Exercise and dieting during menopause: What athletes should know
When it comes to literature on sports science and menopause, it’s about as rare as a unicorn and clear as mud. Apparently, this is because women have “too many” complex cycles like our menstrual cycles, pregnancy, breastfeeding and then menopause, therefore researching male athletes has been the default since it made things a lot less “complex”
So yeah, there really is a lot less information out there, but in all fairness lets not forget that the interest in athletics in older women is really quite a new trend, at least as far as the last few decades is concerned anyway. When you think back to the 70’s and 80’s, there really weren’t that many older athletes to look up to for inspiration.
You only have to look at the portrayal of middle-aged women in The Golden Girls to see how we were expected to move and er… dress.
But the year is currently 2022 and I am “friends” with some athletes that are competing in their 70’s and they’re just getting started!
So while there is really limited information out there about peri and menopause studies on athletes, let’s look at what we do know.
We know that our metabolisms aren’t really to blame for the sudden weight gain during menopause. Our metabolisms stay pretty stable for men and women from ages 20 - 65, even during pregnancy and menopause.
What causes menopause weight gain?
This is often to do with the shift in hormones, which doesn’t necessarily affect our metabolism directly, but more to do with, well…. Just about everything else like our appetite and our circadian rhythm which inadvertently, ends up affecting our metabolism indirectly. In other words, your lifestyle, habits and food choices can and will have a direct impact on how much body fat or lean mass you gain in later life.
Because fat to muscle ratio can have a direct effect on metabolism, making sure that you give yourself the best opportunity to build muscle to avoid sarcopenia, is your best bet for maintaining a healthy body weight during and after menopause.
How does perimenopause affect women’s bodies?
Perimenopause is described as the transitory phase between regular periods and menopause. Unfortunately, because the change is usually gradual (but often physically and emotionally challenging), many women don’t realise they are going through it until they have officially reached menopause.
The sudden changes in women’s bodies during peri and menopause are likely due to a drop in estrogen. Estrogen (also spelt Oestrogen) is a family of three hormones: estrone (E1), estradiol (E2) and estriol (E3).
E1 is made in the ovaries, liver and other peripheral tissues, E2 helps to trigger ovulation and maintains endometrium (inner layer of the uterus) and E3 plays an important role in maintaining the placenta during pregnancy.
When there is a shift in these hormones, many changes can occur both mentally and physically, making it difficult to navigate.
What happens during menopause?
While most women will experience the challenges of menopause at some point in their lives, each person will experience symptoms differently making it even more confusing to find solutions.
If you’re currently struggling with symptoms you probably don't need reminding of what they are, however, if you're in the early stages of perimenopause and are just starting to notice some changes, here are some of the most common symptoms:
Hot flashes
Mood changes
Difficulty falling asleep or staying asleep
Frequent bathroom visits
A sudden increase in abdominal fat
Brain fogginess
Body composition changes during menopause
While it may feel like weight gain is happening as a result of a decrease in hormones, there is strong evidence that this is more to do with the changes in the way fat is distributed around the body, than an actual increase in fat.
Many women describe feeling as though their waistline has expanded in a short time frame. This is where the term “meno-pot” has been coined, which by the way, makes me want to punch my computer. The reasons for an increase in intra-abdominal adipose tissue during menopause are still unclear.
The loss or decrease in estradiol is also the culprit to many undesirable side effects of menopause like depressive mood swings or fatigue which can often lead to emotional eating or a decrease in energy output, both of which are equations for weight gain.
Intermittent fasting during perimenopause and menopause
Peri and menopause have left many women so desperate to find a solution that they often turn to extreme diets like intermittent fasting.
There is a lot of evidence that women suffer more severely from extreme diets. This could be down to the differences in male and female hormones. For example, Kisspepsin, which is a hormone found in both sexes, although much higher in females, is very sensitive to insulin, leptin and ghrelin (hormones that affect appetite and energy balance), making it much more sensitive to calorie restrictions.
