Wednesday, May 18, 2005

Creeping Up

Somehow, as I've gotten older, the weight seems to go on more quickly and come off more slowly -- no matter how much I exercise. I know many women whose once-lean bodies turned matronly as they reached menopause. The good news, though, is that several recent studies prove that weight gain at menopause is not inevitable. The National Institutes of Health sponsored the Study of Women's Health Across the Nation (SWAN) in which researchers tracked 3,064 ethnically diverse women ages 42 to 52 over a three-year period. None had yet gone through menopause at the time the study began. At the end of the three years, the women had gained an average of 4.5 pounds, or 3% of their body weight, and increased waist circumference by about one inch. However -- and this is what's really intriguing -- whether or not the women had gone through menopause made no difference in their weight gain. Furthermore, the study found that women who were highly active or who became active during the course of the study did not gain weight. In fact, with activity, some lost both weight and inches from their waistlines. In the second study, Harvard's famous ongoing Nurses' Health Study, researchers measured 116,686 young and middle-aged women several times during an eight-year period. They discovered that women who drank no more than one sugar-sweetened soft drink per week did not gain weight, but women who drank more put on weight. So, is it simply the age-old issue of "too much in results in too much on"? To discuss how to control weight in middle age, I called Jana Klauer, MD, research fellow at the New York Obesity Research Center at St. Luke's-Roosevelt Hospital in New York City and physician in private practice teaching weight control. Dr. Klauer says that menopause does not dictate weight gain and it is crucial to avoid gaining weight at this time because postmenopausal women's cardiovascular risks go up -- extra weight is an additional risk. She acknowledges that weight can be harder to control in middle age -- not because of hormones, but because metabolism slows by about 10% in these years. If unchecked, this can result in a gain of 10 or so pounds. You can indeed stop and even easily reverse that slowdown. Tests for metabolism are largely based on the body's resting rate (when the body is not in motion), she says, and the determiner of that is mostly the amount of muscle mass a person has. The more muscle you have, the higher your metabolic rate will be. The way to obtain more muscle mass is through exercise, especially strength training. Working with weights several times a week isn't nearly enough when it comes to exercise, says Dr. Klauer. She emphasizes that exercise after age 40 is no longer an option -- to stay healthy, it is a daily imperative. She recommends an hour each day of a weight-bearing exercise such as walking, jogging, cycling, dancing and the like -- whatever takes you beyond the level you experience walking around your house or office. Although this may seem like a lot, if you can manage 15-minute spurts of activity throughout your day, it adds up. Be sure the activity you choose helps you build strength in your legs. Dr. Klauer points out that if the legs aren't strong, people begin to slow in their movements and balance problems set in. After women pass age 40, their food choices also begin to play an ever-bigger role, says Dr. Klauer. Diet should be one that is heart-healthy and nutrient-rich. In fact, she points out that if you are eating all the nutrients you need, there won't be room in your diet for what she considers junk foods -- processed foods, simple carbs, including high-sugar foods, and anything more than one drink of alcohol a day. She reminds people that large quantities of fruits and vegetables are a wonderful way to keep weight under control because they are filling and provide much-needed fiber. She also advises eating about 60 g a day of high-quality protein. (Example: 3.5 ounces of fish has about 21 g of protein... a similar amount of chicken has 25 g... and a pint of milk has 19 g.) To get started on a healthy diet that will help you reduce or maintain a proper weight, Dr. Klauer says to record everything you eat until your new way of eating is firmly entrenched. She finds that most people are shocked to see how many little extras have crept into their daily diet, small splurges that add up to big numbers on the scale. Keeping a record will make you aware of what extra treats you are eating and help protect you from falling back into those bad habits. No doubt, following the high level of exercise and healthy diet that Dr. Klauer describes is the surest way to control weight in and past middle age. It is also the best guarantee of a long and healthy life. And that's not a bad trade-off, not bad at all.

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