10 ways to support your metabolic health
Stocking your 'peri pantry', a GOOD ENERGY primer, and habits for thriving at 35+
I love a good cheesy puff. Those Cheeto’s white cheddar joints with the ‘simply natural’ packaging that make you feel like somehow, they are healthy. You know what I’m talking about. All my besties know I have a sweet tooth too. Baked goods, ice cream, chocolate. That’s why I eat salads, clean protein, and work out to keep it all in balance, right?
That strategy worked for me for years, but recently a couple things rocked my socks.
I got a blood test result back that indicated high inflammation and the beginning of insulin resistance.
I learned how hormone shifts in midlife and throughout perimenopause affect our metabolism and metabolic health.
I nerded out on mitochondria, how our cells function, and why we feel terrible.
With the help of recently published books from Mary Claire Haver, MD; Casey Means, MD; and my Mohana care plan — I built a nutrition and supplement plan to support my body’s hormonal roller coaster ride.
Now I think twice before devouring the rest of my kid’s mac n cheese. And I’ve noticed some great results in my energy and how I feel on the daily.
To make this tedious process a little easier for you - I’m sharing a shoppable ‘peri pantry’ Amazon list. This has just a fraction of the items I have discovered and am incorporating into my life since so many are refrigerated, but it’s a great start.
With no added sugar, no weird oils, and limited processing, most of these items are good healthy swaps for your whole family, regardless of their stage of hormone chaos.
Read on for the full context of why I’m recommending these swaps, and the top 10 things you can do to support your health during perimenopause (and beyond).
How our metabolic health changes during perimenopause
In midlife, fluctuating levels of the hormones estrogen and progesterone often lead to several changes in our metabolic health. These include:
Increased Abdominal Fat and Weight Gain
The decline in estrogen levels redistributes body fat to the abdomen and increases overall body weight and fat mass. I spoke to someone recently who said they gained 20lb in one year with no other changes in diet or lifestyle. Wild.
Insulin Resistance and Diabetes Risk
The hormonal changes of perimenopause can contribute to increased insulin resistance, which raises the risk of developing type 2 diabetes. I was shocked to learn my fasting glucose was in the high range. Without a blood test result, I don’t think I would have been triggered enough to change my habits — thanks Mohana!
Heart Disease Risk
Estrogen helps regulate healthy cholesterol levels. As estrogen declines, we often experience unfavorable changes in our lipid profiles, including increased LDL ("bad") cholesterol and triglycerides, and decreased HDL ("good") cholesterol. This increases cardiovascular disease risk.
Metabolic Syndrome
The combination of abdominal obesity, insulin resistance, heart disease risk, and other factors like hypertension means that women are at higher risk of developing metabolic syndrome during and after the menopause transition.
Blood Sugar Dysregulation
Research shows that as we age, our ability to regulate blood sugar levels after meals declines, leading to higher blood sugar spikes compared to younger women. Data collected by ZOE nutrition platform scientists (image below) show that, on average, women experience larger post-meal blood sugar spikes as we get older.
This can contribute to fatigue, hunger, and metabolic disease risk. In the longer term, higher blood sugar can increase the risk of heart disease, type 2 diabetes, stroke, and other metabolic diseases.
10 ways to support your metabolic health
Hormone therapy can be a huge help to combat all of the above, but it’s not a silver bullet. Those of us in our perimenopause era are in a critical time to re-establish healthy habits and experiment with switching things up from what worked for us in the past.
Here are ten ways you can give your body a solid foundation to deal with the hormonal ups and downs.
1. Increase protein
Helps build and maintain muscle mass, regulate blood sugar levels, and keeps you feeling ‘full’ longer. Organic pasture raised grass fed beef, lamb, chicken, turkey, pork, and eggs, as well as fresh salmon, tuna, and minimally processed Greek yogurt are all great.
2. Increase fiber
Fiber is a carb that isn’t fully broken down by the body and doesn’t convert to glucose. Instead, it is fermented and helps to regulate metabolism, improve insulin, glucose levels, and reduce inflammation. Nuts, seeds, beans, avocadoes, brussels sprouts, sweet potatoes, raspberries and pears are great sources.
3. Eat more fermented foods
A diet high in fermented foods increases gut health by adding probiotic and postbiotic diversity and decreases inflammatory markers. Sauerkraut, fermented vegetables, miso, kimchi, tempeh, yogurt, kefir, and kombucha (look at the label and keep to 2-5 grams of sugar) are good sources.
4. Avoid refined added sugar, carbs, grains and industrial oils
This is actually hard, really hard. Most packaged goods in the grocery store have one or all of these components. Author Casey Means, MD of GOOD ENERGY refers to refined sugar, carbs, grains, and industrial vegetable and seed oils as the ‘unholy trinity’. These ingredients are not food, and your body struggles to use them as fuel. Limit added sugars to 25 grams a day max. This is tough when you consider that a single bottle of kombucha could have 10 grams or more. You don’t have to be perfect, start by reading labels and having less packaged and processed food overall.
