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When women arrive at my clinic, they almost always begin the consultation with the same sentence. “I know what you’re going to say. I just need to eat less.”
After more than 15 years working as a nutritionist, I’ve learnt that this is one of the biggest misconceptions surrounding perimenopause. The women sitting opposite me aren’t lacking motivation; they aren’t lazy, and in most cases they aren’t eating huge portions or living on takeaway food.
Quite the opposite, many are making what they believe are healthy choices every single day, yet they’re exhausted, struggling with weight gain, waking in the middle of the night and wondering why the habits that worked so well in their thirties suddenly seem to have stopped working. It’s hardly surprising they’re confused.
Never before have women had access to so much health information, yet many have never felt more overwhelmed. Every week brings another social media trend promising to “balance hormones”, “boost metabolism” or “beat menopause naturally”.
The irony is that, after working with hundreds of women through perimenopause and menopause, I’ve found that the women who achieve the biggest improvements rarely do anything particularly complicated. They don’t overhaul their entire lives overnight or spend a fortune on wellness products. Instead, they consistently focus on a handful of simple habits that support the physiological changes taking place in midlife.
They stop trying to shrink themselves
One of the first conversations I have with many women is about letting go of the idea that eating less is always better.
Decades of dieting have taught women to fear food. They skip breakfast to save calories, order the smallest thing on the menu and feel virtuous if they finish the day hungry. When the scales refuse to budge, they assume they simply need more willpower.
But when we consistently under-fuel and eat too little, particularly during perimenopause, our bodies respond exactly as they’re designed to. Hunger hormones increase, cravings become stronger and by late afternoon we’re far more likely to reach for quick, energy-dense foods.
Rather than encouraging women to eat less, I encourage them to eat more strategically by building meals around foods that genuinely nourish them.
They make protein the hero of every meal
If I could persuade every woman entering perimenopause to change just one thing, it would be to pay more attention to protein. This isn’t because I want women to become bodybuilders. It’s because muscle becomes increasingly important as we age.
From our forties onwards, we naturally begin losing lean muscle mass, a process that accelerates as oestrogen declines.
That matters because muscle plays a far greater role than most people realise. It helps regulate blood sugar, supports our metabolism, protects our bones, reduces our risk of falls later in life and makes everyday activities, from carrying shopping bags to climbing stairs, feel easier.
Yet one of the most common patterns I see is women eating almost no protein until dinner. Breakfast is cereal or toast, lunch is soup or a salad and dinner becomes the day’s only substantial source of protein.
By then, we’ve missed two valuable opportunities to provide our muscles with the amino acids they need throughout the day. The good news is that fixing it doesn’t require expensive protein powders or elaborate meal plans.
Greek yoghurt with berries, eggs on wholegrain toast, cottage cheese with fruit, tofu scramble or even baked beans on sourdough can all provide a much stronger nutritional foundation than a slice of toast alone. At lunchtime, adding chicken, fish, lentils, tofu or beans to salads transforms them from a light meal into one that genuinely keeps you satisfied.
One of the comments I hear most often after women increase their protein intake is, “I can’t believe how much less I think about food.”
They stop fearing healthy fats
Many of today’s midlife women grew up during the low-fat era. We were told to buy fat-free yoghurt, trim every scrap of fat from meat and avoid avocados because they were “too calorific”. Those messages were repeated so often that many women still find themselves instinctively choosing the lowest-fat option, despite decades of research showing that healthy fats are an essential part of a balanced diet.
Extra virgin olive oil, nuts, seeds, avocado and oily fish don’t just support heart health. They also help us absorb fat-soluble vitamins, keep us fuller for longer and make meals far more satisfying.
I often tell clients that if your salad leaves you hungry an hour later, it was simply missing the ingredients that would have turned it into a complete meal, like grilled salmon, avocado, pumpkin seeds and a drizzle of olive oil.
They stop obsessing over the scales
One of the biggest mindset shifts I try to encourage is moving the focus away from weight alone. Perimenopause changes body composition. Even if the scales stay the same, women often notice more weight around their middle as oestrogen declines and muscle gradually decreases.
That can feel unsettling, particularly for women whose weight has remained stable for decades. Instead of asking: “How much do I weigh?” I encourage women to ask different questions: “Am I stronger than I was three months ago? Am I sleeping better? Do I have more energy? Am I thinking about food less?”
