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The menopausal transition is associated with a myriad of possible physiological changes and symptoms, ranging from hot flashes, altered mood and poor sleep to brain fog, dry skin and many more besides. One symptom that is particularly common during this time is weight gain, especially around the middle. In this article we delve a bit deeper into this important topic and share our top 5 steps for supporting a healthy weight during the menopausal transition.

1. Support hormones
Research has shown that menopause is associated with accelerated loss of fat-free mass, a decline in resting metabolic rate and increased central body fat.1 One of the reasons most commonly cited for this is the change in hormones as ovarian function starts to decline.2The links however between falling hormone levels, weight gain and changes in the distribution of fat are still not completely understood. Early on, during perimenopause, progesterone may drop first, or hormones are fluctuating, often creating a relative oestrogen excess and an associated potential for weight gain. Later on however, as ovarian function declines even further, levels of both oestrogen and progesterone are low, and weight gain (especially the accumulation of fat around the middle) is still a common symptom. Alterations in testosterone levels are likely to have an influence too. What’s interesting to note is that hormone replacement therapy (HRT), especially if started early on in the menopausal transition seems to help attenuate these changes.3 Whilst the full picture may not be completely clear, it’s evident that supporting hormones is an important part of achieving and maintaining a healthy weight during the menopause.4

So what can you do?
Phytoestrogens - From a dietary perspective you can gently support oestrogen levels during the menopause by increasing intake of phytoestrogen-rich foods such as miso, tempeh, tofu, flaxseeds and chickpeas. In addition, hops, soy isoflavones and red clover are natural phytoestrogen-rich ingredients which can be found in menopause supplements.

Get informed - Any recommendations around medications such as HRT are clearly beyond our remit, however we recently interviewed hormone-balancing expert Dr Ghazala Aziz-Scott and she had a wealth of experience to share on the topic.

2. Balance blood sugar
Supporting blood sugar balance is crucial for supporting just about every aspect of the menopausal transition; not surprising then that it’s vital for supporting a healthy weight during this time too. Research has found the menopause to be associated with an increased risk of insulin resistance which appears to be linked to the changes that are occurring in the distribution of fat towards more central abdominal fat. The accumulation of central abdominal fat is associated with a decline in circulating adiponectin - an adipokine produced by fat which increases insulin sensitivity. Low serum adiponectin levels are associated with insulin resistance and metabolic syndrome.5-7 Supporting blood sugar balance and insulin sensitivity are therefore key during the menopause.

So what can you do?
Diet and lifestyles changes are essential for supporting blood sugar balance. Read more about this here in 5 key principles of supporting healthy weight loss and A beginner’s guide to low carb diets. Our guide to supporting blood sugar balance through diet, lifestyle and supplement changes is a comprehensive resource in this area too.

Key nutrients and ingredients - Some ingredients and nutrients can be particularly helpful for supporting insulin sensitivity; these include chromium, cinnamon and alpha lipoic acid. These can all be taken in supplement form.

3. Look after your lean tissue
Whilst there are a range of symptoms that commonly occur during the menopause, it’s important to remain objective and consider other factors (beyond the hormonal shifts) that may be playing a part. For example, weight gain is common in both men and women as they age, and this is in part due to a gradual age-related reduction in lean tissue. From around the age of 30 both men and women will experience a gradual loss of lean tissue year on year, estimated to be as much as 3-5% per decade (unless proactive steps are taken to maintain and even build it instead). The ratio of fat: lean tissue is called ‘body composition’, and having a healthy body composition is both an important determinant of health overall and helps to support optimal weight. This is because lean tissue is more metabolically active or ‘energy-hungry’ than fat tissue. In simple terms this means that you need to eat more calories to feed lean tissue than to feed fat (even in a resting state) - thus maintaining or even building a higher proportion of lean tissue will make it easier to maintain a healthy weight as you get older.

So what can you do?
Consider your total daily food intake - Natural age-related loss of lean tissue lowers metabolic rate – the net effect of which is that you need to eat less to maintain your weight than before. And the converse is true, if you carry on eating the same total quantity of food, your weight will gradually increase (unless of course, you are taking proactive steps to preserve or even build lean tissue). If you notice your weight has started to increase, a small adjustment in your total daily food intake may be required.

Maintain / build lean tissue - From a dietary perspective, blood sugar balance (step 2) is the key to maintaining or building lean tissue and supporting fat loss (or preventing fat accumulation). In addition, regular exercise - especially lifting weights, strength training and weight bearing exercise - is crucial for protecting against the age-related loss of lean tissue.

4. De-stress
Similar to supporting blood sugar balance; taking steps to keep stress in check is a key aspect of managing many aspects of the menopausal transition including maintaining a healthy weight. This is because after menopause, most oestrogen is produced in the peripheral tissues by the conversion of androstenedione, which is secreted by the adrenal cortex, to oestrone. If the adrenal glands are overworked by chronic stress, this conversion process may not happen effectively, further exacerbating low oestrogen levels. Chronic stress may also impact sleep and disrupt blood sugar balance; it can therefore become a barrier to achieving or maintaining a healthy weight. In addition, during times of stress people often reach for unhealthy ‘quick-fixes’ such as alcohol, fast food, sugary drinks or snacks – all of which can promote weight gain.

