Weight gain around menopause can be difficult to deal with, but it doesn’t have to be.
A team of epidemiologists, nutritionists and women’s health experts from the National University of Singapore and Harvard University, USA have come together to figure out which dietary habits and healthy eating plans help women stay trim and avoid weight gain in the years around menopause.
Women who stuck to plant-based diets, had insulin-friendly snacking habits and avoided red meats, they say, found it easier to dodge weight gain and obesity. What’s more, women who follow these eating patterns in the years before and after menopause could slash their risk of developing cardiometabolic disease.
If you want to skip straight to the eating plans, click here.
Why We Gain Weight Around Menopause
Weight gain during and after menopause is a fact of life. It’s not because of anything you are doing wrong, it’s because oestrogen is involved in how we use glucose and store fat. This means that when our oestrogen levels drop, our metabolism changes dramatically. Calories we burned off like nothing before perimenopause get converted into fat more easily and are harder to use.
As a result, once we go through ‘the change’, a woman’s risk of heart disease, type 2 diabetes and other cardiometabolic diseases rockets. Much of this risk is tied to obesity. As of many as 65% of US women between 40 and 65 are classed as obese. Cardiometabolic experts say the best way to lower your chances of dementia, diabetes, cancer, heart attack, stroke, non-alcoholic fatty liver disease and kidney failure is to stay below a waist measurement of 35″ or 89 cm, or a BMI under 30 kg/m2, and waist 31.5 ″ or 80 cm, BMI 25 kg/m2, for women of Asian heritage.
Now, scientists specializing in women’s health and number crunching reckon they have identified the best healthy eating plans to keep your weight from creeping up during perimenopause, menopause and the years postmenopause. While no foods are inherently bad, they also pinpointed certain dishes that statistically correlate with more weight gain than others. So which foods are helpful and which are more likely to sabotage your goals?
Dietary eating patterns and menopausal weight gain
In a JAMA Network Open article, the researchers describe how they tracked the dietary patterns of over 38,000 women across the twelve years surrounding menopause.
The epidemiologists pulled data from the Nurses’ Health Study II. This is a data set created by the US’s National Institute of Health, freely available to researchers. In the years between 1989 and 2019, 38,283 female nurses living in the US regularly answered surveys about their lifestyle and health. Researchers can trace each anonymized nurse across decades to follow variations in their health.
The team here looked at each woman across the 12 years before and after menopause. They tracked how each woman’s weight changed between perimenopause and six years postmenopause. They also had very detailed information about the kinds of food the women were eating. Every four years, the nurses completed semiquantitative food frequency questionnaires.
Categorizing Eating Styles
Participants selected the foods from a list of 130 items and reported how much of each they ate on a regular basis. The women did not say, ‘I follow a high-carb diet’ or ‘I use the DASH diet’. Instead, primary author Dr Tong Xia and colleagues deployed statistical models to carefully match the patterns of each woman’s food survey questions to predetermined descriptions of various types of diet.
The enormous amount of data helped them to spot signatures that mapped on to each kind of eating pattern. For example, women who reported getting most of their protein from plants and rarely consuming animal products might be assigned to the plant-based diet. Women who focused more on avoiding salt and saturated fats might be assigned to the DASH diet.
The researchers accounted for other factors that might affect weight gain such as smoking, age, race, income, marital status and alcohol intake to make sure that most of the variation between women could be attributed to diet.
Which dietary plans keep menopausal weight gain low?
According to this report, the best diets for avoiding weight gain in the years before and after menopause were: a plant-based diet, the DASH diet, a Mediterranean diet, Planetary Health diet and healthy low-carb diet. Women who stuck to these plans were more likely to either maintain their weight or reduce it over the study period.
The interesting thing about all of these eating plans is that while they have some things in common (less red meat, for example), they are not interchangeable. Each eating style has its own advantages. Some of these diets helped women to lose weight, but this was a secondary benefit. The important thing to look at when you are thinking about making changes, is that all of these plans helped to minimize weight gain. The secret to success is choosing a healthy eating style that works with your routine and preferences.
The dietary choices that ranked highest in preventing menopause weight gain in order of effectiveness were:
Plant-based diet
A plant-based diet is one where you eat more plant-based foods than animal products – getting most of your protein from plant sources. This could be a vegetarian diet, a pescatarian diet or even a flexitarian diet. In a healthy plant-based diet, the emphasis is on ‘healthy’ foods. French fries are plant-based, but let’s be real. This diet helped women to prevent weight gain the most effectively, in many cases, helping women to lose weight. On average women on this diet showed a 0.086 kg/year decrease. Another advantage is that plant-based diets can help with menopause symptoms.
The DASH Diet
The DASH diet is a plan formulated by heart specialists that aims to minimize salt in your diet, and to keep your blood pressure down. DASH stands for dietary approaches to stop hypertension. It promotes eating vegetables, fruit and whole grains, fish, poultry, beans and low-fat dairy products. DASH dieters should skip salt; sources of saturated fat like red meat; high fat dairy products, and sugar-laden drinks and snacks. Women whose eating habits alligned with the DASH diet lost an average of 0.066 kg/year. This means that most women managed to avoid weight gain over those 12 years.
The Planetary Health Diet
The Planetary Health Diet has nothing to do with astrology, despite its perhaps confusing name. It’s actually about sustainable ways to eat that help us avoid waste and food scarcity, along with giving us the best nutritional outcomes. The EAT-Lancet Commission on healthy diets developed this evidence-based, pragmatic diet aiming to prevent chronic disease and obesity in 2019. This is a relatively new formalized healthy eating pattern but it has a lot of data behind it.
