More and more research shows that a plant-based diet offers huge health benefits. But what about during menopause specifically? Do you need to eat a bunch of meat in order to meet your higher protein needs, maintain muscle mass, and avoid osteoporosis?

This post will dive into all the benefits and potential risks of eating plant-based during menopause so that you can feel good about your food choices and thrive during this time of your life.

The Basics: What is Perimenopause and Menopause?

First off, let’s define what it actually means to be in perimenopause and menopause.

Perimenopause

This is when the fun begins. Often called the “menopausal transition,” perimenopause is the period leading up to menopause when a woman’s body begins to produce less estrogen, progesterone, and other reproductive hormones.

It typically starts in a woman’s 40s, but it can begin as early as the mid-30s or as late as the early 50s. This is the period when we start to have all the menopausal symptoms that we hear about. I have been in the thick of this phase over the past couple of years!

Due to significant hormonal fluctuations during this time, you can often experience various physical and emotional symptoms. Although not everyone will experience symptoms, roughly 85% of women do.¹

Some common menopausal symptoms include:

• Irregular menstrual cycles (periods can become longer, shorter, heavier, or lighter).
• Hot flashes and night sweats.
• Mood swings, anxiety, irritability, or depression.
• Sleep disturbances, insomnia.
• Weight gain, especially around the middle
• Joint pain and muscle aches
• Brain fog
• Thinning hair
• Vaginal dryness and atrophy, which may cause discomfort during sex.
• Low libido
• Reduced fertility.

This is what it means to be going through menopause. Personally, I love the reduced fertility part, but the rest of it blows!

Menopause

Menopause, in reality, is one day. It is defined by 12 consecutive months without a period, marking the end of reproduction. After that, you are technically considered post-menopausal.

Despite the bliss of no longer having periods, hormone levels remain low, and it is common to continue to experience a lot of the above symptoms. In addition, you are also more at risk for developing cardiovascular disease and osteoporosis.

So, what can you do? Hormone replacement therapy, supplements, diet, and lifestyle can all help. We will focus on diet in this blog, specifically looking at a plant-based diet.

Benefits of a Plant-Based Diet During Menopause

A plant-based diet, rich in fruits, vegetables, whole grains, legumes, nuts, and seeds offers numerous health benefits which may be particularly beneficial during menopause.

Some of these benefits include:

Rich in Phytoestrogens

Phytoestrogens are plant compounds with a similar structure to estrogen but are weaker and have an affinity to bind to certain estrogen receptor sites. They do not act exactly like estrogen but do offer some of the benefits that estrogen provides.

Many foods contain phytoestrogens but two of the most common types are isoflavones (found in soy) and lignans (found in flaxseeds and other plant foods).

A few potential benefits of phytoestrogens include:

• Improved symptoms of perimenopause and menopause: hot flashes, insomnia, and symptoms of depression.²,³,⁴
• May help improve bone health.⁵
• May reduce the risk of heart disease.⁶,⁷
• Reduced risk of cancer (breast, ovarian).⁸,⁹

Despite these benefits, phytoestrogens are often misunderstood. This is especially true when talking about soy foods. For more on soy, read The Pros and Cons of Soy.

Heart Health

As women, our cardiovascular risk increases after menopause. In fact, heart disease continues to be the leading cause of death for women in the United States.

A healthy plant-based diet is generally low in saturated fat and dietary cholesterol and rich in fiber and antioxidants supporting heart health by lowering cholesterol and blood pressure.

But beyond the cholesterol and blood pressure lowering effect, there are other plant compounds like phytonutrients and isoflavones (found in soy) that appear to offer additional protection.¹⁰

However, these protective heart benefits are found with a healthy whole food plant-based approach to eating not with a highly processed plant-based diet.¹¹

Blood Sugar and Insulin Sensitivity

During menopause, many women experience insulin resistance, which can increase the risk of developing type 2 diabetes. This, along with increased inflammation occurs due to hormonal changes making it harder for cells to respond to insulin.

Menopause also tends to bring about weight gain, particularly around the abdomen, which contributes to insulin resistance. Fat in this region is associated with a greater risk of metabolic disorders.¹²

Plant-based diets can improve insulin sensitivity and reduce the risk of type 2 diabetes in several ways:

• High in Fiber

Plant-based diets are rich in fiber from whole grains, legumes, fruits, and vegetables. Fiber slows the absorption of sugar, stabilizes blood glucose levels, and improves insulin sensitivity.

• Low in Processed Foods and Added Oils

Healthy plant-based diets are typically lower in saturated fats and processed foods, which contribute to insulin resistance. Lower added fat intake and avoiding excess calories help cells respond better to insulin.

• Anti-Inflammatory and Antioxidant Properties

Many plant-based foods are high in antioxidants and phytonutrients, which reduce inflammation in the body. Chronic inflammation is linked to insulin resistance and type 2 diabetes, so reducing inflammation improves insulin function. Check out the blog Anti-Inflammatory Diet For Menopause to learn more about anti-inflammatory benefits.

