Is Fasting Right For Me? How to Choose the Right Kind of Fast in Midlife

Is Fasting Right For Me? How to Choose the Right Kind of Fast in Midlife

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This article was first published on

The Midst – The gateway drug for the modern

midlife experience.

From Time Restricted Feeding to the 5:2 Diet, fasting is big news right now.

Fans of fasting say it aids weight loss, supports cognitive function, and boosts energy levels — but is it safe and effective when we’re juggling hormones, menopause, careers, family life, and other major midlife shifts?

Let’s explore the potential benefits and pitfalls of different types of fasting and answer the burning question – is fasting right for me?


What is fasting?

Fasting is simply the practice of not eating food (and occasionally no drinks either) for a set amount of time. Fasts have been practiced in cultures all over the world for thousands of years for religious, ethical, and health reasons. The famous Greek physician Hippocrates recommended therapeutic fasting as far back as the 5th century BCE, and many medical systems rooted in traditional wisdom still incorporate fasting as part of treatment plans today.


What are the pros and cons of fasting?

Good cellular housekeeping

Modern-day science has been catching up with traditional wisdom around fasting to investigate exactly what happens in the body when we abstain from food for long periods.

One of the key discoveries is the way fasting acts like a switch for a process called autophagy – a form of cellular housekeeping. When switched on, autophagy allows cells to clear out misshapen proteins, deal with damaged bits of DNA, and remove harmful toxins. In this way, autophagy helps keep our cells functioning efficiently and may be associated with healthful aging.

Fat-burning and Weight Loss

Fasting for more than 12 hours pushes your body to start using substances called ketones for fuel, rather than glucose. Ketones are produced when fats are broken down. A study of obese women following a 16:8 fasting protocol (a 16-hour fast followed by an 8-hour eating window) for 3 months showed this was effective for reducing weight, Body Mass Index, waist circumference, and cardiovascular risk, even when food intake was not closely monitored.

Better blood sugar balance and insulin sensitivity

Hormone changes during perimenopause and menopause can affect how well our cells respond to insulin, the hormone that carries sugars out of the bloodstream into cells. If we become insulin resistant, we end up with higher amounts of glucose in our blood which then gets stored as fat.

Fasting for 14 hours overnight and eating within a 10-hour eating window is effective at improving insulin sensitivity and blood glucose levels within 12 weeks.

Reducing inflammation

Chronic inflammation is a major factor in nearly all chronic health conditions including arthritis, obesity, auto-immune conditions, and heart disease. Inflammation levels in the body are measured by tracking levels of certain biomarkers like C-reactive protein (CRP). A meta-analysis of human studies investigating the effects of fasting found that fasting can significantly lower CRP levels, particularly in overweight and obese individuals.

Boost brain health

There isn’t a huge amount of research in this area done on humans, but animal studies show promising effects of fasting for cognitive function and possible prevention of neurodegenerative diseases like Alzheimer’s.


Possible side effects of fasting

Fasting certainly isn’t suitable for everyone, and we each have our capacity for managing fasts based on our health and what kind of lifestyle we live.

If we are under a lot of stress then fasting can make this worse as it adds additional physical stress. Equally, if we are handling stress well and don’t have any underlying health conditions, fasting can be a useful tool to use for weight balance, brain health, and healthy aging.

If you are new to fasting, start slowly and build up gradually – don’t jump straight in with a 14-hour fast! And if you start to experience unpleasant side effects, ease back on the length and frequency of your fasts.

Possible side effects of fasting include:

  • Hunger – this is the obvious one!
  • Feeling dizzy or light-headed
  • Bloating
  • Constipation
  • Fatigue and low energy
  • Irritability and low mood
  • Dehydration
  • Insomnia
  • Bad breath

The risk of side effects can be minimized by staying hydrated with water and herbal teas and resting as much as possible during your fast.


5 Types of Fasting and How to Choose The Right One!

There are lots of different ways to approach fasting, depending on how often you want to do it and what kind of lifestyle you have. The benefits of fasting will be even greater if you can make healthful food choices on non-fast days, and always be mindful of how you are feeling day-to-day. If your menstrual cycle is giving you cramps and low energy, don’t fast that day. If menopausal insomnia is driving you nuts, don’t do anything longer than a 12-hour overnight fast. Always adapt the fasts to suit you and not the other way around.

Here’s our easy guide to different types of fasting.


Time Restricted Eating / Time Restricted Feeding

What is it? This is the most common type of fasting and involves eating regular meals within a specific time window. Versions include:

12:12 – fast overnight for 12 hours then eat meals within a 12-hour window.

14:10 – fast for 14 hours, eat meals within a 10-hour window.

16:8 – fast for 16 hours, eat meals within an 8-hour window.

Who is it good for? If you’re new to fasting a 12:12 fast is the easiest one to start with and can gradually be adapted to suit the longer fasting times. Because you are asleep for the majority of the fast and eating normal meals in the eating window, this type of fast is good for people who want all the benefits of fasting with simple, no-fuss fasting protocols.


Circadian Fasting

What is it? Circadian fasting involves aligning your meals with your natural 24-hour internal body clock. Typically, this means eating larger meals earlier in the day, and fasting during the evening and overnight when digestion is less active.

Who is it good for? People who are in tune with their daily rhythms and can adapt meals to suit the fast.


Alternate Day Fasting

What is it? Rather than fasting every day for a set amount of time, Alternate Day Fasting involves alternating between eating normally for one day and then reducing food intake to around 500 calories or abstaining from food completely on the next.