The Planetary Health diet encourages us to eat mostly plant-based foods (seeds, nuts, legumes, vegetables); unsaturated oils like seed oils and olive oil; moderate amounts of fish and poultry, and dairy products. The diet suggests you avoid red meat and sugar. This is a quite prescriptive plan with specific proportions laid out for each food type. For example the authors of the plan suggest that if you average out what you eat in a week, you should be eating: 230 g whole grains, 300 g vegetables, 14 g red meat, 75 g legumes, 50 g starchy veg like potatoes and 29 g poultry each day. Women who ate in similar patterns to what the planetary health diet suggests lost an average of 0.61 kg/year.
Mediterranean Diet
The Mediterranean diet is probably the best known healthy eating plan. This dietary pattern emphasizes olive oil, fresh fruit and vegetables, fish, nuts, legumes and poultry. In old versions of this plan, a glass of red wine was included as a healthy aperitif, but more up-to-date research shows that wine will not help your heart after all. Women who favoured the Mediterranean eating style, on average, reduced their weight by 0.051 kg/year.
A Healthy Low Carb Diet
Finally, the healthy low carb diet is, as it suggests, a low-carb diet, but importantly, the emphasis is on vegetable proteins and unsaturated fats with fewer refined carbohydrates. This is in contrast to many low-carb diets that promote eating animal products as the major source of protein and fat. Women whose diet reflected low-carb plans reduced their weight by 0.021 kg/year.
Honourable mentions also go to the healthy and unhealthy plant-based diets-these also helped women to stay close to their starting perimenopausal weight, with some even losing weight.
Now, when it came to reducing a woman’s chance of being obese, the story was a little different. Women who ate along the lines of the Planetary health diet were least likely to be obese, followed by the DASH and Mediterranean diet. While women who ate a plant-based diet as likely to be obese as the average woman.
Diets to Avoid
The team also noticed that some eating patterns were strongly associated with weight gain in the years surrounding menopause. These tended to be diets that focused on animal fats and proteins. They identified one set of habits in particular that led to weight gain and obesity. These centred around foods that have higher insulinemic potential. This means foods that make you release more insulin.
The researchers used a tool called the empirical dietary index for hyperinsulinemia to describe a diet full of food that causes big insulin spikes. This scale asks you to rate how much of each of 14 different foods you eat. One set of these foods cause insulin spikes, i.e. red and processed meat, poultry, butter, high‐energy beverages, French fries, tomatoes, eggs, and low‐fat dairy. The remaining are foods that don’t trigger a lot of insulin. These are coffee, green and leafy vegetables, whole fruits, and high‐fat dairy. Women who reported eating more of the high insulin triggering foods than the low insulin foods would be classed as having followed a hyperinsulinemic diet.
Women whose eating habits scored highly on the empirical dietary index for hyperinsulinemia gained the most weight in the years surrounding menopause and were the most likely to be obese. Other eating habits that ranked high for weight gain included:
- Diets full of ultra-processed foods.
- Low carb diets emphasizing meat protein and saturated fats over plant oils and plant proteins.
- Diets that scored high on the empirical dietary inflammation pattern.
All of these diets shared a preference for red meat, starchy vegetables, animal proteins, processed meat and refined carbohydrates.
Which Foods Help Keep the pounds off?
The researchers were also able to correlate specific foods to how much weight women gained over the years.
The top 10 foods associated with less weight gain were:
- nuts and legumes
- added unsaturated fats
- fruit carbohydrates
- monounsaturated plant fats
- wine
- fruit juice
- vegetable protein
- whole grains carbs
- soy
- fruit
On the other hand, the worst offenders associated with weight gain in order of most to least were
- Red, processed meat and poultry
- Animal protein
- Animal monounsaturated fat
- Red and processed meat
- Processed meat
- Red meat
- French fries
- Poultry
- Potato carbohydrate
- Starchy vegetable
Overall the types of food that helped women to avoid gaining weight were also common to each of the healthy eating patterns. The researchers point out that diets that emphasized fruits, vegetables, whole grains, nuts and legumes while avoiding red meat, french fries, processed meat, potatoes and salt were more likely to help women keep their weight stable and avoid becoming obese.
Sources
Xia T, Haslam DE, Eliassen AH, et al. Optimal Dietary Patterns for Lower Weight Gain and Risk of Obesity Surrounding Menopause. JAMA Netw Open. 2026;9(5):e2613102. doi:10.1001/jamanetworkopen.2026.13102
Opoku AA, Abushama M, Konje JC. Obesity and menopause. Best Practice & Research Clinical Obstetrics & Gynaecology. 2023;88:102348. doi:10.1016/j.bpobgyn.2023.102348
Sawicki CM, Ramesh G, Bui L, et al. Planetary health diet and cardiovascular disease: results from three large prospective cohort studies in the USA. The Lancet Planetary Health. 2024;8(9):e666-e674. doi:10.1016/S2542-5196(24)00170-0
Seifi N, Bahari H, Foroumandi E, et al. The association of dietary indices for hyperinsulinemia and insulin resistance with the risk of metabolic syndrome: a population‐based cross‐sectional study. J Clin Hypertens (Greenwich). 2024;26(7):832-841. doi:10.1111/jch.14832
Xiao Z, Liu H. The estrogen receptor and metabolism. Womens Health (Lond). 2024;20:17455057241227362. doi:10.1177/17455057241227362
