Are you a woman approaching menopause? If so, there’s no better time to transition to the Mediterranean diet for heart health. According to a new study in Frontiers, it may be the answer to reducing your risk of cardiovascular disease1.
“Since heart disease is still the leading cause of death in women, we can’t ignore this,” says Kim Shapira, registered dietitian, author of This Is What You’re Really Hungry For, and founder of the Kim Shapira Method.
The Details of the Study
The study authors explored the effects of a Mediterranean diet on the lipid levels and body composition of nine menopausal and five perimenopausal women. The study participants ate a diet made up mostly of whole plant-based foods, fish, olive oil, and nuts, and they also avoided processed foods and refined sugars. In addition to these dietary changes, they took two types of supplements: a phytosterol-based supplement containing bergamot, prickly pear extract, and vitamin B1, as well as an omega-3 fatty acid supplement.
The authors observed “significantly improved lipid profiles” often as soon as two months after beginning the protocol. These findings were also accompanied by reductions in total cholesterol and waist circumference, both of which are risk factors for heart disease.
While the study authors note that large-scale, controlled studies are still warranted to confirm the results, it’s a promising outcome. For those looking for non-medical ways of managing the increased risk of cardiovascular disease concurrent with menopause, these findings suggest a change in diet could make all the difference.
“Interventions that stabilize cholesterol, reduce inflammation and support our vascular health are game-changing,” says Shapira. “Food and lifestyle can prevent medicine and disease.”
Why Perimenopausal Women Need to Take Heart Health Seriously
It’s essential to consider heart health at every stage of life — but some stages are even more important than others. According to Dr. Pete Sulack, a nationally respected healthcare provider, recent cancer survivor, and founder of The Be Resilient Program, it’s particularly important in the leadup to menopause.
“Menopause triggers a biological shift that few women are fully prepared for,” he explains. “As estrogen levels fall, the protective buffer against heart disease starts to erode.”
He’s seen firsthand the ways in which women’s bodies change as they approach this biological shift. “Triglycerides increase, insulin sensitivity drops, and systemic inflammation rises,” he says. “What many don’t realize is that cardiovascular disease becomes the #1 cause of death in postmenopausal women, often silently.”
How Menopause Affects Cardiovascular Health
Cardiovascular disease is already the leading cause of death in women overall, but according to a 2020 research review in Circulation (the journal of the American Heart Association), there’s a “notable increase in the risk for this disease after menopause2.”
So what happens during menopause that affects heart health? According to Lena Bakovic, MS, RDN, CNSC at VNutrition, this risk is linked to lowered estrogen levels. “Estrogen carries a cardioprotective effect, minimizing the inflammatory response and lipid profile/atherosclerotic changes,” she says. “Estrogen naturally helps protect our heart and blood vessels. As the estrogen level drops, our protection fades. This is where we see cholesterol levels creep up, blood pressure rise and an increase in our risk for heart disease.”
And according to Courtney Pelitera, MS, RD, CNSC at Live it Up, menopause also leads to a decrease in metabolism and muscle mass. In turn, this can lead to weight gain, insulin resistance, hyperlipidemia, and hypertension. “These all are associated with cardiovascular and heart disease,” she says.
The Benefits of the Mediterranean Diet for Menopause
None of our experts are at all surprised that adopting a Mediterranean diet reduced risk factors for heart disease in menopausal women. “The research simply confirms what functional medicine and ancestral cultures have long known: what we eat either fuels disease or fights it,” says Sulack. “These findings are exciting, but not surprising.”
Shapira agrees. “The Mediterranean diet has won every award for health, brain and longevity benefits for the last 40 years,” she says. “This study is more validation.” Pelitera also notes that given previous research linking the Mediterranean diet to improved blood lipid levels, blood pressure, and even weight control, the observed improvements on body composition and lipid profiles make sense.
“The Mediterranean diet is based on whole, plant foods, omega-3 rich fish, and lean meats,” says Pelitera. “Changes in lipid profile and body composition [are] often seen with an increase in fiber, which the Mediterranean diet promotes (vegetables, whole grains, reducing fried foods, etc.).”
The Mediterranean Diet Could Make a Difference Faster Than You Expect
What struck Dr. Joseph Mercola, Board Certified Family Medicine Physician and author of Your Guide to Cellular Health, was less about the results themselves and more how quickly they were observed.
“Within a few months, cholesterol levels dropped, HDL rose, and waist measurements improved,” he says. “This shows you don’t need to wait years to see results — your body rewards you swiftly when you give it the right nourishment.”
A study published in Scientific Reports also showed this diet could reduce the severity of hot flashes and sexual discomfort linked to menopause3. This makes this new evidence all the more encouraging for women looking to offset the negative side effects of the hormonal change.
Supplementation Is Key
While the Mediterranean diet alone is certainly a great way of improving heart health, the specific supplements tested by the study authors definitely played a part in reducing the risk of cardiovascular disease for women.
“This diet isn’t just about individual foods, it’s about synergy,” says Sulack. “The combination of healthy fats (olive oil, wild fish), phytonutrients (greens, herbs), and fiber (legumes, seeds) creates a metabolic environment that’s hard for disease to thrive in.”
Omega-3 fatty acid supplementation specifically has been recommended by the American Heart Association for years. Recent research also continues to confirm the benefits of fish oil and other omega supplements on the reduction of cardiovascular disease risk factors, including elevated lipid levels4.
Phytosterols, meanwhile, “work in helping to reduce the absorption of LDL cholesterol levels,” explains Bakovic. Combined with the reduced inflammation and lower triglyceride levels encouraged by the omega-3 fatty acid supplementation, it’s the perfect trifecta of a health booster.
“You’re looking at a three-pronged approach,” explains Mercola. “The Mediterranean diet supplies antioxidants and anti-inflammatory compounds from whole foods. Phytosterols from sources like bergamot and prickly pear help block cholesterol absorption, and omega-3 fats reduce triglycerides while supporting mitochondrial membranes. Together, they correct lipid imbalances, lower cardiovascular risk, and counter the estrogen dominance that many women face in midlife. By combining these strategies, you reinforce your metabolic pathways from multiple angles.”
Lifestyle Changes for Heart Disease Prevention
Other lifestyle changes can further decrease your risk of heart disease, such as ensuring you’re getting adequate sleep. A study published this summer in the journal Menopause showed that poor sleep was a top indicator for increased risk of heart disease in menopause5.
To this, Mercola adds reducing exposure to estrogen-mimicking chemicals in plastics and personal care products. “Those sneak into your system and worsen the hormonal imbalance,” he says. “Layer these changes onto a Mediterranean-style template, and you’ll magnify the benefits.”
Sources:
- https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2025.1645102/full
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000000912
- https://www.nature.com/articles/s41598-025-17578-x
- https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00277-7/fulltext
- https://journals.lww.com/menopausejournal/abstract/2025/08000/prospective_associations_of_american_heart.10.aspx
