Perimenopausal or Menopausal … gained a bit of excess weight that you don’t seem to be able to shift … wondering if you should be following a special ‘menopause diet’?
Well read on …
Menopause used to be something that wasn’t really spoken about, it felt like a bit of a taboo subject; but there’s been far more media coverage and awareness around it in recent years. Unfortunately, this also comes with people jumping on the bandwagon and using it as a marketing hook. Recently there seems to be an increasing number of people selling ‘menopause diet plans’ and ‘hormone balancing plans’ – but the reality is diet and exercise advice around the menopause is exactly the same as at any stage of life.
There’s no special diet or training plan, no ‘hormone balancing hacks’, but the increased health risks that come as a result of lower oestrogen levels (CVD, osteopenia / osteoporosis) makes taking care of your health even more important!
If you’re reading this, I’m sure you know what menopause is, but let’s briefly cover the basics.
A woman is referred to as menopausal when it’s been a year since her last period. It occurs when the ovaries stop producing eggs and as a result hormone levels (mainly oestrogen and progesterone) fall.
Perimenopause is the time leading up to this, defined as the ‘transitional period between the reproductive and non-reproductive phases of your life’ – when hormones are fluctuating wildly. The defining symptom of perimenopause is irregular menstrual cycles, but this is also when many women experience the worst symptoms and it can have a drastic impact on their lives, symptoms can include: hot flushes; night sweats; brain fog; poor concentration; difficulty sleeping; fatigue; mood changes such as low mood and anxiety; and many more.
From here on I’m going to make it simple and just use the word menopause – but I’m referring to both perimenopause and menopause throughout.
Many women find they put on weight during this time, find it increasing hard to lose it, and assume it ‘must be because of the menopause’. But menopause itself doesn’t actually cause weight gain.
In fact, research shows than men and women gain fat at roughly the same rate in their 40s and 50s; and it seems that the weight gain many women experience later in life is likely primarily due to a tendency to move less as we got older rather than menopause it’s self.
The drop in oestrogen during menopause can however impact where we store body fat. So while it doesn’t actually cause weight gain in itself, it can result on a shift to more visceral and abdominal fat; when previously it might have been more around the hips, thighs and buttocks.
You may also potentially have a VERY small change in your BMR (the amount of energy used at rest) but I’m almost reluctant to even mention this, as it’s so insignificant you wouldn’t notice the difference – we’re talking around 50 calories per day. This will have no real impact on fat loss (and this is also shown to be attenuated by HRT and resistance training)
Most women experience a loss of muscle mass as they age (but if you resistance train and consume sufficient protein you can avoid this). Muscle is metabolically active; the more muscle mass you have the more calories you burn at rest.
So in that case, why do women struggle with weight during the menopause?
Its more down to the impact the symptoms have on our ability to stick to a diet and exercise regime - it’s not that you lack willpower or discipline – everything just suddenly feels a LOT harder (as a perimenopausal woman trust me, I know the feeling!)
Poor sleep, fatigue, low mood, and stress all impact our ‘hunger hormones’ Ghrelin and Leptin, resulting in increased hunger and cravings and therefore have a big impact on our ability to stick to a diet. But at the end of the day, it always comes down to energy balance - calories in vs calories out.
Add that to the general lack of drive, mojo, confidence, and self-esteem impacting our desire to exercise.
Personally, perimenopause has definitely impacted my enthusiasm to train. I used to be someone who’d throw myself out of bed every morning, bounding into the gym at 6am, virtually pounding the doors down full of enthusiasm. There was never day I wouldn’t want to train, and a rest day seemed like a chore.
But once perimenopause hit I regularly found I was dragging my arse there with no enthusiasm, just to get it done and ‘tick’ the box, and coming away wondering why I’d even bothered.
BUT I know it’s vital for my health – so I will still always get it done regardless!
I cannot stress enough how important resistance training is to strengthen bone and muscles which are at heightened risk due to the drop in oestrogen.
Age associated muscle loss is called Sarcopenia.
After the age of 30, women who are sedentary start losing approximately 3-8% of muscle mass every year – the rate of muscle loss increases once menopause hits, but strength training combined with adequate protein can slow or even reverse the age -related loss of muscle.
Osteopenia is age-associated bone loss that can progress to osteoporosis.
Starting at around the age of 44 women start losing on average 0.4% bone mineral density each year, with a sharp decline around menopause leaving women more susceptible to osteopetrosis - it’s estimated to affect 1 in 3 women and 1 in 12 men in the UK.
However, research has shown that strength training can still increase bone density in postmenopausal women.
Therefore, regular strength training can reduce your risk of sarcopenia, osteopenia, and osteoporosis.
Not only that but resistance training has been shown to reduce the risk of CVD, Type 2 diabetes, and cancer – all of which menopausal women are at higher risk of. It can also help with improved mood and improved vasomotor symptoms (the hot flushes and night sweats).
What else can we do:
-Talk to doctor – not all women can take or want to take HRT; but I recommend everyone at least has a discussion with their doctor about the benefits and risks and makes a decision based on all of the facts.
-Eat according to your energy needs and prioritise protein
Protein becomes even more important as we age – as we get older our body’s ability to digest, absorb, utilise, and respond to protein decline. This is even more important for women as we age because we tend to lose muscle tissue over time.
The suggested protein target for perimenopausal and menopausal women is 1.2 – 2g per kg bodyweight. Now this is quite a broad range but if you’re resistance training (which you should be!) or trying to lose weight then it’s worth aiming towards the upper end.
-The general ‘healthy eating’ advice of consuming a diet of predominantly whole foods and minimal ultra-processed foods still applies here. So fruit, vegetables, lean meats & fish, whole grains, legumes, monounsaturated fats… you know the drill!
There is a small amount of evidence to suggest consuming isoflavones in foods can help to reduce some symptoms such as hot flushes - sources of these include soya beans, legumes, lentils and chickpeas, tofu and soya drinks – so if they’re foods you enjoy then they might be worth including.
-Stay active – aim for a minim 8000 steps per day (and I’ll say it again – resistance training!)
-Supplements which could be useful:
Calcium is the most important mineral for ensuring good bone health; so supplementing could be beneficial if not eating calcium rich foods (milk /yogurt/cheese)
Vitamin D is also important for bone health and is a worthwhile supplement for everyone.
-Limit alcohol (sorry!)
Alcohol can worsen some symptoms – particularly hot flushes and can interfere with sleep quality.
-Reducing spicy food and caffeine, particularly later in the day, can also help if having hot flushes
-Manage your stress – mediation, journaling, mindfulness.
So, there’s no special ‘menopause plan’ – we need to do the same thing everyone else should be doing. And whilst the symptoms can have a big impact on our ability and enthusiasm to do so, eating well and training become even more important now.