BODY SHOP
As menopause approaches, the odds favor gaining weight

By Bryant Stamford
Gannett News Service

Weight gain is likely during and after menopause. Part of the problem is the natural effects of aging, and part is hormonal.

The body can begin losing muscle mass as early as age 40, especially in ultra-sedentary individuals. Significant losses of muscle mass, however, don't begin until about age 50, which means the body gets serious about losing muscle mass at about the same time that menopausal hormone changes are occurring.

Lost muscle mass lowers metabolism, because muscle mass is the most prevalent tissue in the body, and it demands lots of energy, even at rest. As metabolism drops, if you keep eating the same foods and in the same amounts, the result will be an overabundance of caloric intake, which is converted to body fat.

Going on a crash diet as a means of coping with weight gain is the worst thing you can do at this point in life. A crash diet is one that leads to the loss of more than one pound per week (unless you are exercising every day).

The body cannot lose fat quickly, and therefore crash diets cause you to lose muscle mass. The older you are, the more muscle mass you will lose, and the lower your metabolism will go.

A drop in metabolism is bad, but things can get worse quickly.

As we get older, we don't process glucose (sugar) as well as we did when we were younger. This results in a greater insulin release from the pancreas gland. Insulin helps the body store fat, and the more insulin you have in your circulation, the more efficient you will be at adding fat to your frame.

Menopause compounds the problem, because hormone shifts cause stress and mood swings that can trigger a cascade of events leading to a greater insulin release.

In addition, hormone shifts cause a shift in fat storage sites, from the lower body (hips, thighs, buttocks) to the abdominal region. Abdominal fat contributes to insulin resistance, which causes a greater release of insulin in an attempt to overcome the resistance.

Excess insulin sets the stage for enhanced fat storage and rapid weight gain. Two factors maximize effects:

The ordeal of menopause can inspire a craving for "comfort" foods. Such foods are the ones we associate with love, affection and rewards when we are children, and usually are foods that are high in fat and sugar.

High circulating insulin levels maximize the storage of excess calories as body fat.

And, the excess intake of sugar (combined with a lessened ability to process sugar) causes an even greater release of insulin.

Menopausal moods swings and depression, plus the physiologic conditions described above, can cause fatigue and a loss of energy, resulting in less physical activity.

This compounds the problem of a reduced metabolism, causing an even greater abundance of excess calories available to be stored as fat.

Estrogen causes water retention, whereas progesterone has a diuretic effect. The impact of these hormones, which peak at different times during the menstrual cycle, help explain the onset of bloating and subsequent relief.

Menopausal hormone shifts can upset the body's normal water balance, causing fluid retention. Retaining only one pint of fluid will add one pound of body weight, thus fluid retention can cause dramatic changes in weight.

Edema (swelling), especially in the feet and legs, is a sign of water retention. The good news is, while retaining water adds pounds to your body, it's not fat, and water weight can be lost as easily as it is gained.

Is hormone replacement therapy (HRT) helpful? Probably.

HRT will address many of the problems described above, but weight gain is still likely unless you take specific steps to prevent it. HRT also may help prevent bone wasting (osteoporosis), a big plus.

Unfortunately, HRT may create other problems, especially if you have a high risk of breast cancer, and therefore the decision is a very personal one that should be discussed with your doctor.

Bryant Stamford is an exercise physiologist and director of the Health Promotion and Wellness Center at the University of Louisville. If you have questions about sports injuries, health, exercise or fitness, write to Body Shop, Gannett News Service, care of The Courier-Journal, 525 W. Broadway, P.O. Box 740031, Louisville, Ky. 40201-7431, or e-mail bryant@louisville.edu.