Should I Follow a Plant-Based Diet During Perimenopause and Menopause?

As a health professional working with women in perimenopause and menopause, I’ve seen firsthand how diets that once seemed ideal—like veganism and vegetarianism—start to present new challenges. Many women who previously thrived on these diets begin to struggle with body composition, weight gain, mood, sleep, brain function, and even the severity of hot flashes and night sweats.

 

The Perimenopause Challenge: Carbohydrate Tolerance and Protein Sources

One of the primary issues is carbohydrate tolerance. During perimenopause and menopause, hormonal shifts—especially the decline in estrogen and progesterone—make 100% of us less sensitive to insulin, rendering us less capable of utilizing the same amount of daily carbohydrate. This makes it harder to manage blood sugar levels. Vegan and vegetarian diets, rich in plant-based proteins, come with a high carbohydrate load. While lentils, beans, and grains provide necessary protein, they also contribute significant carbohydrates, which can exacerbate blood sugar swings and insulin resistance.

 

The Science Behind It

Studies have shown that women in perimenopause and menopause experience a natural decline in insulin sensitivity due to hormonal changes. Estrogen plays a crucial role in maintaining insulin sensitivity, and its decline can lead to increased blood sugar levels and fat storage, particularly around the abdomen. This makes it essential to adjust carbohydrate intake and focus on balanced macronutrients.

*Fact**: Research has found that high carbohydrate intake can worsen hot flashes and night sweats due to its impact on blood sugar regulation and insulin levels.

 

Protein Recommendations and Carbohydrate Balance

To support optimal health and body composition during perimenopause and menopause, it’s recommended that women consume 1 gram of protein per pound of target body weight. This high protein intake is crucial for maintaining muscle mass, supporting metabolic health, and preventing weight gain. However, achieving this protein goal with plant-based sources can be challenging without significantly overshooting carbohydrate intake.

**Example**: To meet a target of 140 grams of protein per day, a woman might need to consume large amounts of lentils, beans, and grains, which would also add a considerable amount of carbohydrates, potentially leading to fat storage and metabolic issues.

 

The Omega Dilemma: Inflammation and Fatty Acid Balance

Another critical aspect is the balance of omega fatty acids. Plant-based diets often rely on nuts and seeds for protein, which are high in omega-6 fatty acids. While these are necessary for health, an imbalance with omega-3 fatty acids can promote inflammation. This is particularly problematic during perimenopause and menopause, as these stages are already associated with increased inflammatory responses due to hormonal shifts.

 

Estrogen Decline and Inflammation

Estrogen helps regulate inflammation by modulating cytokine production. As estrogen levels drop, there is an upregulation of pro-inflammatory cytokines, leading to increased inflammation. This can manifest in various ways, from chronic disease risk to visible signs of aging, joint pain, and slower connective tissue repair. Consequently, women in this stage of life are more prone to injuries and aches in the knees, back, shoulders, and other joints.

**Fact**: Lower estrogen levels are linked to higher levels of inflammatory markers like CRP and IL-6, which contribute to chronic inflammation and related health issues.

 

Practical Solutions and Adjustments

1. Reducing Carbohydrate Intake

Women in perimenopause and menopause should consider reducing their overall carbohydrate intake compared to their younger years. This helps manage weight and prevent insulin resistance. Focus on low glycemic index (GI) foods, which release glucose slowly and help maintain stable blood sugar levels.

2. Diversifying Protein Sources

Incorporate a variety of vegan protein sources, such as pea, hemp, and rice protein powders, to avoid excessive carbohydrate intake. These sources provide concentrated protein without the high carb load.

3. Balancing Omega Fatty Acids

To maintain a healthy omega-3:6 ratio, consider incorporating omega-3 supplements, such as algal oil. This helps counteract the inflammatory effects of omega-6 fatty acids prevalent in nuts and seeds.

4. Prioritizing Anti-Inflammatory Foods

Focus on anti-inflammatory foods like leafy greens, berries, and flaxseeds. These foods can help mitigate the increased inflammatory response during perimenopause and menopause.

 

Conclusion: Meeting You Where You Are

As a practitioner, my goal is to meet you where you are and provide the most effective strategies for your unique needs. While veganism and vegetarianism can be more challenging during perimenopause and menopause, with thoughtful adjustments and a focus on balanced nutrition, you can continue to thrive. Understanding and managing these dietary challenges can lead to improved body composition, better mood, enhanced brain function, and a reduction in hot flashes and night sweats.

By addressing these issues head-on, we can navigate this transformative stage with grace and vitality.

 

Sources

Carbohydrate Intake and Vasomotor Symptoms: Thurston, R. C., Sowers, M. R., Sutton-Tyrrell, K., Everson-Rose, S. A., Lewis, T. T., & Edmundowicz, D. (2011). Abdominal adiposity and hot flashes among midlife women. Menopause, 18(6), 726-733. doi:10.1097/gme.0b013e318204a94b

Estrogen and Insulin Sensitivity: Carr, M. C. (2003). The emergence of the metabolic syndrome with menopause. The Journal of Clinical Endocrinology & Metabolism, 88(6), 2404-2411. doi:10.1210/jc.2003-030242

Omega-3 and Omega-6 Fatty Acid Balance: Simopoulos, A. P. (2002). The importance of the ratio of omega-6/omega-3 essential fatty acids. Biomedicine & Pharmacotherapy, 56(8), 365-379. doi:10.1016/S0753-3322(02)