Causes of increased Abdominal Weight in Menopause
I am often asked why women experience increased weight around their abdomen when they go through peri and full menopause. These are often women who have relatively healthy diets and who exercise regularly and are perplexed as to why this is happening to them.
Reasons for increased belly fat appear to be multifactorial. Maintaining a good diet and regular exercise is essential at this time in life, however the change can be, in large part, due to a shift in hormones and poor sleep patterns.
Hormones:
Research has found that as oestrogen levels decline, changes in fat distribution occur and fat is then often increased around the belly area. A meta-analysis investigated the effects of hormone replacement therapy (HRT) on the components of metabolic syndrome in post-menopausal women and found HRT reduced abdominal obesity and several metabolic markers in women without diabetes, in addition to pro-coagulant factors and adhesion molecules. It should also be noted that oral HRT increased C-reactive protein (CRP) and decreased the coagulation inhibitor, protein S, however transdermal oestrogens with or without progestin did not demonstrate these effects. (It needs to be noted that a doctor who prescribes HRT must inform their patient of possible adverse outcomes).
However a 2012 review of literature on the menopause transition found that there is no clear understanding of the impact reduced oestrogen makes to abdominal weight gain.
Diet and Exercise:
As we age a nutritious diet and regular exercise is paramount to encourage healthy ageing. A sedentary lifestyle is a contributing factor to abdominal weight gain. Muscle mass and strength both decline as we age which results in reduced burning of energy as well as weight gain.
Sleep Deficit:
Sleep deficit can be the result of stress which dysregulates cortisol and can prevent cortisol reductions in the evening. This leads to reduced melatonin being produced which can interfere with sleep. A negative cycle can ensue as sleep deprivation leads to raised levels of cortisol in the evening as well increasing appetite stimulating hormone ghrelin. As the appetite suppressing hormone leptin is decreased changes in thyroid function can occur. This can lead to insulin resistance and also increased abdominal weight gain.
Liver health is essential and is key to your overall health and weight. It acts as a filter to remove toxins (including medications and alcohol) and nutrient byproducts such as ammonia from the blood; it aids in digestion by producing bile to help break down fat and absorb fat- and water-soluble vitamins and minerals; and it is involved in hormone metabolisation (including oestrogen and insulin) as well as regulating glucose, blood pressure, blood sugar, blood cholesterol production and removal.
Naturopathy can help balance hormones and keep the liver healthy, through nutrition and herbal medicine which focus on supporting the balance of oestrogen and other hormones as well as the elimination of recycling oestrogen that can occur at this time. Liver health is essential for assisting with efficient oestrogen metabolisation as well as good digestion. I also find in many cases the application of personalised detoxification programmes can be beneficial for many women – however every case needs to be assessed independently taking into account a client’s health history and genetic factors.
With regards to sleep dysregulation, the use of herbs and supplementation and assisting clients practice good sleep hygiene can be beneficial in many cases. However there are times when testing is required to ascertain what the actual cause is. Studies have found that yoga and meditation is beneficial in helping reduce stress including through the menopause years. The practice of hatha yoga (or physical postures) support the maintenance of muscle mass and strength. I also work in conjunction with an exercise physiologist to support this aspect of menopause management especially when a client may have musculoskeletal issues.
For more information contact Marianne by phone or through the link on the website.
(References on request)