Perimenopause often feels like your body changed the rules overnight. One day you’re coasting along, and the next you’re dealing with hot flashes, brain fog, restless sleep, or that stubborn weight that seems to settle right around the middle (1,2,3).

None of this is “all in your head.” These shifts are tied to real changes in hormones, inflammation, and metabolism. While we can’t stop the clock, we can change what we eat and how we move. This can make a big difference in how we experience this transition.

When Weight Becomes Harder to Manage

Why does weight seem to show up so easily in perimenopause? It’s one of the most frequently cited frustrations amongst perimenopausal women. Even amongst women who have been able to manage their weight for years and have made no changes to their diet or exercise routine.

Estrogen is a key driver of mid-waist weight gain. As it declines with increasing age, it changes how the body stores fat and how sensitive we are to insulin. Lower estrogen often means more insulin resistance, which makes it harder to handle carbs and sugar without storing them as fat (4,5). 

But it’s not just our hormones to blame; lifestyle habits matter too. Stress, poor sleep, and a slower metabolism all add fuel to the fire. So while we can’t do much about the hormones, the right lifestyle habits can make a difference (5).

Inflammation and Energy Shift

Inflammation often ramps up during perimenopause and shows up as fatigue, joint pain, brain fog, and just feeling “off.” Food has a big impact here.

Highly processed foods, sugary snacks, and refined carbs tend to ramp inflammation up. On the other hand, eating real, nutrient-dense foods like vegetables, berries, olive oil, nuts, seeds, fish, and protein can help calm it down (6). Studies show that women who consistently eat a diet high in fresh produce and low in refined and processed foods improve markers of inflammation, insulin sensitivity, and overall health during midlife transitions (5,7, 8,9).

Building a Sustainable Eating Plan

So what’s the “best” diet for perimenopause? Here’s the honest answer: there isn’t one perfect diet that works for everyone. What the research does show is that diets with the best outcomes for women in this stage share some traits:

• They minimise processed foods and refined sugars.
• They emphasise real, nutrient-dense whole foods.
• They include enough protein and healthy fats to support hormones, muscles, and bones.

For many women, a blend of healthy eating with low-carb principles works well. Think olive oil, fish, green vegetables, and nuts to keep energy steady (10-12).

Why Strength Training Now

Food is foundational, but movement makes the body more resilient. During perimenopause, women naturally lose muscle and bone density, which slows metabolism and increases the risk of osteoporosis (13).

Strength training can help counter that. Even two or three short sessions a week of resistance work can preserve muscle, improve metabolism, and protect bones. Pairing those workouts with protein-rich meals gives the body what it needs to rebuild.

If you’re new to lifting weights, start small. Bodyweight exercises, resistance bands, or light dumbbells are great entry points. Progress gradually and focus on form to avoid injury.

Nourishment Over Restriction

Perimenopause isn’t something to “fix.” It’s a life stage to navigate with the right tools. The women who feel the best aren’t hopping on fad diets or obsessing over calories. They’re focusing on eating whole foods, moving consistently, and taking care of their sleep and stress.

So instead of asking, “What diet should I follow?” a better question might be, “How can I eat in a way that lowers inflammation, balances my energy, and supports the changes my body is going through?”

That answer looks slightly different for everyone, but it almost always begins with simple, nourishing, real food.

Reference List

1. NHS. (2024). Menopause – Symptoms. [online] NHS. Available at: https://www.nhs.uk/conditions/menopause/symptoms/ 
2. UCLA Health. (2025). Sneaky symptoms of perimenopause. [online] UCLA Health. Available at: https://www.uclahealth.org/news/article/sneaky-symptoms-perimenopause 
3. Bilodeau, K. (2021). Sleep, stress, or hormones? Brain fog during perimenopause. Harvard Health Publishing. Available at: https://www.health.harvard.edu/blog/sleep-stress-or-hormones-brain-fog-during-perimenopause-202104092429 
4. Madison Women’s Clinic. (2024). Menopause and Insulin Resistance. [online] Madisonwomensclinic.com. Available at: https://www.madisonwomensclinic.com/menopause-and-insulin-resistance/ 
5. Louise Newson. (2025). Inflammation, menopause and hormones: what’s the connection? [online] DrLouiseNewson.co.uk. Available at: https://www.drlouisenewson.co.uk/knowledge/inflammation-menopause-and-hormones-whats-the-connection 
6. Calder, P.C. (2023). Nutrition, immunity and inflammation: A review of the evidence in midlife women. National Center for Biotechnology Information. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC11995482/ 
7. Khodarahmi, M., Pourteymour Fard Tabrizi, F. and Askari, G. (2025). The effect of low-carbohydrate diets, based on changes in intake of dietary saturated fats on circulating TNF-α and interleukin-6 levels in adults: a systematic review and meta-analysis of randomized controlled trials. BMC Nutrition, 11, p.76. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC11995482/ 
8. Healthline. (2020). Is the Keto Diet Good for Menopausal People? Healthline Media. Written by Rachael Ajmera, MS, RD and Alyssa Northrop, MPH, RD, LMT; medically reviewed by Stacy A. Henigsman, DO. Available at: https://www.healthline.com/nutrition/keto-and-menopause 
9. Volek, J.S., Phinney, S.D., and Forsythe, C.E. (2021). Effect of low carbohydrate diets on insulin resistance and the metabolic syndrome. Nutrients, 13(6), 1703. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8500369/
10. Simões, M.J., Moreira, A.C., Saldanha, C. (2023). Nutritional aspects and dietary patterns in women with menopausal transition: A literature review. Nutrients, 15(12), 2683. Available at: https://pubmed.ncbi.nlm.nih.gov/38201856/ .
11. Medical News Today. (2025). Perimenopause diet: Foods to eat and avoid. Available at: https://www.medicalnewstoday.com/articles/perimenopause-diet-and-nutrition.
12. Medical News Today. (2025). Menopause diet: How what you eat affects your symptoms. Available at: https://www.healthline.com/nutrition/menopause-diet 
13. Kyle, U.G., Chalé-Rush, A., Kossovsky, M.P., Pichard, C. (2023). The efficacy of strength exercises for reducing the symptoms of menopause and improving musculoskeletal health: A systematic review. Nutrients, 15(1), 45. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9864448/