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What is the Mediterranean diet, really? Ask almost any menopause expert what to eat, and you'll hear those two words. The Australasian Menopause Society (AMS) calls it the most widely backed way to eat for overall health [1].
But here's the surprise. The AMS says there's no strict definition of it [1]. No rulebook. No one set menu. It's a flexible pattern, so you get to make it your own.
And it's easy to love. It's colourful, generous and delicious, the kind of food you actually want to sit down to.
What the menopause experts say
Here's exactly what the AMS says: “For overall health benefits, the most widely-endorsed diet is the Mediterranean diet, which has been shown to have a favourable effect on cardiometabolic markers, cardiovascular disease, and possibly cognitive function and psychological wellbeing” [1].
In plain English: better heart and blood sugar numbers, a healthier heart, and possibly a sharper brain and a brighter mood.
That matters right now, because as oestrogen falls around menopause, our risk of heart disease goes up and our bodies become more insulin resistant [2]. This simply means that your cells don’t respond as well to insulin so blood sugar tends to stay higher and can even lead to prediabetes.
A little food history (worth a watch)
If you love a good food story, Belinda Fettke and Dr Peter Brukner's webinar The Mediterranean diet: science or spin? is an interesting watch [3]. They look at how people around the Mediterranean traditionally ate: simple everyday meals, festive feast days, and plenty of olive oil, vegetables, beans, fish and surprisingly, some meat along the way. Pop the kettle on, make a cuppa and settle in.
One lovely example comes from the Greek island of Naxos, in the Cyclades. Many families there kept a yearly tradition of raising and traditionally harvesting pigs to feed the household through the colder months. As the island’s own tourism site puts it, pig farming “assured families of their meat and animal fat supply for the entire year.” In earlier times the whole village joined in, with music as part of the occasion. Families made the most of the whole animal: sausages were made, lard was saved for cooking through the year, and nothing went to waste [4]. It’s just one island’s tradition among many Mediterranean food cultures, but I love how it shows meat, thrift and family feasting sitting happily alongside the olive oil and vegetables.
Another island with a food story worth noticing is Ikaria, in the eastern Aegean (also famous as a ‘Blue Zone’ location. Mary Ruddick is a nutritionist who works with people with complex health conditions, such as autoimmune conditions. She also travels to learn how traditional communities eat, and there are still many Indigenous tribes around the world living traditionally, everywhere from Africa to the Amazon. On Ikaria, Mary spent time filming and chatting with locals in their homes and tavernas [5]. Ikaria is famous as one of the world’s “Blue Zones”, the long-lived communities made popular by Dan Buettner’s Blue Zones project with National Geographic, and its plate is usually pictured as mostly plants [6]. Mary found everyday tables were richer in meat and dairy than that picture suggests. Locals told her they eat meat every day, and the rocky hills suit goats and sheep far better than cattle, so it’s mostly goat, sheep and pork rather than beef. Think pork liver, slow-cooked stews, saganaki (fried cheese), and plenty of goat and sheep milk and cheese, with nothing wasted.
Mary also raises a really interesting point about how diets get measured. The best-known research on the island, the Ikaria Study, was run in 2009 by Greek heart and nutrition researchers including Dr Christina Chrysohoou and Professor Demosthenes Panagiotakos, using a food frequency questionnaire (a checklist of how often you eat broad food groups) [7]. When Mary read through the questionnaire, she noticed pork, lamb and goat had no separate place; they sat under one broad “meat” group. In the published results, meat shows up as “red meat and products”, about once or twice a week [7]. And “red meat” mostly makes us think of beef, which isn’t the island staple. So the meat people actually ate may look rarer on paper than on the plate. Mary’s video Ikaria, Greece: Blue Zone mini-documentary is another interesting watch [5].
What’s on the plate
Olive oil. Vegetables. Beans, lentils and chickpeas. Fish. And some meat, too.
Meat is one of the easiest ways to get good-quality protein, iron, zinc and vitamin B12.
A quick word on protein. Protein is made of building blocks called amino acids, and nine of them must come from food. Think of it like a Lego kit with nine different parts: without enough of every piece, you can’t finish the build, and it may not work as it should. Leave the wheels out of a car kit and it won’t move, and it won’t really look like a proper car either. Fish, eggs, dairy and meat give you all nine, and they score as high-quality proteins [8]. Plant proteins, such as grains and beans, are often low in one or two of those pieces, and your body usually digests them less well. Roughly speaking, we take in about 95% of the protein from animal foods, and only about 80% from plant foods [9].
One more note about iron. Beans, lentils and chickpeas carry natural plant compounds called phytates and polyphenols, which can reduce how much iron your body absorbs from a meal. In a classic absorption study, even small amounts of phytate lowered iron absorption, and the more phytate, the bigger the drop. Adding vitamin C helped counteract it [10]. In another study in young women, the polyphenols and phytic acid in common beans clearly lowered iron absorption from the beans [11]. So animal foods are easier to absorb iron from, partly because they don’t bring those same blockers, and meat’s haem iron is absorbed especially well. If your periods are heavier in perimenopause, iron is worth a little extra thought, and your GP can check your levels.
In perimenopause, hormones can feel all over the place. Many of us wonder whether foods can support our oestrogen. Legumes, especially soy, contain natural plant compounds called phytoestrogens. They can sit on the same oestrogen “docking spots” our own oestrogen uses. They like one type best (oestrogen receptor beta). Soy is the richest source of phytoestrogens and it is a controversial topic, and experts don’t all agree. Human studies on what they do to our hormones are mixed [12].
One caution: your thyroid. Soy, like some other foods, can get in the way of making thyroid hormone in some people. That is more likely if you are low in iodine, or your thyroid is already struggling. So if you have a thyroid condition, talk to your doctor before leaning hard on soy foods or soy supplements [12].
Now the good news. Beans, lentils and chickpeas carry far less than soy. When researchers measured them, chickpeas had a little. Lentils had almost none. Everyday beans are not a strong source the way soy can be [13]. So this is “worth knowing”. It is not a reason to ditch your beans.
If you’re curious about food and inflammation, I also wrote about taurine, a quiet little nutrient found in seafood and meat: Could one tiny nutrient help calm inflammation in perimenopause? https://www.menocraft.com.au/blog%20%20new/taurine-food-inflammation-cardiometabolic-health
Food first, always.
Want a hand?
I’m a health coach, not a doctor, so please chat with your GP about anything specific to your health. Where I help is turning “eat Mediterranean” into real meals that suit your body, your taste and your week, and make the most of the nutrition in them.
If that sounds useful, you’re welcome to book a free discovery call (https://www.menocraft.com.au/booking), and I’ll send you my free Nutrient Absorption Guide afterwards. Or, if you’d like a gentle place to start, try my quiz (https://www.menocraft.com.au/menopause-quiz).