Supporting Menopause with Nutrition
Marcy Kirshenbaum is a licensed nutritionist in private practice in Northbrook, IL, assisting individuals and families in addressing health challenges by incorporating lifestyle factors with functional nutrition testing to create personalized, manageable, and sustainable nutrition plans. Marcy sits on the board of the Accreditation Council for Nutrition Professional Educators (ACNPE). Additionally, she consults with a variety of healthy food startups providing guidance on product quality and nutrition. She volunteers with the Hunger Resource Network to eliminate hunger in the Chicagoland area, and she serves on the Parkinson’s Allied Resources Coalition (PARC).
Leslie: Can you tell us a little bit more about yourself and how you're connected to this space?
Marcy: I found my passion for nutrition later in life after seeing how it affected my family’s health. This inspired me to get a master’s in nutrition and embrace a holistic approach that views people as whole beings, not just symptoms. As a woman going through menopause, I’ve noticed how often women’s health issues are overlooked. Much of the research has focused on men, leaving us with gaps in understanding women’s unique needs. My journey motivates me to share insights that can help women take control of their health and address the challenges we face.
Leslie: How does nutrition fit into overall health?
Marcy: I view nutrition as one of four essential pillars of health, much like a step stool with four legs that need to be balanced to avoid toppling over. The four pillars are nutrition, sleep, exercise, and spirituality/mindfulness, with diet playing a crucial role in influencing them all. For example, good nutrition supports quality sleep by promoting a consistent schedule and proper sleep hygiene. What we eat can affect symptoms like heartburn, GI disturbances, and even insomnia, especially as hormone levels change with age. Exercise, including resistance and cardio training, is vital for maintaining muscle mass and bone density, and muscle helps with balance and burns more calories. If our nutrition is lacking, we might experience weight gain, joint inflammation, and fatigue. Finally, spirituality and mindfulness contribute to stress management. High stress raises cortisol levels, our fight-or-flight hormone, and poor food choices can exacerbate this. Each leg of the stool impacts our health both independently and in connection with the others, highlighting the importance of a balanced approach.
Leslie: How does nutrition impact how someone feels during (peri)menopause?
Marcy: Many people experience a variety of symptoms as they go through hormonal changes, particularly during perimenopause and menopause. One key factor is the imbalance between estrogen and progesterone. As hormone levels drop with age, low estrogen can coincide with low progesterone, leading to symptoms like hot flashes and sleep disturbances. Estrogen, like all hormones, needs to be balanced—too little can cause problems, while the right amount supports overall well-being. Cortisol, our fight-or-flight hormone, and insulin also play significant roles in how we experience these symptoms. Elevated cortisol levels, often triggered by stress—whether emotional, physical, or even dietary—can lead to increased cravings for sugar and carbohydrates. This cycle can cause fluctuations in blood sugar and insulin levels, often referred to as the "blood sugar roller coaster." When blood sugar spikes, the body produces more insulin to bring it back down. Insulin is crucial for managing glucose, but it also acts as a fat-storage hormone, which can lead to increased abdominal fat—a common concern for women during menopause. Chronically high cortisol levels can exacerbate this issue, as estrogen typically helps to regulate cortisol. As estrogen declines in perimenopause and menopause, elevated cortisol levels can persist, contributing to weight gain around the midsection. This belly fat produces inflammatory compounds linked to insulin resistance, impaired glucose control, and increased risks for cardiovascular issues and certain cancers.
Leslie: As there are many interconnected challenges, what can people do to address them?
