Have you ever wondered why so many women put on belly-fat as they move through menopause into post-menopause? This so confused me at the time. My legs were getting thinner, but my belly was getting bigger. Dangerously bigger. I knew it wasn’t good for my heart health and it was sending me down the slippery slope towards a condition called Metabolic Syndrome. This is the chaotic cocktail of health changes linked to high blood pressure, high cholesterol and emerging Type 2 diabetes.
[Getty Images: Jacobs Stock Photography Ltd.]
It seemed that every morning my body had a mind of it’s own. The fat-roll under my diaphragm got bigger and my knees became more sore – not great for someone who has run all her life to help her ‘cope’ with the vagaries of life. My breasts got bigger and don’t even mention the yoga classes. As someone who has been active and fit all her life, touching my toes and the downward-dog was never a problem … until I went into menopause. My waist was expanding and from all my lecturing in exercise and sports science over the years, I also knew that an increased waist circumference in women is linked to heart disease and Type 2 diabetes.
Like so many women on my women’s healthy ageing doctoral study, I was confused. As they mentioned, they had been active throughout their life, and continued to be active, most working with Personal Trainers. But the struggle with weight gain in mid-life was real, as was the sore joints, sore muscles, lack of sleep and spending lots of money on endless supplements and visits to health specialists. Most knew that the slippery-slope towards changing heart-health may be inevitable because their mother’s health had gone that way too – ‘Not like My Mother’ was a dominant theme in my research. It’s why, with my own weight changing by the day, I went on a quest to search the existing science about weight loss in menopause. Everything I discovered helped me to design the online MyMT Transform Me programme, which is changing women’s lives (and waist circumference) for the better. I know this, because they tell me. 🙂
When I became so despondent and confused about my menopause weight, I began to understand that current nutrition and fitness industry advice was only part of the answer. As women who are now in post-menopause (as I am), we are the first generation to come through the modern fitness industry and all the various nutritional advice, however, research has left us behind. There is very little exercise and nutrition research that is specific to this life-stage. Most of the sport, exercise, health and nutritional research has been conducted on males and athletes over the years as well.
We feel forgotten and invisible in mid-life in more ways than one.
As I slowly pieced together the menopause-misery jigsaw I pulled together cardio-vascular research, diabetes and heart- health research as well as physical activity and longevity studies and of course nutrition and exercise research that was focused on mid-life women’s health. The more I read, the more I began to understand that the greatest concern for women as they age, in terms of their expanding waistline and belly-fat, wasn’t necessarily to do with hormonal changes (this is a normal life-stage which I describe as the ‘book-end’ to puberty), but instead was because we aren’t sleeping, our joints feel sore and we are losing precious muscle which helps to boost our metabolism. It’s why I loved this insight from brand new research out of the Australian National University, recently published in the American Journal of Obstetrics and Gynecology.
If I had this research a few years ago, it would have saved a lot of lonely research of my own. In a review of studies that included more than 1 million pre- and post-menopausal women, the researchers learnt what I and many other women, have discovered in real life – that our waist circumference increases during and after menopause and the amount of fat that we have in our legs decreases.
Skinnier legs are great in tight jeans, but the belly fat hanging over the top is not great at all. In fact it is dangerous for our health as we age … and if we want to live as healthily as we can, we need to mange our post-menopause fat-gain.
But here’s the thing. As I often say in my online 12 week programmes – menopause itself isn’t the issue. This is a natural life stage that we all go through. The issue is that we are ageing. And because we are ageing, we are losing our precious muscle and when this happens, we gain fat, especially the fat that is centralised around the abdomen. This changes our heart-health and it’s why, in post-menopause women, the risk for cardio-vascular disease (heart attacks and strokes) are higher than men.
Incredibly, because of our muscle loss as we move into post-menopause, we can add 1-2 kg a week during menopause when we can’t sleep, with much of this going on our belly and under our diaphragm.
