Here’s the bottom line about menopause and nutrition! There are five fundamental dietary changes that can have a tremendous impact on menopausal symptoms and on our long-term health: 1) Anti-inflammatory Eating, 2) Antioxidant-Rich Eating, 3) Low-Glycemic Eating, 4) Phytoestrogen-Rich Eating, and 5) Intermittent Fasting. 

1. Anti-Inflammatory Eating

Many of the symptoms of perimenopause and menopause are driven by inflammation. Inflammation is meant to be the body’s initial response to injury or infection, and the way of signaling the immune system to send white blood cells to protect the area. However, chronic inflammation happens when the body is triggered to continue sending inflammatory messages and cells, thereby damaging tissue. In menopause the inflammation can trigger and worsen common challenges such asjoint pain, skin rashes and acne, digestive discomfort, high cholesterol, and memory challenges, among many other symptoms.

And here’s the kicker: chronic inflammation drives the aging process and is the root cause of many serious illnesses – including heart disease, asthma, many cancers, osteoporosis, cognitive changes, Type II Diabetes and Alzheimer’s Disease. Stress, lack of exercise, too much high-intensity exercise, obesity, genetic predisposition, smoking, exposure to toxins and viruses, food sensitivities, and fast food can all contribute to chronic inflammation. 

FYI: Gluten (from wheat) is a highly inflammatory food that can contribute to digestive problems and increase the likelihood of hot flashes and other peri/menopausal symptoms. Gluten and the broad-spectrum herbicide glyphosate (which is sprayed on American wheat) have been identified as causes of intestinal permeability or “leaky gut”, and in turn associated with lower levels of progesterone production, as well as triggers for autoimmune disease. (Progesterone is one of our “feel good” hormones and essential to stress-reduction and calm in menopause.)

For most people, eating an anti-inflammatory diet (like the Mediterranean Diet) means eating veggies, herbs, berries, nuts, seeds, beans, olive oil, and wild, fatty fish. 

Anti-Inflammatory Powerhouses:

Turmeric 
Ginger
Nuts and seeds – flax, chia, walnuts, hemp
Berries – blueberries, organic strawberries, sour cherries
Olive oil (primarily in salad dressings-never heated above 350 degrees)
Allium vegetables – garlic, onions, scallions, shallots
Cruciferous vegetables – broccoli, cauliflower, Brussels
Dark green leafy greens – collards, kale, spinach
Wild, fatty fish – salmon, sardines, mackerel, and high-quality fish oils (especially DHA)
Bone Broth – combine bones from a roasted chicken with carrots, onions, garlic, apple cider vinegar, water, and herbs in a slow cooker for 24 hours. 

To read more about how bone broth can help, check out our Sage+Sisters menopause programs.

Alternatively, purchase Bonafide Provisions bone broth to make soups and rice, or to drink straight up with a little sea salt.

Anti-inflammatory Recipe: Massaged Kale Salad

Ingredients:

1 bunch organic Kale (any kind)
pinch sea salt
1 Tbsp. extra virgin olive oil
1 apple chopped, with skins on
1/4 cup Raisins
1/4 cup sliced almonds

Optional Add-ons:
1/4 cup pepitas
¼ red onion diced
1/4 cup coconut flakes large (unsweetened)
1 Tbsp. hemp seeds

Mix it up! Make it seasonal!

Orange Ginger Honey Dressing:

½ cup extra virgin olive oil
3/4 inch ginger chopped with skin peeled off
½ Tbsp. raw honey
half an orange, juiced
¼ tsp. sea salt

Instructions:

Chop the kale into thin strips about 2 inches long.
Toss in a bowl with a sprinkle of sea salt and about 1 Tbsp. of olive oil.
With your hands, massage the kale for a minute or two until soft.
Add additional ingredients, mix well, and toss with Orange Ginger Honey dressing 

2. Antioxidant-Rich Eating

As we get older, the cells in our body are under constant attack from unstable molecules called free radicals, which strip electrons from other sources to replace the electrons they have lost. Free radicals damage tissues and DNA, causing chronic and systemic inflammation. 

