Getting fit after 40 and 50: new game, new rules
“Scientia potentia est”
(knowledge is power)
Here we are, at the gateway onto middle-age and our golden years, mourning the loss of our younger and perkier selves to this two-timing, ubiquitous, travel companion called age. Nowadays, there is simply no way of blindfolding it all away, courtesy of a globalization that keeps moving the goalposts on us: the moment we let our guard down, a fit-and-fabulous hottie who seems to know something we don’t know about staying young forever, reels up on our social feed, hitting our panic button. The truth is, mid-life malaise is proof that humans are hard-wired to resist change, individually and socially. The bad news is, change, like it or not, is inevitable. The good news is we can learn how to roll with it and even outwit the beast, without resorting to surgical interventions. Middle age brings along a few brand new crosses to bear, things like brain fog, poor concentration, low libido, depression, anxiety, insomnia and fatigue, but perhaps the most recalcitrant scourge of midlife, for the crushing majority of us, is weight gain, an infliction that has many of us up in arms. Ultimately, the sneaky hormonal shifts that trigger that intractable weight increase are the same that underpin all those other disturbances I mentioned, which we now find ourselves wrestling with. At this stage in the game of life, everything we do can feel like a forced move on multiple threats.
Having a misguided understanding of how we change from a hormonal perspective, and what extent of control we do have on looking and feeling better, can easily throw us women into a full-tilted spiral of more confusion, worse depression and, lo and behold, more weight gain. This is why it is imperative, at this point in our hormonal journey, to learn as much as we can about our physiology and, more specifically, our bio-individuality.
Prior to embarking on the safe path to peri-and post-menopausal weight-loss, remind yourself that the rules may have changed, but so have your game and your scoring system. No one is comparing you to young girls, and neither should you. In fact, no one is comparing you to anyone! Uniqueness has never been so fabulous.
Below are some essential key points and suggestions for fat loss after 40 and 50 I routinely urge my clients to take into account:
Bio-individuality is key.
This is true for any age, but at this stage in your life chances are, both genetics and epigenetics have had their run and have largely shaped who you are, both positively and negatively. Hence, though largely age-determined and genetically justified, your unique hormonal make-up also stems from epigenetic adaptations, which means it reflects your lifestyle and dietary choices leading up to this phase of your life. Thus, the way you tackle a weight-loss program must reckon with any and all contingent imbalances or health conditions (one example is PCOS, another is prediabetes), while managing to somehow accommodate your personal preferences, or you’ll end up giving up fast. More importantly, a self-flagellation or newest-wrinkle dieting intervention may have serious consequences on your metabolic health. That is not to say you cannot realign your body chemistry by making lifestyle modifications, it just means you must be prudent and mindful in how you go about it: one size-fits-all solutions unfailingly cause a rebound blowback, hurting you physically and emotionally. Bottom line: the success of your weight-loss endeavor hinges on how fair and compassionate you are to yourself.
Test and assess.
Before declaring war on unwanted fat, be sure to assess your attack and defense system: you will need to first educate yourself as to how to seek out the right testing methodologies. Knowledge is power, and being aware of what it is exactly you are working with, will set you up for success. What I am referring to is functional metabolic testing. It is very unfortunate that our current conventional health model refuses, to an infuriating extent, to run functional test panels in order to establish what is doing what inside the cells, rather than what happens to be there at the time of testing. One example of that is the outdated approach to diagnostic thyroid testing: most physicians will run labs for TSH (thyroid stimulating hormone), and if you’re really lucky they will add T4, ignoring essential markers like T3, free T3 and Reverse T3. Untrained physicians are - alas - very well trained by Big Pharma to explain to you that those labs are useless, that they will not give us ay sort of insight into what is going on. Meanwhile, these are the markers that reveal the full picture when it comes to how well your thyroid is functioning and adapting to cellular changes. Worse than that, thyroid antibodies are often not tested until it is late in the game, when conditions like Hashimoto, that take years to develop, have already been running amok in your body for a while, having you trudging through your days completely frazzled and bewildered. Oh, I almost forgot - a few tens of pounds overweight, and no apparent cause.
Know your hormones, and know how they’re behaving.