So what can you do?
Active relaxation - The increased reliance on the adrenals during the menopausal transition means that self-care becomes non-negotiable and ideally this needs to be a daily habit. This could be a short walk in nature, 10 minutes of mindfulness practice, deep breathing exercises, yoga, pilates or anything you find enjoyable and relaxing.

Adrenal support nutrients and ingredients - Key nutrients and ingredients to support a balanced stress response may be helpful during this time. These may include magnesium, zinc, B vitamins and vitamin C; rhodiola rosea, ashwagandha, ginseng and cordyceps. Read more about supporting a balanced stress response here.

5. Make a good night’s sleep your top priority
Poor sleep is a common symptom experienced by many women during the hormonal transition, unfortunately poor sleep quality can also contribute to weight gain, altered body composition and make it more difficult to lose weight.8Lack of sleep interferes with melatonin secretion – an important neurotransmitter-like compound best known for its role in the sleep-wake cycle but also involved in energy metabolism and the regulation of body weight.9 Poor sleep is also associated with an increase in ghrelin and a decrease in leptin – the net effect of which is likely to be increased appetite.10 Lack of sleep is also associated with low levels of adiponectin – the adipokine which helps to promote insulin sensitivity.11 And research has found that healthy people with poor sleep quality are more likely to be insulin resistant.12 The argument for prioritising sleep at any stage of life, and especially during the menopause couldn’t be any stronger.

So what can you do?
Sleep hygiene - It’s vital to tighten up on the lifestyle factors that are known to promote restful sleep (sleep hygiene) during the menopausal transition. Find out more about sleep hygiene in this useful infographic here.

Think magnesium glycinate - Magnesium is an essential mineral that’s often low in typical Western diets, yet is critically important for supporting calm, relaxation and sleep. In fact, magnesium is often nicknamed ‘nature’s tranquiliser’ for this very reason. For calming, relaxing, sleep support you can supplement magnesium in a tablet or powder form of magnesium glycinate – this is magnesium attached to an amino acid called glycine which also has calming properties. Read more about magnesium glycinate here.

Managing the menopause – Knowledge is power
Whilst weight gain may be a common symptom experienced by many women during the menopausal transition, it’s certainly not a fait accompli and there’s many proactive steps you can take to help either prevent weight gain or help support gentle weight loss. The first and most important step is understanding what’s going on. Knowledge is most certainly power when it comes to managing the menopause and hopefully this article is another great resource in your toolkit. If you want a deeper dive into managing the menopause we highly recommend you watch Jo Gamble’s Menopause Transition or Turmoil webinar.

1. Poehlman ET, Toth MJ, et al. Sarcopenia in aging humans: the impact of menopause and disease. J Gerontol A Biol Sci Med Sci 1995 Nov; 50 Spec No: 73-7
2. Dionne IJ, Kinaman KA et al. Sarcopenia and muscle function during menopause and hormone replacement therapy. J Nutri Health Aging. 4: 156-161.
3. Sorensen MB, Rosenflack AM, et al. Obesity and sarcopenia after menopause are reversed by sex hormone replacement therapy. Obes Res. 2001 Oct; 9(10): 622-6
4. Davis SR, Castelo-Branco C, et al. Understanding weight gain at menopause. Climacteric. 2012 Oct; 15(5): 419-29
5. Lee CG, Carr MC et al. Adipokines, inflammation and visceral adiposity across the menopausal transition: a prospective study. J Clin Endocrinol Metab 2009; 94: 1104-10
6. Franklin RM, Ploutz-Snyder L et al. Longitudinal changes in abdominal fat distribution with menopause. Metabolism 2009; 58: 311-5
7. https://www.monash.edu/medicine/sphpm/units/womenshealth/info-4-health-practitioners/insulin-resistance-in-the-menopause
8. Jurado-Fasoli L, Amaro-Gahete FJ, et al. Association between sleep quality and body composition in sedentary middle-aged adults. Medicina (Kaunas) 2018 Nov; 54(5): 91
9. Claustrat B, Brun J, et al. The basic physiology and pathophysiology of melatonin. Sleep Med. Rev. 2005; 9: 11–24.
10. Banks S, Dinges DF. Behavioural and physiological consequences of sleep restriction. J. Clin. Sleep Med. 2007; 3: 519–528.
11. Simpson NS, Banks S et al. Effects of sleep restriction on adiponectin levels in healthy men and women. Physiol. Behav. 2010; 101: 693–698.
12. Pyykkonen AJ, Isomaa B, et al. Subjective sleep complaints are associated with insulin resistance in individuals without diabetes. Diabetes Care. 2012 Nov; 35(11): 2271-2278

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