Antioxidants, on the other hand, are molecules that hunt down and neutralize free radicals, breaking them down into harmless substances. Unfortunately, due to lower levels of estrogen, menopausal women experience a less effective antioxidant defense. So, more than ever before, we need to make sure we are getting bright colors into our diets – veggies, fruits, and herbs. This will help us reduce our menopause symptoms.

Antioxidants Help Us: 

1. Reduce blood pressure 
2. Reduce blood sugar and balance insulin
3. Lower LDL cholesterol
4. Prevent LDL cholesterol from becoming oxidized (part of the process of hardening/clotting) in our blood vessels, and thereby help prevent cardiovascular disease
5. Boost our immune system and help prevent cancer
6. Balance hormones 
7. Prevent the aging of our skin from sun damage 
8. Protect our brains from neurodegenerative diseases like Alzheimer’s and Parkinson’s

Antioxidant Powerhouses:

Tomatoes
Garlic
Berries 
Apples
Broccoli, Brussels, cabbage, cauliflower and kale. 
Cacao 

Other great sources include: Artichokes, onions, peppers, pecans, kidney beans, grapes, cilantro, parsley, turmeric, cumin, cinnamon, ginger, green tea, and red clover tea

Antioxidant-Rich Recipe: Broccoli Fennel Soup with Cashew Cream

Serves 3

Ingredients:
1 cup boiling water
1 1/2 cups cashew pieces
sea salt
1 large head broccoli chopped
2 leaves celery stalks reserve for garnish
1 bulb fennel roughly chopped
2 Tbsp. extra virgin olive oil
1/2 cup chopped parsley
3 cups water  
1 Rapunzel bouillon cube 
(or 1 frozen package of Bonafide bone broth instead of 3 cups water and bouillon cube)

For Garnish:

cashew cream
celery leaves
fresh dill
black pepper
extra virgin olive oil

Instructions:

1. In a bowl, combine cashews, sea salt, and boiling water and let cashews soften.
2. Meanwhile, combine broccoli, fennel, celery, EVOO, parsley, water, and bouillon cube and bring to a boil, with lid on, but allowing steam to escape. Over medium heat and with lid still loosely fit, steam veggies for 8-10 minutes. Remove from heat. Add 1 tsp. salt and remove from heat.
3. Puree the cashew and water mixture in a cuisinart or vitamix and set aside.
4. Blend soup with an immersion blender or in a blender. Return to heat and boil down a bit if necessary to acquire perfect thickness.
5. Garnish bowls of soup with cashew cream, celery leaves, fresh or dried dill, pepper, and EVOO.

3. Low-Glycemic Eating

During perimenopause and menopause we experience physiological changes. One of the big ones is that our body’s metabolism changes, and many of us become more sensitive to sugar. This is one of the reasons we can’t drink our favorite cocktail or glass of wine in midlife anymore without feeling lousy. 

When foods are “high glycemic”, it means that they make our blood sugar rise quickly. In general, the more processed the food, the higher the glycemic index. The more fiber, protein and healthy fat in a food, the “lower glycemic”, and the better for us. 

When we consume simple carbohydrates (alcohol, refined carbs and sugar), our blood sugar goes up. If we consume these foods all the time, we ask our bodies to deal with chronically high blood sugar, which decreases our sensitivity to insulin and makes it harder for our bodies to get sugar out of our blood and into our cells for energy. Chronically high blood sugar creates an environment in which excess sugar becomes toxic and is stored as fat. Excess sugars also alter the function of key antioxidant enzymes, which increases oxidative stress and the longer-term risk of disease. 

For better blood sugar balance and improved long-term health, include all three macronutrients (healthy fat, protein, carbohydrates) in your diet:

1. Healthy fats, such as olive oil, avocados, flaxseeds, nuts, wild (coldwater) fish, chia, and grass-fed meat
2. Plenty of protein from nuts, hemp seeds, eggs, wild fish, bone broth, and grass-fed meat
3. High fiber/antioxidant-rich (colorful) carbs, such as broccoli, cauliflower, brussels, carrots, sweet potatoes, asparagus, lentils, soybeans, chia seeds, flax seeds, almonds, avocados, quinoa, oatmeal, apples, blackberries. 
4. Incorporating cinnamon, green tea, and nettles into your diet will also go a long way toward helping to balance your blood sugar and making the menopause transition easier.