By promoting healthy blood sugar regulation, weight management, and reducing inflammation, plant-based diets result in lower insulin resistance and a lower risk of prediabetes and type 2 diabetes.¹³

Weight Management

A plant-based diet focusing on whole foods is rich in nutrients and tends to be lower in calories and higher in fiber, aiding in weight control, reduced abdominal fat, and improved metabolism.¹⁴

Plant-based diets have consistently been associated with reduced body weight in multiple interventional trials.¹⁵ This is good news for women going through menopause who, as mentioned previously, are more prone to weight gain (particularly around our bellies).

Gut Health

Having a healthy gut microbiome is crucial for your overall health. Your diet directly affects the growth of certain bacteria that either negatively or positively alter the health of your gut. This has been linked to your mood, immunity, inflammation, and more.

• High Fiber Supports a Diverse and Balanced Gut Microbiome

Plant-based foods like fruits, vegetables, whole grains, legumes, and seeds are rich in phytonutrients and dietary fiber, which play a crucial role in maintaining a healthy gut. Fiber acts as a prebiotic, feeding the beneficial bacteria (probiotics) in the gut, promoting their growth and diversity.

• Supports a Diverse and Balanced Gut Microbiome

Beneficial bacteria strains associated with plant-based diets have been shown to have potent anti-inflammatory effects. In contrast, diets high in animal protein (especially red meat and processed meat) have been shown to increase unhealthy bacteria and decrease beneficial bacteria.¹⁵

• Promotes Healthy Gut Lining

A high-fiber diet supports the production of short-chain fatty acids (SCFAs), such as butyrate, produced by gut bacteria when they ferment fiber. SCFAs help nourish and maintain the cells lining the colon, promoting a healthy gut barrier and reducing the risk of conditions like leaky gut syndrome.¹⁶

• Improves Regularity and Reduces Risk of Digestive Disorders

A plant-based diet has been linked to a lower risk of colon cancer, diverticulosis, and other digestive disorders, likely due to the combined effects of fiber, antioxidants, and a healthy gut microbiome.

Note that fiber supplements don’t provide all the variety of fibers, vitamins, minerals, and phytochemicals present in plant foods, so do not offer the same health benefits associated with a fiber-rich plant-based diet.

Brain Health

A plant-based diet can also affect your mood, cognitive function, and memory. Besides being rich in antioxidants and anti-inflammatory compounds, a plant-based diet can:

• Support Blood Flow to the Brain

A plant-based diet can improve cardiovascular health, which is essential for maintaining proper blood flow to the brain. Healthy blood flow supplies the brain with oxygen and nutrients, promoting cognitive function and reducing the risk of stroke and other brain-related issues.¹⁷

• Promote a Healthy Gut-Brain Axis

The gut-brain axis is the connection between the gut and the brain, influenced by the gut microbiome. A fiber-rich, plant-based diet supports a healthy gut microbiome, which can produce neurotransmitters (like serotonin) and influence mood, stress levels, and mental well-being. A healthy gut can positively impact brain function and mental health.

• Reduce the Risk of Cognitive Decline

Research suggests that in addition to lifestyle changes, following a whole food plant-based diet rich in whole grains, fruits, vegetables, nuts, and seeds may help prevent or slow age-related cognitive decline and reduce the risk of dementia and Alzheimer’s disease, likely due to their nutrient density and brain-protective compounds.¹⁸

This is a fairly new area of study, but we are starting to learn that diet can play a role in preventing cognitive decline. Exciting!

Potential Risks of a Plant-Based Diet During Menopause

So, what are the potential risks of following a plant-based diet during menopause? Some of the main concerns to be mindful of are:

Risk of Nutrient Deficiencies

A few nutrients of concern are vitamin B12, omega-3 fatty acids, and vitamin D. There are some fortified foods with B12 and vitamin D. Still you can’t find naturally occurring B12 in plant foods and there are very few foods that naturally contain vitamin D.

Even meat eaters often have a deficiency in these nutrients for various reasons. For this reason, it is recommended to supplement both B12 and vitamin D (if you can’t depend on sunlight exposure).

You can find ALA (alpha-linolenic acid) omega 3 in plant-based sources like walnuts, flaxseeds, chia seeds, hemp seeds, and soy foods. ALA can be converted into EPA, and a small amount can be converted to DHA. To ensure you are getting enough DHA, which is important for brain health, you can take an algae-based vitamin D3 supplement. Algae is where fish get omega-3s anyway.

For more on nutrient deficiencies, check out Blood Tests For Vegans and Plant-Based Eaters. Being proactive and eating well-balanced meals with variety will set you up for success.

Bone Health Concerns

Bone health becomes increasingly important during menopause because of the decline in estrogen, which naturally weakens bones and increases the risk of osteoporosis.

Decreased Bone Mineral Density

Previous studies have shown that those following a vegetarian or vegan diet have an increased risk of osteopenia or osteoporosis, decreased bone mineral density, and increased fracture risk. Say what?