Who is it good for? People who have the discipline to stick to the protocol! It can be harder to fit in with social occasions or a busy work diary than Time-Restricted Feeding and may be too extreme for people who have busy and demanding lifestyles.


The 5:2 Diet

What is it? The 5:2 diet allows you to eat normally for 5 days a week and then fast or have a small meal of around 500 calories on 2 other days.

Who is it good for? People who want more flexibility than the Alternate Day Fasting.


Who shouldn’t fast?

Most healthy adults can safely practice a simple 12-hour overnight fast without any difficulties so long as they are eating normally during the day. However, longer fasts and intermittent fasts are not recommended for:

  • Diabetics and those at risk of hypoglycemia
  • Children and teenagers
  • Frail older adults
  • People recovering from illness or exhaustion
  • People with thyroid conditions, chronic kidney disease, heart disease, chronic fatigue syndrome, or immunodeficiency
  • During pregnancy and breastfeeding
  • Anyone with or at risk of an eating disorder or binge eating
  • Those who are underweight or at risk of becoming underweight
  • People taking medications that require consistent and regular food intake

Managed carefully, fasting can be safe and effective but if you have any doubts about whether fasting is suitable for you, speak to your healthcare provider about it first.


How Do I Know if I’m Perimenopausal?

How Do I Know if I’m Perimenopausal?

Picture of a group of women talking about whether they are perimenopausal or not. This is the header image for the article on The Midst entitled How Do I Know if I'm Perimenopausal?

This article was first published on

The Midst – The gateway drug for the modern

midlife experience.

How Do I Know If I’m Perimenopausal?

Most of us grow up aware that menopause will happen at some point in midlife, but how many of us know about perimenopause and when that begins? With so many different symptoms and no clear timeline to follow, a lot of women are asking the question: How do I know if I’m perimenopausal?


What is perimenopause?

There are 3 main stages to the natural menopause journey: perimenopause, menopause, and post-menopause. Perimenopause covers the months and years leading up to menopause when your hormones are fluctuating and causing all kinds of physical and mental symptoms.

On average, women move into perimenopause in their late 30s / early-mid 40s.  However, with premature menopause and Primary Ovarian Insufficiency fertility levels decline, and the menstrual cycle stops before the age of 40.

There are ethnic differences in how women experience perimenopause and menopause. Research shows that Black, Latina, and Asian women may begin perimenopause earlier than white women and may have a longer transition phase.

Periods continue during perimenopause, although it might not be a regular cycle and it may be longer, shorter, lighter, or heavier than before. And if your menopause journey is surgically or medically induced, you may not experience the perimenopause phase at all – you may jump straight to menopause.

Menopause is that point in time when your periods have stopped. The average age for women to reach menopause in the US is 51, though women of color often experience it earlier than this.

Menopause means ‘end of periods’ and is defined as that day on the calendar when you haven’t had a period for 12 months (or 2 years if you’re under 40). At this point you can say you’ve done it; you’ve gone through menopause!

The post-menopause phase is everything after this point – i.e., the rest of your life after your menstrual cycle has stopped. You may find a few symptoms lingering on, but these should settle down as your body adjusts to producing much lower levels of sex hormones.


What are the symptoms of perimenopause?

According to the Menopause Invisibility report by Gen-M, there are at least 48 different symptoms associated with perimenopause and menopause. There are the common ones that you’ve probably heard about, like hot flashes, anxiety, night sweats, weight gain, and brain fog, but there are plenty that are less well-known, including:

  • Altered sense of smell and taste
  • Acid reflux and bloating
  • Vulvovaginal dryness and pain
  • Itchy ears
  • Burning mouth and tongue
  • Dizziness
  • Cold flushes
  • Thinning hair
  • Pins and needles in your hands, feet, arms, or legs
  • Insomnia
  • Palpitations

If you’re in your late 30s or early-mid 40s and you’re starting to notice some of these symptoms – whether your periods are changing or not – you could be in perimenopause.

The reason for such a crazy range of symptoms is because estrogen and progesterone act in lots of areas of the body. From bones and nerves to the heart and digestive tract, our sex hormones do way more than just run the menstrual cycle.

Take the brain for example. A lot of women notice increasing anxiety and difficulty sleeping in their late 30s / early 40s. Their monthly cycle is the same and menopause may be ten or twenty years away yet, so they don’t make the link between these symptoms and their hormones.

But the brain is one of the first places to be affected by changing estrogen and progesterone levels. Progesterone has a calming effect on the nervous system and estrogen influences our sleep/wake cycle. So, when these hormones start to fluctuate during perimenopause, we can experience difficulty sleeping, mood swings, and frequent anxiety.


Can perimenopause symptoms be something else?

There is a crossover between some perimenopause symptoms and other health conditions. It’s always worth speaking to your healthcare provider if you are concerned about what’s going on, especially if you have a family history of health issues.

Health conditions to consider include:

  • Thyroid function can be affected by perimenopause and may cause similar symptoms. Weight gain, constipation, low energy, and brain fog are all signs of low thyroid function (underactive thyroid) while anxiety, racing thoughts, weight loss, diarrhea, and palpitations are classic signs of overactive thyroid.


  • Pregnancy! It may be the last thing on your mind at this point in life, but until you’ve reached menopause there is still a chance you can fall pregnant.


  • Over-exercising: a high-intensity training regime can cause periods to stop.


  • Sleep apnoea: night time waking can be due to hormone changes but can also be caused by sleep apnoea, a serious sleep condition. Left unchecked, sleep apnea can increase the risk of Type II Diabetes, heart disease, and high blood pressure.


  • Depression: mood swings and low mood are common during perimenopause but if symptoms persist or get worse, speak to your healthcare provider about support.