Marcy: I always start with an important qualifier: everyone is unique. While I offer general suggestions, they need to be tailored to individual needs. For example, if soy doesn’t work for you, there’s no reason to include it in your diet. My approach involves understanding each client's specific health challenges and creating personalized protocols. To begin, I encourage clients to keep a food and symptom diary for a week. This helps identify potential triggers for symptoms like hot flashes or fatigue. We also need to consider toxic exposures in our environment—from pesticides and personal care products to microplastics—which can affect our health. When it comes to diet, focus on whole, nutrient-dense foods. Stay hydrated, aiming for half your body weight in ounces of water daily. Incorporate a variety of plant foods, as they contain beneficial compounds that can alleviate menopausal symptoms. Ground flaxseeds and fermented soy products can be particularly helpful, but always consult a professional if you have specific health concerns. Be mindful of pesticide residues by referring to the EWG’s "Dirty Dozen" list. Including cruciferous vegetables like broccoli and healthy fats—such as extra virgin olive oil and avocados—supports hormone balance and overall health. I’ve created a PDF with helpful resources, including links to the EWG and the Dirty Dozen list, to guide you through these concepts without feeling overwhelmed. By focusing on personalized nutrition, we can effectively manage health, especially during perimenopause and menopause.
Leslie: What are the key benefits of increasing fiber and protein intake, especially during menopause, and how can we achieve that through our diet?
Marcy: I love that Vitaminis Gut Health product has five grams of fiber, especially since most people only consume around 10 grams daily, while the recommended intake is 25 to 30 grams. Fiber is vital for gut health, helping with motility, nourishing beneficial bacteria, lowering cholesterol, controlling glucose, and promoting satiety. If you’re eating ultra-processed foods, you might be missing out on fiber. Instead, focus on whole foods like berries, beans, avocados, and kale. These can really enhance your fiber intake, which is crucial for overall health. Now, let’s talk about protein. It’s essential for building and repairing tissues, especially as women go through menopause. Aim for about half to one gram of protein per pound of your ideal body weight, prioritizing high-quality sources like wild-caught fish, legumes, seeds, and nuts. Many people fall short, particularly at breakfast. Also, watch for refined carbohydrates that spike insulin levels. I recommend avoiding ultra-processed foods, which can increase cortisol and worsen menopausal symptoms. Lastly, due to modern farming practices, our fruits and vegetables contain fewer vitamins and minerals than they used to, so considering a high-quality multivitamin may be beneficial.
Leslie: How do supplements fit into all of this?
Marcy: Supplements should be personalized based on our individual nutrient deficiencies. To identify these gaps, I work with clients using functional nutrition testing, but even basic lab results from an annual physical can provide valuable insights. It’s crucial to look at optimal ranges rather than just the broad normal ranges typically considered by doctors. Herbs can also be supportive for menopausal symptoms, but it’s important to be cautious, as some herbs can interact with medications. Two notable options are black cohosh and maca root. Black cohosh is known for alleviating hot flashes, anxiety, insomnia, heart palpitations, and depression by supporting serotonin receptors in the brain without increasing estrogen levels, making it a safer choice for those with a history of breast cancer. Maca root acts as an adaptogen, adjusting to your body’s specific needs. Personalization is essential because, while humans share about 99% of our DNA, that remaining 1% makes each of us unique in how our bodies respond metabolically. It’s important to take this complexity into account.
Leslie: What are some small, manageable steps women can take to prioritize self-care and improve their overall well-being while avoiding feelings of overwhelm?
Marcy: When making changes, focus on one step at a time to avoid feeling overwhelmed. Start small—like tracking your water intake or adding more vegetables and protein to your meals. Be kind to yourself in this process. Movement is also vital; sitting has been labeled the new smoking, contributing to around 35 chronic diseases. Incorporating regular activity and prioritizing restorative sleep can help manage cortisol levels, which ties back into overall well-being. Finally, spending time in nature and practicing restorative belly breathing can significantly reduce stress levels. As women, it’s especially important to prioritize self-care, as we often place others before ourselves. Remember, taking care of yourself enables you to better care for those around you.
Leslie: If people are more interested in learning about you and your services, how can they find you?
Marcy: You can find me at enhancenutrition.net, and you can look me up. I'm in Northbrook, Illinois, so if you put Illinois in, I'll be there. I love working with people because I meet people where they are. I work to understand what their goals are and find ways to easily incorporate some of these changes. These changes then become permanent because it's all about lifestyle changes. It's not just about a six-week diet and thinking that you can go back to what you were doing before once those six weeks are over.
