The Best Menopause Diet: Keto, Paleo, Low Carb, Mediterranean, or Vegan / Plant-Based?

Best Menopause Diet for Menopause Symptoms and Weight Control Keto, Paleo, Vegan/ Plant Based Presented by Bossa Bars
By Barbara Sobel, MS, CNS, LDN. Barbara is a Clinical Nutritionist and contributing team member of Bossa Bars, Menopause Energy Bars

Menopause symptoms and perimenopause symptoms can be tough — hot flashes, sleepless nights, belly fat, weight gain, brain fog, changes in body shape, and unpredictable periods are just a few of the symptoms and signs of menopause. With so many changes, many women find that way of eating they used to rely on no longer works for them. So frustrating!

Do a Google search for diet and menopause, and you will find recommendations for Keto, Paleo, Low Carb, Mediterranean, or Vegan / Plant-Based. How can diets that seem so different all support women’s health at this important time?

Let’s dive into these diets, look for commonalities, see how they differ, and determine the best way to figure out what diet will work best for your menopause journey.

The Keto Diet

The Keto Diet (Ketogenic Diet), a therapeutic diet developed for children with seizures, has become popular as more benefits have been discovered. The Keto Diet is high in fat and very low in carbohydrates, typically less than 50 grams per day. The key to this diet is sticking below a carbohydrate maximum and eating nutrient-dense foods.

Healthy oils and fats like coconut, olive, avocado, and their oils, nuts and seeds and their butters, non-starchy vegetables such as leafy greens (kale, spinach, chard…), peppers, cauliflower, and broccoli are the backbone of this diet. A moderate amount of protein, animal or plant, and full-fat dairy for those who can tolerate it, rounds out this diet. 

Small portions of fruit and very small portions of starchy vegetables (squash, carrots, yams …) can be consumed on this diet when you take into account the net carbs. Net carbs are the carbohydrates that are absorbed by the body after subtracting the fiber from the total carbohydrates. Fiber is great for the gut, helps keep blood sugar stable, supports detoxification, and helps keep you fuller longer. More fiber on this diet means more carbs, more fruits and vegetables, and more nutrients. 

Many women report success losing overall weight and Meno belly fat with a Keto Diet, but some do not. The Keto Diet can be great if you have blood sugar imbalances or are in need of some brain support, but not so great if you have trouble digesting fats. Many women, especially those who are still cycling may need to come in and out of the Keto Diet or add in more carbohydrates during the week of their periods. 

Low Carbohydrate (Carb) Diet

The Low Carb diet is high in protein, healthy fats, and vegetables. While it is similar to the Keto Diet in that it limits carbohydrates, there are enough carbohydrates allowed to enjoy some fruit, whole grains, legumes, and starchy vegetables in moderation. That means a higher fiber diet. 

Typically, the Low Carb Diet will contain somewhere from 50-150 grams of carbs per day. The rest of the diet includes animal or plant protein, vegetables, nuts and seeds, high-fat dairy, and healthy fats and oils. Protein can increase from moderate to high if desired. A little more protein can help with muscle growth. The low carb diet can be helpful for those with blood sugar issues, weight loss, and reducing cardiovascular disease. 

The Paleo Diet

The Paleo Diet is based on eating foods that our early ancestors ate when they were hunters and gathers. The diet is anti-inflammatory and focuses on the quality of food, not the ratio of nutrients. 

This diet includes animal proteins, fruits, vegetables, nuts and seeds, and healthy oils. Dairy, grains, beans and legumes, and added sugar are discouraged as they only became widely available when we switched to farming as a source of our foods. 

We often think of the Paleo Diet as being animal protein forward, plants second, but plants were plentiful during Paleolithic times and with some planning can make up most of your Paleo plate. For those with an autoimmune disease, sensitive digestion, inflammation, gastrointestinal issues, or are looking to lose weight, the Paleo Diet could be your sweet spot.

The Mediterranean Diet

The Mediterranean Diet is made up of real, whole, unprocessed foods including a wide variety of colorful vegetables, fruits, whole grains, nut and seeds, legumes, dairy, extra virgin olive oil, herbs and spices, modest amounts of poultry, fish, and red meat, red wine, and very little sugar. Rather than just focusing on food, the Mediterranean Diet is the combination of plant-forward foods and a supportive lifestyle, (exercise, mindfulness, community...). 