  • Arthritis: joint pains are common in midlife, but persistent pain and swelling may be a sign of osteoarthritis or rheumatoid arthritis.


  • Cancers: persistent fatigue, night sweats, and itchy skin can be signs of lymphoma, a type of cancer.


How can I manage perimenopause symptoms?

Diet and lifestyle changes are a great place to start. Food and drink, movement, relaxation, and sleep all provide the foundations for a healthy well-being and can go a long way toward easing perimenopause symptoms.

And, if you then decide to try Hormone Replacement Therapy (HRT) or herbal alternatives for hormone balance, your body will be in a better place to respond to them.

Try these five top tips for managing perimenopause symptoms:

  1. Minimise caffeine: this can be hard to stomach when you rely on a coffee fix, but caffeine is a major trigger for symptoms of anxiety, gastrointestinal problems, insomnia, and fatigue. Tolerance to caffeine can change over time and you may not be able to handle it as well as you used to. Try gradually replacing coffee, tea, and caffeinated sports drinks with water and herbal alternatives and see what a difference it makes.


  1. Nourish your gut: there’s a group of microbes in the gut called the estrobolome that processes deactivated estrogen. When the estrobolome is out of kilter, it produces too much of an enzyme that reactivates estrogen, sending it back into circulation. More estrogen might sound like a good thing but it’s not, and this recycled estrogen can worsen hormone imbalances. To keep your estrobolome in check, include fermented foods like sauerkraut, kimchi, natural yogurt, and kefir, and eat fiber-rich fruits, vegetables, and whole grains.


  1. Eat a rainbow of fruits and vegetables every day: the colorful compounds in fruits and vegetables help manage inflammation and hormone balance. Aim to include as many different colors as you can in each meal.


  1. Include plenty of good quality protein in every meal and snack: We start to lose more muscle mass after menopause, and this affects metabolism and bone health. Make space for at least ¼ plateful of protein-rich foods with each meal. Eggs, good-quality meat, fish, shellfish, beans, pulses, nuts, and seeds are all good sources. Collagen powder can help top up protein levels – vegetarians and vegans can use pea, hemp, or soy protein.


  1. Include phytoestrogen foods each day: chickpeas, tofu, tempeh, miso, alfalfa sprouts, and ground flaxseeds are all rich in plant-based estrogen compounds called phytoestrogens. These compounds help balance out fluctuating estrogen levels during perimenopause and can ease troublesome symptoms.


Perimenopause is a unique journey for each of us, and symptoms can change as we get nearer to menopause. Making diet and lifestyle changes is a good place to start, alongside finding a supportive healthcare practitioner to discuss any concerns.

Natural Nutrition for Perimenopause - What to eat to feel good and stay sane book cover by Sally Duffin Perimenopause Nutritionist

Discover even more nutrition and lifestyle tips for managing perimenopause and menopause in “Natural Nutrition for Perimenopause – What to eat to feel good and stay sane”.

Available on Amazon or direct from YPD Books, this friendly guidebook covers everything from what perimenopause is and how to spot the signs of change to essential nutrients, supplements, toxins, and lifestyle support.

“Reading this book has helped me understand how my diet and lifestyle can support my body through perimenopause.  And it’s written beautifully too.”   Amazon Reviewer

bones, skin, an

Perimenopause Support – A round up of the best articles

Perimenopause Support – A round up of the best articles

Concerned about perimenopause brain fog?

Anxiety levels rising?

Or maybe you’re experiencing uncomfortable vulvo-vaginal symptoms and need some self-care guidance.

I’ve got you covered.

Here’s a round-up of my most recent perimenopause support articles from around the web.  

Each one is packed with insights and top nutrition and lifestyle tips to help you manage your menopause, your way.

Perimenopausal Brain Fog: A Nutritionist’s Guide to Thinking Clearly

For many women, cognitive changes like brain fog and memory loss are some of the earliest signs of perimenopause. They creep in along with emotional changes like anxiety and mood swings, long before periods begin to stop. As a nutritionist, I’ve heard from women who fear they are losing their minds and are worried about early onset dementia, when in fact these shifts are all part of the menopausal transition…

Blog post: How can collagen help ease menopause symptoms?

Can Menopause Affect Mental Health?

Most people are aware of common menopause symptoms like hot flushes, mood swings, and insomnia. Less well known, however, are the effects menopause can have on mental health.

According to research by Nuffield Health, large numbers of women are struggling to cope with their mental health during menopause and perimenopause among their residing symptoms. Of the women surveyed experiencing symptoms:
– 47% feel depressed
– 37% are experiencing anxiety
– 18% have needed to take time off work because of their menopausal symptoms

How Eating Plant Foods Can Help Ease Symptoms of Perimenopause

During perimenopause, the hormones estrogen and progesterone begin to fluctuate, affecting every part of the body from bones, skin, and hair, to your muscle composition, your cholesterol levels, and even how your brain functions.  Many women turn to hormone replacement therapy (HRT) to gain relief, but HRT isn’t for everyone and ultimately it just delays the inevitable onset of menopause. Making diet and lifestyle changes, on the other hand, is something anyone can do, and there are several key plant foods that have been proven to help ease perimenopause symptoms.

eating plant foods can help ease perimenopause symptoms
menopausal vaginal health

The Menopausal Vagina: Everything You Wanted to Know But Were Afraid to Ask

Vaginal pain and dryness have to be the least talked about symptoms of perimenopause and menopause, yet an estimated 50-60% of women are affected. A lot of women don’t know how to talk about these symptoms because of upbringings that shroud anything to do with vaginas in an aura of shame and stigma. By the time menopause comes along, women can feel too embarrassed to seek help and suffer in silence.