Low-Glycemic Recipe: Holiday Salmon

Serves 2

Ingredients:

¼ cup orange juice
1 clove garlic, minced
1 Tbsp. tamari
1/2 lb wild salmon
2 zucchini, spiralized
1 Tbsp. coconut oil
Pinch pinch Himalayan sea salt
1 orange, peel cut off and sliced into rounds
1 Tbsp. fresh parsley, roughly chopped

Instructions:

1. Make the marinade by whisking together the orange juice, tamari, and garlic in a bowl. Cut your piece of salmon in half and marinate, skin side up, for about ten minutes.
2. Meanwhile, spiralize the zucchini and quickly brown in a cast iron pan with coconut oil and a pinch of salt. Should only take about 5 minutes. Remove and Keep warm!
3. Add a tiny bit more coconut oil and place the salmon skin side down, and then pour the marinade over it. Sprinkle with salt. Cook in med/high heat for about 4-5 min or until the salmon looks cooked about halfway up. Preheat broiler.
4. Place the pain in the broiler and cook for about 1-2 minutes, add an orange slice on top of each piece, and broil for 1-2 minutes more, until there are signs of browning on the orange. 
5. Place half the zoodles on each plate, and top with a piece of salmon (try to remove the skin with the spatula as you lift the salmon out of the pan). Add a sprinkle of fresh parsley.

4. Phytoestrogen-Rich Eating

Leafy greens, seeds and legumes, including soy, are rich in two types of menopause-supportive phytoestrogens, isoflavones and lignans. Phytoestrogens bind to estrogen receptors and exert a balancing effect. This means that if estrogen metabolite levels in the body are low, the foods will have a subtle estrogenic effect, and if estrogen metabolites are high, the phytoestrogens from food will help block the stronger estrogens. Phytoestrogens are not hormones. They are plant-derived compounds that have a high affinity for the type of estrogen receptor (ER-B) that is antiproliferative (suppressing the growth of malignant cells.) 

Studies show that foods rich in phytoestrogens have a positive impact on sleep, cognition and vaginal atrophy (Chen et al., 2014.) Recent research shows a link between higher legume (bean) consumption and lower all-cause mortality, with every additional 50g per day increase in legume intake associated with a 6% decrease risk (Zargarzadeh et al, 2023.) 

Soy, which is full of isoflavones, has been shown to reduce moderate hot flashes, slow bone loss, improve cholesterol numbers and blood pressure and reduce cardiovascular risk. Soy has also been linked to lower breast and endometrial cancer. A critical thing to keep in mind is the idea of how traditional Eastern cultures consume soy. It is not by drinking huge amounts of processed soy milk, for example. With time-honored Japanese diets, much of the soy is fermented (natto, tempeh, miso) and adults typically have approximately 50-150mg of soy isoflavones daily. While the isoflavone content in food varies, this is rarely more than one or two servings a day. Soy must be non-GMO, organic and fermented.

Phytoestrogen Powerhouses:

Cruciferous veggies – cooked cabbage, kale, broccoli, cauliflower, bok choy, arugula, collards, spinach, Brussels
Legumes – cooked (or fermented) yellow split peas, baby limas, black beans, red kidney beans, black and red lentils and soybeans. (Legumes are also high in protein, fiber, B vitamins, and magnesium.) Wonderful to get in 3-4 servings of legumes/week, as long as you do not have an autoimmune disease
Fennel, beets, carrots, celery, parsley, rhubarb and alfalfa
Sesame, sunflowers, freshly-ground flaxseed, nuts
Garlic and turmeric
Dates, apricots, peaches, olives

Phytoestrogen-Rich Recipe: Black Pepper Tempeh

If you haven’t tried tempeh before (which is a fermented soy), we think you’ll really like the texture and the way it can absorb flavor. This recipe is packed with zest and we hope it will become a regular for you! Also, we love a one-dish meal!