“It’s important to understand how women’s bodies change as they age because women have higher rates of some diseases than men”, said Ananthan Ambikairajah, a PhD candidate at the Australian National University, who led the study. “The implications are important, because central fat has been linked with dementia risk, and central fat is linked with cardiovascular disease risk.”
“More attention needs to be paid to central fat accumulation, because that’s the bad stuff,” mentioned Ambikairajah.
Every extra kilo of weight is an added burden on your joints, heart, liver, cholesterol, muscle function and insulin levels as you age. It’s also the reason that I know that many of you can’t do the exercise necessary to ward off changing heart-health and Type 2 diabetes. New research suggests that a combination of more vigorous cardio and strength is important to battle the bulge BUT we are often to exhausted from not sleeping and worsening hot flushes to care. That’s how I felt myself. And for someone who has been at the forefront of the exercise industry in New Zealand, I was as disheartened as many of you are as well.
Here’s the good news though – when you turn around your sleep, energy levels, sore joints, hot flushes and you stop gaining weight, you can get back into the exercise that you not only know will help your health, but will make you feel great.
The women who join me on the MyMT Transform Me programme, know that turning around post-menopause belly-fat has nothing to do with hours spent exercising, or low carb, high protein, high fat, hard-to-adhere to, popular diets. It’s all to do with sleeping all night so that, first and foremost, we stop gaining fat. Then it’s about balancing our blood-sugar levels and reducing the impact of insulin, our blood sugar regulation hormone. Along the way, we also need to focus on giving ourselves a liver rescue so that excess oestrogens are metabolised. As we go into post-menopause, our body doesn’t need as much oestrogen any more. In fact, it’s the excess oestrogen that’s the problem. If we have high levels of oestrogens in our diet and through environmental exposure (xeno-oestrogens), then our fat cells store the excess. Our fat cells love oestrogen and store this readily.
When we aren’t sleeping, excess oestrogen that is being produced in the body goes to fat cells, so we must improve clearance of this excess oestrogen from our liver. The starting point for post-menopause weight loss, lies with the liver, not lots of exhausting exercise.
In fact, when we store excess oestrogens in our fat cells (including liver and breast tissue) then we can develop a condition called oestrogen dominance. What this means is that oestrogen becomes the ‘dominant’ hormone to the detriment of progesterone as we move through menopause and into post-menopause.
I never knew about oestrogen dominance when I went into menopause – nor did I realise how much muscle can be lost when we are too exhausted to exercise properly and aren’t sleeping. These two factors combined are a post-menopause weight gain nightmare. I only learnt about the powerful combination of these factors when nothing worked for my menopause weight loss. Despite being on Menopause HRT, and following the popular diet and exercise advice that I was given by various health and nutrition professionals, every week, my belly-fat, bloating and sore boobs continued to increase. It was the same too, for so many women who I was interviewing for my women’s healthy ageing studies at the time. When I heard their stories, I knew I had to look into what was really going on in our menopause transition because if we don’t, then menopause weight gain becomes a ticking time-bomb for our health as we age.
So, if you are as bewildered as I was, here’s the real (and new) science behind your menopause weight gain:
- Not sleeping increases your blood-sugar hormone called insulin – both overnight and during the day. The role of insulin is to shift glucose around your body, especially to your brain, liver and muscle cells where it gets stored in your cells. But when we don’t sleep, our blood pressure and heart rate remain higher during the day, which in turn increases two hormones which impact weight gain – insulin and our chronic stress hormone, called cortisol. To lose belly-fat and change our risk for Type 2 diabetes in post-menopause, both insulin and cortisol need to be low, especially at night. If they remain high, they interfere with the production of your sleep hormone called ‘melatonin‘. As we prepare to go to sleep and stay asleep, then melatonin levels should be as high as they can be. This is why I teach women what to do to achieve the right balance between melatonin and insulin production as part of the first module they listen to in their private learning area on the 12 week MyMT Transform Me programme. If you want to start losing weight, you must sleep.
