In our previous blog post, we explored the stages of perimenopause and menopause, common symptoms, and the importance of blood tests, all based on insights from Dr. Dovile Kalvinskaite, a skilled obstetrician-gynecologist and lifestyle medicine expert at a menopause clinic in England.
In this article, we continue to draw on Dr. Dovile’s expertise, this time focusing on the crucial role of nutrition and supplements. Dr. Dovile shares her valuable insights on how proper nutrition and the right supplements can help alleviate symptoms, support bone and muscle health, and improve overall well-being during this transformative time.
Nutrition
No. 1 key factor for longevity and health is maintaining muscle mass throughout life. Scientifically, the Mediterranean diet is considered the healthiest. However, Dr. Dovile takes a simpler approach. It doesn't matter whether you're an omnivore, vegetarian, vegan, or follow another diet—what matters is that your diet includes enough protein. Protein is important not only for muscle mass but also for immune function, skin, hair, and hormone production.
The standard recommended protein intake is 0.8g/kg of body weight per day, which is enough to support basic bodily functions but is often insufficient for optimal health, particularly when aiming to maintain and rebuild muscle mass.
The main sources of protein include meat, fish, dairy products, eggs, legumes, grains, and nuts. Animal-based proteins are unique because they contain all essential amino acids and are absorbed more efficiently—up to 95%. In contrast, plant-based proteins have an absorption rate of 60-80%. To ensure a diverse intake of amino acids, it’s important to eat a variety of foods.
You should consume around 90-120 g of protein per day (calculated by multiplying your body weight in kilograms by 1.2-1.6 g), with approximately 30-40 g per main meal. For example, 100 g of chicken breast contains about 30 g of protein, one egg provides around 6 g, and 100 g of cottage cheese has about 20 g. A high-protein diet is beneficial for most people, and only in certain severe conditions (such as end-stage kidney failure) should protein intake be restricted—consult your doctor if necessary.
The second important aspect of nutrition is getting enough fiber. Our gut is like our second brain. Did you know that we have more bacteria in our gut than cells in our entire body? The gut microbiota produces vitamins, activates certain chemicals, and plays a key role in hormone metabolism. In fact, 90% of the 'happiness hormone' serotonin is produced in the gut. For a healthy gut microbiome, it’s recommended to consume 25-30 g of fiber per day. This can be achieved by eating about 500 g of crunchy vegetables (such as lettuce, cabbage, broccoli, etc.). It’s important to include a variety of colorful foods, as they affect gut bacteria in different ways. Other sources of fiber include fruits, berries, seeds, nuts, and whole grains.
The third important aspect is consuming healthy fats, which are essential for hormone production. Sources of healthy fats include fish (rich in omega-3), cold-pressed olive oil, avocados, and nuts.
Remember, it’s important to drink enough water daily and replenish lost minerals. Tap water alone is not sufficient for this, so include mineral water or simply add a small amount of natural, unrefined sea or Himalayan salt to your water a few times a day. If you have a headache, dehydration might be the cause—try drinking salted or mineral water.
What about intermittent fasting? For some women experiencing brain fog, intermittent fasting or a cyclical keto diet may offer benefits. However, this approach is not suitable for everyone. The best way to determine if it works for you is through personal experimentation and by listening to your body. It's best to start intermittent fasting gradually, particularly with the 16:8 method, which includes an 8-hour eating window and a 16-hour fasting period. It's recommended to start with a shorter fasting window, like 12-14 hours. Keep in mind that it can be challenging to consume an optimal amount of protein within an 8-hour eating window, and as we know, protein intake is the most important aspect of nutrition.
Dietary supplements
The foundation of our health is nutrition and other healthy lifestyle choices. It's best to obtain all the essential nutrients, vitamins, and minerals through our diet. However, this isn't always possible. Supplements can help fill nutritional gaps, while also alleviating symptoms and supporting long-term health. They can be a valuable addition to a balanced diet, especially when addressing specific health concerns or deficiencies. It's important to choose supplements carefully and consult with a healthcare professional to ensure they meet your individual needs.