In addition to this, there is evidence that intermittent fasting can have more detrimental effects on women.
One study in 2005 instructed a group of volunteers to fast intermittently for alternating days for 3 weeks,s the results found that men came out with an improved insulin sensitivity while the women came out with a worse glucose tolerance than when they first went in.
Extreme calorie restrictions and for a long period of time for females can lead to RED-S, or relative energy deficiency in sports which was initially categorised by the following features:
Disordered eating
Low bone density
Irregular periods
These symptoms together were a part of a more serious issue known as LEA or low energy availability, often characterised by:
Decrease in metabolic activity
Decrease production of sex hormones
Poor bone density
Decrease protein synthesis which can often lead to sarcopenia
Impaired cardiovascular health
When your body experiences LEA or RED-S it’s really a struggle especially if you’re an active female or an athlete with performance and physique goals. Not only will being in an energy deficit for a long time make your performance suffer, it will also slow down your metabolism.
For this reason, deficits should only be practiced in short cycles that include reversing and a long maintenance. To learn about how to periodise your diet and why that is important for avoiding relative energy deficiency in sports check out Diet periodisation: what is it and how to do it.
Managing weight gain without extreme calorie restrictions
It all starts with the mindset. Menopause can’t simply be “fixed”, and if you try to fix it, you’re going to be fighting against hundreds of thousands of years of evolution, so don’t try to. With that said, you can of course learn to manage some of the symptoms by focusing on the elements that you can control.
The weight loss triad
When it comes down to managing your weight, nutrition, exercise and sleep are still the foundations that good health is built on.
Exercise
Research shows that ‘weight bearing’ exercises are potentially more impactful than cardiovascular for improving body composition since it increases muscle mass and by default increases an athlete’s metabolism. Strength training can also slow down the effects of bone mass reduction during menopause. Increasing strength during this time can help prevent injuries in later life, which can help older adults remain independent for as long as possible, increasing their quality of life.
Plus, is there a more effective way to make a woman feel powerful than being able to lift her own body weight?
Here’s what one research said about strength training in menopausal women:
“strength training has been shown to significantly impact intra-abdominal fat in postmenopausal women, even in the absence of whole-body weight, fat, and fat-free mass changes […], suggesting that important health benefits from strength training may go unnoticed when less precise measures of regional adiposity are used.” (Teixeirai et al, 2003)
Nutrition
As women go through menopause, they may find their bodies are more sensitive to carbohydrates. Higher levels of estradiol (that diminishes during peri and menopause) has been shown to increase carbohydrate use, therefore when it begins to drop, this can have an effect on insulin sensitivity.
Fun fact: scientists increased estradiol in men, and found that it caused them to move away from carb oxidation and more towards fat oxidation.
With that knowledge, you could make small changes to your diet by choosing mostly whole foods and slower-releasing carb sources outside of the ‘peri workout’ windows, opting for whole grains and fresh fruit instead of processed grains.
On that note, nutrient timing is a strategy I use often with my athletes, that many have described as a “game changer”. For more information on how and when to eat which macronutrient for both fat loss, recovery and body composition, check out this blog here 7 science-based ways for athletes to lose weight without losing muscle.
Carb and fat utilisation actually fluctuate regularly for women even during healthy ovulation periods. For more information on how the menstrual cycle may affect fat oxidation, visit this blog here.
There is also evidence that a diet higher in soy may alleviate symptoms of hot flashes. Only 25% of menopausal women in Japan reported experiencing hot flashes compared to 85% of white North American women. Soy and other plant-based foods contain isoflavones, which have been shown to help with hormonal activity, although the current recommendation for isoflavones is 50-100mg per day, ideally in the form of whole foods rather than supplements.
Sleep
While you may not always be able to control how well you sleep, you can plan your sleeping arrangements so that they can be less affected by external factors such as bedroom temperature, brightness, and consider not having phones and computers in the bedroom might also help you sleep better.
