MyMT™ Blog

Your dietary protein, menopause hot flushes and the Okinawan ratio.

It took me a long time to understand why my menopause hot flushes were getting worse, despite the medications. My hot flushes were not only embarrassing and exhausting, especially the red-face, but seemed to increase in intensity in the evening. After dinner was the worst. But I now know why this is.

The high-protein diet mantra that continues to dominate the nutritional information shared from sport and fitness enthusiasts followed me for years. When I began to realise that much of this advice to have a high protein diet (1.5 – 2.2gms/kg day) was better suited to women doing heavy resistance training, rather than me, who didn’t have time to spend hours at the gym, my women’s healthy ageing studies took me down a different dietary route – not only in the type of diet, but the amount of protein I was having.

If your hot flushes are driving you mad and you are on various supplements that are no longer 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, 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 and strength 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, which are keeping you awake. 

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’ (Le 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. It helped me to untangle some of the source of our hot flushes, night sweats and menopause insomnia. Understanding the Okinawan Ratio was crucial to this.

The longest living people (especially women) are the residents of the Japanese island of Okinawa. Not only are they the oldest-living, but in general, many remain free from diseases of older age that beset older 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). As such, this 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, research continues to confuse many of us, about ‘how much is enough?’ especially when it comes to midlife needs.

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’. This thermic effect seems to be influenced by the composition and amount of food consumed. 

There is convincing evidence that a higher protein intake increases thermogenesis and satiety (feelings of fullness) compared to diets of lower protein content, and that this may be good for weight loss and muscle retention, but what’s it doing for your body heat?

It is well known in exercise and nutritional science that increased thermogenesis from a high protein diet, creates some change to temperature regulation in the body.

this isn’t so good for women who are frustrated and exhausted from their hot flushes, is it?

But there’s another problem with diets that are too high in protein (over 25-30% of total daily intake). When I was trying to understand why my hot flushes were so frequent, 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. 

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, and there are numerous women who don’t even make the minimal requirements for protein intake (1.0 – 1.2gm/kg/day or up to 20% of total daily intake), women who are overweight in post-menopause and/or have gut health concerns, may need to explore how much total protein (including animal protein) they are having daily. 

The digestion of animal protein is known to increase the work of the gut, not only due to the work that for the increased thermogenesis, but because their kidneys are ageing and changing. High protein diets may 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. 

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