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Food Fabulous

Notes from midlife

Is insulin resistance causing your menopausal hot flushes?

Are you experiencing hot flushes and night sweats during menopause? Have you ever considered that it might be caused by insulin resistance? I’m not saying that this definitely will be the case, but it’s certainly worth looking at. I see a lot of this in my midlife nutrition clinic and it really could be the reason you’re tired, hungry and that losing weight seems impossible.

Let me tell you what insulin resistance is…

Insulin resistance occurs when the body's cells don't respond properly to insulin, leading to high blood sugar levels. Insulin is the fat storage hormone and it plays a key role in helping your cells absorb glucose from the food you eat. When this process doesn't work as it should, it can cause a variety of symptoms, including hot flushes and night sweats – and an inability to lose weight in spite of doing all then "right" things.

These are the common symptoms of insulin resistance

  • Increased hunger and cravings, especially for sweet and sugary foods

  • Fatigue and weakness, especially after eating

  • Unintended weight gain, particularly around the middle

  • Difficulty losing weight, even with diet and exercise

  • Irritability and mood swings

  • Skin changes, such as dark patches of skin on the neck or under the arms.

  • Slow wound healing and frequent infections

  • High blood pressure

  • Polycystic ovary syndrome (PCOS) in women

  • Hot flushes and night sweats

  • Insulin resistance can also be asymptomatic, so don’t rule it out if you’re over 40.

If you recognise yourself in a few of these, it’s worth getting some tests done but read on to find out how and why this matters.

Why would I be insulin resistant?

One of the most common causes of insulin resistance is a diet high in processed foods and added sugars. Before you get offended that I’m being judgey, I want to tell you that this doesn’t mean you’ve been eating ‘bad food’. The Western diet has changed so much over the last 50 years such that we are a long way from the kind of diet women’s work best with. So there's that.

And in perimenopause, changes in levels of oestrogen mean that your body handles starchy carbs like potatoes, rice, pasta, bread, pastries and anything at all with sugar in it differently. As a result, your body produces more insulin than it needs to in response to eating this kind of food, and eventually this causes problems with insulin signalling in the body.

Over and over, I’ve seen insulin resistance in women who have really thrown everything at having a ‘healthy diet’ or losing weight. That often looks like cutting right back on calories (not the answer), going for 0% fat products (terrible idea), eating terrible cardboard-like breakfast cereals (life is too short and they're often full of sugar) and eating their bodyweight in fruit (still just sugar, albeit natural).

4There is something you can do for yourself without resorting to medication and it’s this:

The answer is to switch to a diet rich in whole, unprocessed foods, based on protein, lots of veggies, some fruits (low sugar fruits like berries rather than tropical fruits) and smaller amounts of wholegrains like brown rice, whole wheat pasta, wholemeal bread and such like. Check out my e-book on weight loss in perimenopause to find out the kind of foods to focus on at this stage in your life. You can get it here, which will explain what you need to do. And, if you want a fab little programme filled with suggestions and recipes to actually do that, check out my 7-day Sugar Detox programme here -

If you’re looking to improve your insulin sensitivity and boost your overall health, look no further than these delicious and nutritious foods:

Berries. Strawberries, blueberries, raspberries, blackberries, and all the rest of the berry gang are packed with antioxidants and fibre, making them a great choice for managing insulin resistance.

Leafy greens. So sorry, I bet you were hoping I wasn’t going to mention vegetables. Kale, spinach, broccoli, and other leafy greens are high in fibre, vitamins, and minerals, making them a great choice for maintaining healthy blood sugar levels.

Whole grains. Whole wheat, quinoa, brown rice, and other whole grains are a great source of fibre and essential nutrients, which can help improve insulin sensitivity. Side note, go easy on the rice, pasta and wholegrain bread since these are still quite starchy. They contain good levels of fibre so what I’m really saying is to choose the wholegrain versions ahead of the white stuff but serve only moderate portions.

Lean protein. Fish, chicken, turkey, and lean cuts of beef and pork are a great source of protein, which can help keep you feeling full and satisfied, and can also help regulate blood sugar levels. If you eat more of a plant-based diet, that’s no problem – my experience is that people just need to be a little more mindful…

Nuts and seeds. Almonds, walnuts, chia seeds, and other nuts and seeds are a great source of healthy fats, fibre, and protein, which can help improve insulin sensitivity. If you’re wondering why fibre keeps coming up, it can slow down how quickly sugars land in your bloodstream.

