What is the best diet for perimenopause and menopause?

healthy food

One of the most common questions we are asked is “what is a healthy diet” and our answer is always “what are you trying to achieve?”. Ultimately it depends on what is happening with your health profile and what your goals are but there are some basics that we all need to adhere to if we want those strong foundations of health.

The most important aspect of learning how to eat healthily is understanding the macronutrients.

Understanding Macronutrients

There are three macronutrients: protein, fat, and carbohydrates. They are called ‘macronutrients’ because we need a lot of them in our diet. 

All our food is made up of the ‘macronutrients’.

What is Protein?

Proteins are large molecules made up of amino acids.  Protein and amino acids are the building blocks for life, and they play many critical roles in the body.

What Are Fats?

Regardless of what the low-fat movement said in the 1980s, fat in your diet is essential for health, but the knock-on effect of the ‘low fat’ trend is that many people are still scared of having fat in their diet as they believe it is either going to be detrimental to their health or make them put on weight, however, natural fat from whole foods does not make you fat. In fact, it helps regulate our hormones and can even aid with weight loss.

Fat has multiple essential functions in the body:

  • It functions as an energy reserve, meaning we can break it down and use it as fuel.
  • It is how we absorb fat-soluble vitamins like vitamins A, D, E and K
  • It keeps hair and skin healthy.
  • It insulates the body and protects organs.
  • As we explored In Chapter 6 it is part of the production process for oestrogen, progesterone, and testosterone (yes! fat makes hormones!)
  • Balances blood sugars
  • Helps fight infection.
  • Reduces inflammation.


People are often confused about what carbohydrates are. They are the sugars, starches and fibres found in:

  • dairy products
  • fruits
  • vegetables
  • grains
  • legumes
  • sugary foods and confectionary

Carbohydrates are the easiest way our body can make energy.  They support brain function, muscle protection and regulation of the central nervous system. They are also beneficial for the thyroid and hormone regulation.

It is common for people to say that they “don’t eat sugar” but their diet is full of fruit, grains, and root vegetables. Whilst these are nutrient rich, it is important to remember that once the carbohydrates are broken down in the bowel, they are just sugar.

Diets full of vegetables, porridge, granola, toast, rice, pasta, potatoes or sweet potatoes, fruit and quinoa, all sound healthy, but when these are consumed without being balanced with protein and fats, we overload our bodies with carbohydrates and therefore cause blood sugar destabilisation.

As insulin resistance is common in peri menopause, there can often be a period where women struggle to be able to metabolise any carbohydrates at all and instead will feel like they are piling on weight regardless of what they do. This would be when we would recommend reducing your intake significantly of any carbohydrates.  But this doesn’t last forever, once your hormones have settled down post menopause and your weight has stabilised you can try reintroducing them carefully!

It would be remiss to discuss carbohydrates without talking about refined carbohydrates.

These are grain products that have been processed by a food manufacturer so that the whole grain is taken apart. The refining or milling process removes dietary fibre, vitamins, and minerals, meaning the carbs are not only processed “unnatural” foods they are also often simple carbohydrates. They are often high in calories and when they are found in pre-packaged foods, they are commonly paired with seed oils.

Examples of refined carbs would be:

Pasta (especially white pasta)

Biscuits and pastries

Cakes and baked goods

White bread

Baked desserts

Pizza dough

Whilst many of us find these delicious, combination of them being predominantly wheat, processed and refined and paired with seed oils makes them a serious ‘triple threat’ to our health and they must be eaten sparingly if we want to feel well!

This is a simplified way of looking at macronutrients as many foods contain a few of the macronutrients. For example, cheese and nuts contains protein and fat, and beans contain protein and carbohydrate.

Because of this many vegetarians and vegans believe that they are eating protein when they eat beans, but they contain a much higher level of carbohydrates than protein. For example, 100g of chickpeas contain 19g of protein and 6g of fat but they also contain a whopping 61g of carbohydrate. So, for the purposes of ensuring we are getting the right amount of protein and not too much carbohydrate these sit very clearly in the carbohydrate category.

