Menopause and Weight Loss

Many women associate menopause or the use of hormone replacement therapy with weight gain. But what are the facts? And what can you do about it?

In both women and men, there is an increase in Body Mass Index (BMI) with age, with the peak BMI occurring between 50 and 59 years of age (1). Many women claim that this weight gain is caused by menopause, however research doesn't support these claims. Women gain total body weight at a linear rate from age 35 - 65, a trend that is not related to loss of ovarian hormones or their subsequent replacement (2).

Menopause results in body composition changes that could indirectly lead to weight gain. During the menopausal years there is a shift in the distribution of fat from the traditional hourglass figure of the younger woman to a more central deposition in the abdomen.

These changes in fat distribution are independently associated with an increased risk of developing hypertension, abnormal lipid profiles, Type II Diabetes and cardiovascular disease (3). In addition to the change in the distribution of body fat, there is more body fat and less muscle mass. This may decrease resting metabolic rate, which in turn results in weight gain (4).

What's the best advice for women dealing with weight gain in their menopausal years?

Exercise. Try walking at a moderate intensity for at least 30 minutes a day (in 10 - 30 minute bouts) and partake in bi-weekly resistance training sessions. This prescription is supported by a study that demonstrated numerous health benefits for exercise in menopausal women, including loss of abdominal fat and overall body fat (5).

References:
1. Kuczmarski RJ, Flegal KM, Campbell SM, Johnson CL. 1994, 'Increasing prevalence of overweight among US adults, A National Health and Nutrition Examination Survey 1960-1991' Journal of the Americal Medical Association, 272:205-11

2. Davies KM, Heaney RP, Recker RR, Barger-Lux MJ and Lappe JM. 2001, 'Hormones, Weight Change and Menopause' International Journal of Obesity, 25:874-879

3. Sturdee D, MacLennan A. 2007, 'The weight problem', Climacteric, 10:2

4. Smith K. 2005, 'Exercise Can Help Control Body Changes During Menopause', Healthcare, Food and Nutrition, 22(10)10-11

5. Asikainen T, Kukkonen-Harjula K, Miilunpalo S. 2004, 'Exercise for Health for Early Postmenopausal Women', Sports Medicine, 34:753-778

Find Your Motivation to Exercise: 10 Tips

Struggling to get out the door for your afternoon walk? Or finding that extra hour of sleep more appealing than hitting the pavement for your morning stroll?

Despite being well aware of the benefits of exercise - and knowing how great you will feel after exercising - you may find yourself struggling with motivation. Read on for some tips:

1. Adopt an Exercise Buddy

Exercise buddies keep you accountable - there's nothing like the commitment of knowing that someone is waiting for you. Walking groups or cycling bunch rides are a great way to meet people, and as your fitness improves, other people who have greater fitness will spur you on!

2. Walk to a Beat

Listening to music can motivate you during exercise, resulting in longer, more enjoyable sessions. If music isn't your thing, try listening to books on CD or podcasts.

3. Try Something New

Try cycling, aqua aerobics, water running, walking, swimming or even dancing. There is a form of exercise that you will love out there - you just may not have found it yet!

4. Just Do It

Sometimes overanalysing can be detrimental - you just need to get out there and exercise!

5. Enter Fun Runs and Walks

You don't have to be a serious runner or athlete to enter races, most have 'walker' divisions. Aim to do a fun run or walk to sustain interest and give yourself a goal to work towards.

6. Schedule It

Book an appointment with yourself and prioritise exercise just like you would any other appointment.

7. Exercise Early

If you want to get something done, do it before other tasks and responsibilities accumulate. If you exercise early you will benefit from an elevated metabolic rate for the remainder of the day, which means you are likely to burn more calories. If you can't fit exercise in early, try to do it before you get home. Once you get home, it can be difficult to go back outside!

8. Be Prepared

Keep a bag of exercise clothes at your work or in your car - you never know when you may be able to fit in an exercise session. If you are going to exercise in the morning, organise the gear you need the night before.

9. Keep Track

Keep an exercise diary, or use a heart rate monitor to measure your exercise intensity, duration and calories burned. When you meet your exercise goals, treat yourself to a non food-related reward. When you are pressed for time, a pedometer is a great way of measuring your incidental exercise.

10. Be Flexible

Don't worry too much about missed exercise days, but try to identify the barriers that prevent you from exercising and address them.

How Much Exercise Do I Need to Do to Lose Weight?

