Perimenopause is likely setting up camp for a nice long while, so now that you understand why your body is acting differently, let’s talk about what you can do to support it. These strategies are about working with your hormones, not against them, so you can regain control over energy, mood, and body composition.

Anti-Inflammatory, Insulin-Controlled Eating

A. Fill Half Your Plate with Vegetables & Fruit

Make sure your plate is at least half full of fruits and vegetables. Focus on dark leafy greens, cooked cruciferous veggies (like broccoli and cauliflower), and berries. These foods reduce inflammation, provide fiber, and support insulin regulation.

B. Add Other Fiber-Rich Foods

Beans, lentils, nuts, seeds like chia and flax, or high-fiber wraps/pasta help 25–35 grams of fiber per day, which aids digestion, blood sugar control, and visceral fat reduction.

→ Increase slowly to avoid gas or bloating. Listen to your body — too much fiber can contribute to gas and bloating or start grabbing up hormones. So, track your fiber consumption first, and see where you’re at. Increase gradually in 5-gram increments until you hit 25. Then play around with 30 or 35 and see how you feel.

If you’re struggling to hit that target in the beginning, you can add a small amount of psyllium husk!

C. Include Healthy Fats

Include healthy fats from whole foods like avocados, olives, nuts, seeds, grass-fed butter, eggs, and wild caught fatty fish (salmon, sardines, mackerel) in every meal.

→ Walnuts, flax & chia seeds, and fatty fish are particularly great sources of omega-3 fatty acids important for supporting hormone balance and reducing inflammation.

✨While we do need some omega-6 fatty acids, most Americans consume too many relative to their consumption of Omega-3’s. This is because 60% of our food supply is now made up of highly palatable, ultra-processed foods high in omega-6’s. So try to focus on getting your fats from whole foods rather than processed foods.

D. Prioritize Lean & Complete Protein

Sufficient protein is especially non-negotiable after 40:

Stabilizes blood sugar and cortisol
Improves satiety — protein keeps you full longer, minimizing needless snacking and more frequent insulin spikes.
Preserves and builds muscle — Our bodies are less efficient with amino acids as we age, so you need more protein than before to build muscle which can improve insulin sensitivity, cortisol & visceral fat.

How much protein:

This can vary based on biology, history, and goals, but a good target to start with is 1 gram of protein per pound of ideal body weight. Spread in larger chunks at meals (35–50 grams) rather than sprinkling all through your day.

Complete proteins — whole foods vs. powders?

- Complete proteins have the 20 amino acids your body needs and especially the 9 that our body can’t make.
- Minus a few exceptions like edamame, lean and complete proteins come from animal products like chicken or turkey breast, lean ground beef, fish, eggs (I balance macros with 2 or 3 whites per yolk), and pork tenderloin.
- Drinks/powders can supplement, not replace. I aim for less than 20% of my daily protein from these — about 1/3 of a protein shake as coffee creamer (AFTER 24 oz of water with electrolytes of course ) and maybe the rest later with a snack. I also use protein powder in my baked goods and my protein balls. But these are adjuncts to my real food protein.

I prefer whey protein by Unmatched due to its bioavailability and quality (Use code ALISATHEALTH for a 10% discount). Vital Performance (milk/collagen protein) is another option— you can get a 10% discount here on Fullscript. For a plant-based option higher in fiber, I recommend the Juice Plus Complete which you can buy here.

✨Tip: Struggling to get enough protein & fiber? Grab my free 7-day meal plan here to see how to build meals around protein & fiber. Scroll past the 28-day plan for purchase & enter contact info at the bottom. The calories (1200 or 1500) may not be your range, but the concepts hold true.

What if you’re vegan?

Most plant proteins are incomplete (missing some amino acids) so keep tabs on which are missing. Combining nuts, grains & legumes together can help.
Most plant proteins also come with significant fat and/or carbs, so you’ll eat more total calories making a calorie deficit more challenging to hit.
Just because something worked in your 20’s doesn’t mean it will now. I was a vegetarian for years, but the high % of calories from carbs and fat stopped working for me. I eat and love carbs — they just don’t make up 65% of my calories anymore, and they come largely in the form of fruit because I only tolerate grains and beans in small quantities.
There’s no right or wrong — If you’re committed to a vegan lifestyle, great! Consider monitoring your blood sugar regularly, and possibly supplementing amino acids. You can get these for a discount here on my FullScript.

