We’ve created clever euphemisms to describe it – like muffin top, mid-life bulge, and a thickening waist. But however you want to refer to belly fat, it’s an unfortunate fact of life for most women in mid-life and getting rid of it is, as a friend of mine put it, like chiseling cement.

I’ve been in search of diet and exercise books to find the cause as well as a cure to belly fat and I came across From Belly Fat to Belly Flat: How Your Hormones Are Adding Inches to Your Waist and Subtracting Years from Your Life — the Medically Proven Way to Reset Your Metabolism and Reshape Your Body, by Dr. C.W. Randolph.

Dr. Randolph, a board certified OB-GYN, is well known for advocating the use of natural medicine to treat women’s health concerns and he has been a leading proponent in the use of human-identical hormones to treat symptoms of hormone imbalances. I contacted Dr. Randolph by email to ask about the connection between hormones and abdominal weight gain and how hormone-balancing can help. His responses follow:

Wendy: A lot of women begin complaining about abdominal weight gain, along with sleep problems and an inability to focus or concentrate in their 40s, but because they’re still getting their periods, they don’t attribute it to menopause. When do a woman’s hormone levels begin to get out of whack?

Dr. Randolph: In a women’s early to mid-30′s, progesterone levels are the first of the three sex hormones (progesterone, estrogen and testosterone) to decline. In fact, progesterone levels decline 120x more rapidly than estrogen levels. The result is a disequilibrium of estrogen to progesterone medically termed “estrogen dominance.” Too much estrogen with too little progesterone is the culprit responsible for the more subtle (or less well recognized/diagnosed) symptoms of hormone imbalance such as sleep disturbances, foggy thinking and abdominal weight gain. Dr. Erika Schwartz explains it well in her book, The Hormone Solution: Naturally Alleviate Symptoms of Hormone Imbalance from Adolescence Through Menopause”

No, you’re not losing your mind: you’re just losing your much-needed progesterone. When you don’t have enough progesterone circulating, estrogen is the dominant hormone. Estrogen in overabundance makes you angry, edgy, short-tempered and anxious. At the same time, estrogen increases the water content in your brain making you groggy, fuzzy and unfocused.

Wendy: The weight creep experienced in mid-life seems to land (and remain) right in our abdomen. Why is this?

Actually, hormone related abdominal weight gain typically begins in the early to mid-30s, coinciding with decline in progesterone production and the incumbent estrogen dominance. Medical research shows that the average woman will gain one to two pounds each year between the ages of 35 and 55 and these pounds will cement around the waist, butt and thighs.

Estrogen dominance is the culprit. To get and keep those pounds off, it is essential the optimum hormone balance be restored via bio-identical hormone replacement therapy (BHRT). To accelerate the body’s off-loading of its extra estrogen, there are foods and supplements medically proven to help the body eliminate the extra estrogen.

Wendy: What types of foods do you recommend?

Dr. Randolph: The stars of my nutritional plan are cruciferous vegetables, citrus fruits, insoluble fiber and lignans because these foods will all function within the body to reduce an unhealthy estrogen load. The consumption of cruciferous vegetables is a critical pivot of my plan’s success.

Cranberries, with their powerful proanthocyanidins, were believed to be helpful in avoiding, rather than curing UTIs by preventing the bacteria from sticking to the bladder wall and multiplying in the first place.

However, new research published just last week in the Archives of Internal Medicine showed, that commonly used antibiotics are more effective than cranberry capsules in preventing recurrent UTIs. The downside of course is the possibility of becoming resistant to the antibiotic if you have to take them frequently.  For those women, researchers said that cranberries “may” be a useful alternative despite its lower effectiveness.

Have you been successful at staving off a UTI with daily doses of cranberry juice?

The current issue of the Berkeley Wellness Letter devotes an entire page to magnesium, calling it a “mighty mineral that’s involved in energy production, cell growth, blood pressure, bone health and the functioning of the heart, nerves and muscles.”  The writers suggest that most American’s don’t consume the recommended daily intake of magnesium, but  it’s hard to know if you’re truly deficient.  The answer lies in a wide range of symptoms such as muscle weakness, cramps and spasms and arrhythmias. But they question whether it’s better to get your magnesium from food or from a supplement.  The medical experts contributing to this article believe that you should only take a separate magnesium supplement if you’re at a high risk for a deficiency or you take a medication (for reflux, for example) that can impede absorption.  If you fall into one of those categories, ask your physician or a naturopathic doctor about the dosage that’s right for you.  But remember, there are plenty of magnesium-rich foods that you can choose from including green vegetables, some legumes and nuts and seeds.  Here are the top five. For a longer list, visit the website of the NIH Office of Dietary Supplements.