Those are often the first signs that a healthier body is beginning to emerge, long before the scales catch up. More importantly, they’re changes that genuinely improve quality of life.
They make strength training non-negotiable
If there’s one habit I’ve encouraged more women to adopt over the past decade, it’s strength training. That doesn’t mean spending hours in the gym or lifting enormous weights. For most women, two or three sessions a week using dumbbells, resistance bands or even their own body weight is enough to make a meaningful difference.
Walking remains one of the best forms of exercise for our heart, mental health and overall wellbeing. But once we reach perimenopause, walking alone isn’t enough to counteract the natural loss of muscle that accompanies falling oestrogen levels.
So many women still judge exercise solely by how many calories it burns, rather than what it does for their long-term health. But I often remind my clients that we’re not strength training for next summer.
We’re strength training so we can lift grandchildren, carry our shopping, travel, garden and remain active well into our seventies and eighties. Changing that mindset transforms exercise from a punishment into an investment.
They give fibre the attention it deserves
Protein may be having its moment, but if there’s one nutrient that still doesn’t receive the attention it deserves, it’s fibre.
When I analyse food diaries, I often find women eating plenty of vegetables but still falling well short of the recommended 30g of fibre a day. A handful of lettuce leaves, cucumber and tomato might look colourful on the plate, but they don’t provide the diversity or quantity of fibre our gut needs to thrive.
Instead, I encourage women to think more broadly. Oats and chia seeds at breakfast, lentils in soups, chickpeas and beans in salads, berries and kiwi with yoghurt, nuts and seeds scattered over meals and swapping white rice or pasta for wholegrain alternatives can dramatically increase fibre intake without making eating feel restrictive.
This matters because fibre does far more than keep us regular. It supports the trillions of bacteria living in our gut, helps regulate cholesterol and blood sugar, and plays an important role in keeping us fuller for longer. As research into the gut microbiome continues to evolve, we’re also learning more about the role it may play in inflammation, immunity and overall health during midlife.
They become far more sceptical of wellness trends
One thing that’s changed dramatically since I first started practising is the sheer volume of health advice women are exposed to every day.
One week, everyone is talking about seed cycling. The next it’s glucose monitors, cold plunges or expensive powders promising to “reset” hormones. I see women spending hundreds of pounds each month on supplements while skipping meals, avoiding carbohydrates or eating very little protein. Others become so anxious about finding the “perfect” diet that they lose sight of the basics altogether.
I’m not against supplements when they’re needed, but I’ve learnt that no capsule can compensate for poor sleep, inadequate protein, a lack of resistance training or a diet that’s missing whole foods.
They stop treating sleep as a luxury
If nutrition is the foundation of good health, sleep is the glue that holds everything together, but unfortunately, it’s often the first thing to suffer during perimenopause.
Night sweats, anxiety, fluctuating hormones and the pressures of midlife can all make restorative sleep difficult to achieve. Yet after just one poor night’s sleep, we’re more likely to crave sugary foods, rely on caffeine, skip exercise and make choices that don’t reflect how we’d usually like to eat.
Rather than viewing sleep as something we’ll catch up on later, I encourage women to protect it as fiercely as they would any other aspect of their health.
That might mean establishing a regular bedtime, limiting alcohol, reducing caffeine in the afternoon, eating your last meal at least three hours before bedtime and creating a cool, dark bedroom or simply giving themselves permission to slow down before bed. Small rituals repeated consistently often make a much bigger difference than people expect.
Above all, they learn to work with their bodies rather than against them
Perhaps the greatest privilege of my job is watching women rediscover confidence in their bodies.
Many arrive feeling frightened by the changes they’re experiencing. They assume their best years are behind them or that feeling tired, uncomfortable and frustrated is simply the price of getting older.
That’s rarely the case; perimenopause is a significant hormonal transition, but it isn’t a life sentence. Our bodies are changing, and our nutrition and lifestyle need to change alongside them. Once women understand that, something remarkable often happens. They stop fighting their bodies and begin supporting them instead.
Over the past 15 years, I’ve watched women regain energy they thought had disappeared forever. I’ve seen them become stronger in their fifties than they were in their thirties, improve their bone health, sleep through the night again and develop a far more relaxed relationship with food than they ever had during decades of dieting.
None of that happened because they discovered a miracle supplement or followed the latest wellness fad. It happened because they focused on the habits that consistently matter most.
Faye James is an accredited nutritionist and author of The Menopause Diet,Perimenopause Planand High Protein 100+