We’re here to change that attitude. Let’s explore what happens to menopausal vulvas and vaginas (yes, there’s a difference!) and what steps you can take to get relief from painful discomfort…

Managing Midlife Anxiety

Most women are familiar with feelings of anxiety. Whether it’s a few pre-menstrual jitters, anxiety about work, or worrying about your child on their first day at school or college, we know what it’s like to experience that sense of panicky dread and uncertainty. But during midlife, a new kind of anxiety emerges. One with no particular rhyme or reason but enough power to make you think you’re losing your mind.

Katherine Tyack-Grant, from Yorkshire, UK, was in her early forties when she started to experience overwhelming anxiety…

Managing midlife anxiety
How Collagen Can Support Bone Health

How Pura Collagen Can Support Bone Health

Oestrogen plays a key role in bone health.  Once oestrogen levels drop post-menopause, the risk of bone fracture increases significantly. According to statistics from the Royal Osteoporosis Society, 1 in 2 women over the age of 50 will develop osteoporosis, with as many dying from fracture-related causes as from lung cancer.

Oestrogen influences bone health by regulating the activity of osteoblasts and osteoclasts. When oestrogen levels decline after the menopause, osteoclast cells start resorbing bone faster than osteoblasts can build it.  This leads to weak bones that are more prone to fracture.

Stress in the Menopause and How to Manage It

The way stress affects us can change during menopause. On top of the usual everyday demands of family, life, and work, our fluctuating hormones risk leaving us more exhausted and frazzled than ever. We may not be able to completely escape stress in the menopause, but there are tips and techniques we can use to manage it…

Stress in the menopause and how to manage it
Natural Nutrition for Perimenopause - What to eat to feel good and stay sane book cover by Sally Duffin Perimenopause Nutritionist

Enjoyed these articles?

You can discover even more nutrition and lifestyle tips for managing perimenopause and menopause in “Natural Nutrition for Perimenopause – What to eat to feel good and stay sane”.

Available on Amazon or direct from YPD Books, this friendly guidebook covers everything from what perimenopause is and how to spot the signs of change to essential nutrients, supplements, toxins, and lifestyle support.

“Reading this book has helped me understand how my diet and lifestyle can support my body through perimenopause.  And it’s written beautifully too.”   Amazon Reviewer

bones, skin, an

5 Clever Tips to Help Your Good Food Habits Grow!

5 Clever Tips to Help Your Good Food Habits Grow!

Starting a Nutrition Plan, giving up caffeine or sugar, or even just quitting chocolate for Lent requires changing your habits around food. 

You have to think about meals in advance and be prepared to say no to foods you previously relied upon.


It can take up to 6 weeks for new habits to become firmly established in your life so it’s useful to have a few tricks up your sleeve to help those habits get a hold.

Get organised

As school teachers like to remind us, “failure to prepare is preparing to fail!” Plan your meals for the week ahead and only buy in what you need to make them. 

Keep healthy snack options like nuts, seeds and dried fruit in your car and desk drawer, carry a re-usable water bottle and keep a couple of herbal teabags with you ready for any unplanned brews.

Only change 1 thing at a time

It’s tempting to try and completely overhaul your meals because you want to feel better – now!  But this can lead to confusion and overwhelm.  Choose 1 thing (what you have for breakfast or what you drink each day) and stick with it for 7 days.  Then add something else to the mix.  This gives you chance to get used to each small change and helps them develop into regular habits.


Deal with Food Pushers

There is always someone saying “go on, just have a couple of biscuits, it won’t kill you!” and they’re right, it probably won’t. 

But it will derail all your good work and keep you trapped in the unhelpful old habits. 

So how to respond to these people?

Simply say: “no thank you, if I eat that I won’t feel well”.  Food pushers are often envious of your willpower and motivation and secretly wish they had the drive to make powerful positive changes to their wellbeing too.

Go off menu

Don’t be afraid to order off menu when eating out.  If you want to have grilled chicken, steamed vegetables and a baked potato but that exact combination is not on the menu, but chicken, side orders of veg and jacket potatoes are, ask if they can put it together for you.  If a dish comes with a creamy sauce and you’re dairy free, ask for no sauce.  Most restaurants are more than happy to help with reasonable requests like this.

Open sandwiches with colourful vegetables for good food habits.

Failsafe Meals

Keep a supply of frozen homemade soups, frozen vegetables and storecupboard staples like eggs, pesto, pasta, lentils, and tinned fish for when you’re too tired to cook anything complicated. 

You can soon put together a mackerel & pasta salad, soup and oatcakes or vegetable omelette to keep your energy levels up.

With a bit of forward planning and preparation you can help your new good food habits settle in and become part of your daily routine. And don’t worry if you have a bad day – this happens to us all, and it doesn’t mean your habits are broken completely. Just start again the next day. Positive change comes from repeated practise, so keep on keeping on and your habits will flourish.

Need more help? 

Click the link below to find out more about my 1-1 support plans tailored to your specific nutrition needs.

Perimenopause – Your Questions Answered

Perimenopause – Your Questions Answered


Perimenopause is a different experience for each of us, yet there are several common themes and questions.

Fortunately, nutrition and lifestyle medicine can be a big help at this time of transition.

From hot flushes and anxiety to low mood and vaginal dryness, making changes to what we eat and how we live can make a powerful difference during perimenopause.

This blog answers some common perimenopause questions, and you can find out more in my new book ‘Natural Nutrition for Perimenopause – What to eat to feel good and stay sane’ available from Amazon, YPD Books, Waterstones online, and Tullivers in York.