E. Flavor Wisely

Using herbs and spices like ginger, garlic, rosemary, cinnamon, black pepper, and turmeric can help manage inflammation and blood sugar and add variety to your staple foods. Here’s a few examples:

Use them to make salad dressings. You can find recipes here:
Brighten up your batch cooked chicken
Use your favorites when roasting vegetables.
Cinnamon is great on sweet potatoes and in your coffee.

When using store-bought sauces and dressings, read ingredients. Consider this: If your grandmother wouldn’t know what it is, do you want it in your body.

F. Don’t Skip Breakfast

Skipping breakfast alters hormonal responses influencing hunger and energy balance. It’s omission has been “consistently associated with insulin resistance, cardiovascular risk, obesity, microbiome dysbiosis, increased appetite, impaired neuronal signaling, circadian rhythm disruption, and systemic inflammation.” Minari, T. P., & Pisani, L. P. (2025)

Here’s a few tips:

Drink 16-24 oz water with electrolytes BEFORE caffeine. I love LMNT because I get tired of plain salted water, but sea salt also works. Click here to order, and they’ll send you a free sample pack.
Avoid “naked” coffee. Having fat & protein calories with your caffeine helps mitigate the energy and blood sugar “roller coaster”. So if you absolutely can’t eat breakfast, at least add collagen, fiber, protein creamer (I use Fair Life shakes) and MCT oil in your coffee.
Think eggs, yogurt, protein-based smoothies. Check out the recipes page on my website for some ideas, and remember, protein is key!
Time restricted eating works for some people but the timing is key — Don’t start the eating window later; instead stop the eating window earlier. I know that’s less convenient, but it’s extremely important.

G. Limit These With Grace

The hard truth: Especially after 40, these are just more likely to get stored as belly fat.

✨There’s no added sugar in anything grown in or raised on the ground so aim for a 90/10 mindset: 90% clean, balanced eating, 10% flexibility.

✨Our brains are wired to experience pleasure with food. If everyone is having cake, don’t feel like you have to restrict. Celebration with food is part of life — it just doesn’t need to be part of daily or even weekly life.

Added sugar → <25g/day (WHO guideline).

There’s more than 25 grams of sugar in some yogurt cups. It’s hidden everywhere under dozens of different names just to trick you — so read labels!

Ultra-processed foods and refined carbohydrates

→ low in fiber, high in hidden sugar, seed oils & mysterious additives

→ research on “seed oils” (especially canola, corn & soybean common in ultra-processed food) is muddy & controversial because these industries are HUGE and we can’t always tell who is really funding the study. Conspiracy theory aside, it’s safe to say that the ultra-processed foods (which are dripping in seed oil and coated in sugar) are not helping brain fog, inflammation, or your waistline in perimenopause.

→ Remember…the delicious carb/fat combo of ultra-processed food was engineered to taste amazing so it would sell! It’s addictive — the more you eat, the more you crave.

Alcohol → disrupts hormones, liver function, and weight management

I can’t stress this one enough —Even just a few alcoholic beverages on a regular weekly basis can wreak hormonal havoc and pack on pounds or derail weight loss efforts. Even if you’re doing everything else right.

I’m not saying you can’t have a glass of champagne on New Years, but aside from occasional celebration it has to go.

If you opt to have those few drinks every week, there’s your 10% freedom — that means 100% whole, clean, unprocessed food. You choose.

✨Tip: Healthy homemade swaps for your favorite processed foods can be very helpful. Make them in large quantities and store in the freezer so you always have something for unexpected cravings. Here’s a link to my peanut butter cup recipe.

Strength Training — A Hormonal Game-Changer

If you’ve dialed in your diet and exercise and are still battling with your body in perimenopause, you’re likely aware of the role your hormones have on fat/muscle.