Additionally, the protein can only be utilised fully once the food has been broken down. This is important to remember when we are looking at foods which are predominantly carbohydrates being used as a protein source because as we said earlier “every time I put food in my mouth, I have a hormone response”. In the case of foods like chickpeas the initial hormone response will be for a carbohydrate. The body will only recognise the protein component much later. For all intents and purposes therefore, when we eat chickpeas the body acts as if it’s getting carbohydrates and the protein comes as a nice surprise later but, when we eat a pure protein source such as eggs, the body will instantly recognise it is eating protein and produce the hormones for protein. That is how we maintain good blood sugar balancing.

Bioavailability of protein

There is another factor to consider here and that is how much protein we yield from the food we eat. This is called ‘bioavailability’.

A quick look on google shows us that proteins from animal foods such as meat, fish and eggs score much higher on a ‘bio-availability index’ (also called DIAAS – Digested Indispensable Amino Acid Score) than proteins from plants such as rice protein, pea protein or hemp protein.

What this means is that if you are eating a protein bar that says that it contains 16g of protein from plant proteins or nuts, you might only absorb 8g. Whereas if that protein came from whey protein or another meat-based protein source you might absorb around 12-14g. 

This is why it is essential, at every meal to:

  • Prioritise protein.
  • Don’t fear fat.
  • Cut carbs.

The PFC Food Strategy

There are thousands of different types of diets and food strategies, but where many fail is that they don’t focus on the fact that every time we eat, we have a hormonal response, and the hormones can either spike or balance our blood sugars.

Balancing blood sugars is exactly what the “PFC” food strategy was created to do and is at the heart of all our food strategies.

PFC was developed by renowned nutrition expert Mark Macdonald to overcome the issues in the food industry. The letters P, F, and C stand for the three “macronutrient” categories that every food falls into: protein, fat, and carbohydrate and the idea that every time we eat, we eat the right balance of all the macronutrients.

“PFC Every Three” is the term coined referring to eating a combination of the three “macros” every 3-4 hours, starting within an hour of waking up, until your head hits the pillow at night.

This keeps your blood sugar levels balanced which is the KEY to everything from awesome energy levels, positive moods, improved mental clarity, supported metabolism, and vanished sugar cravings.

PFC is a great food strategy during perimenopause and menopause, as many people are not having proteins at each meal for example a day’s diet that consisted of porridge for breakfast, a cheese sandwich for lunch and spaghetti bolognaise for dinner has no protein at breakfast or lunch and is high in starchy carbohydrates so isn’t a balanced representation of each macronutrient.

For a PFC food strategy sheet and recipes visit www.hormone-wellness.co.uk

PFC Rules

  • Choose a protein and fat source for each meal.
  • Protein needs to be 57-114g per meal (fist size portion)
  • Add as many non-starchy carbs (salad and greens) as you like but only have ONE starchy carbohydrate in a half cup portion per meal (i.e., a small potato). Non starchy carbohydrates will not spike blood sugars, where are starchy carbohydrates do, which is why they are limited.
  • Fat intake is important. Eat approx. 10g per meal (tablespoon size)
  • If you have sleep difficulties have a bedtime snack of a few mouthfuls of a fat and carb combination, 20 minutes before sleep. This can help improve sleep if sleep disturbances are due to instable blood sugars.
  • Drink plenty of water. Minimum 2 litres per day (can include herbal tea)
  • Eat regularly every 3 hours. Eat 3 meals and 3 snacks per day.
  • Exercise. Even going for a walk improves blood sugar stability.
  • Avoid stimulants and irritants such as caffeine, alcohol, and nicotine.
  • If carbohydrates are indulged in (i.e., a piece of chocolate or a glass of wine) offset the sugar with fat (e.g. add coconut cream, olives or nuts.
Protein 115-250gFat 2tbspNon-Starchy Carbohydrates UnlimitedStarchy Carbohydrates 1/2cup  
All MeatAvocadoAll non-starchy veg andAll root vegetables
All FishCoconut oil, cream & milkSaladsGrains & beans Legumes
EggsOlives and Olive oil All Fruit
TofuOrganic Mayonnaise Honey & Maple Syrup
Protein PowdersDripping, Suet & Lard Butter Cheese Nuts and Seeds GF Pork Scratchings Tahini     Dark Chocolate Small alcoholic drink