Natural Nutrition for Perimenopause - What to eat to feel good and stay sane book cover by Sally Duffin Perimenopause Nutritionist

Heavy Periods

Q. My periods are getting heavier and I’m starting to experience a lot more irritability and anxiety. I’ve just turned 41 – could this be perimenopause?

A. Yes. Some of the first signs of perimenopause are changes to moods, period frequency, and/or period flow. These can start happening in your mid to late 30s. However, many women don’t notice this if they’re taking the Pill or using hormonal implants.
Fluctuating oestrogen levels affect our brain just as much as the ovaries and womb lining. There are oestrogen receptors throughout the brain, and each area responds differently to changes in oestrogen levels. For example, if the amygdala doesn’t receive enough oestrogen we can feel more anxious and fearful. If the hypothalamus (our central temperature regulator) is affected we can experience hot flushes.

Try keeping track of your symptoms to see if they fit into any kind of monthly pattern. To help manage the anxiety. follow the tips below in the Q&A for Anxiety & Low Mood.

Heavy periods can increase your iron loss, so be mindful of regularly including iron-rich foods throughout your cycle:

– Haem iron (animal source) is the most bioavailable form for us to absorb and use, and is found in red meat, poultry, fish, and eggs.
– Non-haem iron is found in animal foods too, and also in vegetables – especially dark green leafy veg; pulses, dried fruits, nuts, wholegrains, and Blackstrap molasses. Combine vitamin C rich foods with non-haem iron sources to aid absorption.

Q. My periods are incredibly painful and heavy and I don’t want to take the Pill or have a coil fitted. Do I have to put up with this until after menopause?

A. Symptoms like this can be a sign of fibroids or endometriosis. Both conditions are influenced by oestrogen and hormone fluctuations. During the early stages of perimenopause we can be in a temporary state of oestrogen dominance. Because we stop ovulating every month, there’s very little progesterone produced to counter-balance oestrogen. Unfortunately it can take months, even years, for fibroids or endometriosis to be diagnosed as many doctors fail to recognise how serious the symptoms are. Ask for a referral to a gynaecologist who will be able to offer the right support and testing. It will also be helpful to get your iron levels checked to make sure the heavy periods aren’t depleting your iron stores.

Hot flushes

Q. Hot flushes are keeping me awake every night. I’m feeling exhausted all day, and having difficulty concentrating at work. What can I do?

A. Hot flushes are one of the most distressing perimenopausal symptoms. I can’t promise these tips will get rid of them completely but they can certainly reduce the severity and frequency:

– Minimise caffeine as much as possible. Avoid it altogether if you can! This means tea, coffee, energy drinks, and chocolate. And decaff versions too – sensitive people can react to the trace amounts of caffeine left in decaffeinated drinks.

– Keep your blood sugar levels balanced by eating within 2 hours of waking, replacing refined carbohydrates (white bread, white pasta, cakes, sweets, biscuits etc) with smaller portions of wholegrain versions, and only snacking if there’s a gap of more than 5hrs between meals.

– Try drinking sage tea or taking sage tablets or tincture. The A.Vogel ‘Menosan’ tablets and tincture are a licensed herbal remedy for managing hot flushes and sweats and can help with temperature regulation.

– Relax! Stress is a big trigger for hot flushes. We can’t always make stress go away but we can change how we respond to it. We can do this by building daily downtime into our schedules. This might mean going for a mindful walk, listening to music, following a guided meditation, doing crafts or creative writing, or simply soaking in a bath with essential oils. Mindful relaxation (as opposed to flopping in front of Netflix) is a great way to build our resilience to stress.

Anxiety & low mood

Q. Since starting perimenopause my moods have been really low. I feel anxious and depressed a lot of the time. I’m also really tired. Is this normal?

A. Mood swings and anxiety can be symptoms of perimenopause, but they can also be linked to other conditions. Have you had your thyroid checked? Depression and fatigue can be signs of an underactive thyroid. Many women start to experience thyroid issues around the time of menopause so it’s worth getting your thyroid hormome levels checked with your GP. Ask them to check your levels of TSH (thyroid stimulating hormone), T4 and T3 (thyroid hormones) and thyroid antibodies. The thyroid antibodies are important because an underactive thyroid may be due to auto-immunity.

If your thyroid is OK, look at ways to manage the anxiety and depression and low energy:

– Follow the blood sugar balancing tips (see previous Q&A) as poor blood sugar balance can worsen mood swings.

– Include at least 3 servings each day of foods rich in magnesium and B-vitamins such as avocado, sweet potato, nuts, seeds, dark green leafy vegetables, poultry, and eggs. These nutrients are vital for mood balance and energy levels.

– Make sure you’re getting enough sleep. Our brains need 7-9hrs each night, with at least 1 hr of that before midnight. Aim to be in bed by 10.30pm-11pm to give yourself the opportunity for a good rest.

– Include mindful relaxation time each day. Yoga, journalling, mediation, spending time outdoors in natural surroundings, and crafts are all known to be beneficial for managing depression and anxiety.

– Swap regular tea and coffee for herbal teas that soothe and support the nervous system. Lemon balm, chamomile, oat straw, valerian, and lavendar are good options.


Q. I’ve been told to eat phytoestrogens. What are they and where can I find them?

A. Phytoestrogens (phyto = plant) are naturally occurring substances found in fruits, vegetables, and grains. They have a similar effect to human oestrogen, but are hundreds and hundreds of times weaker. They’re not a hormone replacement therapy by any means.  Instead, they have a modulating effect on our fluctuating oestrogen levels and may help reduce hot flushes and offer protection to our bones.

