Menopause is a physiological process that most women experience naturally, marking the end of their reproductive years. It generally begins between the ages of 45 and 55 and is a distinctive feature of female aging.
After the first symptoms appear, a transition period known as perimenopause begins, during which the production of specific hormones such as estrogen and progesterone progressively decreases. This stage affects the central nervous system and produces metabolic changes, weight gain, cardiovascular and musculoskeletal disorders, skin problems, and sexual dysfunction, among other symptoms .
Although menopause is inevitable, can diet make it more bearable?
Diet in perimenopause
When the first symptoms appear during the transition period, women often turn to hormonal or behavioral therapies to alleviate physical and emotional symptoms. The diet also plays a crucial role at this time, although a healthy diet should be maintained from the earliest stages of life: a daily menu providing sufficient essential nutrients, anti-inflammatory substances, fiber, vegetable proteins, unsaturated fatty acids, and electrolytes is indispensable for healthy aging.
Incorporating foods rich in calcium, vitamin D, and protein during adulthood is essential to prevent osteoporosis and sarcopenia (decreased muscle strength) once menopause has set in. What is not clear is whether soy isoflavones are as effective during this phase, since the results obtained in different populations and at different doses do not allow definitive conclusions to be drawn.
One of the most important aspects is maintaining a healthy weight. During the perimenopausal transition, it is common to experience changes in body composition, including a loss of muscle mass and an increase in fat mass. This could be related to the so-called “protein leverage effect”, a physiological mechanism caused by the loss of body proteins that requires an increase in those obtained through diet.
Thus, if a healthy diet includes approximately 15% of energy from protein, increasing the percentage to between 17% and 19% could contribute to maintaining body weight.
Mediterranean diet in postmenopause
In the postmenopausal period, the most well-known symptoms of menopause stabilize. The main concern then becomes osteoporosis .
Other studies also show that good adherence to the Mediterranean pattern is associated with a decrease in the severity of symptoms in menopausal women with obesity, mainly due to the regular consumption of legumes. At the same time, the daily presence of extra virgin olive oil would be able to reduce emotional disturbances.
The best menu against osteoporosis
A 2024 review established a food pyramid to prevent bone density loss in patients with osteoporosis or osteopenia. This work accumulated a good amount of evidence related to nutrition in postmenopausal women.
In terms of exercise, the experts found that 30 minutes of high-intensity resistance and impact training twice a week had no adverse effects on these women. Still, physical activity should be aimed at improving posture, balance, gait, coordination, and hip and trunk stabilization rather than focusing on general aerobic capacity.
From a nutritional point of view, eating 295 grams of vegetables and 175 grams of fruit daily reduces the risk of negative results in bone density tests when menopause occurs. Consuming fiber through raisins, raspberries, pears, blueberries, kiwis, mushrooms, artichokes, Brussels sprouts, chicory, and broccoli ensures a good prognosis. In addition, excessive sugar intake should be avoided.
In terms of fats, it is recommended to consume between 20 and 50 grams per day (g/d) of extra virgin olive oil and eat four portions of oily fish per week to achieve around 0.52 g/d of omega-3 polyunsaturated fatty acids. A protein intake of between 1 and 1.2 grams per kilo of body weight per day would be ideal to maintain a correct muscle mass, accompanied by exercise.
Among the fat-soluble vitamins (A, D, E, K), only supplementation with vitamin A precursors such as β-carotenes would be useful, since maintaining a healthy dietary pattern would suffice to meet the requirements of the remaining vitamins in this group. Among the water-soluble vitamins (groups B and C), folic acid appears to have a greater preventive effect against osteoporosis.
As far as minerals are concerned, it is necessary to consume enough products with calcium and magnesium, without the need for external supplementation. Interestingly, it is necessary to pay attention to the content of these minerals in different drinking waters (tap and bottled), since they represent a great extra contribution to food.
Adequate intakes of phosphorus and iron should also be taken, without going into excess, while copper and zinc supplements of 2.5–3 mg/d and 27.5 mg/d, respectively, may be appropriate. And although there is still no evidence on the ideal intake of silicon, manganese, and boron during menopause, everything points to them being essential for preventing osteoporosis, without the need for supplements at the moment.
Finally, coffee consumption is not considered harmful, as long as it does not exceed 400 mg/d of caffeine (3-4 espressos). Reducing salt to less than 2 g/d would be beneficial to prevent sodium from altering calcium metabolism.
In short, adhering to the Mediterranean diet from the early stages of life can alleviate the symptoms of perimenopause and postmenopause, especially those related to osteoporosis. A comprehensive approach that combines proper nutrition, regular physical exercise, and the possible use of hormonal treatments can be useful to facilitate the transition during this stage of a woman’s life.
