Dear Sue:

I am a menopausal woman, 4'11" tall and weighing 108 pounds. The weight around my middle has created an annoying tire, and recently my body fat measured around 28 or 29, up from 22 pre-menopause. What diet do you recommend for women like me? I take natural hormones. Thanks,
--Raissa

Dear Raissa:

First of all, know that your experience is very normal. Almost two-thirds of women gain weight during menopause, and distribution is often around the middle.

Aging facilitates weight gain as your metabolic rate decreases -- but your metabolic rate falls with menopause, regardless of age, so it's a double whammy. This rate decrease results in a fat buildup, especially if no lifestyle changes counteract it.

Many women experience weight gain when taking hormones. Hormone replacement therapy usually minimizes fat around the middle and distributes it more evenly, but this doesn't seem to be true for you. Hormones may also contribute to water-retention weight gain.

Unfortunately, there is no such thing a "spot" reduction. You can, however, help decrease body weight or fat by adapting your diet and exercise habits. Dieting tends to further reduce metabolic rate, while exercising increases it, resulting in a higher calorie burn all day. Therefore, even if you choose not to alter your eating habits, you should add 20 minutes or more of daily aerobic exercise to your schedule. Cross-country skiing, biking, swimming and vigorous walking are examples. Find an exercise that you enjoy and stick with it, and find leisure activities that are physical.

Make weight-bearing exercise part of at least two or three of your weekly workouts. These exercises don't reduce fat, but they help deposit calcium in bones involved in the exercise, such as the hip bone, one of the most frequently broken by post-menopausal women.

Weight training is critical for all women but is especially crucial for post- menopausal women as it helps fight osteoporosis. Studies show that falls resulting in bone fractures are reduced in women who have done weight training because they have greater balance and stronger muscles supporting the bones. It also increases metabolism.

As metabolic rate decreases with age, you will probably need to decrease your food intake to better match your calorie expenditure. Because you are so small to begin with, you do not need many calories. Therefore, you have to get a lot of nutrition in a small quantity. Focus on eating fresh fruits and vegetables, whole grains, low-fat dairy products, and lean meat and fish. Eat anything else sparingly.

Be careful with the amount of fat in your diet. A little bit can add a lot of calories and often lacks other nutrients. Sugary food can also provide calories without nutrients, so although you do not have to eliminate sweets entirely from your diet, eat them infrequently or in smaller portions. Rather than passing up cake for dessert, say, have only a few bites. Or eat non-fat dessert substitutes (like yogurt or popcorn).

Menopause does have challenges, but it can be an impetus to spring into a new life -- one that embraces healthy eating, exercise and a new body image. If you know you are doing all you can for your body from the inside out, your outward appearance will take on less meaning.

Good luck with meeting your challenge. I hope these insights and suggestions help. Thank you for writing.

Sincerely,
Sue Gilbert