For World Menopause Day, 18 October

I’ve found that I need to eat differently now. If I have larger portions of starchy carbohydrates more regularly, my weight seems to increase quite quickly. Paying attention to the amount of bread, rice, pasta or potatoes on my plate has become more important for me.

That’s my own observation, rather than a rule for everyone. But it raises a question that many women will recognise: why do familiar eating habits sometimes stop working so well for us around menopause?

What changes around menopause?

Insulin helps control blood sugar. Around menopause, the body can become less responsive to it, meaning more insulin is needed to do the same job. This is called insulin resistance. A new study found that it increased faster around women’s last period, and changes in weight alone did not fully explain this. [1]

Women can also gain fat and lose lean tissue, which includes muscle, without a marked change on the scales. [2]

These findings help explain why it can be useful to reconsider our meals. They don’t mean every woman becomes insulin resistant, or that carbohydrate foods suddenly become unsuitable.

Looking again at the balance of a meal

For me, that means paying more attention to portions of starchy foods. For someone else, the starting point might be a breakfast that leaves them hungry, or meals that contain very little protein.

Bread, potatoes, oats, rice and pasta can all have a place. A useful question is how much of your plate they take up, and what else you’re eating with them.

A pasta meal, for example, could include a smaller pasta portion with fish, chicken, beans or lentils and plenty of vegetables. A jacket potato could come with a filling such as tuna or beans, and a salad. Breakfast might combine oats with plain yoghurt, nuts or seeds, rather than relying on a large bowl of cereal alone.

These are ways of adjusting a familiar meal while keeping it satisfying. Wholegrains, beans and lentils also provide fibre, so cutting out whole groups of carbohydrate foods can mean missing out on that too.

There isn’t one portion size that suits every woman. Appetite, activity, body size, health and the rest of the day’s food all matter.

Where does the gut fit in?

The gut microbiome — the community of microorganisms living in the gut — can differ before and after menopause. Research has linked some of these differences with measures of heart and metabolic health, but we don’t yet know whether the gut changes help cause those health changes. [3]

For everyday eating, there is no need to wait for all the answers before including a variety of vegetables, fruit, wholegrains, nuts, seeds, beans and lentils in amounts that suit your digestion.

If foods high in fibre leave you uncomfortable, you could build up the amount gradually rather than suddenly adding large quantities of beans, bran or fibre supplements. New digestive symptoms, or symptoms that don’t settle, are worth discussing with your GP; they shouldn’t automatically be put down to menopause.

Eating enough still matters

In clinic, I see women who are frustrated by weight gain around menopause. Often, their response is to eat less and exercise more. It’s understandable, especially if that approach has worked for them before.

But continually cutting back on food while increasing exercise can leave you eating too little for your needs. Smaller meals can also mean less protein and fewer vitamins and minerals. When I look at someone’s diet, I consider whether they’re eating enough, as well as how their meals are put together.

Meals with protein foods such as eggs, fish, yoghurt, tofu, beans or lentils, together with a varied diet, help provide what the body needs. Calcium-rich foods, such as milk, yoghurt or calcium-fortified alternatives, deserve attention too. Exercises that build strength, such as using weights or resistance bands, also help support muscles and bones.

For World Menopause Day, I’d encourage you to look at a few familiar meals. Do they leave you satisfied? Do they include a source of protein? Is there room for vegetables and other foods that provide fibre? Do the portions suit you now?

I still want food to taste good and be enjoyable. I’ve simply found that the balance on my plate needs more thought than it once did.

References

1. Karlamangla AS et al. (2026). Development of insulin resistance in women over the menopause transition. JCI Insight. Published 6 October. https://pubmed.ncbi.nlm.nih.gov/42837175/

2. Greendale GA et al. (2019). Changes in body composition and weight during the menopause transition. JCI Insight. https://insight.jci.org/articles/view/124865

3. Peters BA et al. (2022). Menopause Is Associated with an Altered Gut Microbiome and Estrobolome, with Implications for Adverse Cardiometabolic Risk in the Hispanic Community Health Study/Study of Latinos. mSystems. https://pmc.ncbi.nlm.nih.gov/articles/PMC9239235/