The Mediterranean Diet is high in fiber and low glycemic. It has been well studied to support cardiovascular health, increase longevity, and support brain health, weight loss, and blood sugar balance, and is a great place to start if you are ready to make some diet changes, but need some flexibility, or don’t want to jump into anything too restrictive. 

As a functional nutritionist, for my perimenopausal and menopausal clients, the Mediterranean Diet is the eating plan I recommend starting with. 

The Vegan or Plant Based-Diet

Vegan and Plant-Based Diets are 100 percent based on plant foods with proteins, fats, and carbohydrates all coming from vegetables, fruits, nuts and seeds, beans and legumes, and whole grains. The diets can include only raw foods or a combination of raw and cooked foods. No need to keep track of any macronutrients or ratios, just focus on eating colorful foods from plants.

The Vegan and Plant-Based diets are high in fiber, and tend to be higher in carbohydrates and lower in fat. While they can be lacking in some nutrients such as iron and B12, which may be an issue for women who are having heavy periods, it can be beneficial for weight loss, cancer prevention, and reducing cardiovascular risk - especially during the stages of menopause. 

How to Choose the Best Menopause Diet for You

All of the diets we discussed are rooted in nutrient-dense foods, so it can be confusing to try and figure out which diet is best for you -- especially when we can walk through a supermarket and find Keto ice cream, Paleo brownies, and Vegan donuts. Yikes!

However, regardless of the diet we choose, the quality of the food we eat matters most. Let me say that again…


The easiest way to determine quality food is when it's a real food or made with only real food ingredients you can pronounce!

Here are 5 transformational tips to help choose the best perimenopause and menopause way of eating for YOUR body:

1. Before you make any changes to your diet, grab a notebook or your phone and keep a log for 7 days. Write down your food, mood (or mood swings), bowel movements (yes, they matter too!), sleep, exercise, concentration, hot flashes, and any other symptoms you have. This may seem tedious, but it will provide you with valuable data about your body and how what you are eating affects you. Bonus Tip: Eat slowly, eat until you are satisfied, not overly full, and consciously enjoy every bite!

2. Next, look at the data you created over the week. What do you notice? Can you find some patterns? Do certain meals leave you low on energy, with stomach upset, worsen your hot flashes, moody, or more like to wake with night sweats? Look for the top 3 meals or foods that have an impact - for better AND for worse.

3. Also take into consideration any conditions or imbalances that may require you to eat a certain way and your preference and lifestyle. If you have a hard time digesting fat, the Keto Diet might not be for you. If you are sensitive to grains, a Paleo Diet might be the best place to start. This step can be hard. Sometimes we want to follow a diet that might not be serving us the way we want it to. Be honest with yourself and be open to change along this journey. What works for you might not work for your best friend, neighbor, sister, or partner.  

4. Based on what you discover, select a way of eating that feels like it will support the foods and meals that make you feel better, and reduce or eliminate the food and meals that made you feel less than great. 

5. Now with your new eating plan, repeat steps 1 through 4 until you discover the Pause Perfect Menopause Diet customized for you! This may take you a few cycles, but it is absolutely worth it. Besides, the stages of menopause take YEARS, so why not invest a few weeks in making your experience more joyful and less puffy, because when you eat better, you feel better! 

If all of this STILL seems overwhelming, start with a Mediterranean Diet!  The Mediterranean Diet is the most well-studied diet and may be easiest to embrace if you need to make a big change… fast!

In closing, whichever diet you choose, from Keto to Vegan and every other diet in between, focus on quality ingredients and preparing satisfying meals and snacks that you enjoy. Eat mostly plants (rich in nutrients and fiber), health fats (olive oil, nuts, and seeds, coconut oil, avocado, dark chocolate), high-quality protein (plant or animal depending on what works for your body, and leave the added sugars and overly processed foods behind. Pay attention to how your body feels and if something feels off, your symptoms are getting worse, or you feel too restricted, change things up, make a shift or try one of the other diets.

Menopause is a new beginning! Jump in with an open mind, a willingness to keep learning and listening to your body, and you’ll soon discover a diet that positively supports your menopausal symptoms and helps keep you feeling energetic and vibrant for years to come!