Amidlife metabolic crisis occurs during perimenopause and menopause, as every organ in the body adjusts to a severe drop in hormones: estrogen, progesterone, and testosterone. Your skin, brain, heart, bones, and muscles all contain receptors for these hormones.
Declining hormones lead to changes in body composition: increased fat mass and decreased lean muscle mass. This shift increases the risk for heart disease, cognitive decline, and type 2 diabetes.
Throughout the perimenopause and menopause years, aim for quality calories, optimize macronutrient intake by prioritizing protein while moderating carbohydrates and fat, keep portion sizes in check, and balance eating with physical activity — ideally more strength training — to maintain a healthy body weight.
Brain
Your brain benefits from at least two 6-ounce servings of fatty fish per week — such as salmon, halibut, tuna, or sardines. These seafood sources provide high-quality protein and omega-3 fatty acids, which help protect cognitive health and improve mental clarity. Also, incorporate fiber-rich plant foods. Aim for up to three ½-cup servings of grains daily (such as whole-grain bread or pasta, brown rice, or wild rice), plus nonstarchy vegetables, fruits, and seeds like chia, flax, or hemp.
Heart
Unsaturated fats help raise HDL (good) cholesterol and keep blood vessels flexible. Include sources like avocados, nuts, seeds (chia, flax, or hemp), and extra-virgin olive oil. For antioxidants, fill half your plate with colorful fruits and vegetables, and enhance meals with herbs, spices, and chopped nuts. Brazil nuts are a selenium-rich option that supports circulation and heart health.
Aim for at least 30 grams of fiber daily from fruits, vegetables, legumes, nuts, seeds, and whole grains, such as oats and barley, to further protect heart health.
Bones and muscles
Protein is essential for maintaining strong bones and muscle mass. Aim for 25 to 30 grams of high-quality protein at meals and at least 10 grams at snacks throughout the day. Sources include lean red meat, chicken, turkey, fish, yogurt, cottage cheese, milk, legumes, nuts, and seeds. Protein-rich foods also slightly boost metabolism, since they require more energy to digest.
Vitamin D and calcium are also vital for bone health. Get vitamin D from egg yolks, fortified milk, fatty fish, and mushrooms exposed to ultraviolet light. For calcium, choose dairy (milk, cheese, yogurt), fortified beverages (soymilk, almond milk, and orange juice), almonds, fish with edible bones (sardines, for example), and leafy green vegetables. If you take supplements, choose brands that have third-party certifications from USP, NSF, or ConsumerLab.com.
Skin and urinary tract health
Declining hormone levels during menopause also affect the body’s largest organ: your skin. Water, along with water-rich fruits and vegetables, helps keep your skin firm, plump, moisturized, and well-nourished. Aim to drink half of your body weight in ounces of fluids daily. Coffee and tea count toward hydration, unless your daily caffeine intake exceeds 400 mg.
Proper hydration also supports vaginal and urinary tract health. Menopause can cause changes to the vulva, vagina, and lower urinary tract, leading to symptoms like dryness, irritation, reduced lubrication, pain during intercourse, and recurrent urinary tract infections. Drinking water throughout the day helps maintain vaginal lubrication and flushes bacteria from the urinary tract, reducing the risk of infection.
Originally published in the Fall 2025/Winter 2026 print issue.
By Victoria Shanta Retelny, RDN, LDN
Vicki is a registered dietitian nutritionist, lifestyle nutrition expert, writer, culinary and media consultant and author of two books.
