Moderate to Low-Carb Eating for Perimenopause: Why It Matters and How to Do It

Karla Andrade
Sep 4
3 min read

0:00

Perimenopause is the time before menopause when estrogen levels go up and down, then drop. This can make it harder for your body to handle carbs. Many women notice more belly fat and higher blood sugar, which raises the risk for diabetes and heart disease.¹–⁴

Eating a moderate-to-low amount of carbs—especially high-fiber, unprocessed ones—can help keep energy steady, reduce cravings, and support weight control.

Why Carb Tolerance Changes

- Estrogen helps insulin work better. With less estrogen,

blood sugar may rise more after meals.¹–³

- Belly fat often increases during perimenopause, even without weight gain, and is linked to insulin resistance.²–⁴

How to Eat Moderate-to-Low Carb

Carb range: 50–130 g/day (25–40% of calories), adjusted for your needs.⁵–⁷

Best carbs: quinoa, oats, lentils, sweet potato, chickpeas, berries, apples, carrots

Also eat: chicken, fish, eggs, avocado, olive oil, nuts, leafy

greens, broccoli, zucchini

Limit: sugary snacks, white bread/pasta, processed foods,

low-fiber carbs

Evidence

- Menopause transition: Linked to more belly fat and insulin resistance; lower-glycemic diets may help.¹–⁴

- Lower-carb diets: Improve blood sugar, insulin, and triglycerides in people with insulin resistance or type 2 diabetes.⁸,¹⁰–¹²

- Carb quality matters: High-fiber, lower-GI diets in midlife

women can reduce belly size and improve symptoms.¹³–¹⁵

Tips

Choose high-fiber, less-processed carbs.¹³–¹⁵
Pair carbs with protein and healthy fats.⁸–¹⁰
Spread carbs through the day, not all at once.
Strength train 2–3×/week to keep muscle and
improve blood sugar.⁸–¹⁰
Track waist size, blood sugar, and triglycerides
every 8–12 weeks.

Sample Day (~110–130 g carbs)

- Breakfast: Greek yogurt + chia + blueberries + eggs

- Lunch: Lentil-quinoa salad with veggies and olive oil.

- Snack: Apple + almond butter.

- Dinner: Salmon, roasted Brussels sprouts, sweet potato

Cautions

If you have type 1 diabetes, kidney disease, an eating

disorder or are underweight, get medical guidance

first.⁹,¹⁰ Very-low-carb (<50 g/day) works for some but

is not needed for most.⁵–⁷,¹⁰–¹²

If you take hormone therapy, check fasting insulin and talk to a

menopause-focused dietitian. Moderate to low-carbohydrate diets

are not meant for individuals on hormone therapy.

Reach out to one of our dietitians that specialize in

peri/menopause by scheduling a free consultation

on our website. Simply click "talk to an expert" on

our home page.

References

Derby CA, Crawford SL, Pasternak RC, et al. Insulin resistance and hormone interactions across the menopausal transition (SWAN). J Clin Endocrinol Metab. 2003;88(10):4904-4910.
Samargandy S, et al. Abdominal visceral adipose tissue over the menopause transition. Menopause. 2021;28(5):534-542.
El Khoudary SR, et al. The menopause transition and women’s health at midlife: a progress report from SWAN. Obstet Gynecol Clin North Am. 2019;46(3):x–y.
Janssen I, et al. Testosterone and visceral fat in midlife women: the SWAN study. Obesity (Silver Spring). 2010;18(3):604-610.
Kirkpatrick CF, et al. Low-Carbohydrate Diet. StatPearls. Updated 2023.
ADA Professional Practice. Nutrition & Wellness. Diabetes Care. 2024.
Hite A, et al. Expert consensus on nutrition and lower-carbohydrate diets. Curr Dev Nutr. 2024;8(2):nzae024.
ADA. Standards of Care in Diabetes—2024/2025. Diabetes Care. 2024/2025.
Evert AB, et al. Nutrition therapy for adults with diabetes or prediabetes: a consensus report. Diabetes Care. 2019;42(5):731-754.
Goldenberg JZ, et al. Efficacy and safety of low and very low carbohydrate diets for type 2 diabetes remission. BMJ. 2021;372:m4743.
Klement RJ, et al. Effect of low-carbohydrate diets on insulin resistance and metabolic syndrome: a review. Nutrients. 2021;13(11):E3924.
Gajdács P, et al. Myths and facts regarding low-carbohydrate diets. Nutrients. 2025;17(6):1047.
Silva TR, et al. High-protein, low-GI diet and adiposity in late postmenopausal women: RCT. Arch Endocrinol Metab. 2024;68:1-5.
Jarošová E, et al. Nutrition in menopausal women: narrative review. Nutrients. 2021;13(7):2149.
Ghazizadeh H, et al. Carbohydrate quality index and menopausal symptoms. BMC Women’s Health. 2025;25:xx.