5. Reduce (or eliminate) caffeine
As a Seattleite who loves her coffee, this one is a big woof for me. While individual sensitivity varies, limiting caffeine can help improve sleep, regulate mood, optimize nutrient levels, reduce hot flashes, and more. I’m starting slowly with reducing my 2-3 morning cups to just one cup or replacing with Matcha. The caffeine in Matcha is significantly less than a cup of coffee, and it is absorbed more slowly by the body.
Matcha has powerful anti-inflammatory benefits and contains the amino acid L-theanine, which binds to the caffeine and slows its absorption. You’ll get a gentler, more sustained energy boost over several hours without the spike and crash. Just make sure you ask what sweetener is put in if you are ordering out and ask your barista to cut that in half or eliminate the sweetener entirely.
6. Reduce (or eliminate) alcohol
This one is really hard for me too as it’s such a social norm in my circles. As we age, our bodies have an increasingly difficult time metabolizing alcohol (female anatomy especially). When fluctuating hormones are disrupting our internal thermostat and causing hot flashes and night sweats, alcohol shows up like a can of gas to the bonfire. It’s linked to raising levels of the stress hormone cortisol, disrupting sleep, worsening depression, and causing mood swings.
Move to higher quality, lower quantity drinking occasions, try making kombucha cocktails at home, and check out the alcohol-free libations on the menu whenever possible. Recent studies (1, 2) suggest many women are turning to cannabis to relieve perimenopause symptoms - which could double as an alcohol replacement especially with microdosed ready-to-drink options on the market. (Not an endorsement, just an observation)
7. Support dietary deficiencies with supplements
Specific supplements like magnesium, B vitamins, omega-3s, vitamin D, and probiotics can do wonders to support your hormones and overall health. While we should be getting most of these from food and lifestyle, most of us aren’t getting enough. You can get a blood test to determine where you are deficient to dose with more precision.
Good clean supplement brands that are third-party tested and manufactured to GMP standards include Now, Thorne, and Nordic Naturals. Be careful grabbing just any bottle off the shelf, as supplements are not regulated in the US. This means literally anything could be in those little capsules if the company cares more about profits than honest business practices and your health. Check my peri pantry list for specific recommendations.
8. Move more and strength train with weights
Movement is medicine. More movement helps our bodies process the energy (food) we consume vs. give it a signal to store it as intracellular fat (which leads to insulin resistance. Walk more, especially right after meals if you can. Incorporate resistance training with weights to build and maintain muscle mass and bone strength, which decline with age and hormonal changes.
If you are a HIIT fan or cardio queen, be aware this type of exercise impacts your cortisol levels. In perimenopause, declining estrogen levels reduce our body's ability to counteract the effects of cortisol, the stress hormone. High-intensity cardio may exacerbate issues like weight gain, sleep disturbances, fatigue, mood changes and irritability. If cortisol is something you are working to manage, you might benefit more from yoga, Pilates, and weight training.
9. Manage your stress and perceived stress levels
Fear and stress are powerful communicators that tell your body to stop functioning as an efficient machine so you can deal with the proverbial lion that is trying to eat you. Chronic stress increases inflammation, mitochondrial dysfunction (how your cells process energy), and glucose levels. Unhealed traumas, work stress, relationship stress, and other psychological stressors can stack up to impact our metabolism, mental health, and more.
I’ve been learning about the difference between perceived (psychological) stress vs. physical stress (extreme temps, physical harm, sleep deprivation) and how powerful it is to lower your level of perceived stress. We need to essentially find ways to feel safe through intentional practice in order to feel our best. Therapy, meditation, deep breathing, and spending time in nature can help. The key is finding what works best for you — as stress exacerbates perimenopause and menopausal symptoms.
10. Sleep
If you are starting to think ‘wow, so EVERYTHING is connected?” That’s exactly right. And sleep is no exception. Sleep helps regulate your appetite, improves glucose metabolism, reduces inflammation, and impacts our overall circadian rhythms which helps us function optimally. Lack of quality sleep is a danger signal to the body. Sleep is aided by the hormone progesterone, which gets wonky and lowers overall during perimenopause — so you will likely have to put more effort into getting solid Zzs’s over time.
A good place to start is getting on a consistent sleep schedule and improving your sleep environment. No screens 1-2 hours before bed if possible (double woof). Remove disruptive lighting, get a good pillow, and pay attention to temperature as most of us benefit from lower temps at night. We bought an Eight Sleep system to help with my husband’s sleep issues and I’ve noticed it’s improving mine too. It’s also making me acutely aware of how a couple drinks affect my heart rate variability and sleep quality.
If this all sounds like a lot, well… it is. But starting somewhere, anywhere will help. I built the peri pantry list to help you take a quick action on something today. We are all a process, not a ‘thing’ — and our health journey is as well. So just start!
Sources:
[1] GOOD ENERGY, by Casey Means, MD with Calley Means
[2] The New Menopause, by Dr. Mary Clarie Haver
[3] https://zoe.com/learn/perimenopause-diet
[4] https://www.healthline.com/health/perimenopause-diet
[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8972960/
[6] https://www.health.harvard.edu/womens-health/perimenopause-rocky-road-to-menopause
[7] https://www.levelshealth.com/blog/how-does-menopause-impact-weight-and-metabolic-health