MyMT™ Blog

Dietary protein, menopause hot flushes and the Okinawan ratio.

It took me a long time to understand why my menopause HRT wasn’t working. My hot flushes were not only embarrassing and exhausting, but seemed to increase in intensity in the evening. After dinner was worst. Now I know why this is. I was following the high protein diet mantra that continues to dominate the nutritional information shared from sport and fitness enthusiasts and from popular contemporary dietary advice, instead of following research from women’s health and ageing studies. 

If your hot flushes are driving you mad and you are on HRT or various supplements that aren’t working for you, then I wonder if you are also on a high protein diet? It could well be the missing link in your menopause-toolbox. I talk a lot about protein in the MyMT™ programmes and women who join me on them, learn about the contribution of high protein diets to their hot flushes. You see protein, is ‘thermogenic’ or heat-generating. This means it increases your metabolism. Whilst this important macronutrient has appeared in sport science nutrition and is heavily promoted for muscle density improvement as we get older (65+ yrs), if you are having too much protein during your menopause transition, then this could well be the cause of your higher body temperature and of course, your hot flushes and night sweats. 

The recommendations for high protein diets ‘seems to be at odds with basic research in animals and observational studies in humans showing that low-protein or low protein-high (plant carbohydrate) diets delay ageing and increase lifespan’ (Couteur, Solon-Biet et al, 2016), stated the research I was reading as part of my women’s health and ageing doctoral studies.

This paper was a turning point for me … as well as women on my 12 week menopause transformation programmes. I’ve used the women’s ageing and longevity research to help untangle some of the source of our hot flushes and night sweats. Understanding the Okinawan Ratio was crucial to this.

The longest living people are the residents of the Japanese island of Okinawa. Not only are they the oldest-living, but they are free from diseases of older age that beset many women living in Western Societies. If you’ve been following my newsletter articles for a while now (thank you) then you will have head me talk about the high incidence of heart disease as women transition menopause and move into their post-menopause years. Heart disease remains the number one health concern for women as they age, however, older women living on Okinawa Island don’t experience the same cardiovascular health concerns compared to western women (Buettner, 2017). 

Whilst there are numerous factors that contribute to the health and longevity of Okinawan women, one of these factors relates to their daily nutrition, including food quality, caloric restriction and their protein to carbohydrate ratio. Total energy from their diets was derived from only around 9-10% of protein per day. This ratio differs from the average western diet of around 30-40% intake of protein, often in the form of meat and dairy products (Cordain, Eaton et al, 2005). The lower ratio of protein compared to plant carbohydrates (which was around 75-80% of the total daily diet) contributed to caloric restriction in Okinawan inhabitants.

Protein restriction is just one approach that allows for caloric reduction, which is increasingly seen as helping to extend lifespan. However, my interest was piqued about reducing protein intake because in energy expenditure studies, protein, especially animal protein, is known to be thermogenic. This is the term used for ‘heat generating’. I learnt that years ago whilst teaching sports nutrition. I talk more about this in my online 2 hr Masterclass on Menopause, which you can read about HERE and perhaps find time to listen to over the Easter break (you can also ‘pause’ me anytime as well). 


There is convincing evidence that a higher protein intake increases thermogenesis and satiety (feelings of fullness) compared to diets of lower protein content, but with increased thermogenesis from a high protein diet, comes change to temperature regulation in the body – not good for women who are frustrated and exhausted from their hot flushes.

When I was trying to understand why my hot flushes were so bad, I remembered from my lecturing days that high protein diets may also cause stress on the thyroid, liver, kidneys and gut. The result of this is increased inflammation, especially in the epithelial lining of blood vessels. With additional inflammation in cells and tissues, the immune system and thyroid kick in to re-balance the internal temperature. Sweating is your natural response to your body trying to cool down. That’s why in the newly revised MyMT™ Food Guide, which is in both of my different 12 week programmes, I teach you not only about cooling foods to eat in menopause, but also how much protein is ‘enough’. The amount differs from 0.8 grams/kg/day up to 1.4 gms/kg/day, depending on whether you are overweight, or lean, or exercising or sedentary.  Different strokes for different folks. 

MyMT Banner Heather

Improved nutrition is a major contributor to increased human lifespan in the last two centuries, but with this improved nutritional knowledge has come food-confusion, especially with regard to protein type and consumption. But it’s an important topic for women in their menopause transition, because numerous human health and longevity studies indicate that the reduction of access to total number of calories and/ or protein, delays the ageing process. It is also of note that elevated branched chain amino acids (BCAAs) are a marker of diabetes mellitus in humans too. (Giesbertz & Daniel (2016). Whilst research in this area continues to progress, women who are overweight in post-menopause should be cautious about their animal protein intake, not only for the increased thermogenesis, but because their kidneys are ageing and changing. High protein diets place undue stress on these important but vulnerable organs. 

When my own hot flushes were troubling me day and night, especially as I moved into post-menopause, I knew I had to get to the bottom of the science of them. Today, hot flushes no longer control me or define me. This is the same for many of the women who are following the strategies I have researched. There are numerous testimonials for you to read HERE when you have time. 

I don’t want you to still be experiencing hot flushes in your post-menopause years and if you are on HRT, then research suggests that 5 years is long enough. So, if you are not coping with your heat regulation, sleep, anxiety, depression, weight or joint problems as you move through menopause and beyond, then will you join me? No matter where you live in the world, I would love to support you to feel like your old-self again. My video explaining the MyMT™ programmes is below. 

Dr Wendy Sweet (PhD) MyMT Founder & Member: Australasian Society of Lifestyle Medicine. 


Buettner, D. (2017). The Blue Zones Solution. National Geographic Publ. 

Cordain, L., Eaton, SB., Sebastian, A., Mann, N., Lindeberg, S., Watkins, B., O’Keefe, J., & Brand-Miller, J. (2005). Origins and evolution of the Western diet: health implications for the 21st century, The American Journal of Clinical Nutrition, Volume 81, Issue 2, 341–354.

Halton T., Hu F. (2004). The effects of high protein diets on thermogenesis, satiety and weight loss: a critical review. J Am Coll Nutr. 23(5):373-85. 

Le Couteur, D. G., Solon-Biet, S., Wahl, D., Cogger, V. C., Willcox, B. J., Willcox, D. C., Raubenheimer, D., & Simpson, S. J. (2016). New Horizons: Dietary protein, ageing and the Okinawan ratio. Age and ageing45(4), 443–447.

Stachowiak, G., Pertyński, T., & Pertyńska-Marczewska, M. (2015). Metabolic disorders in menopause. Przeglad menopauzalny = Menopause review14(1), 59–64. 

“If you have ever wondered if there was a clear easy plan to follow to sleep all night, reduce hot flushes and prevent or reduce your weight gain during menopause, then ‘welcome’ – you’re in the right place now.”

Discover how either of my two Menopause Transformation programmes might help you too or take my Symptoms Quiz below… 

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