Weight gain and Central obesity are common symptoms women complain of during menopause. Weight gain and lack of oestrogen predisposes to heart attack and stroke which causes 1:2 deaths after menopause. There are more deaths from heart disease than from breast cancer.
On average women gain 2 kgs ( 4.4 lbs) over a 3 year period after menopause. Women state that in spite of no changes in their diet and exercise routine they gain weight and it is harder to lose weight.
Evidence has shown that weight gain is not due to menopause or HRT but is due to increasing age.
Other contributory factors are genetic factors, reduced exercise, increase in caloric intake, medical conditions like osteoarthritis, depression, anxiety, heart disease, under active thyroid, reduce in muscle mass (makes it harder to exercise) and some psychotropic medicines like antidepressants and mood stabilisers.
Central Obesity is an increase in body fat around the mid portion. This is due to reduce oestrogen from the ovary and a relative increase in free amount of male hormone - testosterone (due to decrease in its binding to the protein called sex hormone binding globulin) which causes hormonal imbalance.
Central obesity reduces the efficacy of Insulin hormone which increases risk of Diabetes, High cholesterol and Hypertension.
Metabolic syndrome is a constellation of the above cardiovascular risk factors – Diabetes, High Cholesterol, Hypertension and Central Obesity.
Women of normal weight with central obesity can also be at a higher risk of Metabolic syndrome.
Lifestyle changes with a healthy diet, regular exercise, reducing alcohol intake and stopping smoking will reduce Metabolic syndrome by improving Insulin sensitivity.
Hormone Replacement Therapy (HRT) is an effective treatment for menopausal Symptoms. It has added benefits of preventing Metabolic syndrome.
HRT helps with redistribution of fat, improves insulin sensitivity (makes insulin more effective), reduces cholesterol and Blood pressure if combined with weight optimisation.
HRT when started within 10 years of menopause and in women with Premature Ovarian Insufficiency (menopause before age 40) reduces heart attacks and strokes.
Mediterranean diet: Plenty of fruit and vegetable (>2 vegetables/day and 3 fruits/day).
Reducing intake of saturated fats.
Increasing fibre intake, protein intake 1gm/kg/day.
Increase intake of Complex carbohydrates with Low GI index such as sweet potato, brown rice, brown bread, pulses, grains , cereals.
Linseed, flaxseed, walnuts.
Reducing intake of starchy foods like white bread, rice, potatoes, cakes, biscuits.
Increase in protein intake mainly soya, white meat – chicken and fish.
Oily fish like salmon once or twice a week (rich in Omega 3 fatty acids).
Having smaller portions and avoid snacking, eating sweets, pastries, cakes.
Consume Calcium rich foods (800-1000 mg/day) and take Vitamin D supplements 400 IU/day which will maintain bone health.
There is some evidence that Intermittent Fasting, a 16:8 diet prevents Metabolic Syndrome and helps with weight loss.
Aerobic exercises 30 minutes 5 times a week.
Brisk walking 30 - 45 minutes every morning resets biorhythm and helps sleep.
Daily morning walks, getting some sunlight and reducing exposure to white light from using cell phones will increase melatonin production, increase happy hormone Serotonin and improve sleep which will reduce Obesity and Metabolic syndrome.
Muscle strengthening exercises twice a week.
Any physical activity is good – climbing stairs instead of taking the lift, walking your errands, walking or cycling to work if possible or parking your car further away from entrance to shopping centre are just a few steps to help with weight loss.
Stop smoking.
Reduce alcohol intake.
Adequate sleep.
