Well, this is not going to be easy for anyone. As a matter fact, it will be downright painful. So go on upstairs and put on your big girl or big boy panties and I’ll be right here when you get back.

Here’s the bottom line right here at the beginning: if you want to be the size and weight you were when you were 25, you will need to work out MORE and eat LESS.

Ouch. That hurts.

The primary reason is that our basal metabolic rate slows both with age and with the lack of estrogen or testosterone. Most of this is due to the decrease in fat-free mass. Menopause and Andropause are associated with significant increases in fat mass especially abdominal fat mass. As you can imagine, this increases risks for cardiovascular disease and metabolic diseases.

Postmenopausal women have been found to have 36% more trunk fat and 49% more intra-abdominal fat. Poelman and Tchernof studied this in 1998 and found that the most important component is the decreased resting metabolic rate.  This is the rate at which you burn calories just sitting around or typing on your computer. They did also find a decreased rate of burning calories while doing physical activity as well.

Life is not fair.

The only good news is that they also reviewed the literature and found both interventional trials and retrospective trials which showed hormone replacement therapy prevents the increased rate of gaining central fat.

Yes,  treatment with HRT prevented the increase in central adiposity!

What about Insulin resistance?  Recent studies (2016) showed that diets highest in carbohydrate had the highest insulin and glucose secretion. This and other studies showed postmenopausal women must cut all refined carbohydrates to avoid diabetes and the increase in abdominal fat. It’s a whole new paradigm for how you must look at food. These Paleo and Whole 30 people may be right.

Although the above studies were done for women, the same applies to men who have low Testosterone ie., central obesity, insulin resistance and increased risk of metabolic syndrome.

So , here’s the goal for 2018:  Eat less, walk more, critically look at what you eat to make sure it is high fiber , low carbohydrate, and consider Hormone Replacement.

To your Good Health!

Dr. Harris

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