What to eat in perimenopause (and why it matters)

When you’re navigating perimenopause <link to our Dr Louise Newson “Perimenopause Explained” feature>, supporting your body with good nutrition is crucial. Women often gain weight at this time, and turn to calorie counting or restrictive diets. But there is a better way. “Menopause isn’t a problem that needs ‘fixing’ with extreme dieting,” says menopause nutritionist Emma Bardwell. “Many women think they need to cut out entire food groups or drastically restrict calories in order to see results. In reality, menopause is a natural transition that happens to all women, and nutrition should focus on supporting and nourishing – it’s definitely not a time to be depriving yourself. We need to be thinking about eating for energy, mood, muscle mass, hair and skin, and for the future health of our bones, hearts and brains.”

Eating for perimenopause
While food alone can’t eliminate perimenopause symptoms, it can play a powerful role in easing brain fog, mood swings and sleep disturbances, and improving overall resilience. “For mental acuity and emotional balance, nutrients like B vitamins, omega-3 fatty acids and complex carbohydrates are essential, as they support the production of neurotransmitters like serotonin and dopamine,” says Emma.

“Protein is essential – alongside resistance training <link to our feature on exercise for perimenopause> – to counteract the muscle loss that can occur at this time, and it also supports bone, skin and hair health,” Emma adds. “Protein fills you up and helps you feel satisfied, which can be really helpful if weight loss is a goal. As we get older, our protein requirements increase, which is one of the main reasons I wrote my book, The 30g Plan.”

Protein and fibre also help to stabilise blood sugar, reducing the frequency and intensity of mood fluctuations and energy crashes, while magnesium can promote rest and relaxation, and reducing caffeine and alcohol can make a noticeable difference to sleep quality. Fibre also feeds our gut bugs, supporting mental health, skin health, hormones and immune function.

And don’t underestimate the importance of staying hydrated. “Even a slight dip can leave your mind feeling cloudy,” Emma adds.

Supplements for perimenopause
Supplements can play a crucial supporting role in perimenopause. “Calcium and vitamin D are vital for protecting bone density, which can be affected as oestrogen declines. Vitamin D is also key for regulating mood, helping with muscle aches and supporting immune health,” says Emma. “I recommend getting your vitamin D levels checked by your GP – or via a private testing company – to see whether supplementation is actually needed.”

“Magnesium helps with sleep, mood regulation and blood sugar control and is found in leafy greens, nuts and seeds,” she adds. “There’s also an argument that food is now depleted in magnesium due to modern farming practices, which means supplementation can be helpful. If you do supplement, look for magnesium bisglycinate, as it’s well tolerated and easily absorbed.”

Magnesium helps with sleep, mood regulation and blood sugar control.

“Omega-3 fats, mainly from oily fish like sardines and salmon, help reduce inflammation and support brain, eye, skin and heart health,” says Emma. “It’s one of the few supplements I regularly recommend, as many women don’t eat the recommended two portions of fish per week. There are also algae-based versions for those who don’t eat fish.”

“B vitamins – particularly B6, B12 and folate – support mood, brain function and energy. Stress and alcohol can deplete B vitamin stores, so if that’s you, or if you don’t regularly eat foods rich in them, a daily B-complex supplement can be helpful.”

How to lose weight in perimenopause
Many women gain weight during peri-menopause. “Hormonal shifts, particularly declining oestrogen, promote fat storage around the middle,” Emma explains. “At the same time, muscle mass tends to decrease, which lowers the number of calories the body burns at rest. Sleep disturbances and increased stress, both common in perimenopause, can also disrupt hunger hormones and increase cravings or emotional eating. Together, these changes create a perfect storm for gradual weight gain – but it’s not inevitable. With the right strategies, it’s entirely possible to maintain a healthy weight or lose belly fat during this transition – you just need to be consistent.”

“Weight loss is simple, but it’s not easy,” says Emma. “You need to be in a calorie deficit – eating less energy than you expend. The issue is that most people go hell for leather. They restrict, deny and deprive themselves, can’t sustain it, and then end up feeling disheartened and like nothing works. My approach is to go low and slow. Shaving off around 300–500 calories a day feels doable, doesn’t leave you famished, and means no foods are off the table. You won’t lose seven pounds in seven days – this isn’t a 1990s body-blitz diet – but you will get results if you’re consistent. Realistically, this is about thinking six to twelve months ahead, not overnight change.”

Back to protein and fibre. “I teach people to fill up on high-volume foods so they don’t feel hungry or restricted, and that essentially comes down to protein and fibre,” Emma explains. “These physically fill us up, keep us fuller for longer, regulate blood sugar, control appetite by releasing GLP-1, and slow the rate at which food leaves the stomach.”

“Nutrition during perimenopause can feel overwhelming,” Emma notes. “One week carbs are the enemy, the next it’s fat. But carbohydrates aren’t bad – fibre-rich whole carbs like oats, legumes and wholegrains support energy, gut health and hormone balance,” she explains. “And healthy fats, like those from avocados, nuts and olive oil, play a critical role in brain health and inflammation. The key is focusing on quality and balance rather than extremes.”

Fasting in perimenopause
“As we get older, when we eat can become just as important as what we eat,” says Emma. “Changes in insulin sensitivity mean large or late meals can lead to energy crashes, cravings and weight gain.” Intermittent fasting can be beneficial, but it’s not a magic bullet and isn’t for everyone. “A gentle form of time-restricted eating, with a 10-12 hour eating window, can help stabilise blood sugar and support metabolic health,” she adds. “But the goal is to create a rhythm that supports your body. If fasting causes fatigue, anxiety or sleep disturbances, it can do more harm than good.”

When we eat can become just as important as what we eat.

And make sure you’re eating enough. “If you’re overly restricting, you can end up feeling foggy and lethargic,” Emma warns.

The key? Listen to your body and consider what makes you feel balanced, satisfied and energised. “Unfollow accounts that promote fear-based messaging or one-size-fits-all solutions, and follow evidence-based, qualified voices,” Emma recommends. “Reducing the noise makes it much easier to stay consistent and confident in your choices.”