- Halibut or mackerel  (4 oz) 120 mg

- Dried Sunflower Seeds, (1 oz)  100 mg

- Cooked spinach or chard (1/2 cup) 80mg

- Almonds or cashews (1 oz) 77mg

- Flounder or sole (4 oz) 75 mg

The Everything Health Guide to Menopause, is written by Kate Bracy Kalb RN, a women’s health care practitioner, with a technical review by a gynecologist, Kathryn Arendt, MD. The book is packed with information from the basic facts of menopause (including perimenopause) and hormone therapy to managing physical changes that often occur such as heart palpitations, weight gain and even involuntary urine release.  The authors also explain the cognitive and neurological changes that occur in midlife including insomnia, headaches, low libido, mood swings and depression.   Additional chapters are devoted to the changes that occur to our vision and  brain as we age, with advice on how to keep both as sharp as possible.
What Nurses Know …About Menopause is written by Karen Roush, RN, the former editorial director of the American Journal of Nursing. She begins with “just the facts,” an explanation of what’s happening to our body and why. Then she devotes chapters to some of the most common complaints of the menopause transition (i.e. hot flashes, night sweats, bone health) and explains what they mean and how to treat them.   She concludes each chapter with a list of websites for further research on your own. Karen does a particularly good  job covering hormone therapy starting with an overview of research studies including the Women’s Health Initiative and current recommendations about HRT. For those who are considering HRT, and are weighing the risks vs. benefits, she provides a list of factors that you should think about and review with your physician. And for those who are thoroughly confused about what bio-identical hormones really are, you’ll find a comprehensive explanation without bias, which is rare these days.

Finally, Mia Lunden, a registered nurse and the founder/director of the Center for Hormonal and Nutritional Balance in Santa Barbara, CA, has authored, “Female Brain Gone Insane: An Emergency Guide For Women Who Feel Like They Are Falling Apart,” which focuses on the emotional symptoms associated with hormone imbalances such as mood swings, depression, irritability, and lack of motivation. This is an area of our health that is often overlooked if not totally ignored by medical professionals. Her interest in this area of mid-life health stems from her own experience with postpartum depression following the birth of her second child.  You’ll find a thorough explanation of the hormone-brain connection and bio-identical hormone therapy, which she advocates in this book.

Lifestyle choices made in midlife can have a major impact on your functional ability late in life.  If you begin a daily walking program at age 45, you could delay immobility to 90 and beyond… Even the smallest interventions can produce substantial benefits and significantly delay your date with disability. It’s never too late for a coarse correction.”

I’m off to the gym… how about you?

]]> http://www.menopausetheblog.com/2010/10/26/a-prescription-for-aging-well/feed/ 2 http://www.menopausetheblog.com/2010/10/14/a-five-point-exercise-plan-for-osteoporosis/?utm_source=rss&utm_medium=rss&utm_campaign=a-five-point-exercise-plan-for-osteoporosis http://www.menopausetheblog.com/2010/10/14/a-five-point-exercise-plan-for-osteoporosis/#comments Thu, 14 Oct 2010 14:00:54 +0000 Joan Pagano http://www.menopausetheblog.com/?p=1665 Continue Reading]]> Note from Wendy:  Joan Pagano is a personal fitness trainer in New York City and has worked with hundreds of mid-life women to  strengthen, tone and shape their bodies.  Joan advocates a well-rounded exercise program to fight osteoporosis and to help women age well.  In this guest blogpost, she offers guidelines that can help protect and strengthen your bones.

My mother’s skeleton crumbled when she was in her 80′s.  I have a mental picture of a collapsing infrastructure that can no longer support the body around it.  In the space of five years, she had joint replacements in both hips (one required two surgeries) and both knees (deteriorated by advanced arthritis which eventually can destroy the bone).

Now at the age of 92, we feel fortunate that she had the surgeries which have allowed her to stay mobile.  She loves to exercise, and there are many safe and effective exercises for osteoporosis, but you need to bone up on the guidelines.  The Five-Point Exercise Plan offers you a well-rounded fitness training program, including exercises to protect and strengthen the weakened bones, improve posture and core stability and prevent falls.

1) Weight-bearing aerobic exercise: Why?  Because gravity exerts a positive force on the bones.  Protect the spine – avoid impact exercise and any jarring or twisting movements.  Perform low-impact exercise, like walking, at a brisk pace.  Add intervals of faster walking, if appropriate.  Incorporate hills, steps and inclines to increase intensity.

2) Strength training: Why?  Because the pull of the muscle on the bone stimulates formation. Since loading is site-specific, reinforce the vulnerable fracture sites:  the hip, spine and wrist.  Strengthen the large muscles of the upper legs as well as the smaller muscles of the lower legs for stability.  Start with lighter weights and high repetitions and progress to more challenging weights with lower repetitions.

3) Stretching: Why?  To correct postural alignment and prevent a shift in the center of gravity, which can increase the risk of falling.  Avoid spinal flexion (forward bending) in all positions (e.g. standing or seated toe touches, the plough) which places additional forces on the weakened vertebrae. Perform back extension exercises which gently arch the upper back and strengthen the spine.  Avoid stretching or strengthening areas prone to fracture when pain is present.

4) Balance exercise: Why?  To enhance the skills that help you recover from a stumble, change direction and prevent a fall.  Do static balance exercises like the stork stance and dynamic (moving) balance exercises like the “tight rope walk.”

