Weight Gain in the Peri-Menopausal and Menopausal Years

So many changes! My oldest daughter heading off to college soon, our exchange student returning to Italy and yikes, weight changes too! Menopause usually occurs between the ages of 45 and 55. And here I am in the middle of that age range. I’m sure many of you can relate, keeping my weight in check has been tricky!!!

Many of the changes related to weight control during the menopausal years are rooted in circulating levels of estrogen.(1)

Estrogen has several actions including:

1. Keeping the metabolism working well
2. Insulin sensitivity
3. Adipose tissue health and normal blood lipids

Estrogen Deficiency can result in:

1. Increases in the amount of abdominal fat known as visceral fat
2. Inflammation and fatty liver
3. Impaired adipocyte health and inflammation of adipose tissue
4. Impaired glucose tolerance

The changes in estrogen is exacerbated by the changes in progesterone and testosterone leading to

1. Greater insulin resistance
2. Decreases in muscle mass
3. Impairment of leptin (the satiety hormone) signaling

When the cells become resistant to insulin, the pancreas is triggered to release more insulin which increases our capacity to store fat. All of these changes lead to increase risk for metabolic syndrome and cardiovascular disease in women.

Likewise, a set group of microbes called the estrobolome are needed to maintain a good balance of estrogen metabolites.(2) Dysbiosis of the microbiome can lead to disruption of estrogen balance which can prompt fat-burning pathways to be turned off.

At the core of battling this mid-life weight gain is maintaining a healthy microbiome:

1. Aim for a more whole-food, plant-centered diet foods in your diet and less processed, refined, and highs-sugar foods. Higher levels of the anti-inflammatory short-chained fatty acids that promote a healthy microbiome and protect against leaky gut were found in vegans, vegetarians and individuals who follow a Mediterranean diet (3)

2. Minimize exposure to environmental toxins. Chose organic food whenever possible. Avoid or reduce exposure to glyphosate (the chemical in Round-up and other lawn treatments). These chemicals have been shown to disrupt and kill the beneficial bacteria in our gut. They are also known to be obesogenic endocrine hormone-disruptors. (4) Visit the Environmental Working Group at www.ewg.org for more information.
3. Use antibiotics only when absolutely, medically necessary. Antibiotics not only kill bad bacteria, they kill beneficial bacteria in the gut leading to low species diversity in our microbiome.
4. Exercise daily. Exercise promotes the growth of a diverse and varied microbiota which improves health and decreases your risk for disease.
5. Avoid simple sugar and refined carbohydrates. These foods fuel the bad bacteria in your gut and are pro-inflammatory which increases your risk for developing a leaky gut.
6. Eat fermented and other probiotic rich and prebiotic rich foods. Probiotic foods include fermented vegetables, kombucha, sauerkraut, tempeh, yogurt (unsweetened). Prebiotic foods are foods high in fiber that feed the good bugs (probiotics). These include asparagus, bananas, garlic, legumes, and peas. Also, consider adding a medical or professional-grade probiotic supplement.
7. Limit or avoid foods that you are sensitive or reactive to. Food intolerances or sensitivities promote inflammation in the gut and disrupt the microbiome. If you are unsure of what foods may be causing trouble for you, talk to your dietitian or doctor about doing an elimination diet. Common culprits include gluten, soy, corn, dairy, eggs, fish, peanuts, and tree nuts.
8. Drink plenty of water. Adequate hydration is critical for maintaining a healthy and balanced microbiome.

In addition to caring for the health of the microbiome, it is important to consider meal balance. With the insulin-resistance that accompanies menopause, we become less able to metabolize carbohydrates.(5) Because of this, it is helpful to limit carbohydrate intake to about 30 grams at a time. Here are some guidelines:

1. Chose mainly whole-food carbohydrates with a lower glycemic index: non-starchy vegetables, fresh fruit, legumes, yams, potatoes, brown rice, quinoa
2. Examples of 30 grams of carbohydrates:1 piece of fresh fruit with 1/4^th cup dry steel cut oats; 2/3 cup brown rice;  1 medium or sweet potato; 2 cups green leafy vegetables with 1/3 cup garbanzo beans
3. Be sure to round out the carbohydrates at meals with protein (organic lean meats, organic free-range eggs, nut butters…) and healthy fats (see below)
4. Limit more refined carbohydrates such as: sweets of any kind, pasta, white rice, juices, breads and cereals.
5. Do not use artificial sweeteners. Even more natural concentrated low or no calorie sweeteners like stevia can not only disrupt the microbiome, they can increase insulin resistance as well.
6. Increase your intake of healthy fat to help promote satiety: avocados, extra-virgin olive oil, nuts, seeds, natural nut and seed butters, olives, coconut oil

Additional consideration:

Smart Supplementation. Here are some nutrients worth considering during the menopausal years.

1. Drink green tea daily or take a green tea supplement. Green tea contains a potent antioxidant call epigallocatechin gallate (EGCG) that boosts metabolism. (6)
2. Coenzyme Q10 (ubiquinol). It is needed for the production of energy.
3. Omega 3 fatty acids. For general anti-inflammatory properties but it has been shown to increase insulin sensitivity. Ground flaxseeds as well as a high-quality fish oil supplement would work.(7)
4. Vitamin D. This is a hormone! It has many functions including estrogen and insulin regulation. Get your vitamin D levels checked. Most labs use a reference range that is too low and are appropriate only if you are trying to prevent rickets. Studies show that vitamin D should be between 45-60ng/dl for optimal health.(8)
5. Curcumin. It is a phytoestrogen and a powerful anti-inflammatory. Not all supplements are created equal. Curcumin needs to be paired with black pepper to make it bioavailable. Check with your functional dietitian for a preferred formula.
6. Magnesium glycinate. Many adults are deficient in magnesium. I take 200-400mg of magnesium before bed to promote a calm and restful night sleep. Sleep is critical for hormone regulation, detoxification and weight control.
7. N-acetyl Cysteine. A precursor for your body’s most powerful antioxidant(glutathione). It is needed for liver health which is very important as the changes in estrogen levels increase risk for fatty liver.

Exercise and Stress management.

1. We cannot maintain a healthy weight without either of these.
2. Strive to burn a minimum of 400 calories via physical activity each day. Incorporate some form of strength or resistance training 2-3 times per week to help offset the drop in lean body mass that comes with lower circulating estrogen.
3. Exercise is a great way to promote stress management. Stress hormones such as adrenaline and cortisol further exacerbate menopausal associated belly weight gain and negatively impact memory.

With all the changes headed my way, I’m choosing to be gentle with myself and seeking help where I need it. Controlling menopausal weight gain can seem daunting. Contact me if you would like some help with meal balance, exercise and stress management options to help promote a healthy body weight.