Why do we gain weight gain in perimenopause and what can you do about it? 

If you are a perimenopausal women, chances are you may have noticed your waistline expanding even though your diet and exercise regime are the same.  During perimenopause it does become harder to maintain your weight. This happens for a number of reasons. Firstly, you become less sensitive to insulin and more likely develop insulin resistance which leads to weight gain, secondlyyou start to lose muscle mass which leads to a decrease in your metabolic rate by up to 15% (your metabolic rate is the rate at which calories are burned whilst you are at rest) and thirdly is down the the loss of progesterone. Progesterone increases your metabolic rate (this is why your temperature rises during the second half of your cycle). This increase in metabolic rate can equate to upto an additional 270 calories burnt without lifting a finger. The loss of progesterone means the loss of its metabolic benefit. So, even if you eat the same foods you always have and maintain your exercise levels, you may find that the weight creeps on.

However, there are things that you can do to avoid excess weight gain although the reality is that some weight gain is inevitable.

Firstly lets look at insulin resistance and how that leads to weight gain.

Glucose is a sugar and is the main fuel for the body, we need it to survive but both too much and too little are not a good thing and so blood glucose levels are tightly regulated by the hormonesglucagon and insulin. 

When blood glucose levels are low, glucagon is released and stimulates the release of glucose from the body’s stores. When blood glucose levels are high, insulin is released from the pancreas which stimulates the uptake of sugar by the cells where it is either used for energy or stored as fat. This is why excess sugar intake can lead to increased weight gain, in particular around the middle. 

Oestrogen plays a role in regulating the action of insulin which is why when women hit menopause and oestrogen levels drop, they are more at risk of insulin resistance. Insulin resistance is a bit like when your child says ‘mummy’ to get your attention. If you don’t respond immediately the child shouts louder and louder until they have your attention. In the same way, when the cells of your body become less sensitive to insulin, it’s as though they are not hearing the message from the pancreas. So the pancreas starts to pump out higher and higher levels of insulin in order to get a reaction. The pancreas is now shouting at your cells to listen.  

Insulin has a huge impact on sex hormones and high levels can cause imbalances that can exacerbate your symptoms and also increase the risk of heart disease, diabetes and dementia as well as gaining weight. The other impact of insulin resistance is that despite plenty of insulin in the blood and plenty of glucose in the blood, the glucose cannot get your cells where it will be used to produce energy. Suddenly, your energy levels are all on the floor and weight starts piling on even though you are eating the same foods you have always done. So as you hit perimenopause and enter this new phase of life, you need to adopt a new way of eating that helps to balance blood glucose levels and avoids triggering a big insulin response.

A blood sugar balancing diet is one that maintains healthy insulin sensitivity and focuses on whole, real foods such as meat, fish, eggs, tofu, lentils, beans, chickpeas, nuts, seeds, wholegrains and plenty of brightly coloured fruit and vegetables. The secret to making this way of eating work is to make sure you follow a low glycaemic load diet (more on this in a moment) and include protein with each meal and snack.

The glycaemic load or GL is the measure of how much a food will cause your blood sugar to rise. Although protein can have a small impact on blood sugar levels, it is the carbohydrate content of the diet that has a significant impact on blood sugar levels. Carbohydrates are all made of chains of simple sugars. When we digest carbohydrates, these chains of single sugars are broken down are free to pass from the digestive tract into the blood stream.

Some carbohydrates are rapidly digested and release these sugars quickly. These are said to have ahigh glycaemic load. They are known as simple carbohydrates and are found in refined flours and foods such as white bread, sweets, cakes, biscuits, white rice, potatoes. Complex carbohydrates on the other hand, have chains of simple sugars that are digested slowly and so the single sugar isreleased more slowly into the bloodstream. These are said to have a low glycaemic load. Complex carbohydrates are found in foods such as wholegrains, vegetables, beans, lentils. As the release of glucose is much slower from complex carbohydrates, it has a smaller impact on blood sugar levelsand insulin. Furthermore, because these foods are less processed they tend to be more nutrient dense and contain many of the nutrients that are needed to process the sugar efficiently and make energy.

But it is not just diet that causes blood sugar to rise. Watching a scary movie, alcohol, a stressful day at the office or at home with the kids, a cup of coffee or having a cigarette can also cause blood sugar levels to rise. So as well as focusing on complex carbohydrates, it is also essential to reduce intake of stimulants (caffeine, nicotine), avoid alcohol and reduce stress.  

So the second factor was declining muscle mass. The loss of muscle leads to a decline in your basal metabolic rate which means your daily energy requirement decreases. The type of exercise you do during perimenopause therefore becomes more important. NHS recommends that for general health you should do at least 2 session of muscle strengthening exercises a week but you may need more than this during perimenopause. Muscle building exercise includes lifting weights, using resistance bands, climbing the stairs, walking up hills, dancing, cycling, squats, push ups, yoga and Pilates. Doing this will help you build muscle which will not only increase your basal metabolic rate, it also helps to improve insulin sensitivity.

Finally, progesterone. The loss of progesterone is inevitable. One solution is HRT in the form of body identical progesterone but be aware that synthetic progestins found in some forms of HRT and the pill do not have the same metabolic benefit as actual progesterone.

So yes whilst it is possible to avoid excess weight gain during perimenopause, you will need to change your diet and lifestyle to achieve it.

If you would like help to make changes to your diet and lifestyle to support your perimenopause journey, book in a complimentary consultation using the link below.

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