There are 3 types of phytoestrogens. The top food sources include:

  • Isoflavones found mainly in soybeans (edamame) and fermented soy products like tofu and miso. You can also find them in chickpeas, aduki beans, kidney beans, and red clover. Red clover seeds can be sprouted – try sprouting them alongside mung beans and alfalfa seeds.
  • Lignans flax seed is by far the richest source, followed by sesame seeds, broccoli, and cashew nuts.
  • Coumestans found in mung bean sprouts and alfalfa sprouts.

Q. Is soy safe to eat? I’ve read so many conflicting things about it!

A. Soy foods certainly are a controversial subject! Unfortunately a lot of the research done on soy uses raw soy extract – not the natural wholefoods recommended for perimenopausal women. The soy foods suggested for perimenopause are the fermented soy products like tofu and miso, and whole cooked soy beans. These foods are part of the traditional diet in Far Eastern countries where women have far fewer menopausal issues. Having said that, no food is entirely suitable for everyone, and some people find soy difficult to digest. If you have any concerns about soy, give yourself peace of mind and enjoy other phytoestrogen foods instead.

Meet the Practitioner – Kerry Taylor, Menopause Coach

Meet the Practitioner – Kerry Taylor, Menopause Coach

Today I’m talking to Kerry Taylor, Menopause Coach.

Kerry works with large organisations and private 1-1 clients to offer support on all aspects of the menopause transition.

Based in a beautiful part of the world – south west France – Kerry has a global reach with her online business.

Kerry Taylor, Menopause Coach

SD Hi Kerry, thank you for joining me today. Can you start by sharing a little about your background and how you came to be a Menopause Coach?

KT Hi Sally, of course. So, I qualified as a nurse originally, 18/19 years ago. Then about 10-12 years ago I worked on a joint project between the NHS and Department for Work and Pensions (DWP) helping people with long term health conditions to get back into work. 

After that project ended, I began to work freelance in workplace health and occupational health with people who had long-term mental health conditions. 

I worked with lots of different organisations and employment sectors and noticed a lot of referrals from women in their 40s and 50s.  These women were suddenly experiencing symptoms like anxiety, depression, loss of concentration, poor memory – to the point where they thought they might have dementia.

None of this was being picked up as menopause, and this really piqued my interest. I thought there’s a lot of this going on and there’s not a lot of support being given. 

What these women needed was a lot of practical advice on how they can manage their symptoms, how they can maintain their attendance at work. So, I did additional training with the British Menopause Society and transitioned into doing menopause coaching.

Two women at work, chatting

Fantastic, it sounds like each stepping stone of your career has led you to this point!  Who do you currently work with?

KT I work with a large organisation on their occupational health, and with women in 1-1 sessions.  I ran a session with a client’s husband recently.  Their relationship was really struggling, and she wanted him to hear from someone else about what’s going on for her and how he can help.  He found it really helpful and has become a lot more understanding and empathetic, even to the point of knowing when to walk away and give her some space!

SD Getting the partner onboard is so important, isn’t it.  Often the husband or partner is struggling because the woman is so overwhelmed and can’t communicate what she needs.  Once they know what’s happening, they feel more able to offer support.

What is the situation like in France regarding public perception of menopause and how it is managed by healthcare professionals?

KT France is slightly lagging behind in terms of accessing up to date research on HRT (hormone replacement therapy). But the main difference is that if you visit a doctor here, they will do a full raft of investigations right away because they recognize that early intervention prevents problems further down the line. 

They are big on complementary therapies and natural remedies here.  If I go to my doctor and say I’m experiencing brain fog and other symptoms and I think it’s menopause she will immediately send me for a mammogram, a smear test, and a gynaecologist referral.  And that will all be done within 2-3 weeks.

But the gynaecologist will first say they are going to prescribe herbal remedies and skin creams and so on before thinking about synthetic medications like HRT.  Which is fine, but in some cases, HRT is the best approach and yet you must go through everything else first to get there.

SD Wow, this is such a contrast to the UK system.  Women here are struggling to get a telephone appointment with a GP and if you do manage to get one, the treatment approach is usually HRT or nothing! Even once you have a HRT prescription, there’s no guarantee the pharmacy will have any!

SD Can you explain a bit about what sort of workplace support is available to women, and how they can access it?

KT Sure.  So, this obviously varies between organisations and what resources they have available, but generally speaking employers are keen to offer support. 

I always start by advising women to look through the company policies on staff wellbeing and read them through the lens of menopause.  For example, it’s easy to think that a policy on stress management doesn’t apply to menopause but stress makes menopausal symptoms worse. 

Once you’ve identified some relevant policies approach your manager and start the conversation about getting help and support. 

The kind of support companies offer varies but it might include:

  • A specific menopause policy
  • Stress management and/or staff wellbeing policy
  • Employee Assistance Programme that might cover counselling, CBT (Cognitive Behavioural Therapy), or seeing a physiotherapist
Woman talking on the phone

Hot flushes are one of the most disturbing symptoms for women.  In terms of specific practical support, women can ask to be seated near a window and have a desk fan if it’s an office situation and have access to cold drinking water facilities.

Uniforms can be problematic for hot flushes.  If the uniform is provided ask about size and fabric options.  Some women find the maternity size most comfortable because of its loose fit and often lighter fabric.  This is really helpful when bloating is a problem too.  If there isn’t a maternity option, ask about having the uniform in 2 different sizes.

Working from home may be an option for some women. This can help with managing symptoms of brain fog and anxiety.  It removes all the distraction and demands of an office.

