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Cravings in perimenopause – the cause is probably not what you think!

Perimenopause is the transitional time around menopause. Menopause is when a woman, trans or non-binary person's periods stop. It's marked by changes in the menstrual cycle, along with other physical and emotional symptoms. This time can last 2 to 10 years before someone reaches menopause (at around 51 years of age).

On average, people gain between 2 to 3 kilograms during this time, but this is highly variable. It doesn’t have to happen but is driven strongly by oestrogen deficiency. Interestingly, a new paper just released (also summarised beautifully in an 11min interview on the ABC here) also shows that an unlikely player is involved – protein!

Cravings and causes

Many of us have heard the old myth of ‘our body craves what it lacks’. Often a handy excuse to justify a little extra of a treat here and there in pregnancy, but otherwise not particularly founded in science.

However, in a recent Concept Paper from the University of Sydney Charles Perkins Centre, it has been suggested that minor adjustments to the balance of macronutrients in a person’s daily diet during the transition to menopause could lessen or even prevent weight gain and lean tissue (muscle) loss.

What are the usual body and activity changes seen in the perimenopause?

In the perimenopause some people don’t experience a change in weight, but their fat free mass (muscle) and bone mineral density decreases while their fat mass (adipose tissues) increase. Body composition (muscle and fat stores) changes accelerate during the perimenopausal phase and stabilises during the post-menopausal phase.

An increased kilojoule intake can contribute to weight gain. However, studies that have followed people over longer periods (rather than just a one-off measurement) have shown that in the three to four years in the lead up to menopause onset energy intake has been shown to decrease. This validates so many people’s experiences of “I’m not eating more but the weight is going on to my middle!”.

Studies have also shown that decreases in oestrogen results in decreased energy expenditure (including physical activity) and fat oxidation (the body burning fat).

So, this means, people are often eating the same or less, are less active, but experience weight gain and muscle loss.

So, what does the body crave in perimenopause?

The researchers from the Charles Perkins Centre suggest that the body’s appetite for protein increases during perimenopause. This is thought to be due to the knock-on effect from all of the hormonal changes and results in “tissue protein breakdown” (e.g. of muscles). They point out that if protein requirements aren’t met, people overconsume other forms of energy as this loss of muscle drives the body to crave protein.

The double whammy here comes from the way a lot of (ultra-processed) foods are made. This perimenopausal craving for umami flavours – think savoury foods that should contain proteins like meat, shellfish, some cheeses – can be met through the way ultra-processed foods are produced. If we try to meet this unconscious drive for protein through processed meats like bacon or salami, or even consume savoury snacks like BBQ chips that mimic this flavour without the nourishment. The scientific name for this craving is the “protein leverage” effect. In essence, this means that if the proportion of protein in the diet isn’t increased, the body’s drive to reach its target protein intake will make us continue to eat unnecessary calories until we do so.

What are the practical changes I can make during the perimenopause?

Since energy expenditure tends to fall during menopause, the researchers hypothesise that women need to eat both less energy (from carbohydrates and fats) and more protein to compensate for the biological changes at menopause.

The good news this can be achieved through tweaks rather than a major dietary overhaul. The researchers noted that it appears very small changes to the diet in terms of prioritising protein, reducing fats and carbohydrates and being physically active could make a big difference in the long-term.

They’ve done the calculations which we won’t bore you with. But in real terms they suggest it equates to about 6g extra of protein per day and dropping kilojoules from carbs and/or fats by targeting ‘discretionary’ (i.e. junk) foods. This shouldn’t be hard as the average Australian consumes almost one-third of their kilojoules from junk food!

What does 6g of protein look like? Six grams of protein equates to one egg OR 20g of lean meat, chicken or fish OR ½ cup of baked beans OR 200mL of milk OR 100g of yoghurt OR a handful of nuts. #simples More information on food sources of protein can be found here. Remember to go for minimally-processed whole foods and drinks rather than powders and fake-lab-created meat substitutes for good gut health.

How much do I have to cut back on treats? The paper’s authors suggest that, for many, cutting out a bag of chips, a glass of sugar sweetened beverage, or a glass of wine will do the trick. Our blog on non-hungry eating will help give you strategies to master this.

If you would like to discuss your weight or metabolic health concerns, you can make an appointment to see Dr Terri-Lynne South via the link below

Other ideas for nourishing your body’s health during perimenopause can be found in our blog, Are you “very peri”? Here are six things you can do now to support your health.

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