menopause

Lose weight in Menopause

What does it mean to lose weight in menopause?

The slimming in menopause favors the rebalancing of the body composition, promoting the percentage of lean mass at the expense of the fat one; on the other hand it is a result "often" quite difficult to obtain.

Contrary to what many readers may understand, this problem is NOT DIRECTLY correlated to hormonal flows, to the slowing down of metabolism or to other physiological or para-physiological elements; rather, it depends strongly on the extremely precarious psychological condition that (sometimes, but not always) accompanies this phase of female life.

Below we will analyze in a detailed manner (albeit suitable for a popular reading) what happens at menopause, its consequences on the body of a mature woman and the reasons why losing weight in menopause may be less simple than the ordinary.

Why lose weight? When it is necessary? What are the risks?

Why lose weight in menopause?

First of all, let us remember that the need to lose weight during menopause derives EXCLUSIVELY from metabolic and healthy needs. In the course of existence, the female organism is grown (development), enriched (sexual characteristics such as development of the breasts, fat accumulation and distribution, piliferous location, etc.) and protected (increase in HDL-good cholesterol, maintenance of bone density and ginoid distribution of fat) from the estrogenic hormonal flow .

Upon entering menopause, the production of estrogen first undergoes numerous fluctuations and then a drastic reduction; in parallel, even the levels of progesterone (another female hormone related to fertility), although more linearly, decrease significantly. It can therefore be deduced that the estrogenic action, which protects against bone loss and cardiovascular diseases, suffers (gradually or abruptly) an impairment to say the least, exposing menopausal women to the famous rebound effect (or rebound) due to exposure to osteoporosis ( worsening of bone metabolism) and atherosclerotic cardiovascular compromises (reduction of good-HDL cholesterol and increase in bad-LDL cholesterol).

Relevance of weight loss in menopause; when to do it and related risks

Weight loss during menopause involves a nutritional intervention and a modification of the general lifestyle aimed exclusively at compensating for a worsening of the general state of health induced by the menopause itself.

Rather than losing weight, assuming that the woman is already in NORMOpeso ​​condition, it is certainly more important to AVOID, over time, to progressively and / or seriously gain weight. Although apparently similar, the reduction of overweight and the maintenance of the normal weight are NOT synonymous or mutually superimposable; while maintenance in menopause is "generically" based on the application of some basic principles such as: increase in general physical activity, correct distribution of meals, correct frequency of consumption of foods, correct approximate estimate of portions, etc., slimming in menopause represents a well-defined dietary therapy and is associated with a rigid program of desirable motor activity.

Weight maintenance of the normal weight is univocally applicable as it is totally harmless, while the therapy aimed at losing weight during the menopause includes some risks to be taken into account; first of all, the worsening of the humoral state. Menopausal weight loss MUST NEVER, in any way, FAIL or transmit to the subject a SENSATION of therapeutic failure. This is because a similar negative event could significantly compromise the emotional stability of the woman (already severely tested) and foment some of the main etiological causes of post-menopausal weight gain (which, as anticipated, are of a psychological nature). Among these we mention: climacteric syndrome and associated physical symptoms, perception of the sense of "uselessness", reduction of self-esteem, reduction of libido, depressive or anxious symptoms (more or less important) etc .; obviously, all this translates (most of the time) into an increase in nervous hunger and, rarely, in a reduction in appetite with a tendency to anorexia nervosa (understood as a symptom and not as a full-blown psychiatric pathology).

At the same time, there are also organic and / or metabolic drawbacks. We remind you that (obviously) losing weight in menopause involves the reduction of most high energy density foods. This implies an inexorable moderation of the main sources of alimentary calcium (Ca), that is of the most caloric cheeses (usually the seasoned ones). As many readers will already know, menopause (and more precisely the estrogenic - progestin decline) exposes women to the risk of bone demineralization (osteoporosis); to prevent its occurrence (taking for granted an optimal bone density level in the pre-menopausal phase) the subject must undertake a hormone replacement therapy (where applicable) to which it is always necessary to associate the increase of: calcium (mineral salt ), vit. D food, desirable physical activity and (possibly) the intake of phytoestrogens (contained for example in soy and red clover extract). Reaching 1200mg / day of food calcium without the use of supplements by reducing mature cheeses is NOT a simple nutritional operation, even more so if the dietary correction takes place in the absence of hormone replacement therapy (deemed irrelevant or unnecessary) since, in this case, the daily dietary calcium requirement rises to 1500mg / day.