SD Fantastic advice there, thank you.  Lots of practical tips for women to try.

Finally, if you could share one golden nugget of advice for women experiencing perimenopause and menopause, what would it be?

KT When I see women who are overwhelmed and being hard on themselves about how they are struggling to cope I always say, “what would you say to your best friend if they’d just come to you and told you all this?” 9 times out of 10 they come back with a much kinder response!

It’s so important to be kind to yourself, to recognize the need for help and don’t assume you can power through on your own.  If it all feels like too much, do a brain dump of all your symptoms and worries on paper and then work out the main barriers and challenges.  Break them down into manageable chunks and go from there.

SD Small steps, that’s the best way forward.  Thank you so much Kerry, it has been a joy speaking with you.

Find out more about Kerry’s work and connect with her at:

Instagram @kerrytaylormenopausecoach

Facebook Kerry Taylor Menopause Coach

Kerry Taylor, Menopause Coach
picture of my hand holding a copy of Natural Nutrition for Perimenopause


Order your copy today!


York Publishing Services

Tullivers health store

“Reading this book has helped me understand how my diet (and lifestyle) can support my body through perimenopause. And it’s written beautifully too.” – Amazon reviewer


50 Different Foods

50 Different Foods

Eating 50 different foods each week is a great way to feed your gut microbiota.

The microbiota is the collective name for the millions of bacteria, yeasts, and fungi living in our digestive system.

These bugs work incredibly hard, and are involved in:

– Modulating our immune response

– Influencing immune cell function

– Regulating inflammatory pathways

– Communicating with the brain to regulate mood and mental wellbeing

– Detoxifying hormones and toxins

– Maintaining the lining of the gut wall

– Producing various vitamins

They feed on dietary fibre and utilise phytonutrients (plant-based compounds) like polyphenols to work effectively and keep potentially harmful microbes in check.

Eating a varied and colourful diet that contains lots of different fruits, vegetables, beans, pulses, wholegrains, herbs and spices supports a balanced and well functioning microbiota.

This doesn’t have to be a vegetarian or vegan diet, eating good quality meat, fish, eggs, and dairy is fine alongside a wide range of colourful plant foods.

Variety is the key here – eating the same foods everyday makes for a boring diet for you and your gut bugs!

Find out how many different foods you are currently eating each week by using the 50 Foods tracker chart, created by Nutritionist & Clinical Neuroscientist Miguel Toribio-Mateas.

You are aiming for 50 to give your gut bugs plenty of variety  – how close are you?

Remember, herbs and spices count too, and are a great way to add more diversity and flavour to meals.

Let me know how you get on with this!  I’m on Twitter & Instagram as @nutritioninyork, or you can hop over to the Facebook Group at

P.S. Spoiler alert – it was easier than I thought and I got to 50 within 5 days!

Book Review – ‘Nutrition Brought to Life’ by Kirsten Chick

Book Review – ‘Nutrition Brought to Life’ by Kirsten Chick

Nutrition Brought to Life is the first book from holistic nutritional therapist Kirsten Chick – and it’s fantastic!

Written in Kirsten’s trademark accessible style, the book provides a firm grounding in natural nutrition, and how we can truly nourish ourselves physically, mentally, and emotionally.

Part 1 begins with the digestive system – the foundation of all health and wellbeing.  Kirsten then skillfully guides us through energy production, the highs and lows of sugar, managing our stress response, adrenal support, the gut microbiome, inflammation, immunity, “liver whispering” (brilliant!), hormone balancing, and creating our own personal action plan for health. Part 2 provides 50 different recipes; from soups and main meals, to nourishing smoothies, salads, and warming drinks, all designed to support optimum health and vitality.


Contents list for Nutrition Brought to Life

Each chapter includes a few reflective questions to help readers think about what they’ve just learnt, and how they can start making manageable changes for better health.

This isn’t just a book to flick through and put down; it’s a book that can help you transform how you nourish yourself, on every level, and get back in touch with what your body is telling you.

Kirsten has been working as a nutritional therapist since 2003, and combines private nutrition practice with teaching, writing, public speaking, and whizzing up recipes in her kitchen.  Her areas of expertise include fertility, pregnancy, cancer care, and general nutrition. She’s kindly agreed to let me include an excerpt of the book here so you can get a taster of what to expect…


Chapter 4

Sugar – the highs and lowdown

When life is sweet I don’t seem to crave so much sugar. I may enjoy sweet foods from time to time, but I don’t actively seek it out. When my mood or zest for life drop, when I feel let down, or when I feel like the ground has fallen away beneath me, my thoughts turn to sugar. It’s a pattern I learnt when I was very small, and reinforced with abandon as I grew up. It’s one I now smile at like an old friend I have drifted away from. We sometimes hang out for a brief while, but I spend more time with my other friends these days. They don’t challenge my insulin pathways so much.

Insulin and glucagon – balancing blood sugar

When you eat, your pancreas releases hormones that directly affect your energy pathways and fat levels. Remember that your pancreas sits near your stomach, and most of it is busy producing digestive enzymes to squirt into your small intestine.  A small section of it, however, has a specialist role in balancing blood sugar.

About 2-3% of your pancreas, an exotic resort called the Islets of Langerhans, releases blood sugar regulating hormones called insulin and glucagon, plus a moderating hormone called somatostatin.  These hormones then course through your bloodstream, with instructions for what to do with glucose, the sugar released from your latest meal or snack.

When you have high levels of glucose in your blood:

– insulin can trigger some of it to be sent into your cells to make ATP ‘energy batteries’

– any excess with be converted to a substance called glycogen in your liver, where you can keep a store cupboard of about a day’s supply

– if there’s still more glucose left over, insulin will turn it into fats, which are sent to your fat cells (aka adipose cells) for more long-term storage – this is how sugar can make you fat. 

