Menopause, the official end of your menstrual period, and perimenopause, the lead-up to it, mark major change. During these years, you’ll experience significant hormonal shifts as the body stops producing reproductive hormones like estrogen. Some pretty dramatic symptoms can result, from hot flashes to sleep disturbances to mood swings, per the American College of Obstetricians and Gynecologists (ACOG). 

These hormonal changes, combined with advancing age, increase your risk of developing a number of health conditions, says Alyssa Dweck, MD, a board-certified gynecologist, chief medical officer of Bonafide Health, and a Menopause Society Certified Practitioner. Many conditions, such as adult-onset diabetes or osteoporosis, are influenced by factors beyond your control, she says—but there’s still plenty you can do to take charge of your health. “One definitively modifiable risk factor is diet and nutrition,” she stresses. “It’s never too late to initiate change for the better.”

What’s more, following a healthy diet is especially critical surrounding menopause because your body requires different nutrients as a result of those hormone changes. “Nutritional needs shift during the menopause transition as estrogen levels decline,” says registered dietitian Heidi McIndoo, RD. “This impacts bone density, metabolism, muscle mass, and even how the body manages blood sugar and cholesterol.”

Below, five experts share their top menopause nutrition tips to help you best fuel your body during perimenopause, menopause, and the years beyond.

1. Eat with Your Bone Health In Mind

As estrogen levels drop, bone loss can occur, particularly in the first few years after you’ve officially reached menopause, ACOG notes—and this, in turn, can present challenges for your bones. “Low estrogen negatively affects bone, and over time can lead to low bone mass and eventually osteoporosis,” Dr. Dweck explains. With osteoporosis, bones become increasingly weak and brittle, making fractures more likely, particularly in a person’s hips, wrists, and spine.

Eating plenty of bone-strengthening foods won’t completely offset these changes, but it can help, says Navya Mysore, MD, a primary care physician and women’s health expert. “Leafy greens, fatty fish, and dairy provide calcium, vitamin D, and omega-3s to protect bones and reduce inflammation,” she says. (Incorporating more weight-bearing exercises, which you can find on the Peloton App, into your workout routine will benefit your bones too.) 

In one recent review of studies on nutritional support for osteoporosis in postmenopausal women, researchers observed solid evidence for upping your intake of omega-3 fatty acids (which may help reduce risk of fractures), vitamin K (which can be found in fermented foods like cheeses, as well as fish and eggs), and dairy products (they’re packed with calcium, vitamin D, and proteins to support overall bone health).

2. Fill up on Healthy Fats

The risk of developing cardiovascular disease goes up after you’ve reached menopause. Although more research on why this happens is needed, research from the American Heart Association reports that many factors are at play, from menopause-driven changes, such as a decrease in estrogen to an increase in lipids, to age-related changes, such as higher blood pressure and blood sugar levels, among others. 

Many people also experience increases in visceral fat (body fat stored deep inside the abdomen) and decreases in lean muscle mass during menopause, which is another risk factor for high cholesterol and cardiovascular disease, notes Mindy Goldman, MD, an OB/GYN and chief clinical officer at Midi Health. 

All this is to say that eating foods that support your cardiovascular health throughout this time is important. Excellent choices include fatty fish like salmon, sardines, and mackerel, which are packed with healthy omega-3 fatty acids. “[These] reduce inflammatory markers and reduce joint stiffness, help stabilize mood, and decrease cardiovascular risk by improving lipid profiles,” Dr. Goldman says. 

Other good choices: Chia seeds (they have omega-3s as well as fiber and protein), olive oil, avocados, and nuts, all of which also deliver healthy fats.

3. Consider More Mediterranean Foods

A Mediterranean eating style, which emphasizes lean proteins, lots of fruit and veggies, whole grains, and healthy fats like olive oil, “is favored for various reasons” during menopause, Dr. Dweck says. 

For one, it’s usually a low-glycemic style of eating, meaning it limits sharp rises in blood sugar, possibly helping to support weight management and blood sugar levels. It also delivers tons of fiber, Dr. Dweck adds, “which is great for digestion and maintenance of a healthy gut microbiome,” plus protein, “which helps build and maintain muscle.”

