The Menopausal Glucose Problem

The Menopausal Glucose Problem

The ubiquitous refrain of women entering menopause, “I am eating the same but have gained weight, what am I doing wrong?”  Women start exercising more and eating less.  The scale barely budges. Since nothing is working, perhaps we should think about this from a different angle? Keep in mind these are just my thoughts for you to consider and may have absolutely no bearing on your individual situation, but here we go anyway.

What is going on?

Maybe the set up for menopausal weight gain started much earlier. Perhaps well before the first hot flash. Hear me out.

First the basics on how the body works:

We take in calories to produce energy so we can function—ie, walk, talk, think…. We all know this. Every cell in our body uses glucose for energy.  We also have heard things like “calories in (food)  should equal calories out (exercise)” and “not all calories are created equal (a cookie is not a carrot even if the same calories are eaten)”.  I am proposing that calories from sugar and starch, because they convert to glucose so quickly and efficiently are uniquely problematic.  Particularly in the setting of inflammation from a highly processed diet over the years.

It’s the speed and efficiency of a glucose rise or “spike” that causes the problem --particularly when this occurs regularly over a lifetime.

Consider this: too much glucose at one go is like giving a plant too much water at one go.  The right amount is nourishing, overdoing it is deadly.

AVOID THE SUGAR SPIKE!

How is the SPIKE a problem?

1. Mitochondria- remember 7th grade science class? “Mitochondria are the powerhouse of the cell”.  They are super important for converting the glucose into the energy that we can use. Mitochondria like to do this at a steady rate so if you overload them with a spike of glucose, well they shut down and break down. This increases stress in your body and adds to inflammation.  You feel fatigue. Not good.
2. Glycation- repetitive spikes speed up glycation which speeds up aging.  On the outside you see wrinkles, on the inside (especially when spiking occurred at a younger age) you get weaker sooner (function deteriorates at a younger age).
3. Insulin—released from the pancreas and more so the larger the glucose spike.  The insulin grabs the glucose and stores it in your muscles, liver and fat.  Too much insulin = too much fat. If you are not using the stored glucose by using your muscles, well then…too much fat.

So here we arrive at menopause with another huge stressor —that of hormonal shift.  The loss of estrogen does not cause weight gain. Nor will replacing estrogen cause weight loss. However, the additional stressor of estrogen loss (that just about every cell notices) simply adds to the mix, the mitochondria are not as sensitive nor effective, glycation occurs (now with less glucose exposure) and insulin is just doing its thing—storing glucose. This is why there is an increase in Type 2 diabetes as women enter menopause.

You can see how this is the perfect storm for weight gain at the menopause transition.

HOW TO AVOID THE SPIKE

The good news is that the body is highly forgiving (to a point).  Slow down the insult and help your body do what it is designed to do.

1. The easiest behavioral change:  DON’T DRINK YOUR CALORIES!  Seriously, this is low hanging fruit. Drink water, tea, coffee. Avoid too many fake sweeteners as that is another problem (and perhaps another blog).  When taking in liquid calories, it is far easier to get the sugar into the bloodstream and intensify the glucose spike.  Don’t do this.  Our goal is to SLOW DOWN the absorption of sugar and starch to slow down the spike.
2. FIBER- eat food with fiber in it.  There is a reason dessert is after a meal. The meal (that ideally includes fiber) will hopefully not only fill you up so you eat less sweet but also slows the absorption of the added sugar. Never start the meal with bread, it is like starting with cake.
3. Sweet taste stimulates appetite. This is why traditional cultures give sweet ripe fruit to the person recovering from an injury or illness.  Menopausal women typically do not need the encouragement. Best to work on avoiding sweets unless it’s a special occasion. It will be much more difficult to stop once you restart on sugar. Have a bit of someone else’s sweet instead.
4. Walk for 10 minutes after a meal.  Movement attenuates the spike. Be creative here, you could sweep the floor, go out in the garden, get on the treadmill or even better- grab someone to walk around the block or up and down the street with you.  Just don’t sit after eating.

I really love the idea of the continuous glucose monitor for menopause.  This is a device called a CGM that tells you your blood glucose levels in real time.  You can see very quickly what foods cause you to spike and then you can target your nutrition and movement changes more appropriately.  Sadly, in our current sick care system, prevention is not prioritized so this is not covered by insurance unless your are ALREADY diabetic. Gradually though, costs are coming down for cash paying women. Some doctors are willing to prescribe a CGM and you can also find access to a CGM online.  I do recommend working with a health care professional if you choose to go this route, as using one and interpreting the data can be confusing.

So, these are my thought on the menopausal glucose problem. Please note that I am not approaching this from a “lose 10lbs” perspective.  Menopause is a journey and I offer you ideas for consideration and actionable advice that will hopefully support you in being a much healthier human.

Wellness always,

Integrative Menopause MD

This blog is intended for educational and entertainment purposes only. Please consult your own health care provider before acting on any information or advice in my blog or on my website. Remember, healthcare and wellness are unique to your personal history and needs.