) and lean protein choices,” Grace explains. “It can be recommended for women going through menopause since this diet has been associated with numerous health benefits such as reduced risk of cardiovascular disease, stroke, certain cancers and improved sleep quality as well as longevity.”

However, she points out a few important things to take note of when following this diet. First, while olive oil, nuts and seeds are heart-healthy monounsaturated fats commonly used in the Mediterranean diet, these foods do contain significant amounts of fat which can contribute to excessive weight gain. Therefore, it is prudent to use such healthy fats in moderation and it will confer more health benefits if such monounsaturated fats replace your current intake of unhealthy fats (saturated and trans-fat). 

Secondly, some versions of the Mediterranean diet suggest consuming red wine in moderation, particularly during meals, due to its potential cardiovascular benefits. However, Grace says this is optional and should be done responsibly since excessive alcohol consumption can cause increases in blood pressure and the added calories with alcohol intake can also further increase unwanted weight gain. 

Also, the Mediterranean diet typically includes limited dairy and calcium-containing dietary sources. Menopausal women may need to ensure they are getting enough calcium from other sources to support bone health. 

Finally, Grace cautions that the Mediterranean diet is not a one-size-fits-all solution and individual dietary preferences and needs can vary, especially for those with pre-existing medical conditions.

This article was originally published on Oct 28, 2023 and updated on Dec 4, 2024.