It took me a long time to understand why my menopause hot flushes were getting worse as I moved through my early 50s, despite the hormone medication.
Not only were they embarrassing in public, but also exhausting. Especially the red face and night-time sweating. From evening onwards, they seemed to get worse. A few years on with my studies on women’s health and ageing and the menopause transition and the impact of certain macronutrients on temperature regulation and blood pressure, I now wish I had this information at the time!
The high-protein diet mantra that continues to dominate the nutritional information shared from sport and fitness enthusiasts, has also followed me for years.
I began to realise that the advice for a high protein diet (1.6 – 2.6gms/kg day), often promoted by strength and conditioning exercise professionials for women in menopause based on the advice by leading Sports Nutritionist, Dr Stacy Sims and others, might be better suited to women doing heavy resistance training for hypertrophy and body image, rather than me, who didn’t have time or energy to ‘lift heavy and hard’ nearly every day of the week.
This realisation came when my women’s health and ageing studies took me down a different dietary route – not only in the type of diet, but also the advice from longevity studies on the quality and amount of protein I was having.
If your clients’ (or your own) hot flushes/ flashes are frustrating them and they are taking protein powders, eating animal protein, including lots of eggs, chicken red meat and having a very high protein diet, then I wonder if this is the ‘missing link’ in their menopause-symptom management toolbox.
I talk a lot about protein in the MyMT™ programmes and in the MyMT™ Education Courses. I’ve also designed a Critical Analysis Template on Protein and the Evidence for Practitioners and Exercise Professionals to consider the risks and benefits on protein. Not all Practitioners, Coaches and Exercise Professionals have nutritional advice in their Scope of Practice either, and this is also what concerns me about the advice being readily available on the internet and social media.
Joining the dots on the link between very high protein diets (over 1.8gms/kg/day), gut problems, liver health, blood pressure and temperature dysregulation is important. And one of the reasons for this, is because protein, especially animal protein is ‘thermogenic’ or heat-generating.
Whilst this important macronutrient has appeared in sport science nutrition for female athletes (Sims et al., 2023) and is heavily promoted for muscle density improvement and strength as women get older, if your clients are having too much protein during their menopause transition, then this could well be the cause of their higher body temperature and of course, their night sweats if they have had a heavy, animal protein meal for dinner.
Protein Intake in Health and Longevity Studies
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 … it helped me to make sense of the nutrition debates, especially protein discussions, for women on my 12 week menopause transformation programmes. It helped me to untangle some of the contributing factors to 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, followed closely by breast cancer. This is why I became intrigued that older women living on Okinawa Island don’t experience the same cardiovascular health concerns compared to western women (Buettner, 2017). Nor it seems do they experience the same rates of breast cancer that occurs in other countries, although research reports that this may be changing in Japan as a whole as BMI levels change. (Liu et al., 2019).
The primary source of protein in the Mediterranean and Okinawan Diets is plant proteins (Preedy, 2026)
Whilst there are numerous factors that contribute to the health and longevity of Okinawan women, one of these factors relates to their daily nutrition. This includes 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.
My interest was piqued about reducing protein intake to reduce hot flushes and improve sleep quality and duration, through studies on energy expenditure. 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 protein consumed.
Animal protein boosts thermogenesis (heat production from food) more than plant protein, thereby increasing energy expenditure. Protein has been used to increase energy metabolism in wieght loss and this is due to its amino acid profile (especially leucine) and higher metabolic cost for digestion/absorption. However, some studies have also shown that high intake of animal protein has been linked to weight gain too (Thompson, 2011). Futhermore, ageing kidneys have to excrete excess nitrogen which may be problematic for women in menopause.
Is animal protein generating greater heat in menopausal women?
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 client’s body heat?
It is well known in exercise and nutritional science that increased thermogenesis from a high protein diet, especially animal protein, creates some change to temperature regulation in the body.Protein thermogenesis significantly increases body heat because the body uses more energy (calories) to digest, break down, and absorb protein than it does for fats or carbs, a process called the Thermic Effect of Food (TEF) or diet-induced thermogenesis (DIT). Believe me, I’ve been observing body-builders in the gym for years who continually sweat, even when they aren’t working out!
Yet 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 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 the body’s natural response to cooling. That’s why in the certified Weight Loss Coach Course (Levels 1 and 2) and the Certified Menopause and Lifestyle Practitioner Course, 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 (WHO Guidelines of minimum protein for human health) up to 1.6 gms/kg/day, depending on whether you are overweight, or lean, or exercising or sedentary. Different strokes for different folks.
Dietary proteins have complex effects on inflammation and ageing
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).
Plant-based diets, including plant proteins are associated with lower inflammatory markers, however, a well-balanced diet also includes some animal and fish proteins too. Some animal proteins are also pro-inflammatory due to components such as methylamines, hence when it comes to managing inflammatory changes, lean proteins are best and preferably from plant-proteins. (Yari et al., Chapter 4, Preedy, 2026).
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 them! And yes, menopause HRT is also valuable for so many women, but if clients are finding no relief from their medications and are working with their medical Physician, then perhaps this information may help as well. There are numerous testimonials for you to read HERE when you have time.
Regulating body temperature is a crucial aspect of women’s healthy ageing, as is sleep, symptom management, and managing weight and/or joint problems. All of the ‘how-to’ information is in the various certififed courses for Practitioners, and there are numerous choices to meet your budget and Scope of Practice. Have a listen to the video below to learn more.
Dr Wendy Sweet (PhD) MyMT Founder & Member: Australasian Society of Lifestyle Medicine.
References:
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.
Ho, K. (2018). Diet-induced Thermogenesis: Fake Friend or Foe. J. of Endocrinology, 238, 185-191.
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 ageing, 45(4), 443–447. https://doi.org/10.1093/ageing/afw069
Liu R, Kitamura Y, Kitamura T, Sobue T, Sado J, Sugawara Y, Matsuo K, Nakayama T, Tsuji I, Ito H, Suzuki T, Katanoda K, Tominaga S; Three-Prefecture Cohort Study Group. Reproductive and lifestyle factors related to breast cancer among Japanese women: An observational cohort study. Medicine (Baltimore). 2019 Dec;98(51):e18315. doi: 10.1097/MD.0000000000018315. PMID: 31860982.
Preedy, V. (2026). Protein Intake in Health and Disease. London, UK: CRC Press, Taylor & Francis Group Publ.
Stachowiak, G., Pertyński, T., & Pertyńska-Marczewska, M. (2015). Metabolic disorders in menopause. Przeglad menopauzalny = Menopause review, 14(1), 59–64.
Thompson, R. High animal protein intake linked to long-term weight gain. Nat Rev Gastroenterol Hepatol 8, 66 (2011). https://doi.org/10.1038/nrgastro.2010.231
Yari. Z., Rabiei, S., Nikooyeh, B. and Neyestani, T. (2026). Dietary Proteins and Systemic Inflammation. In Preedy (Ed.), Chapter 4, Protein Intake in Health and Disease. London, UK: CRC Press, Taylor & Francis Group.