Plus, some research has suggested a Mediterranean diet may help ease menopause symptoms. In a large 2013 study of different dietary patterns, middle-aged women who consumed a Mediterranean-style diet were less likely to report vasomotor symptoms like hot flashes. And a more recent review observed that a Mediterranean diet has been associated with weight management as well as reductions in blood pressure, triglycerides, total cholesterol, and LDL (aka “bad” cholesterol) levels among menopausal women.

4. Include Plenty of Protein 

Your protein needs may go up a bit during menopause, experts note. “Protein becomes especially important during and after menopause to help preserve muscle mass and metabolic health,” McIndoo says. Getting enough protein in your diet may also help lower the risk of hip fractures in postmenopausal women, some research has found.

The standard recommendation for protein in adults is 0.8 grams per kilogram of body weight per day, but some experts suggest that people going through menopause may need a little more than that: Both McIndoo and Dr. Mysore suggest aiming for around 1–1.2 grams. In other words, if you weigh 170 pounds, that would be about 90 grams of protein in a day—but if you have a muscle-growth goal, you might aim for even more. Just keep things balanced, Dr. Mysore adds. (Protein is crucial, but it is possible to overdo it, so reach out to a registered dietitian for any unique guidance.) 

Your best bet is to combine lean proteins with high-fiber foods that will “keep the body satiated and full for a longer period of time,” says Courtney Pelitera, RD, a registered dietitian at Top Nutrition Coaching. A few of her favorite combos: Salads with lots of vegetables topped with grilled chicken, feta cheese, and quinoa; a whole-grain tuna wrap with a side of cucumbers and carrots; or a taco bowl with turkey meat, black beans, and a few of your favorite veggies. 

5. Add More Phytoestrogen Foods

Although the evidence is mixed, some research suggests that phytoestrogen-rich foods can be particularly beneficial during menopause. Many of these foods contain compounds called isoflavones, including tofu, edamame, and legumes. 

Because phytoestrogens mimic the effects of estrogen in the body, the theory is that these foods may help support more balanced levels of this hormone as it dips. “They may ease hot flashes and other symptoms of perimenopause and menopause,” Dr. Goldman says. 

6. Know Which Foods Experts Recommend Limiting

Just as important as the foods you add to your plate during menopause are the ones you choose to be mindful of, experts say. While all foods can have a place in a balanced diet, “it’s best to limit added sugars, refined carbs, and processed foods,” Dr. Mysore says. “They can worsen weight gain, mood swings, and blood sugar spikes.”

Reducing your alcohol and caffeine intake may be a good idea, too, since these could be triggers for hot flashes. In one large 2015 study published in the journal Menopause, for example, researchers found that caffeine intake was associated with more bothersome vasomotor symptoms such as hot flashes and night sweats. Spicy foods may also aggravate these symptoms for some people, Dr. Dweck adds. 

Finally, everyone, whether or not they’re going through menopause, should also aim to limit foods that contain a lot of sodium and saturated fat, experts say, since these may increase your risk of developing high blood pressure or heart disease. “I would recommend limited fried foods and foods with a high sodium content, such as canned and frozen meals,” Pelitera says. “Cutting back on these foods supports better hormone balance, sleep, and long-term health,” adds Dr. Mysore.

7. Ask Your Doctor About Supplementation

It’s a good idea to be in regular contact with your healthcare provider about your symptoms and flag if you have any concerns that you’re not meeting your dietary needs. Depending on your unique circumstances, they may recommend a supplement, such as calcium (for those who cannot tolerate dairy), vitamin D (for bone health), or magnesium (if you’re found to be deficient), Dr. Dweck says.  

Just make sure to always check in with your doctor before starting any new supplement, no matter how “natural” the label claims it is. Dietary supplements aren’t regulated by the Food and Drug Administration the same way medications are, nor are they right for everyone (for example, black cohosh, which is popular among people with menopause, may damage your liver, the Mayo Clinic notes).

The Takeaway

“Lower estrogen levels have an impact on all organs and tissue in the body,” Dr. Dweck notes—and that includes your metabolism. The major hormonal shift you’re experiencing requires you to eat a little differently during perimenopause, menopause, and the years beyond, experts say. Make sure you’re prioritizing critical nutrients (such as calcium, protein, vitamin D, and omega-3 fatty acids) to support your overall health. Most importantly, stay in touch with your doctor during this time, and never hesitate to bring up symptoms you’re experiencing. A healthy menopause nutrition strategy is an excellent start, but your practitioner may recommend other interventions too.