Pharmacist and researcher Mike Wakeman has issued nutrition advice for women approaching or going through menopause, urging them to check the labels of plant-based milk alternatives. He highlights that many are calcium-fortified but not necessarily iodine-fortified, which could leave women deficient in a nutrient essential for thyroid function and cognition.
Why nutrition matters in menopause
With October marking Menopause Awareness Month, Wakeman, the founder of Evera Nutrition, said nutrition becomes particularly important in the years leading up to menopause. "Menopause isn't simply about hot flushes," he said. "Falling oestrogen affects bone, while ageing brings changes to cardiometabolic health, muscle and often body shape."
Approximately half of women over 50 are projected to suffer an osteoporosis-related fracture at some point in their lifetime, while shifting nutritional requirements during menopause can also impact muscle and overall health. Wakeman noted that "what often appear to be healthy eating habits can still leave nutritional gaps."
Plant-based milk and iodine
Wakeman said: "Plant 'milk' can look like a straightforward healthy swap, but many alternatives are calcium-fortified but not necessarily iodine-fortified. Iodine is needed for normal thyroid hormone production and cognitive function. UK data has previously found 15% of adult women had intakes below the Lower Reference Nutrient Intake. So read the label and make sure to choose an alternative fortified with both calcium and iodine, or make sure iodine comes from foods such as fish, eggs and dairy."
He also advised including calcium-rich dairy, fortified alternatives, tofu and leafy greens, alongside vitamin D. "UK guidance advises adults to consider a daily 10mcg vitamin D supplement during autumn and winter," he added.
Soy, protein and diet quality
On soy foods such as tofu, edamame and soya beans, Wakeman said they provide protein and contain isoflavones, plant compounds known as phytoestrogens. He cited an analysis of 17 clinical trials that found soy isoflavones reduced hot-flush severity by around 26% and frequency by around 21% compared with placebo.
He also stressed the importance of adequate protein intake, noting that "lean mass falls across the menopausal transition" and that "the response to protein and exercise may become less efficient in muscle with age." He recommended including eggs, fish, poultry, yoghurt, tofu, beans or lentils across all meals, combined with resistance exercise.
On calorie restriction, Wakeman warned that "simply eating less can also mean consuming less protein, magnesium, calcium, and other micronutrients." He advised focusing on nutrient density, with more vegetables, fruit, wholegrains, pulses, nuts, seeds, fish and quality protein, noting that Mediterranean-style eating has been associated with improvements in several cardiovascular risk factors in menopausal women.
Finally, he cautioned against searching for a single "menopause superfood," saying that sleep, mood, muscle, metabolic and bone health are all inter-related, and that a varied diet with protein, plant foods, healthy fats, wholegrains and a wide spread of micronutrients should be the foundation.