Serves 2

Ingredients:
3 Tbsp. coconut oil
3 shallots (or onions), thinly sliced
½ tsp. Red pepper flakes
1 Tbsp. grated fresh ginger
7 large garlic cloves, smashed
3 Tbsp. tamari
2 Tbsp + 1 tsp. coconut sugar
2 Tbsp. water
8 oz tempeh, sliced into pencil-thick strips
1 cup spinach leaves
1 bag frozen cauliflower rice
2 tsp. Freshly ground pepper

Instructions:

1. Combine oil, shallots, red pepper, and ginger in a large skillet over low heat. Cook slowly for about 10 minutes, stirring occasionally.
2. Add the garlic and stir for a moment until fragrant. 
3. Add the water and tamari, and 2 Tbsp. coconut sugar. Stir well. 
4. Lay the tempeh evenly over the mixture. Sprinkle with tamari, and then heavily season with freshly ground pepper. Lightly sprinkle 1 tsp. of the coconut sugar over the tempeh. Let cook for about 5 minutes without moving, until one side of the tempeh is browned.
5. Meanwhile, in another pan, Add coconut oil and then the cauliflower rice.  Stir and cook for about ten minutes, until golden. Set aside.  
   Flip the tempeh and cook for another 4 minutes until golden on both sides. 
6. Sprinkle with spinach leaves (and top the spinach with a bit of sea salt and olive oil). Stir into the tempeh mixture (disrupting the evenly spaced, now browned, tempeh for the first time. Once wilted, remove from heat. 
7. Serve over a bed of cauliflower rice. 

5. Intermittent Fasting

Dozens of studies have shown that the long-term benefits of intermittent fasting include improvements in all of the following areas that commonly affect women during perimenopause and menopause: 

Fat mass
LDL cholesterol, total cholesterol, and triglycerides
Blood pressure
Blood sugar and insulin resistance
Gut health
Mood 
Longevity

(Mattson, 2017.)

In order to practice intermittent fasting (IF), simply reduce your eating window some days or every day. This lets your body have time to rest and recuperate, and allows it to focus on balancing your gut microbiome and putting absorbed nutrients to good use. Most intermittent fasting studies look at an eating window of about 8 hours, for example eating between the hours of 9am and 5pm. 

A recent article in the New York Times claimed, “Scientists found no benefit to time-restricted eating” and specifically that it did not promote weight loss (Kolata, 2022.) The actual study in the New England Journal of Medicine, followed only patients with obesity, and showed that time-restricted eating and calorie restriction was not more effective for weight loss than simple calorie restriction (Dyeing et al., 2022). Alarmingly, the scientists were looking only at the amount of calories and not at the quality of the calories. The participants could eat anything, however processed, high-glycemic, and inflammatory. 

Menopause and Nutrition Take-Aways:

1. Chronic inflammation is a root cause of illness and can exacerbate perimenopausal and menopausal challenges; eating anti-inflammatory foods, such as vegetables, fruits, nuts, beans and fatty fish, can help reduce inflammation and menopause symptoms.
2. Increasing our consumption of antioxidant-rich (colorful vegetables) can protect us from inflammation, skin damage and heart disease. 
3. Excess sugar is toxic to our bodies and is stored as fat. To balance blood sugar, include healthy fats, protein and high-fiber, colorful veggies at every meal.
4. Eating phytoestrogens from greens, beans, and seeds can reduce our hot flashes and improve our long-term health.
5. Intermittent fasting also supports heart health and longevity.

Chen, M. Lin, C. & Liu, C. (2014). Efficacy of phytoestrogens for menopausal symptoms: A meta-analysis and systematic review. Climactic, 18(2), 260-9.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4389700/

Dyeing, L. (2022). Calorie restriction with or without time-restricted eating in weight loss. New England Journal of Medicine, (386), 1495-1504. https://www.nejm.org/doi/full/10.1056/NEJMoa2114833

Kolata, Gina. (2022, April). Scientists find no benefit to time-restricted eating. New York Times. https://www.nytimes.com/2022/04/20/health/time-restricted-diets.html

Mattson M. P., Longo, V.D. & Harvie, M. (2017). Impact of intermittent fasting on health and disease processes. Ageing Research Review, (39), 46-58.
Zargarzadeh, N. et al. (2023). Legume consumption and risk of all-cause and cause-specific mortality: A systematic review and dose-response meta-analysis of prospective studies. Advances in Nutrition, 14 (1), 64-76.