5) Core training: Why?  To build strength in the postural support muscles of the trunk and pelvis.  In abdominal exercises, avoid spinal flexion (forward bending, as in a crunch) and flexion with rotation (as in a side crunch).  Instead do exercises which work the abdominals with the trunk in neutral spine alignment, like the plank and “dead bug” series.  Include exercises for the muscles that support the length of the spine, e.g. back extensions.

Of course, this information should not take the place of guidance from your own physician or other medical professional.  Always consult your doctor before beginning an exercise program or becoming much more physically active.

Joan is the author of three books that I highly recommend:”Strength Training for Women, “8 Weeks to a Younger Body” and 15 Minute Total Body Workout (+DVD).

Despite commercials flooding the airwaves about ED remedies like Cialis, whose voiceover script refers to ‘an erection lasting more than four hours,’ any mention of female sexual pleasure is clearly verboten.  According to the New York Times article, even Facebook, with its growing population of mid-life women, pulled ad an that read ‘Zestra Essential Arousal Oils –  Try Zestra for Free’ saying that ‘Facebook did not allow advertisements that contain or promote adult content including sexual terms/and or images.’  It’s hard to believe that this double-standard still prevails – even on Cable and the Internet. I think  the commercial would achieve for women what Cialis and Viagra commercials have for men: they’ve learned that they’re not alone and it’s an acceptable topic to discuss with your physician.

Low sexual desire in the second half of life was also the cover story of the August issue of the Mayo Clinic Health Letter, which takes a more buttoned up approach to explaining the reasons for a libido that wilts with age.  For women, they explain, the culprits are decreased estrogen production, urinary or genital tract changes as well as changes in our body shape and size, which affects how desirable we feel.  The National Women’s Health Resource Center also publishes “Fast Facts” about Sex and Intimacy after Menopause, which offers a more detailed explanation.  But for a really good medical explanation about low libido in mid-life I asked Rebecca Hulem, (pictured below) a personal menopause coach, why a lot of mid-life women lose their desire for sex:

The loss of sexual desire in mid-life women involves several factors. The first and foremost is the drop in two hormones: estrogen and testosterone. Testosterone is the “hormone of desire” and is produced in equal parts by the ovary during ovulation, and the adrenal glands. When ovulation stops during menopause 50% of our testosterone production automatically is gone, leaving the adrenal glands to provide the other 50%. When you lose half of your testosterone production it makes a big impact. This is why the majority of women who have transitioned thru menopause complain that they never really think about having sex anymore. If their partners “initiate” love making and they can wrap their mind around having sex many can still enjoy it. But the “initiation” from the woman is usually gone and as you can imagine this can have a big impact on the relationship.

The second hormone estrogen plays a huge part in the “mechanics” of sexual intimacy. Estrogen affects every aspect of the vagina. Estrogen keeps the vaginal tissue healthy and elastic. It provides the lubrication necessary for comfort and pleasure with intercourse. It helps to provide adequate blood flow and circulation to the clitoris and vaginal tissue thus allowing for adequate arousal and orgasms. Without adequate estrogen the vagina eventually will lose its elasticity, the tissue becomes thin and easily irritated by clothing, soaps and ,of course, intercourse. A woman may then experience a dry, itchy, burning feeling in and around the vaginal tissue. This sets up a painful cycle. If there is not adequate lubrication, intercourse and foreplay is painful. If intercourse is painful naturally a woman wants to avoid it. Most women feel embarrassed to discuss this with their partners or their health care providers. The relationship is then compromised. The man feels rejected and thinks it is him.

So, what do you think about the Zestra Commercial?  Would seeing it air on TV make you uncomfortable? Please use the comment box below to share your opinions.

Update: There’s now a petition to end the double standard in advertising.  It will target network executives at Turner Broadcasting Network, ABC, CBS, NBC and Fox.

As nutritionist and author Dr. Johnny Bowden explains in his latest book (see review below), the blueberry is just one example of  a “superstar” food that has scored high on the ORAC test, which measures a food’s oxygen radical absorbance capacity. This test, conducted by scientists at the USDA, reveals a food’s true age-fighting potential.  Here’s a list of the top performing, high antioxidant (high-ORAC) foods that Bowden says “will help protect us from a virtual encyclopedia of syndromes and diseases associated with aging:

• Prunes
• Raisins
• Blueberries
• Blackberries
• Kale
• Strawberries
• Spinach
• Rasberries
• Yellow squash
• Brussel Sprouts

Bowden offers this nutritional advice for anti-aging:  ”Shop so your grocery basket looks colorful.  You’ll automatically be eating a ton of high-antioxidant (high-ORAC) foods.”

The information summarized here was taken from Johnny Bowden’s latest book, “The Most Effective Ways to Live Longer: The Surprising, Unbiased Truth About What You Should Do to Prevent Disease, Feel Great, and Have Optimum Health and Longevity.  A more detailed review can be found in last week’s blogpost below.

If you have a favorite recipe using any of these foods, I’d love to hear from you. You can copy and paste the recipe in the comment box below.