2. In post-menopause, testosterone production increases if you still have your ovaries – this disrupts insulin and cortisol. Your body is amazing. Never forget that. As women going into post-menopause, if we still have our ovaries, we are producing some testosterone. We all have varying degrees of testosterone in us and some of you stronger, larger ladies with an adrenal or pituitary body-type might produce more as well. But levels of this hormone go UP when you are feeling stressed, causing even more production of your stress hormones and the one that we don’t want called cortisol. The powerful combination of higher testosterone and high cortisol keeps your belly fat going up. Add to that not sleeping and fat cells then store the extra testosterone which your adrenal glands are busily making because you are feeling stressed!
Testosterone is an androgen, or sex-related hormone. It is produced in your ovaries, adrenal glands and fat cells and in women, testosterone contributes to over 200 actions in our body, from muscle development, to growing facial hair on our chins, to influencing anger and frustration. In natural menopause, androgen levels don’t suddenly drop, but at this time of life, you are producing about 50% less than in puberty, which is often the cause of women losing their libido and mojo at this time as well!
But there is something else affecting your weight gain during menopause as well – your loss of muscle. I call it, the forgotten factor in understanding menopause weight gain.
3. Muscle loss in post-menopause contributes to lowered metabolism and fat gain. When we lose oestrogen as a normal outcome of our changing biology, we also lose muscle size and density. It’s a condition called sarcopenia, which is a fancy name for muscle loss. If we aren’t sleeping, then the muscle loss speeds up as your metabolism changes because you aren’t getting the benefit of muscle recovery overnight – even for those of you doing weights. When we don’t sleep however, as I said earlier, one of our chronic stress hormones, called cortisol remains high. One of the outcomes, is that as you lose muscle density, then you also lose the number and size of mitochondrial cells. These beautiful cells store oxygen and this is where fat is burned. In menopause and as a natural part of our biological ageing, we lose precious mitochondrial cells and this wrecks havoc on menopause fat-burning potential.
All of these factors combined – not sleeping, increased insulin, high stress levels, testosterone changes and loss of muscle tissue – have the greatest impact on our changing health and weight gain as we move into post-menopause.
I would love you to transition through menopause and into post-menopause using the powerful lifestyle strategies which I’ve researched specifically to help you manage your symptoms and turn around the weight that may have stacked on as it did for me too. I called the 12 week weight loss programme ‘Transform Me’ because that’s what I wanted to achieve during menopause when I felt bloated and uncomfortable and exercise and nutrition wasn’t shifting my weight as it used to do for years. After I looked into menopause and positioned it in women’s healthy ageing studies, I began to understand why. If you would like to learn more, then when you have time, then please visit the My Menopause Transformation website and join me as soon as you can. I can’t wait to help you too.
Dr Wendy Sweet (PhD)
References:
Edwards, B. & Jin Li, [2013]. Endocrinology of menopause. Periodontology, 61, 177–194.
Ford, C. et al. [2017]. Evaluation of diet pattern and weight gain in postmenopausal women enrolled in the Women’s Health Initiative Observational Study. British Journal of Nutrition, 117, 1189–1197.
Harvard Health, [2018]. Lose weight and keep it off. Harvard Health Online Publications. Boston: MA
Kendall, B. & Ester, R. [2002]. Exercise-induced muscle damage and the potential protective role of estrogen. Sports Med., 32 (2), 103-123
Lerchbaum, E. [2014]. Vitamin D and Menopause: A review. Maturitas, 79, 3-7.
Moudi, A. et.al [2018]. The relationship between health-promoting lifestyle and sleep quality in menopausal women. Biomedicine, 8(2), 34-40.
Rizzi, M. [2016]. Sleep disorders in fibromyalgia syndrome. J. of Pain & Relief, 5:2.
Ryan, M. Itsiopoulos, C. et al. (2014). The Mediterranean diet improves hepatic steatosis and insulin sensitivity in individuals with non-alcoholic fatty liver disease. Journal of Hepatology, 59(1), 138-143.
Santosa, S. & Jensen, M. (2013). Adipocyte fatty acid storage factors enhance subcutaneous fat storage in postmenopausal women. Diabetes, 62,3, 775-782, ProQuest Central.