Statistically as women age, they tend to gain weight. This is caused by multiple factors, not just menopause. Life is busier and more stressful. Overall activity levels decline, and muscle mass can begin to decrease. However, the hormonal changes of menopause and perimenopause, with their tendency to make us gain weight around our midsection, do not help either.
There is no “ideal” body weight. Your goal is to be the healthiest version of yourself as you age. You want to be strong and not frail. You want to avoid osteoporosis, hypertension, diabetes and heart disease. Yes, we all want to look and feel good, but lets focus on our health and not a number on a scale.
Some patients are truly in a unhealthy place. If your BMI is greater than 30 and you have medical conditions affected by your weight, then there is no time like present to accept that you need to find a way to embrace healthy lifestyle changes. The choices you make today will greatly affect your quality of like in the coming decades.
For other patients the extra 10 pounds of perimenopause may be more of a vanity issue. If you have a healthy BMI and no medical concerns, then you have to decide if you are willing to go to the workout and diet extremes it takes to maintain your perceived goal weight or if you can accept your new normal. Most of us in our forties don’t have the time or energy to exercise 2 hours a day and count every calorie that passes through our lips.
Below are the best evidence based strategies to maintain a healthy weight as you mature in life.
The best eating plan for perimenopause has been debated, but the latest research supports Mediterranean style eating. This including lots of vegetables and lean proteins.
Daily Goal-
- 5-7 servings of fruits and vegetables
- Protein 1- 1.5 g/ day (i.e. If you weigh 100kg then you should eat between 100-150 grams of protein each day)
- Limit sugar and simple carbs
2. Increase Fiber to 25-30 g / day
Fiber does many things including encouraging healthy intestinal bacteria, helping you feel full longer and reducing constipation.
Some high fiber foods include:
- High fiber cereal (the most fiber is in Kelloogs Bran Buds)
- Oatmeal, chia seeds
- Raspberries, dates
- Almonds
- Beans, lentils,chickpeas
3. Good Quality Sleep
Poor sleep adds to elevated stress hormones (cortisol) which can cause you to store fat around your abdomen. Poor sleep also makes you hungrier the next day
Strategies to help with sleep:
- Reducing alcohol
- No caffeine after noon
- No screens for 30 min before bed
- Taking a magnesium supplement (magnesium glycinate 400mg with evening meal)
- Taking a warm bath before bed
- Keeping your bedroom cool or using a cooling bed pad
- Apps – Headspace. iRest.
- Menopausal hormone therapy
4. Exercise
We should all be moving our body at least body 30 minutes a day. Walking, Zumba, biking, spin, aerobics, running or whatever works for you. Exercise helps your heart, mood, and sex drive, and prevents osteoporosis.
However, if you are only doing cardio, you will likely begin to lose muscle as you approach menopause, so you need to add some type of weight training to your routine to build muscle and improve your metabolism. If the thought of lifting traditional weights seems boring, intimidating, or not feasible in your schedule there are many other options available. I personally recommend a crossfit style workout because it combines your cardio and weight training, and while it might seem intimidating at first, it can be scalable to all ages and fitness levels. Yoga may be more your style. Types of yoga that really engage your muscles and core (like power yoga or vinyasa) can also help with your strength and metabolism. Yoga has also been shown to reduce other menopausal symptoms like brain fog, hot flashes, and insomnia.
5. Limit alcohol to 1 serving/ day
Your body has less tolerance for alcohol as you age. It can affect sleep, increase risk of osteoporosis and dementia. Much like our food serving size, alcohol serving sizes have increased over the years. One “serving” of alcohol is 6 oz of wine, 12 oz beer or 1.5 oz of liquor.
6. Supplements
There is a lot of misinformation about supplements, especially in menopause. Currently the only recommended supplement is Vit D 800 IU/ d.
Ideally you should try to get 1000mg/d (premenopause) or 1200mg/d (postmenopause) of calcium from your diet. If you are not able to get adequate calcium from your food intake, then a calcium supplement is recommended as well.
Tip: Low fat Greek yogurt and cheese are great sources of calcium and protein.
Perimenopause is awesome opportunity to set a healthy tone for the second half of your life. It’s not a time for yo-yo diets and self loathing, but a time to objectively look at your health and make the best choices you can. Increase your veggies, put down that second glass of wine, add in some weight training and see your PCP for a check up; because you only live once and you want that once to be an awesome healthy fulfilling life.
Resources:
“MyFitnessPal” is a free app that will allow you to track your fiber/ protein/ calories.
Weight Loss for the Last Time by Dr. Katrina Ubell has good strategies for making healthy habits and dealing with stress eating. (I don’t agree with her recommendation for intermittent fasting.)
Menopause Manifesto by Dr. Jen Gunter. Good overall menopause information.
Dr. Heather Rupe 