During a study conducted at Pittsburgh university, researchers looked at the sleep pattern of 4,837 participants and found that poor sleep quality effected the brain’s reward system leading to food choices that were higher in fats, sugar and overall portions.
Needless to say, an increased in food cravings combined with less energy expenditure as a result of fatigue and broken sleep, can quickly lead to fat gain.
Focus on the total daily energy expenditure
EAT (Energy activity thermogenesis)
TEF (thermic effect of food)NEAT (non exercise activity thermogenesis)
BMR (basal metabolic rate)
For more details on how to calculate your TDEE, visit this blog What is TDEE and how do you calculate it for weight loss.
Your TDEE is the total energy you “burn” in any given day, and the part that makes up the majority of that pie is not exercise. While exercise activity thermogenesis (EAT) is extremely important for overall health, it only makes up 5% of your TDEE (give or take depending on how much you actually exercise).
Your basal metabolic rate, is the energy required for your body to stay alive, within that is also your resting metabolic rate, which makes up about 70% of the overall TDEE. Your RMR is somewhat outside of your sphere of control since it mostly driven by your age, sex, genetics and body composition.
Next is the thermic effect of food (TEF) this is the energy that is required to absorb and digest food. Protein for example has a high thermic effect of food, meaning that if you consumed 100 calories of protein, you won’t necessarily be absorbing 100 calories net, since some of the calories you eat will be “burned” simply by digesting it. You can see why increasing your protein intake might also be an effective strategy for weight management here.
Finally, there is your non exercise activity thermogenesis (NEAT), and because this makes up at least 15% of your overall TDEE, and is also within your sphere of control, this is often where I get my athletes to focus.
Making sure that you move your body as often as you can during the day can make a huge impact on your overall energy expenditure, which might make it a little easier to remain in a deficit when you’re already tracking your food and choosing high volume foods rather than calorie dense foods.
Takeaways
The changes in women’s bodies during perimenopause and menopause are linked to a drop in estradiol which can affect how fat is distributed in the body. Many women experience an increase in abdominal fat as a result of this change.
Changing your mindset to focusing on the elements you can control like your food choices and your daily movements can be a great place to start when things feel overwhelming.
Strength training is one of the most effective strategies for improving body composition in menopausal athletes, so make sure that weightlifting is added to your weekly training schedule.
Research shows that intermittent fasting has more detrimental effects on female athletes than male athletes and may not be an effective way to manage weight gain during menopause. Increasing overall energy expenditure through day-to-day activities and enjoying a balanced diet with a slight deficit may be a more effective strategy for weight loss in the long run.
Resources
A Tchernof 1, E T Poehlman,Effects of the menopause transition on body fatness and body fat distribution, Obes Res. 1998 May;6(3):246-54. doi: 10.1002/j.1550-8528.1998.tb00344.x.
Anisha A. Gupte, 1 , * Henry J. Pownall, 2 and Dale J. Hamilton 1 , 3, Estrogen: An Emerging Regulator of Insulin Action and Mitochondrial Function, J Diabetes Res. 2015; 2015: 916585. doi: 10.1155/2015/916585
Pedro J. Teixeirai, Scott R. Going, Linda B. Houtkooper, Lauve L. Metcalfe, Robert M. Blew, Hilary G. Flint-Wagner, Ellen C. Cussler, Luis B. Sardinha, Timothy G. Lohman, Resistance Training in Postmenopausal Women with and without Hormone Therapy, MEDICINE & SCIENCE IN SPORTS & EXERCISE® Copyright © 2003 by the American College of Sports Medicine DOI: 10.1249/01.MSS.0000058437.17262.11
,C. Castelo-Branco,P. Chedraui,M. A. Lumsden,R. E. Nappi,D. Shah,P. Villaseca, Understanding weight gain at menopause, Taylor & Francis online, https://doi.org/10.3109/13697137.2012.707385
