Hormonal changes during menopause alter how the body responds to diet, making traditional approaches based on restriction and increased training less effective and, in some cases, counterproductive. These shifts affect metabolism, muscle retention, and energy use, requiring a more deliberate approach to nutrition that supports performance, recovery, and long-term health.
This article is part of a series from Angela Harper exploring exercise, diet, hormones, sex, sleep, resilience, and recovery during menopause.
For decades, women have been told that they should simply eat less and train more if they want results. However, that approach is outdated because, as hormone levels shift, that strategy starts to work against them.
The old model of eating less and training harder is harmful in menopause, as it forces the body to break down its own muscle, slow metabolism, and increase fat storage.
The result is the body no longer responds to diet and training in the same way, and requires a fundamental shift in how women fuel their bodies for peak performance.
Dr Stacy Sims, an exercise physiologist specialising in female performance, says the eat-less, train-more approach is one of the most damaging misconceptions women carry into menopause.
“Women are often told to eat less and train more, but that’s the worst thing you can do in menopause,” Dr Sims says. “If you’re under-fuelling, your body will start to break down lean mass to meet energy demands and chronic low energy availability disrupts metabolism, increases fat storage, and reduces performance.”
As oestrogen declines, the body undergoes a series of changes that directly affect metabolism, body composition, and performance. Muscle mass begins to decrease, lowering basal metabolic rate, while insulin sensitivity declines and the body becomes more prone to storing fat, particularly around the abdomen.
Dr Mary Claire Haver, an obstetrician-gynaecologist and menopause specialist, says the change is not simply about weight gain, but about body composition.
“The key things that are happening is we are losing muscle and we are gaining visceral fat,” Dr Haver said.
Research shows that visceral fat, which is linked to metabolic disease, cardiovascular risk, and reduced overall health, can increase significantly during menopause, even without changes in diet or exercise.
Faced with these changes, many women respond by eating less, but Dr Sims says under-eating increases stress on the body, elevates cortisol, and makes it harder to recover.
At the same time, low energy availability forces the body to prioritise survival over performance, which can break down muscle tissue to meet energy demands while holding onto fat stores. Training in a fasted state can compound this effect.
“When we’re talking about fasted workouts… it increases stress on the woman,” Dr Sims said, noting that elevated cortisol levels can blunt the very training adaptations women are trying to achieve.
Instead of becoming leaner, the body shifts into a stress state that slows metabolism, increases fat storage, and stilts performance.
One of the most significant shifts during menopause is the need for increased protein intake.
Dr Sims recommends women significantly increase their protein to support muscle retention, recovery, and metabolic health, helping counteract reduced protein sensitivity as oestrogen declines. Typical guidance sits around 1.6 – 2.2 grams/kg/day, distributed evenly across meals.
Dr Haver says many women are falling well short, often consuming just 50 – 60 grams/day, when closer to 80 – 120 grams may be required depending upon body composition.
Contrary to popular belief, carbohydrates are not the enemy, particularly for active women, as they play a critical role in fuelling high-intensity training, supporting thyroid function, and reducing cortisol.
In menopause, the focus should shift away from restriction and towards quality and timing. Women become sensitive to blood sugar fluctuations as hormone levels change, which can be exacerbated by caffeine. Dr Sims says that women who rely on coffee before training without adequate nutrition may experience hypoglycaemia, leading to dizziness and reduced performance.
Dietary fats also play a key role, particularly in managing inflammation and supporting brain function.
Dr Rhonda Patrick, a biomedical scientist specialising in ageing, nutrition, and cellular health, highlights the importance of omega-3 fatty acids for reducing inflammation, supporting cognitive health, and improving mood. More broadly, experts recommend prioritising fats from whole food sources such as olive oil, nuts, and seeds, while limiting heavily processed foods.
Beyond macronutrients, micronutrient intake becomes increasingly important, and experts emphasise the role of fibre for gut health and oestrogen metabolism, calcium and vitamin D for bone health, and magnesium for sleep and recovery. The menopausal diet should also be rich in colourful whole foods to support gut health and hormone regulation while decreasing inflammation.
While whole foods are the dietary foundation, supplements can support performance and recovery, and Dr Sims recommends three-to-five grams/day of creatine for its beneficial role in muscle function, brain health, and overall performance.
Vitamin D and iron are also important, particularly given their role in bone health, energy, and overall metabolic function. Protein or isolate powders can help to meet protein requirements, particularly for women who struggle to consume enough through food alone.
In this phase of life, nutrition is about fuelling your body, which is under more physiological pressure than ever before. Taken together, these changes reflect a broader shift in how women need to approach nutrition in menopause and eat strategically to preserve muscle, manage stress, support hormonal health, and maintain performance.
