About the Author
Dr Jennifer Ashton is the founder and President of Ajenda, a multimedia company focused on women’s health, weight management and nutrition. Double board-certified in Obstetrics & Gynaecology and Obesity Medicine, with a Master’s in Nutrition from Columbia University, she is one of the few physicians nationally recognised across these specialties. Formerly Chief Medical Correspondent for ABC News and co-host of GMA3, she became a leading voice during the COVID-19 pandemic. A four-time Emmy Award winner and bestselling author of six books, she currently serves on the national board of the American Heart Association. In 2023, she launched her own national magazine and expanded Ajenda with a weekly newsletter and The Wellness Experiment programme. She lives between Boston, New York and Los Angeles with her husband, Tom Werner, and their dog, Mason.
The 40s: Gut Health and Hormonal Shifts
By the time women enter their 40s, perimenopause is almost always underway, with fluctuating oestrogen and progesterone levels. These hormonal changes can trigger digestive symptoms, from bloating to changes in bowel regularity. Here’s where the gut takes centre stage.
A growing body of research links the gut microbiome to hormonal metabolism. Certain bacterial species influence oestrogen recycling through the estrobolome – a network of microbes that help metabolise oestrogens. Supporting gut health with fibre-rich foods such as beans, lentils, whole grains and vegetables can ease digestive discomfort and may even smooth out some of the hormonal bumps of perimenopause.
The key to minimising mid-section weight gain in the decade after menopause is going into that stage with a solid nutritional and behavioural strategy. Target: 30–35 grams of fibre daily. A helpful metric is the carbohydrate-to-fibre ratio on food labels – ideally under 10:1.
Adding fermented foods like yoghurt, kefir or kimchi can further diversify gut microbes and reduce inflammation.
For the brain, soy deserves attention. Isoflavones – plant-based oestrogens found in soybeans and tofu – may modestly improve cognitive performance and vasomotor symptoms in postmenopausal women. Including soy a few times a week offers both protein and potential cognitive benefits.
The 50s: Protecting the Heart and Brain
In the decade when most women complete the menopause transition, oestrogen’s protective effects on the cardiovascular system and brain decline. Not coincidentally, rates of heart disease and cognitive changes start to rise. Nutrition becomes both prevention and therapy.
For heart health, diets rich in fruits, vegetables, olive oil, nuts, fish and whole grains have consistently been shown to reduce cardiovascular risk. Omega-3 fatty acids from salmon, sardines or walnuts can lower inflammation and support brain function.
And here’s some good news: dark chocolate, at least 70% cacao, is linked to improved endothelial function and lower blood pressure when consumed in moderation.
Dietary stimulation of autophagy through an 850–900 calorie per day, relatively low-protein diet, such as the Chenot Diet, has cellular benefits. The key is the word “occasional”.
The 60s: Guarding Against Sarcopenia and Bone Loss
The 60s bring an emphasis on new priorities: muscle and bone. Ideally, this focus has started decades before. Sarcopenia, or age-related loss of muscle mass, accelerates during this decade, raising the risk of falls, frailty and loss of independence.
Nutrition can slow this trajectory. Protein is essential. I recommend 1.6 g per kilogram of body weight daily, spread across three meals. Pairing protein with resistance exercise is even more effective in preserving lean mass.
Think Greek yoghurt at breakfast, lentil soup at lunch, and grilled salmon or tofu at dinner.
For bones, calcium remains a non-negotiable. Women over 50 should aim for 1,200 mg daily, ideally from food. Dairy, fortified plant milks, leafy greens and almonds all contribute. Soy products offer a double benefit: calcium (if fortified) plus isoflavones, which have been linked to improved bone density in some studies.
The 70s: Longevity and Quality of Life
In the 70s, nutrition’s role is about protecting independence, cognition, strength and vitality. Hydration becomes more critical, as the thirst mechanism diminishes with age. Smaller, nutrient-dense meals often work better than large portions.
Polyphenols – found in berries, tea, olive oil and dark chocolate – support vascular and brain health. At this stage, maintaining muscle and bone continues to be important, but equally vital is preventing malnutrition.
Weight loss in older adults can sometimes signal inadequate protein or micronutrient intake rather than success. Frequent monitoring of calcium, vitamin D and B12 status is prudent.
Nutritional gynaecology is about precision, not perfection. The foods that support our gut in our 40s, our hearts and brains in our 50s, our muscles and bones in our 60s, and our vitality in our 70s aren’t exotic or inaccessible. They are everyday foods – plants, protein, calcium-rich choices, healthy fats and polyphenols – arranged in the right balance.
And woven through all of it? A little soy, a lot of fibre, minimal to no alcohol, and the occasional square of dark chocolate.
“What we put on our plates doesn’t just shape our bodies. It influences our hormones, our brains, our bones, and even how we age.”
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