Nutrition Brought to Life podcast


To carry on reading Nutrition Brought to Life order your copy today from one of the stockists listed on Kirsten’s website, or Amazon.  And listen along to the Nutrition Brought to Life podcast too!

You can find our more about Kirsten’s work at Connect with Nutrition and follow her on Twitter – @kirstenchick1

Oat & Apricot Fingers

Oat & Apricot Fingers

Oat & Apricot Fingers

These oaty bars are unbelievably easy to make and perfect for pack-ups or snacks.

The oats provide fibre and B-vitamins, while the apricots are a valuable source of plant-based iron and beta-carotene.  Nuts and seeds are packed with vitamin E, magnesium, zinc, and fibre; and if you opt for good quality dark chocolate you’ll be getting a bit more magnesium and some antioxidant polyphenols!


Oat and apricot fingers drizzled with chocolate

You will need:

8-10 dried apricots (opt for unsulphured apricots if you have sulphite sensitivities)

50g oats / gluten-free oats

30g of chopped mixed nuts and seeds

50ml water

30g dark or white chocolate

A greased and lined baking sheet

Oven set to 180*c

Here’s how to make them…

Soak the apricots in water for at least 3hrs until soft.  Drain, and puree them in a blender.

Put the oats in a saucepan with the apricot puree, 50ml water, and the chopped mixed nuts and seeds, mix them well and gently heat for a few minutes until the mixture is soft and mushy.

Grease and line a baking sheet.  Press the mixture evenly onto the sheet – it shouldn’t be too thick, about 1-1.5cms is about right.

Bake in the oven at 180*c for around 15mins, or until firmly set.

Remove from the oven and carve into fingers before it cools. One cooled, remove from the tray and set onto a cooling rack.

Melt the chocolate and drizzle it over the oat & apricot fingers.  Allow the chocolate to set (pop the fingers in the fridge to speed this bit up), then store them in an airtight tin.


For more recipe ideas and friendly nutrition chat follow me on Twitter and Facebook or hop over to the Facebook Group at

‘Natural Nutrition for Perimenopause’ is available now!

‘Natural Nutrition for Perimenopause’ is available now!

*Trumpet fanfare* Yes, I’m pleased (and ridiculously excited) to say that ‘Natural Nutrition for Perimenopause: What to eat to feel good and stay sane’ is available to buy now!

Packed with practical nutrition and lifestyle tips, it’s an easy to use guidebook full of suggestions for navigating the ups and downs of perimenopause and menopause

Topics covered include:
 – What is perimenopause?
 – Signs and symptoms
 – How perimenopause affects your brain, heart, and bones
 – Blood sugar balance for energy, weight balance, and managing stress
 – Key nutrients to include and where to find them
 – Phytoestrogens: what are they and where to find them
 – Supplements
 – Movement & exercise
 – Sleep tips
 – Emotional wellbeing
Plus, there’s a whole section on references and resources for further help. It’s a cracking read (I know, I’m biased!).

It’s ideal for women in their mid-late 30s/early 40s and heading into perimenopause; for those in the throes of it, or those coming out the other side.  And, it’s a helpful book for partners and loved ones to read to help them understand what perimenopause and menopause is like.

Here’s a sneek peek at part of the first chapter…

How are you doing?

How are you really doing?

Did you sleep well or wake every hour with hot flushes?

Are you getting anxious and forgetful?

Do your jeans feel tighter and tighter?

You are not alone. This is what happens as we head towards menopause – as we become ‘menopausers’ (new word, hope you like it).

This messy bit (the bit before the actual menopause which is simply the point in time when we haven’t had a period for a year) is known as perimenopause and can feel like an endurance trial of confusing and random symptoms. From hot flushes, palpitations and anxiety, to weight gain and levels of forgetfulness that cause some menopausers to fear they’re developing dementia: perimenopause doesn’t mess around.

One minute we’re being rational humans, making sensible decisions and knowing what’s what. Next minute we’re bathed in sweat, gripped with anxiety, and biting back tears – usually at the most inappropriate moment.

As hormonal rollercoasters go, perimenopause is as transformational as puberty, only this time around we’ve got a heck of a lot more to juggle compared to those heady teenage years of worrying about what to wear on Friday night and whether we’ll get served in the pub.

This guidebook is a response to the experiences of hundreds of amazing perimenopausal and menopausal clients with whom I’ve had the pleasure of working in my nutrition & lifestyle medicine clinic. Many of these clients were already struggling with long-term health conditions (fatigue, fibromyalgia, underactive thyroid, autoimmunity, digestive problems – sometimes all these combined) before finding themselves in the grip of perimenopause and desperate for help.

Their doctors were suggesting HRT (hormone replacement therapy) and/or an attitude of “it’s your age, just get on with it”. Quite how they were meant ot get on with ‘it’ while facing daily, life-altering symptoms is beyond anyones guess, but there we go. I must add that there are many medical professionals recommending more than just replacement hormones for perimenopause support: counselling for example, or CBT (Cognitive Behavioural Therapy) – and an increasing number recognise the value of nutritional changes and herbal medicine too.

The wonderful thing about nutrition and lifestyle medicine is that it’s open to all regardless of whether you’re taking HRT or not. We all need to eat, drink, breathe, move, and sleep every day, which means we have endless opportunities to positively influence our hormones via food and lifestyle choices.

To carry on reading order the book from Amazon or direct from York Publishing Services online store – the e-book version is coming soon.