Eat to Stay Strong: Rethinking Nutrition for the Active Woman During Menopause

You've probably been eating pretty much the same way for years. Maybe you're a runner. Maybe you mountain bike, ski, hike, lift weights, or some combination of all of them. You know how to train. You know what it feels like to get stronger and fitter. And you've probably figured out what foods work for you, too.

Then menopause comes along and suddenly you're questioning things. Should you be eating more protein? Fewer carbohydrates? No carbohydrates? Should you be fasting? Should you be following a Mediterranean diet? Should you be eating a huge amount of protein because you're losing muscle? And eventually the question becomes: What am I actually supposed to be eating now?

The answer isn't a menopause diet. But menopause can be a good time to rethink how you're fueling yourself, particularly if you're an active woman.

Are you eating enough?

This is probably not the first thing you expect me to say. A lot of women come to menopause worried about weight gain, so their instinct is to eat less and exercise more. But this is where it gets complicated. If you're regularly exercising and consistently not eating enough to meet your body's needs, you can end up with low energy availability, or LEA. In simple terms, there isn't enough energy left over after exercise to support all of the other things your body needs to do.

Over time, this can contribute to what we call Relative Energy Deficiency in Sport, or RED-S. And you don't have to be an elite athlete to run into this problem. You can be a busy woman who works all day, gets up early to exercise, and routinely skips breakfast or eats a salad for lunch because you're trying to be "good." You may not think of yourself as someone who could be under-fueling. But your body doesn't care whether you're training for the Olympics. It cares how much energy is coming in and how much you're asking it to do.

Low energy availability can show up as fatigue, declining performance, poor recovery, increased hunger, irritability, recurrent injuries, or getting sick more often. It can also affect bone health, including bone mineral density and stress-fracture risk, as well as reproductive hormones, metabolism, and muscle. And menopause can make this harder to recognize. Changes in your menstrual cycle are no longer a reliable warning sign that you're under-fueling.

So if you're exercising regularly and suddenly finding that your workouts are getting harder, you're not recovering the way you used to, or you're exhausted all the time, don't automatically assume you need to train harder or eat less. Sometimes you need more fuel.

Protein matters. But you probably don't need as much as Instagram says.

You've probably heard that you need more protein during menopause. This one isn't completely wrong. As we get older, our muscles become somewhat less responsive to the protein we eat. This is sometimes called anabolic resistance. The decline in estrogen during menopause is also part of the story, since estrogen has effects on muscle and other tissues.

But that doesn't mean you need to eat 150 grams of protein every day. For most active women, somewhere around 1.2 to 1.6 grams of protein per kilogram of body weight per day is a reasonable target. If you're doing a lot of resistance training, trying to preserve muscle during weight loss, or have particularly high training demands, you may benefit from being toward the higher end or somewhat above it.

More isn't automatically better, either. If you're already getting enough protein, adding another shake or another 30 grams isn't necessarily going to build more muscle. What matters is getting enough protein consistently and pairing it with resistance training if your goal is to maintain or build muscle. You don't need a protein shake after every workout, and you don't need to turn your entire diet into a collection of protein products.

What I care about more is that you're getting protein consistently throughout the day rather than trying to make up for a low-protein breakfast with a huge amount at dinner. For many women, that means including a meaningful protein source at each meal and, when needed, at a snack. Eggs or Greek yogurt at breakfast. Beans, lentils, fish, chicken, tofu, or another protein source at lunch and dinner. Cottage cheese, yogurt, nuts, seeds, or a protein shake when a snack makes sense. The goal is a pattern you can actually live with.

And please don't give up carbohydrates

"But I thought I wasn't supposed to eat carbs anymore."

No.

Carbohydrates are one of the main fuels your body uses for exercise. They're also important for your brain and help replenish the glycogen your muscles use during harder or longer activity. That doesn't mean you need unlimited pasta and pastries. It means you don't need to be afraid of carbohydrates simply because you're in menopause.

The type and amount matter. Good carbohydrate sources include fruit, vegetables, potatoes and other root vegetables, beans and lentils, oats, whole-grain bread, rice, and other whole grains. If you're active, carbohydrates are part of fueling that activity. How much you need will depend on what you're doing and how much you're doing.

You can eat a generally healthy diet and still eat enough carbohydrates to support the activities you enjoy.

So what should you actually eat?

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