The amount of exercise you need to do depends on your weight loss goal. If your goal is:

1. Weight loss 150-250 minutes of moderate intensity* physical activity per week provides modest weight loss. People with a body mass index that classifies them as overweight or obese should aim for more than 250 minutes of exercise per week (e.g. 5 sessions of one hour per week) and perform resistance training to increase the amount of metabolically active muscle tissue in their bodies and reduce their health risks.

2. Weight maintenance More than 250 minutes per week of moderate intensity physical activity per week (e.g. 5 sessions of 50 minutes per week).

3. Preventing weight gain 150-250 minutes of moderate intensity physical activity per week (e.g. 5 sessions of 30 - 50 minutes per week).

*Moderate intensity physical activity is an increase in your breathing rate to a point where you are still able to talk comfortably but not sing. A more technical explanation is that it is exercising in a range of 65-75% of your maximum heart rate. Modes of exercise which are best suited to moderate intensity exercise are brisk walking, swimming, bike riding or cardio machines at the gym. Exercise should be continuous rather than in short bursts (these short bursts occur in sports such as tennis or touch football).

Remember that it's very difficult to lose weight through exercise alone. If you try to lose weight without reducing your calorie intake you'll need to exercise for at least 300 minutes a week! The best way to lose weight is to exercise AND consume fewer calories. Not only will you lose weight at a faster rate, but by engaging in regular aerobic exercise you'll keep the weight off for life.

Reference
Donnelly, J. et al., 2009, ' Appropriate Physical Activity Intervention Strategies for Weight Loss and Prevention of Weight Regain for Adults', Medicine & Science in Sports & Exercise Vol. 41:459-471.

Habitual Eating: How to Break the Cycle

Here are some tips to help you outsmart habitual eating and take control of your weight:

Eat Slowly

People who eat quickly are twice as likely to be overweight than those who eat more sensibly. And people who eat quickly and eat too much are three times as likely to be overweight than those who eat more sensibly (1). Here's how to eat in a more controlled manner:

- Allocate 20 minutes for main meals and 10 minutes for snacks
- Put a jug of water on the table and sip water throughout your meal
- Put your cutlery down between mouthfuls
- Cut your food into small bite sized pieces and eat one piece at a time
- Increase the number of times you chew your food before swallowing
- Pause in the middle of meals or between courses
- Talk during mealtimes: people who do so are often still eating after their companions have finished.

By eating slowly, you give your taste buds time to register the flavours in your food. Plus you experience a greater sense of control as you have more time to decide how much food you will eat.

Portion Your Food

Most people use visual cues to tell them when to stop eating, so when a big portion is placed in front of them they eat the whole lot (2). Some tips for limiting your portion sizes are:

- Serve yourself in medium sized portions from the stove (if your serve sizes are too small you will return for second helpings) and avoid placing dishes on the table.
- Eat your food from a plate to increase your awareness of how much you are eating: don't eat out of bags or containers.
- Remove any leftovers as soon as possible after eating. Put them in the fridge for the next day, throw them away or if you are entertaining, give them to guests to take home. Don't fall into the trap of thinking that you are wasting food by throwing it away: unlike excess food in the bin, excess food in your stomach can lead to weight gain and poor health!
- If your plates are large, don't feel the need to fill them with food.
- Leave a small portion of food on your plate at the end of every meal. Don't feel that you have to 'clean your plate': many people are conditioned to do this from an early age but it's not healthy.
- If you are eating out, don't feel that you need to eat the entire dish: take the leftovers home.

Take Control of Emotional Eating

Emotions can become powerful cues to eat inappropriately. People use food to reduce frustration, control boredom, or to comfort themselves when they are feeling lonely, anxious, angry or depressed. If you eat as a means of coping with emotions, you need to find non food-related ways to deal with your emotions such as going for a walk, taking a bath or calling a friend.

It's also useful to learn to attune to your body and distinguish between physical hunger (where your stomach is rumbling and you physically need to eat) and psychological hunger (where cues such as emotions, settings, social occasions and sights and smells of food encourage you to eat). Physical hunger is a useful and appropriate cue to eat - psychological hunger is not.

Practice Mindful Eating

Take the time to sit down and savour the flavours of your food rather than eating on the run:

- Limit your eating to a specific room such as the dining room or kitchen. Eating in other rooms such as the bedroom or living room can trigger a desire to eat when you are in these rooms: even when you aren't hungry.
- Break the link between eating and activities such as talking on the phone or watching a movie.

- Clear you mind of distractions before you eat so you can register an enjoyment of your food and acknowledge the calories.
- Sit down and enjoy your meal so your brain has time to register that your stomach is full.

