In the last post, we explored fundamental nutritional habits to manage inflammation, insulin resistance, gut health and stress resilience which can all impact perimenopause symptoms. Now, let’s build on that foundation with advanced strategies to further tackle the effects of fluctuating and fading hormones.

Perimenopause often prompts us to think about long-term well-being. As estrogen, progesterone and testosterone levels decline, we may face challenges such as muscle loss, rising LDL cholesterol and blood sugar, and an increased risk of osteoporosis, heart disease and diabetes. But these are NOT inevitable. By prioritizing nutrient-rich foods and targeting specific nutrients, you can support your body and keep these risks at bay.

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Essential Nutrients for Perimenopause and Beyond

Calcium: Supports bone density. Found in dairy, leafy greens and fortified foods.
Vitamin D: Essential for calcium absorption, hormone regulation, gut health and immune support. Sunlight exposure helps, but many people require supplementation.
Magnesium: Aids vitamin D metabolism, muscle and nerve function, and may ease cramps and headaches. Found in nuts, seeds, leafy greens and whole grains.
Vitamin K2: Helps bind calcium to bone. Found in fermented foods and pasture-raised/grass-fed animal products.
Omega-3 Fatty Acids: Reduce inflammation and support heart and brain health. Sources include cold-water fish (high in EPA and DHA, both of which are essential for health), and flaxseeds and walnuts (high in anti-inflammatory ALA).
Protein: Needed to preserve muscle mass, which becomes increasingly important with age. Aim for quality sources like lean meats, fish and whole soy foods.
Antioxidants: Combat cell damage and support overall health. Vitamin C, Vitamin E and selenium are a few examples. Found in colorful plant foods (vegetables, nuts, seeds, legumes, fruit, tea, herbs and spices).
Fiber: Supports gut health, detoxification, weight management and long-term health. Different types of soluble and insoluble fiber are found in a variety of plant foods, so quantity and variety of plant foods is key!

Daily Nutrition Strategies

Once you've cut out ultra-processed foods and are eating well-balanced meals routinely, consider adding the following daily to target the nutrients mentioned above:

2 – 5 magnesium-rich foods. Think about taking a magnesium supplement if you don’t get at least 320 mg consistently from your diet or if factors like high stress or certain health condition increase your needs.
At least 700 – 800 mg of calcium, preferably from natural dietary sources. If supplementation is needed to reach this amount, choose a high-quality supplement with no more than 500 mg calcium and make sure you are also getting magnesium, vitamin K2 and vitamin D3.
25 – 45 grams of protein with each meal for a total of 90-120 g protein daily. Optimal levels vary, usually within that range, based on body size/composition, activity level and health status.
1 – 2 forkfuls of fermented foods for prebiotics, probiotics, and postbiotics like vitamin K2.
A high-quality multivitamin (e.g., Thorne Research Basic Nutrients 2/Day, Pure Encapsulations O.N.E. or PureGenomics).
2 – 3 tablespoons of ground flax seeds. Add them to smoothies, yogurt, oats or chia pudding. Start with just a teaspoon and work up over time.
2 – 3 cups of green tea for bone health, decreased inflammation and calming L-theanine. (If you really don’t like green, black tea also has some bone health benefits.)

Weekly Nutrition Goals

Low mercury, high omega-3 fish — 3 servings per week.
Organic, whole soy foods such as tempeh, tofu, miso, edamame or natto – at least once a week.
Other legumes (beans, peas, lentils), if tolerated.
Start a list and aim for 30 different plant foods throughout the week to support a healthy gut microbiome. You can include all types of produce, herbs, spices, legumes, nuts, seeds, and even coffee and tea.

Personalizing Your Approach

Work with a registered dietitian nutritionist or other health care provider regarding:

Vitamin D3: Supplement (ideally with a vitamin D3/K2 combo) if blood levels are suboptimal. Multivitamins contain vitamin D3, but some people require more. Optimal vitamin D blood levels are 50-80 ng/mL, so get tested before supplementing with more than 2000 IUs total to avoid over supplementation.
Omega-3s: Check with your Registered Dietitian Nutritionist or other health care provider to see if a supplement is appropriate for you. Quality counts!
Intermittent fasting: Fasting can support metabolic health but ensure adequate protein intake.
Gut health & digestion: If you struggle with constipation, take steps to have 1-3 well-formed, complete bowel movements daily.

Daily Lifestyle Recommendations

Nutrition is just one piece of the perimenopause puzzle — quality sleep, stress management and regular movement are equally essential to help you feel your best now and support your long-term health.

Sleep: Work on strategies to get 7-8 hours of quality sleep beginning with syncing your circadian rhythms.
Joy & Relaxation: Protect time on your schedule for “you time” and for relationships that rejuvenate you. Spend time outdoors and doing activities that bring you joy.
Mindfulness & Stress Reduction: Practice 4-7-8 breathing, meditation or HRV biofeedback/cultivating coherence.
Exercise: Move your body. Include strength training, weight bearing, cardio, stretching and balancing exercises
Reduce Hormone-Disrupting Toxins: Choose safer/less toxic cookware and personal care products.

Doing your best with nutrition and lifestyle habits is key to setting the stage for all other support strategies to work their best. See the resources below for a deeper dive into nutrition and lifestyle:

You may also be interested in Hormone Replacement Therapy and Sexual Health during Menopause.

Ginger Mint Garden Smoothie

Makes 2 servings
PRINT RECIPE

Ingredients
1 cup milk of choice
2 inches ginger root
fresh mint
2 cups raw leafy greens or 1 cup frozen spinach
⅓ English cucumber
½-1 block silken tofu
1-2 kiwis with skin (chopped and frozen ahead of time preferred)
1 cup frozen mango cubes or honeydew melon
hemp seeds (optional)
up to 2 tsp honey (optional)

Instructions

Add milk, ginger and mint to blender and blend on high for 1 minute.
Add the remaining ingredients and blend until smooth. Use extra water as needed until desired consistency is reached.

Notes: Fat is beneficial to help you absorb some of the nutrients in the produce, so opt for a milk that contains fat (e.g., nut-based milk or full-fat dairy), especially if you are not adding the hemp seeds. As an alternative, you can use water as your liquid and add avocado for creaminess and healthy fats. If you are trying to cut down on added sugar, make sure your fruit is ripe and omit the honey.

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