You are not just gaining weight because you’re eating junk or not being active: on this curve of your lifecycle, since you are either no longer primed for reproduction or nearing ovary retirement, your hormone levels are not the same. Estrogen and progesterone may be acting insubordinate if you are in perimenopause, or are altogether MIA post-menopause. and you have surely lost the protective and metabolically boosting effects they were meant to have in your reproductive years. I bemoan the same institutional disregard with relation to steroid hormone testing, routinely done in mainstream medicine by bloodwork only, which fails to provide a thorough glimpse into bio-individual endocrine interplay (hormones take different biological paths in different individuals). I see allopathic physicians placing women on HRT (hormone replacement therapy), running inaccurate labs if and when they deem it necessary. Oh, I almost forgot - I’m referring to conventional hormone therapy, the horse urine kind (PREMARIN: pregnant mares urine), known to increase the incidence of breast cancer, stroke, CVD, autoimmune conditions, etc., particularly if administered incorrectly and without other support hormones [you may verify this information on the web]. If you are considering hormone replacement therapy, your safest option is bio-identical hormone therapy, or BHRT. Find a provider that offers BHRT along with urine metabolite testing. Having some form of control over your hormones is a true game changer.
Manage your stress and sleep - it really makes a huge difference.
Chances are, you have heard about cortisol, the dreaded stress hormone that causes us to gain weight. And indeed high or low cortisol levels due to prolonged or chronic stress will cause your hormonal equilibrium to falter by virtue of a survival mechanism, making you prone to gaining weight, notably in all the wrong places. However, cortisol is only the second half of the story, as some of the research is now focusing on adrenaline dominance, a condition in which an excessive amount of adrenaline, the fight-or-flight neurotransmitter that makes us ready and willing to wrestle a ferocious beast or run away as fast as we can, gets pumped out and floods the system, causing glucose levels to constantly rise and insulin resistance to ensue. An output of adrenaline is, in fact, the trigger to a rise in cortisol levels. In his book ‘Adrenaline Dominance’. Dr Michael Platt explores the many medical conditions associated with consistently high adrenaline levels, which include insulin resistance and of course weight gain. Dr Platt proposes a bio-identical progesterone cream therapy (progesterone is an adrenaline antagonist). I will discuss this in detail in another article. Managing stress levels can be achieved through meditation, breathing practices and regular exercise. Supplementation may be helpful: magnesium; D3; some amino-acids such as glycine, L-theanine and GABA shift the brain chemistry in favor of inhibitory neurotransmitters, blunting the excitatory ones; Inositol; a good quality methylated B complex; Ashwaghanda and other adaptogenic herbs. Managing your stress levels will help you achieve better sleep hygiene, and the quality of our sleep has a profound effect on our health and weight management. Just one night of poor sleep causes your insulin levels to rise and fall throughout the day for several days, triggering cravings and causing you to overeat in an effort to compensate for drops in glucose levels (hypoglycemia). Keeping your circadian rhythms in check will also help to manage cravings during the day and surges in glucose and insulin at night, which will disturb your sleep. You can read more about circadian rhythms here.
Gut health, now more than ever.
I have repeatedly talked about gut health, and microbiome diversity and balance. Maintaining a healthy microbiome is absolutely critical to boost insulin sensitivity, maintain emotional stability, achieve and optimize hormonal balance and keep chronic inflammation at bay. If you decide to take the BHRT route, then optimizing your bile function and maintaining a healthy microflora is paramount to hormone function and detoxification. I usually recommend a diet that includes a score of different vegetables, fermented foods like kefir and kimchi if they can be tolerated, plenty of fiber (including resistant starches), the right kind of fats and grass-fed meat. You can read more about microbiome health here.
Last but certainly not least - exercise, in any way, shape or form.
Increasing the amount of activity in your daily life, even just by a small percentage, will do wonders for your health. The benefits of walking extend well beyond calorie burning, so try to take 20 to 45 min walks, at least 3 times per week. Do you remember that old advice - take the stairs, park as far as you can, walk your dog, play with your kids/grandkids? As it turns out, NEAT (non-exercise activity thermogenesis) is a thing, and it truly does make a difference. You can read more on it here. Additionally, and most importantly, aim to work at least 3 weight lifting sessions per week into your exercise routine. Lifting heavy enough weights boosts your testosterone production, balancing hormones naturally, and maintains lean muscle mass, raising your RMR (resting metabolic rate), meaning you will burn more fat even when you’re sitting still or idling. Weight-bearing exercises help counteract sarcopenia, or age-related muscle tissue decline, and ward off osteoporosis, by prompting new bone formation and modulating bone breakdown. A combination of strength training and cardio is remarkably beneficial to the cardiovascular system, and boosts the natural production of ‘feel-good brain chemicals’ such as dopamine and serotonin, while it also increases resilience to internal and external stressors. Exercise of any kind, including simple walking, Pilates and yoga, naturally modulate the immune response, by training the immune system to properly regulate inflammatory processes. This is not to be underestimated, as chronic inflammation is at the root of many metabolic conditions leading to weight gain.