Dr. Dovile's Top-5 Supplements:
- Vitamin D – It’s best to get a vitamin D test and take the dosage prescribed by your doctor if you have a deficiency. The standard recommended dose for adults is 800-1000 IU, but in many cases, this may be insufficient if there is a significant deficiency. Additionally, some people, due to genetic factors, may not absorb vitamin D from supplements effectively, so they may need much higher doses, such as 4000 or even 10,000 IU. In such cases, it’s recommended to have blood tests every few months to monitor your vitamin D levels.
- Vitamin K2 – It’s recommended to take vitamin D along with vitamin K2, as K2 helps calcium absorb more effectively into cells and protects the heart. Discuss with your doctor if there are any reasons why you might not be able to take vitamin K2, such as being on blood thinners or other medications.
- Magnesium – About 80% of women in menopause have a magnesium deficiency. When magnesium is deficient, vitamin D is also poorly absorbed. The most easily absorbed forms of magnesium are bisglycinate and L-threonate, as they pass more easily through the blood-brain barrier and have a positive effect on brain function. Magnesium bisglycinate is more effective for improving sleep quality, so it’s recommended to take it in the evening. Magnesium L-threonate is better for managing anxiety and other psychological symptoms. Both forms can be taken at different times of the day for different effects, without exceeding a dosage of 300-500 mg of elemental magnesium—bisglycinate in the evening and L-threonate in the morning or during the day. Other forms of magnesium, such as malate and orotate, are also well absorbed, but it’s best to avoid magnesium oxide, as the body only absorbs about 4% of it. Oxide may be useful for constipation. Magnesium citrate is also less absorbable. Unfortunately, blood tests don't show the true magnesium levels in the body, as only 4% of magnesium is in the blood, with most of it stored in cells that blood tests can't measure.
- Omega 3 – Our brain is made up of 60% fat, and a large portion of this fat consists of omega-3 fatty acids. Omega-3 supplements help restore brain structure and improve brain function, positively impacting the gut, bones, joints, and more. The recommended dose is 1000-1200 mg of combined EPA and DHA (this information can be found on the packaging).
- Creatine Monohydrate – One of the oldest and most studied supplements, creatine is essential for muscle strength, mass, endurance, brain function, focus, and short-term memory. The recommended dose is 5 g of creatine monohydrate daily. If you experience bloating or other digestive symptoms, divide the dose and take it multiple times throughout the day. It’s best to consume it in powdered form without flavor, as it can be easily added to coffee or tea. It dissolves better in warm liquids. Before testing kidney function, it’s advised to stop taking creatine for a while and inform your doctor, as the test may show elevated levels due to increased breakdown and use of creatine. However, it’s important to know that creatine does not affect kidney function – this is a myth.
This is the top five essential supplements. Other supplements may also be prescribed individually, such as B vitamins, selenium, and zinc. For example, in Germany, women in menopause are often prescribed relatively high doses of B vitamins. Interestingly, 40% of the population cannot convert vitamin B9 (folic acid) into its active form – folate. Therefore, it is recommended to use the active 'methyl' form for better absorption.
Herbal supplements like isoflavonoids and red clover may help some women, though some studies suggest their effects are similar to a placebo. The absorption of red clover preparations depends on gut health. If a woman’s gut lacks the bacteria responsible for breaking down red clover, the supplement is unlikely to be effective. Isoflavonoids are recommended to be avoided if there is a history of breast cancer. Black cohosh supplements are more effective than a placebo in controlling menopause symptoms. Ashwagandha and golden root (rhodiola) may help with anxiety, stress management, and sleep quality. Curcumin and resveratrol (75 mg twice a day) supplements may be effective for joint and bone pain due to their anti-inflammatory effects.
Important: Since dietary supplements are not regulated in the same way as pharmaceutical products, it is recommended to purchase only those supplements that have been tested and approved by independent third-party laboratories. It is also advisable to always consult with a doctor regarding the use of supplements, their dosages, and potential interactions with other medications to avoid harm.
Nutrition is just one part of the equation. In our final blog post of this series, we’ll take a closer look at the importance of physical activity, sleep, and stress management in supporting overall well-being during (peri)menopause. Stay tuned, and don’t forget to subscribe to our newsletter so you’ll be the first to know when the next post goes live!
