The menopause is a natural biological process that marks the end of our reproductive years and is defined as a complete year without a menstrual bleed. Every woman is different and the changes occurring at the time of the menopause will vary from woman to woman but as we get older, we may notice that maintaining our usual weight becomes more difficult. In fact, many women gain weight around the time of the menopause.

 

Why do we gain weight at the time of the menopause?

• The fall in oestrogen after the menopause makes us more likely to gain weight around the middle. Studies have also indicated that changes at the time of the menopause alter the appetite and satiety hormones resulting in an increased appetite and weight gain. 
• Additionally, as we age, our muscle mass decreases and our metabolism slows down so we burn fewer calories. If we continue to eat as we always have and don’t increase our physical activity, we are likely to gain weight.
• Genetic factors might also play a role in menopause weight gain. If our parents or other close relatives carry extra weight around the abdomen, we are likely to do the same.
• Finally, other factors, such as stress and not enough sleep might contribute to weight gain at the time of the menopause. 

 

What can we do to stop menopausal weight gain?

Although the risk of weight gain after the menopause is higher, this does not mean that it is inevitable. It means that we may have to work a little harder to prevent it from happening. We will need to eat less in our 50s than we did in our 30s. The secret to successful weight loss and becoming healthier is to make sustainable lifestyle changes.

A healthy lifestyle, such as a Mediterranean-type lifestyle, may also reduce our risks of disease associated with older age such as heart disease, cognitive decline and osteoporosis.

 

What is the Mediterranean diet?

The Mediterranean diet is a way of eating based on the traditional cuisine of the olive-growing areas of Southern Europe. Researchers became interested in the lifestyle of people living near the Mediterranean Sea as they were noted to have low levels of disease and longer lives.

Numerous studies have now shown that people following the Mediterranean diet have reduced risk of chronic diseases such as heart disease dementia and type 2 diabetes. In many studies, people following the Mediterranean diet were also far less likely to suffer from obesity. 

The diet is not about calorie restriction – instead, it is part of an overall healthy lifestyle. There is no one way of following the Mediterranean diet as there are many countries around the Mediterranean Sea and people from different countries will eat different food. However, the principles are: 

1. Primarily plant-based with an abundance of fresh vegetables, fruit, legumes, seeds, nuts, lots of herbs and spices and whole grains.
2. Fish, avocado and olive oil as the main sources of fat. Olive oil provides monounsaturated fat, which has been found to lower “bad” cholesterol levels. Nuts and seeds also contain monounsaturated fat and omega-3. Fatty fish, such as mackerel,  sardines, salmon and trout, are also rich in omega-3 fatty acids, a type of polyunsaturated fat that may reduce inflammation in the body. The diet is low in saturated fat.
3. Moderate amounts of cheese, yoghurt, chicken and eggs are also eaten.
4. Red meat is eaten only occasionally
5. Red wine in moderation
6. Minimal amounts of processed and refined foods, including sugar. 

Other important elements of the Mediterranean diet are sharing meals with family and friends and being physically active, both of which are important factors in optimising health. 

 

Is there any evidence that the Mediterranean diet specifically helps peri- and postmenopausal women? 

A recent review suggests it does. It suggests that peri- and post-menopausal women who adopt the traditional Mediterranean diet may:

1. Have less hot flushes. In a large study of 6000 women, researchers found that menopausal women who ate diets high in fruit, certain vegetables and red wine were 20% less likely to have hot flushes and night sweats. There is some evidence that the intake of phyto-oestrogens in nuts and seeds can help reduce symptoms of the menopause.
2. Be less likely to struggle with obesity. Researchers found that postmenopausal women who followed the Mediterranean diet had a lower body weight. The high fibre content may help with satiety and promote healthy weight maintenance.
3. Have reduced risk of heart disease and stroke. The Mediterranean diet tends to be low in saturated fat and includes heart-healthy plant-based foods
4. Reduce their risk of dementia. A good intake of omega-3 in oily fish and nuts as well as reduced inflammation as a result of increased ingestion of plants and fibre help reduce cognitive decline. 
5. Maintain bone mineral density, reducing the risk of osteoporosis.
6. Have improved mood and symptoms of depression. One study looking at women in the early peri-menopause with depression found that adherence to the Mediterranean diet for 3 months significantly improved depressive symptoms.
7. Have a reduced risk of breast cancer.
8. Reduce the risk of premature death.

 

11 easy steps to help you get started on a Mediterranean lifestyle:

1. Eat more fruits and vegetables. Choose a fruit or vegetable to have with every meal.
2. Opt for whole grains. Replace processed or refined grains (think white flour) with whole-grain bread, cereal or pasta. 
3. Use healthy fats. Try olive oil as a replacement for butter when cooking. Instead of putting butter or margarine on bread, try dipping it in flavoured olive oil.
4. Eat more seafood. Eat fish twice a week. Salmon, trout, mackerel and herring are healthy choices.
5. Reduce red meat. Substitute fish, poultry or beans for meat. If you eat meat, make sure it is lean and keep portions small.
6. Enjoy some dairy. Greek or plain yoghurt and small amounts of a variety of cheeses.
7. Add in more nuts, seeds and legumes. 
8. Spice it up. Herbs and spices boost flavour and lessen the need for salt.
9. If you drink alcohol, enjoy a glass of red wine with your dinner a couple of times a week.
10. Increase your physical activity to include aerobic exercise, balance and strength training. Keep active by finding exercises that you enjoy. A brisk walk is great for both physical and mental well-being.
11. Strategies to improve sleep may help reduce the risk of weight gain in addition to improving your overall health and quality of life. A good night’s sleep will improve your mood, reduce food cravings and enhance your physical and mental performance.

 By Dr Mohgah Elsheikh