At the same time we recall that, in old age, the moderate increase in fat thickness is PROTECTIVE from bone fractures due to contusion. This means that, in the absence of significant risk factors or metabolic complications due to being overweight, losing weight during menopause is NOT always a useful measure to improve health. Whether or not to undertake food therapy at this time in women's life depends on the evaluation and weighting of all the risk factors that characterize the specific case.

Other causes of weight gain in menopause

Know them to avoid them! Reduce the chances of having to lose weight during menopause

The first general interventions to be applied to the onset of menopause in order to avoid an increase in body weight are: cognitive - behavioral, nutritional, motor and pharmacological. Specifying that it is always considered appropriate to evaluate the specific case, we list those considered most important:

  1. Increased time dedicated to personal care: menopause is an extremely delicate phase for women. Contrary to what is perceived by the subjects concerned, the transition from fertility to non-fertility implies an increase in awareness and self-knowledge. The social function of menopausal women acquires an added value that is extremely useful and indispensable in guiding and maintaining families. On the other hand, this metamorphosis, being extremely fast, does not always leave the necessary time for the female mind to process change. To facilitate the "psychological metabolism" (the inappropriate term is given to me) of entering menopause it is necessary for the woman to change her perspective completely and put (albeit temporarily) above all her personal interests. Recreational activities, collective sports activities, possible participation in psychological consultations, etc. are very welcome. Unjustified low-calorie diets are strongly RECOMMENDED and the pursuit of practices aimed at achieving mere aesthetic goals.
  2. Nutritional scheme and correction of eating behavior: as anticipated, it is not always necessary to lose weight during menopause; on the contrary, the hypocaloric intervention must be applied ONLY when inevitable. In this case, a professional intervention is necessary, although it is possible to summarize some key principles of the menopausal diet :
    1. Introduce a quantity of energy suitable to maintain the weight or (if necessary) to reduce it progressively
    2. Regularize the energy distribution in five meals (three main and two snacks) and "normalize" the portions of pasta, bread, seasoning fats, fatty meats, seasoned cheeses and sweet foods
    3. Eliminate: all fats of animal origin ADDED (due to the high intake of saturated fatty acids and cholesterol), processed foods that contain them and foods that are not manufactured but that add too much
    4. Prefer NON-hydrogenated vegetable fats, not chemically or thermally treated and rich in fatty acids ω ‰ 3, ω ‰ 6 and ω ‰ 9 (beneficial and protective from the cardio-circulatory point of view)
    5. Consume vitamin D-rich fishery products at least two or three times a week
    6. In CONSONI schedules and with due precautions, increase exposure to sunlight in all seasons, especially in late spring, summer and early autumn (to facilitate endogenous vit. D synthesis)
    7. Consume animal milk and / or yogurt or calcium-flavored foods daily
    8. Consume at least two or three times a week ricotta and / or low-fat cheese
    9. Consume at least two servings of fresh and / or cooked vegetables a day and about two servings of fresh fruit
    10. Increase soy consumption and, possibly, supplement the diet with red clover supplements rich in phytosterols.
  3. Increase in energy consumption: increase in general physical activity and desirable physical activity (possibly mixed and group aerobic / anaerobic)
  4. If necessary, periodically undertake hormone replacement therapy: this is essential if there is a strong climacteric symptomatology or a high risk of osteoporosis.

But remember that this last procedure, if not associated with a parallel dosage of progestins (other female sex hormones), could increase the risk of tumors of the uterus. At the same time, regardless of the presence or absence of progestin therapy, estrogen-based therapy can increase the chances of breast cancer (the contraceptive pill, on the contrary, is protective against the uterus).

In the presence of estrogen hormone replacement therapy, weight loss in menopause is INDIRECTLY simpler; these drugs, compensating for the elimination of endogenous estrogens and progesterone, favor the gradual redistribution of body fat (from the ginoid to the android), the scalar metabolic readjustment of the lipid profile, the reduction of the risk of osteoporosis, etc. All this reduces the levels of nervous stress and the risk to health.