Many of you are stuck in a “move more, eat less” paradigm that may have worked in your twenties or thirties. You keep cutting calories lower and adding more cardio, but nothing changes. Believe me, I’ve been there too! You have to buy into a new paradigm for this next season of life.

Here’s the deal — Yes, if you eat more calories than you use, you will store them as fat. But especially now, it’s about much more than calories —your hormones are playing a larger part than ever in how you “use vs. store” them.

Extreme calorie cutting and intense cardio for “calorie burning” is most likely making weight issues worse. You can only “move more/eat less” so much before your hormones protest and your metabolism seems to come to a complete stop.

Muscle is your metabolic engine. Check out this blog post where I go into all the details. Losing muscle in mid life slows calorie burn and worsens the insulin sensitivity already impacted by estrogen decline. And unless you are intentionally trying to build it, you are most definitely losing it. So here’s what you need to know.

1.You will NOT “Get Bulky” (Unless you consider me bulky — I have been trying to get bigger for the better part of a decade)

A. Strength Benefits

Increase energy demands → Muscle requires extra calories to build and maintain.
Improve Insulin Sensitivity → Makes it easier to burn fat and regulate blood sugar.
Support Sleep → Insufficient, poor quality sleep has always been terrible for your health, but the days of sleeping 6 hours and managing weight are over!
Help manage stress and cortisol levels →Chronically elevated cortisol promotes fat storage
Strengthen Bones

B. Frequency & Approach

2–3 days/week minimum
Progressive overload: gradually increase reps or weights
If you’re comfortable with dumbbells and a barbell the progressive overload approach is key to maximizing muscle and strength gains and minimizing recovery demands. This is how it looks with my trainer:
- One warmup set, 2 working sets (push each working set to 1 or 2 reps before total failure)
- Take 2 minute breaks per set (if you’re pushing hard enough you should NEED that break)
- Once you can do 2 working sets of 8 or 10 max, go up in weight. More reps increases time & recovery demands for minimal results.
- I do 6 exercises per strength day (3-4 lower, 1-2 upper, and 1 core), but you may choose a different split depending on your goals. This takes me 60-75 minutes to complete
- Find 3 workouts you can stick with for 8-12 weeks. If you’re not doing the same thing week over week, there’s no way to tell if you’re actually progressively overloading your muscles.
If you’ve never stepped into a gym, start with bodyweight exercises, resistance bands, or work with a trainer to show you form and technique.

C. Balance Your Cardio / Active Recovery

HIIT workouts are great for strengthening your cardiovascular system, but those higher HR zones also add stress on the body (remember…cortisol is already ramping up as estrogen declines) so dial back the intensity. High intensity cardio may have been your jam in your 20’s, but if it’s not working for you now, the answer is NOT to add more. Here are some tips:

Add 150 min per week of zone 2 cardio/active recovery. (brisk walking or moderate pace biking/swimming) Effort level should require conscious thought but feel like you could do it almost indefinitely.

Track your heart rate until you get the feel for zone 2 — most people think they’re in zone 2 when they’re really in zone 3. You’re looking to stay between 60-70% of your maximum heart rate.

Gentle Yoga — Optional but highly recommended — Yoga. I

D. Sample Weekly Structure

3x progressive overload strength sessions (60–75 min, 6 exercises, 2 min rest between sets)
3-4x zone 2 cardio sessions (40–60 min)
1x gentle yoga
Walk 7–10k steps daily

✅ Key Takeaways

Eat to support hormones — protein, fiber, healthy fats, colorful vegetables, and moderate carbs
Strength train to preserve metabolism and muscle
Move strategically — zone 2 cardio and gentle activity, limit excessive HIIT
Start your day right — protein, fat, and hydration

✨ In Part 3, we’ll tackle stress, sleep, and supplements — the final pieces to help you feel fully supported and resilient in perimenopause.

Weight Loss in Perimenopause Part 2: How to Work With Your Hormones — Nutrition and Strength