Breaking ingrained habits can be tough, but if you give yourself time to practice and persevere when you make mistakes, you will regain control of your eating habits.

References:
1. Maruyama K, et al. 2008, 'The joint impact of self reported behaviours of eating quickly and eating until full on overweight: cross sectional survey' British Medical Journal 337:a2002.
2. Dr Elizabeth Denney-Wilson, Research Fellow at the University of NSW quoted by ABC News in Science

Exercise and Weight Loss – Getting the Balance Right

When it comes to exercise, it’s often difficult to know where to start. There are many different approaches from ‘do it yourself’ gym memberships, group exercise, personal trainers. The Biggest Loser television program provides an extreme view of exercise and weight loss. Don’t forget contestants are recommended to consume only 1200 calories per day compared to their pre-program intake of 5,000 plus calories per day reminding us that calorie control is the first step in any weight loss journey. Calorie control comes from the quality and quantity of food we consume.

The Goal

There is no right or wrong answer but you need to find a routine that is going to complement your goals. Are you trying to lose weight, maintain a healthy weight or just improve your fitness? Also it needs to be practical for your lifestyle and still allows time for adequate rest. With weight loss, the primary goal of exercise is calorie expenditure from burning fat as the preferred fuel for our muscles. But if your exercise intensity is too high, then your body switches to burning stored sugars for fuel and tiredness and hunger can set in. Going too hard, too early can also lead to soreness and injury and a feeling of it’s not going to work. So working out with a personal trainer can be great for working up a sweat but not so great for weight loss.

Frequency and Consistency

With any form of exercise frequency and consistency are the key. Establishing some form of physical activity that is a regular part of your routine, 4-6 days per week, is ideal. Choosing the right exercise is simple, walking, gym classes, swimming, riding and even the Wii fit are all good options, as long as you are getting your heart rate up for an extended period, preferably 30 mins or more. Increasing your heart rate to the right intensity means you will burn fat as the preferred fuel source, the longer you do it the more you burn.

Enjoyment

When the alarm goes at 5:30am getting out of bed for something we enjoy makes it a lot easier. So think about an activity you will still enjoy on the days when you are lacking motivation or tired? We recommend walking as the best option because walking means putting on some decent shoes and heading out the door for half an hour. It also is the most efficient way to mainly burn fat during exercise. Other exercises like cycling or swimming are also great for elevating your heart rate and what is even better is varying your routine between all three to really add some spice to your routine. Activities you can do with other people give you that motivation not to miss a session.

Burning Fat = Losing Weight

During exercise fats and carbohydrates are metabolized for energy. As exercise intensity increases the fuel mix needed changes from predominantly fat to stored sugars. Our body stores sugars in the liver and muscles but only enough for several hours of intense exercise so when these stores are used they will need to be replenished through diet. That is what marathon runners do during a race. Burning fat stores is what we want to achieve when losing or maintaining weight is our goal. This occurs at lower exercise intensities. Each kg of fat stored has enough stored energy to power us for 25 hours of walking or150 kilometres at a brisk walking speed.

How Hard

Intensity (or heart rate achieved) of exercise is a critical aspect when it comes to weight loss and weight management. Intensity can be broken into ranges from light through to vigorous which is determined by the energy demands placed on the body. As exercise intensity increases so do the body’s responses, including higher respiratory rates, increased blood flow to the large muscle groups and the greater need for nutrients and fuel.

Heart Rate for Burning Fat as the Preferred Fuel Source

Heart rate and age are often used to estimate a target heart rate range for fat burning

Minimum target heart rate = (220 – age) x 65%

Maximum target heart rate = (220 – age) x 75%

For example, a 40 year old person’s minimum target heart rate is calculated as:

(220 – 40) x 0.65 = 180 x 0.65 = 117 beats per minute

Their maximum target heart rate is calculated as:

(220 – 40) x 0.75 = 180 x 0.75 = 135 beats per minute

So in this example keeping our heart rate between 117 and 135 beats per minute will keep us burning fat as our primary fuel source.

Tips

Heart Rate Monitors (HRMs) are an accurate way of recording your exercise intensity. Another rule of thumb is to make sure you can still hold a conversation while exercising. If your breathing rate is so high that you can’t talk, then you are probably burning sugars and not fat.

Routine

Completing your exercise sessions at the same time each day can be very helpful and enable you to stick to routine more effectively as well as eliminating any exercise-related motivational issues you may have. Initially, you may find that your exercise intensity is the component you find the most difficult to keep up, however this will ease over time as your body adapts to the routine and becomes fitter.