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Everyday Fitness

with Pamela Peeke, MD, MPH, FACP

This blog has been retired. We appreciate the wisdom and encouragement that Dr. Peeke has offered the WebMD Community.

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Wednesday, August 12, 2009

Minimize Your Menopot

Alright, raise your hand if you’re a woman trying to navigate the treacherous waters of the perimenopausal (40-52) or menopause years (cessation of all menses, usually by age 52-54)? Yep, just as I thought. There are about 78 million baby boomers and over half of them are women, so you’re in good company. Can you relate to this post I received on my weight management board?

“I am 57 years old and am postmenopausel. I work out at least one hour 5 days per week. I eat less than 1000 calories every day, and I CAN’T LOSE ANY WEIGHT! My current weight is 165 pounds. I have had my thyroid checked, and blood drawn, everything is normal. help!” from dmlevins

OK, for dmlevins and all the rest of you who feel her pain, here are some tips and tools. I spent many years in my laboratory at the National Institutes of Health, as well as clinical years working with women over 40, studying what the heck was going on with their ever expanding tummies. Lo and behold, I published Fight Fat after Forty which described why we start having such girth control problems, and I named the extra fat collecting around the middle the “Menopot”. All women get this fat accumulation. On average it can be in the range of 3-6 pounds. It should not be double digits. And, you can’t completely get rid of it. Your goal is to minimize it.

Where does the Menopot come from? As a woman enters her perimenopause, she is slowly withdrawing from powerful sex hormones. Pre-40′s, estrogen usually directed any fat storage to the hip, thigh and buttocks. Post-40, estrogen begins to wax and wane, and any extra fat heads for the abdomen, resulting in the mission impossible of zipping up those jeans. In Body for Life for Women, I wrote that what’s important during this critical time in a woman’s life is that she pay attention to her body composition, not just her weight – the amount of muscle, fat and bone. Every woman should march into her gym or buy a body fat scale and know what her numbers are. Body fat should be in the 20′s, preferably around 25%. Fewer fat cells mean a reduced risk of breast cancer. Her girth should measure less than 35″ to decrease her risk for diabetes and heart disease.

I would advise women who want to drop their over 40 weight to:

  1. Get your body composition and waist measurement done.
  2. Know your thyroid and cholesterol profiles, as well as your fasting blood sugar and blood pressure.
  3. Keep a journal of your eating for one week to observe your patterns— it may be quite an eye opener.
  4. Never eat less than 1200 cals per day or you’ll effectively shut down your metabolic drive, and thus your calorie burning potential. Aim for 1400-1600 calories per day based on activity level.
  5. Eat smaller, balanced feedings every 3-4 hours starting with breakfast and ending with dinner.
  6. Eat lean protein at every meal and the mid afternoon snack. Protein is your appetite, carb crave killing friend.
  7. Avoid alcohol except once or twice on weekends. Too much packs on the belly weight.
  8. Cross train your cardio (don’t do the same thing all of the time— mix it up). Burn 400 calories of cardio 5 days per week. Increase your activities of daily living. Get up and move more.
  9. Add intensity intervals. Too many women look like night of the living dead on their treadmill or elliptical. Ramp it up and shake up those post-40 fat cells. Sweat!
  10. Lift weights 2 x week, paying attention to your upper body especially, since your legs are getting their cardio workout. Don’t forget your core and stretches at the end of each session.

Please take a patience pill. For crying out loud, you’re over 40 and you need to give your body a chance to adapt and adjust as you shed excess weight. Practice a little self love and don’t starve yourself or live in a physical boot camp for weeks on end. Gradually and patiently, you can minimize your Menopot.

Posted by: Pamela Peeke, MD at 5:49 am

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