MENOPAUSE
The Importance of Nutrition
Prepared by Joanna Krzeslak-Hoogland
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The Metabolic Shift
• Basal metabolic rate drops by up to 250 - 300 kcal/day during
menopause.
• That can mean a weight gain of ~2 kg/year if nothing else
changes.
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What Drives This Change?
Estrogen decline contributes to:
• ↓ Insulin sensitivity
• ↑ Visceral fat
• ↓ Muscle mass
= A storm for metabolic slowdown
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Why It Matters
Menopause increases the risk of:
• Cardiovascular disease
• Type 2 Diabetes
• Osteoporosis
• Sarcopenic obesity
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What to Eat
Mediterranean-style diet
Your Friends: Dietary Fiber – Adequate Protein – Healthy Fats
• Plant-Forward Eating: Vegetables, fruits, legumes, whole grains, herbs & spices
– daily
• Aim for 30+ different types of plant-based foods every week
• Healthy Fats: Extra-virgin olive oil, nuts, seeds, and fatty fish - rich in omega-3s
• Moderate Animal Products: Fish & seafood, poultry, eggs & fermented dairy
• Lifestyle Matters Too: Shared meals, seasonal foods, physical activity, and
mindful living
AVOID: Simple, refined fast-acting sugars, smoking, sugary and alcoholic beverages, sedentary life, excess salt, excess saturated fat.
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How to Compose a Mediterranean-like meal
Carbs: foods rich in resistant starches
(grains, legumes, tubers, pseudo-grains; Protein sources. The best sources of protein-rich foods are
approx. 20 - 30% by volume) unprocessed, organic animal products and vegan options
such as tempeh/tofu, seeds, nuts, and plant protein powders.
Fat sources. The best sources of healthy fats are raw nuts
and seeds, and quality plant oils.
Carbohydrate sources. Carbs are best when they come from
vegetables, fruits, intact whole grains, tubers, and beans.
Fat-rich foods
Resistant starch-rich foods include potatoes, sweet potatoes,
(avocado, seeds, peas, yams, plantain, lentils, chickpeas, beans, buckwheat,
nuts; approx. 15 - oats, barley, etc.
20% by volume)
Carbs: foods rich in complex carbs = dietary fiber
(non-starchy veggies; approx. 35 - 50% by volume)
Protein-rich foods Protein: 1 - 2 g/kg/day
(chicken, fish, tofu, eggs; Dietary Fiber: 30 - 50 g/day
approx. 20 - 25% by volume)
Veggies: 0,5 - 1 kg/day
Fruits: 0,1 - 0,2 kg/day
Herbs & spices
Note: different proportions may apply in certain situations 6
Nutrition & Menopausal Health
What the Evidence Shows
Bone Health Diet & Menopausal Metabolic & Micronutrients &
Symptoms Cardiovascular Benefits Supplementation
High fiber intake: Legumes: Mediterranean diet adherence: Vitamin D + K:
• ↑ hip BMD • ↓ overall menopausal • ↓ weight, blood pressure, • Supports bone &
• ↓ osteoporosis risk symptom severity omega-6:3 ratio, TG, TC, LDL cardiovascular health
• Vitamin D + K
High carbohydrate/fiber ratio: Extra virgin olive oil: • Promotes better quality of supplementation should be
• ↑ risk of osteoporosis • ↓ psychological symptoms life & long-term health considered
• ↓ hip BMD Key Menopause Nutrients:
Plant-based diet with daily Adequate protein, Vitamin D,
Anti-inflammatory Diet: soy: Vitamin K, Magnesium (Mg),
• ↑ bone markers • ↓ hot flash frequency and Calcium, B-vitamins, Vitamin C
• ↓ osteopenia risk severity
Flaxseed:
• ↓ certain menopausal
symptoms
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BMD: Bone Mass Density; TG: Triglycerides; TC: Total Cholesterol; LDL: Low Density Cholesterol
Protein = Muscle Insurance
• Protein needs increase with age
• Protein supports muscle mass
• Protein helps maintain strength
• Combine with resistance training and regular physical activity!
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Don’t Starve Yourself Out
Diets below BMR (<1200 kcal) can:
• Lead to micronutrient deficiencies
• Trigger rebound weight gain
• Reduce muscle mass
Sustainable loss = -500 to -700 kcal/day from actual needs for no
longer than 4 - 6 weeks.
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Other Lifestyle Keys
• Adequate Water Intake
• Daily Movement
• Sleep Quality
• Stress Management
• Emotional Balance
• Vitamin D & sun exposure
• Body composition tracking (not just BMI)
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Concluding Note
A New Chapter, A New Strategy
Menopause is a chance to redefine vitality with the right strategy
Prepared by Joanna Krzeslak-Hoogland
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Reference List
• Erdélyi A, et al. The Importance of Nutrition in Menopause and Perimenopause-A Review. Nutrients. 2023 Dec 21;16(1):27.
• Zhang L, et al. Association of dietary carbohydrate and fiber ratio with postmenopausal bone mineral density and prevalence of osteoporosis: A
cross-sectional study. PLoS One. 2024 Feb 14;19(2):e0297332.
• Song D, et al. Association between the dietary inflammatory index and bone markers in postmenopausal women. PLoS One. 2022 Mar
17;17(3):e0265630.
• Shrivastava R, et al. Dietary Status and the Effect of Flaxseed Supplementation on the Severity of Perimenopausal Symptoms. Cureus. 2025
Feb 26;17(2):e79725.
• Vetrani C, et al. Mediterranean Diet: What Are the Consequences for Menopause? Front Endocrinol (Lausanne). 2022 Apr 25;13:886824.
• Barnard ND, et al. A dietary intervention for vasomotor symptoms of menopause: a randomized, controlled trial. Menopause. 2023 Jan
1;30(1):80-87.
• Gonçalves C, et al. Systematic review of mediterranean diet interventions in menopausal women. AIMS Public Health. 2024 Jan 10;11(1):110-
129.
• Rusu ME, et al. Investigating the Effects and Mechanisms of Combined Vitamin D and K Supplementation in Postmenopausal Women: An Up-
to-Date Comprehensive Review of Clinical Studies. Nutrients. 2024 Jul 20;16(14):2356.
• Coelho-Júnior HJ, et al. Protein intake and physical function in older adults: A systematic review and meta-analysis. Ageing Res Rev. 2022
Nov;81:101731.
• Thornton M, et al. Nutrition Interventions on Muscle-Related Components of Sarcopenia in Females: A Systematic Review of Randomized
Controlled Trials. Calcif Tissue Int. 2024 Jan;114(1):38-52. doi: 10.1007/s00223-023-01157-1. Epub 2023 Dec 3. PMID: 38043101.
Prepared by Joanna Krzeslak-Hoogland
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