Legumes. Beans, lentils, and other legumes are a great source of fibre, protein, and complex carbohydrates, which can help improve insulin sensitivity and keep blood sugar levels stable.

Avocados. These creamy green fruits are a great source of healthy fats and fibre, which can help improve insulin sensitivity and keep blood sugar levels stable. Don’t shy away from them because of the fat content. The public health messaging about fat making you fat has been incorrect for more than 50 years. What’s worse, the science has supported this for generations but Big Food likes to keep you stuck on the diet treadmill by peddling low fat stuff with more sugar but fewer calories. Please don’t fall for it!

As a nutrition coach, I can tell you that the food and lifestyle piece will help a lot of things, not just your hot flushes. You don’t have to do things all at one, you can make changes meal by meal if that is better for you. This is not a race. This is the rest of your life!

Regular exercise can also help improve insulin sensitivity and reduce menopause symptoms. That doesn’t mean taking up spinning or running in an attempt to get healthy and lose any excess weight. Instead, aim for at least 30 minutes of moderate-intensity exercise, such as brisk walking, cycling, rowing or swimming, most days of the week. It’s easier than you think if you really make it a priority. Obviously, I don’t expect you to have a pool at home but maybe you have some exercise equipment that you can dig out, find a fun dance workout online or just get outside during your lunch break to move your body.

HRT is not magic and nor will it reverse insulin resistance

Of course, HRT (hormone replacement therapy) can also help but it is not magic and it’s also not suitable for everyone. I take HRT myself, just so you can see where I am in this, and I also work with a lot of women who are taking HRT. It is not going to fix everything and it might not even make much of a difference to some of your annoying symptoms of menopause if you don’t also do the food and lifestyle work. But back to my tale about insulin resistance…

So, if you're struggling with menopause symptoms, don't overlook the possibility of insulin resistance. It’s possible to test for it - if you want to. The test you want is called an HbA1c test and you can get an HbA1c test done privately relatively cheaply from a private lab. Or you can discuss with your doctor. I do a lot of this kind of testing with my private clients. If you need help, let me know.

HbA1c insulin resistance testing for women in perimenopause/ menopause

HbA1c testing is a simple blood test that measures your average blood sugar levels over the past two to three months. It's an important test for women in menopause, as they are at a higher risk for developing diabetes and other metabolic disorders.

During menopause, hormonal changes can affect the way your body processes sugar, making you more susceptible to insulin resistance and high blood sugar levels. This is why it's important to have regular HbA1c testing to monitor your blood sugar levels and detect any potential issues early on.

I frequently see women who have had a single test at their doctor’s to measure their blood glucose levels but that’s just one single moment in time. By the way, often these women, when they measure they blood glucose regularly, find that their results are telling a completely different picture to the one they got in their single blood test report.

What is a normal HbA1c result for a menopausal woman?

A normal HbA1c level is less than 5.7%, while levels between 5.7% and 6.4% indicate prediabetes (think of it as the warning zone in which you need to prioritise taking action), and levels above 6.5% indicate diabetes. If your test results show that you have high blood sugar levels, you will want to make diet and lifestyle changes a real priority. Doctors might recommend medications like metformin but as a nutritionist for midlife women, I think the diet and lifestyle option is best. No surprise there, but consider that every medication has side effects and diet and lifestyle can be just as effective if not more so.

HbA1c testing is not the only way to monitor or test for diabetes and prediabetes, your healthcare provider may also suggest other tests like fasting blood glucose or OGTT (this glucose tolerance test is less frequently used these days). However, it’s a good one if you’re wondering why you’re struggling with hot flushes or why you’re struggling to lose weight in perimenopause. If the weight loss struggle in perimenopause is getting you down, I wrote a book on it and you can get it here -

So, if you're a woman in menopause, don't overlook the importance of regular HbA1c testing. By staying on top of your blood sugar levels, you can take steps to prevent diabetes and other metabolic disorders, and maintain your overall health and well-being.

Don't forget to follow me on my social channels too for more tips and tricks on menopause health and wellness!


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