Curiously, it is well known that estrogens (responsible for female physical and sexual development) are certainly linked to a better efficiency of muscular energy metabolism, but also to a tendency for water retention and fat accumulation. This confirms that: hormone replacement therapy, although positively affecting a woman's state of health, has NO direct effect on weight loss; nevertheless, these drugs improve: metabolic parameters, bone metabolism and "probably" the overall mood, consequently increasing the success of menopausal weight loss.

Also progesterone is a female hormone whose flow is significantly reduced with menopause; it is the main mediator of ovulation (produced by the corpus luteum) and of hormonal changes in pregnancy (produced by the placenta). Its increase is related to the increase in fertility, body temperature, symptoms such as nausea, etc. In the fertile and healthy woman, her oscillatory behavior determines the construction and the exfoliation of the uterine mucosa (menstrual losses), while if the reduction becomes progressive and irreversible (pathological or for menopause) it is closely related to the impairment or loss of fertility. The progestational component is therefore essential in hormone replacement therapy and also, in addition to estrogen, can indirectly favor the success of menopausal weight loss thanks to the moderation of the general symptomatology.

Calcium and Vitamin D

A few tricks to guarantee the right supply and metabolism of calcium for the bone and not only

Should it be necessary to lose weight to restore certain metabolic parameters such as: arterial pressure, cholesterolemia, triglyceridemia, glycaemia, etc., it should be remembered that calcium and vitamin D are nutrients that should never be scarce in the diet to lose weight in menopause.

As we have already pointed out, in the presence of hormone replacement therapy the supply of alimentary calcium is around 1200mg / of; on the contrary, without drugs, it corresponds to 1500mg / day. The main sources are milk and derivatives (65%) and to a lesser extent vegetables (12%), cereals (8.5%), meat and fish (6.5%), legumes, nuts and eggs. In addition to the inclusion in the diet of the main foods containing calcium, it is also NECESSARY to consider other variables:

  1. The intestinal absorption of calcium decreases in old age
  2. Calcium absorption decreases concurrently with pathological malabsorption
  3. The absorption and metabolism of calcium are increased by the presence of vit. D
  4. Calcium absorption is increased by the presence of sugars, especially lactose
  5. Calcium absorption is increased by the presence of lysine and arginine amino acids
  6. Calcium absorption is increased by the presence of a basic intraluminal pH
  7. Calcium absorption is decreased by the presence of oxalates, phytates, phosphates and tannins (anti-nutritional molecules), present in some beverages such as black tea and in some vegetables such as legumes, rhubarb, spinach, etc.
  8. Calcium absorption is decreased by the presence of nerves (caffeine, alcohol - anti-nutritional molecules), therefore it is advisable to moderate alcohol and coffee above all
  9. Calcium absorption is decreased by the presence of uronic acids contained in dietary fiber
  10. Urinary calcium excretion increases with excessive intake of sodium, dietary proteins (even if the mechanism affects the PRAL more globally) and phosphorus
  11. The fecal excretion of calcium increases with secretory diarrhea
  12. The sweating excretion of calcium increases significantly with the practice of intense and frequent sports.

Vitamin D, on the other hand, is synthesized mainly by the body thanks to a complex mechanism of exploitation of sunlight (80% of the total), and only 20% of the total comes from food: the richest are the liver (of animals terrestrial, fish), herring and salmon meat. It is always advisable to make the right exposure to sunlight.

The nutritional measures to reach the recommended calcium rations must therefore take into consideration the rules for a good and healthy diet, taking care to respect the acid base balance (compromised by ketogenic diets or serious pathologies), not to exceed with salt from cooking, to take into account the right relationship between calcium and phosphorus, etc. We recommend reading the dedicated articles here on our site.

We conclude by recalling that the intake of calcium in the diet for menopause (with or without weight loss) can only slow down a pre-existing osteoporotic mechanism and not cure the disease. The only trick useful to prevent its onset is to reach the peak of bone mass during skeletal development, while estrogen therapy can be useful if applied in the initial phase of menopause.