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Dr. K: Maintain healthy eating habits during menopause

DEAR DOCTOR K: Does menopause cause weight gain?

DEAR READER: In the United States, women typically go through menopause between 47 and 59 years of age. And the average woman gains about one pound per year around the time of menopause. Not surprisingly, we tend to assume that menopause causes weight gain.

Research suggests that there is no direct link between menopause and weight gain. But menopause may play an indirect role.

For example, poor sleep can lead to weight gain. And many menopausal women have trouble falling asleep or staying asleep. Lack of sleep may alter the hormones that regulate hunger. If you’re not sleeping well, you may feel hungrier before meals and less full after meals.

Stress can also play a role in weight gain. At menopause, the body stops making the hormone estrogen. This reduces the body’s ability to regulate the hormone cortisol, which helps to manage stress. Higher cortisol levels may trigger an increase in appetite.

Other changes that occur around the same time as menopause may also contribute to weight gain. As women age, muscle mass decreases and fat mass increases. This slows metabolism. As a result, the body burns off fewer calories than it did previously.

Many women’s eating patterns change around menopause, due to other changes in their lives. When children move out of the house, some women may no longer cook or eat dinner regularly. Eating infrequently or skipping meals can slow metabolism, further interfering with your body’s ability to burn calories.

There’s another reason that eating patterns start to change around menopause, when kids move out of the house. I’ve had several patients who told me that they always prepared healthy meals when they had kids at home. They knew that what kids ate as children could affect their health in later years. But when the kids left, and they were cooking only for themselves and their spouses, they started preparing higher-calorie meals, with less healthy foods.

Many women also change how they carry their weight around menopause. Fat tends to move from the hips to the abdomen (belly). Even if this shift in fat stores does not cause an increase in weight, increased abdominal fat does increase the risk of many serious health conditions. These include heart disease, high blood pressure, insulin resistance and Type 2 diabetes.

If you find yourself gaining weight at midlife, refocus on the basics:

— Eat a healthful diet.

— Practice portion control.

— Eat at regular intervals and avoid skipping meals.

— Be physically active.

— Find ways to manage your stress.

— Get enough sleep.

These tips may help you to maintain your weight. Even better, they may help you lose weight before, during and after menopause. Avoiding excess weight gain will lower your risks of diabetes and heart disease. It also will help you to live a more healthful life.

Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.

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