For one, vegetarians and vegans tend to be leaner with lower body weight. People with obesity tend to have higher bone density because they are carrying more weight and tend to have higher 17β-estradiol levels.¹⁹ But, bone density is not the only factor in bone health, and people with obesity may have other bone quality issues that increase their risk of fracture.

Bone Fractures

From what I can tell, based on previous studies, plant-based eaters with a higher incidence of bone fractures had two things in common: a diet low in calcium and low in plant protein.²⁰,²¹ This is something we can control!

The irony is the evidence does not support the idea that a high calcium intake, either with diet or supplements, reduces hip fracture risk.²² But, it still stands that getting enough calcium and vitamin D is important for bone health.

I found this Harvard Health article interesting, which explains why women over 50 (in the United States) are still recommended to get 1200mg of calcium daily when the sweet spot may be closer to 700mg.

Interestingly, a cohort study published just this year, which included 70,285 postmenopausal women participating in the US Nurses’ Health Study, showed that long-term adherence to a plant-based diet was not associated with the risk of hip fracture. In fact, intake of a healthy plant-based diet was associated with a 21% lower risk of fracture.²³

It’s important to note, however, that the same study showed that intake of an unhealthy plant-based diet was associated with a 28% higher risk of fracture. This is where ditching a lot of the ultra-processed foods and eating a variety of whole plant foods becomes important.

Menopause and Muscle Mass Loss

As a natural part of aging, after age 30, women can lose approximately 3-8% of their muscle mass per decade. These percentages increase after menopause due to the loss of estrogen.

Estrogen plays a key role in maintaining muscle mass by supporting muscle repair and regeneration. As estrogen declines during menopause, the body’s ability to preserve muscle mass diminishes, leading to sarcopenia (age-related muscle loss).

Lower estrogen levels can contribute to weaker muscle fibers and a loss of strength and functional capacity. In addition, estrogen supports the body’s ability to synthesize protein, a critical process for building and maintaining muscle. When estrogen declines, protein synthesis slows down, making it harder to maintain or build lean muscle.

This is why it’s important to increase your protein intake during perimenopause and menopause, but how much do you really need?

Daily Protein Needs

The truth is, we don’t know the exact amount for sure but based on what we do know, this is the following recommendation:

• For women in perimenopause and menopause, to maintain or increase fat-free body weight and skeletal muscle mass you need to consume at least 1.0-1.2g/kg body weight/day.²⁴

• For more active women, the recommendation goes up to 1.2-1.6g/kg body weight/day.²⁵

Too Much Protein?

Contrary to what you may see on social media, chronic high protein intake >2 g/kg body weight per day has not been shown to provide any more benefit and may result in digestive, kidney, and vascular issues.²⁶

Also, a point often forgotten is that excess protein beyond what your body needs is converted into glucose (sugar). If your muscle and liver already have enough glucose (stored as glycogen), the rest is stored as fat, which can add to weight gain. Unlike fat and carbohydrates, your body cannot store excess protein.

So, there’s a balance to getting enough to support your muscles without having to eat a whole cow in the process.

The Idea That Plant-Based Protein Is Inferior

Many continue to hold on to the archaic belief that plant-based proteins are missing certain amino acids and are “incomplete” proteins. For more on why this is not true, I suggest checking out “Complete Protein Vs Incomplete” 3 Common Myths.

Leucine, an essential amino acid for muscle health, tends to be lower in plant-based proteins. But, as long as you are consuming adequate calories and eating enough total protein from a variety of plant-based proteins, you can support muscle growth and maintenance.²⁷

For sufficient amounts of protein, the recommendation is to eat around 30g per meal. I feel this is especially important in the morning for breakfast as eating healthy protein plays a role in regulating hormones and promoting cortisol balance (cortisol levels are naturally high in the morning).

Healthy plant-based proteins also contain healthy fats, which are important in maintaining sex hormones (estrogen and testosterone) and absorbing fat-soluble vitamins.

Adding variety to your diet is important not only to ensure adequate protein, vitamin, and mineral intake but it’s also key to a healthy gut and immune system. All of these things impact your overall health and longevity.

Menopause and a Plant-Based Diet: Bottomline

Following a plant-based diet during menopause offers numerous health benefits and, if done right, can alleviate any potential risks.

Rich in fiber, antioxidants, phytoestrogens, and essential nutrients, plant-based diets can help alleviate menopause symptoms, support brain and gut health, and reduce the risk of chronic diseases like diabetes and cardiovascular disease.

You can better support muscle mass and bone health by including fortified and calcium-rich plant foods, a variety of plant-based protein sources, and vitamin D supplements when needed. This is in addition to a healthy lifestyle and incorporating enough resistance exercise.

Ultimately, a thoughtfully balanced plant-based diet can empower women to embrace menopause, feel good about their food choices, manage symptoms, support mental and physical health, and foster overall vitality. Bring it on.