The best diet for perimenopause, by the evidence
The Women's Health Initiative, the SWAN study and a 2023 meta-analysis all point in the same direction: a modified Mediterranean pattern with extra protein is the best all-rounder for perimenopausal women. It moves the needle on weight, hot flushes, mood, bone density and cardiovascular risk simultaneously.
Why protein matters more now
Falling oestrogen accelerates muscle loss (sarcopenia). The ICFSR position statement recommends 1.0–1.6 g/kg of protein daily for women over 40 — roughly 25–35 g per meal. Below that, you can't preserve muscle even with strength training.
Is keto good for perimenopause?
Strict keto raises cortisol, often disrupts sleep further and can blunt thyroid output. A "lower-carb Mediterranean" approach (100–150 g carbs from beans, oats and fruit) gives most metabolic benefits without the downsides.
Is plant-based good for perimenopause?
Yes — plant-based diets are rich in phytoestrogens (soy, flax, chickpeas) which can reduce hot flushes by ~20–30% in studies. The watchout: hit your protein target (it's harder on plants), and supplement B12, omega-3, iodine and vitamin D.
Should I do intermittent fasting?
A 12:12 or 14:10 eating window is fine for most. Going beyond 16 hours regularly stresses the HPA axis, worsens sleep and makes muscle preservation harder. If fasting feels like it helps your weight but trashes your sleep, it isn't a net win.
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