Dr. Phil Shares: 8 Bad Habits That Kill Your Metabolism

You may already suspect your metabolism slows as you age. According to research published in the Public Health Nutrition journal, you’re right. In a review of data on energy expenditure, researchers found simply getting older is associated with progressive declines in basal metabolic rate. On top of that, there are many daily habits that can drain your metabolism even further.

But you don’t have to go down without a fight. Cut out the below habits and watch your metabolism and energy levels improve.

Eating a nutritious breakfast is always a good way to start your morning. Because your metabolism slows down during sleep, eating can fire it up and help you burn more calories throughout the day. According to Rush University Medical Center, “When you eat breakfast, you’re telling your body that there are plenty of calories to be had for the day. When you skip breakfast, the message your body gets is that it needs to conserve rather than burn any incoming calories.”

OK, so it’s about more than just eating something in the morning. If you grab a sugary donut or eat a muffin in the car, you’re setting yourself up to crash later. Instead, choose something with filling protein and fiber like eggs, yogurt and berries or whole-wheat toast topped with peanut butter.

Going from your office chair to your car to your couch can lead to a very sedentary routine. And sitting for extended periods puts your body into energy-conservation mode, which means your metabolism can suffer. According to the UK’s National Health Service, “Sitting for long periods is thought to slow metabolism, which affects the body’s ability to regulate blood sugar, blood pressure and break down body fat.”

Cardio is great, and it can quickly burn calories, but once you’re done running or cycling, your calorie burn quickly returns to normal. When you do HIIT and resistance-based workouts, however, your calorie burn stays elevated for longer as your muscles repair themselves. Per the American Council on Exercise (ACE): “Strength training is a key component of metabolism because it is directly linked to muscle mass. The more active muscle tissue you have, the higher your metabolic rate.” And, according to ACE, a pound of muscle burns an additional 4–6 calories each day compared to a pound of fat.

Protein feeds your muscles, promotes satiety and is an important component to sustaining a healthy weight. Eat too little, and you may have trouble building or maintaining muscle mass — and per the above, we know muscle’s importance to metabolism. Also, protein requires more energy to break down than carbs or fat, so you’ll actually burn more calories during digestion.

One bad night’s sleep is enough to leave you feeling sluggish and impair your cognitive processing. String together several nights in a row — or a lifetime of inadequate sleep — and science shows decreased metabolism and hormonal imbalances may follow.

In a study published in The Journal of Clinical Endocrinology & Metabolism, researchers found drinking 500 milliliters of water (about 2 cups) increases metabolic rate by 30%, and that spike lasts for more than an hour. So, drink water throughout the day to stay hydrated, and you’ll get the added benefit of a boosted metabolism.

When stress levels increase, your body produces a hormone called cortisol. Cortisol leads to increased appetite, makes us crave comfort foods, decreases our desire to exercise and reduces sleep quality — all things that negatively impact metabolism. So, while you can’t always control your stress levels, managing stress can go a long way toward protecting your body’s internal fire.

by Kevin Gray

Shared by Dr. Phil McAllister @ Forward Health Guelph

SaveTagscreating healthy habitslosing weightmetabolism

Dr. Phil Shares: Why You Should Get up and Walk After Dinner

Why You Should Get up and Walk After Dinner

When you eat a heavy meal, it can often make you feel sluggish afterward and even disrupt sleep. But getting up and taking a short walk after eating can help combat this. Not only is walking a great low-impact activity to help you stay healthy overall, it can specifically aid digestion and control blood sugar levels — preventing crashes in energy. Here, a look at the research and why evening walks are particularly beneficial for digestion and controlling blood sugar:

EFFECTS OF HIGH BLOOD SUGAR

Chronic high blood sugar can negatively affect your health. Over time, it can cause damaged blood vessels, nerve problems, kidney disease and vision issues. Chronic high blood sugar can also lead to insulin resistance and impaired glucose tolerance, risk factors for Type 2 diabetes.

HOW WALKING AFTER EATING HELPS

While walking any time of the day can have positive effects on health, taking a stroll after a meal may be especially effective for managing blood sugar levels. A study published in Diabetes Care found walking for 15 minutes after a meal three times a day was more effective in lowering glucose levels three hours after eating compared to 45 minutes of sustained walking during the day.

Walking at night might be the most beneficial since many people eat their largest meal in the evening and then tend to sit on the couch or lay down after. Another study focusing on individuals with Type 2 diabetes found that even 20 minutes of walking post-meals may have a stronger effect on lowering the glycemic impact of an evening meal in individuals with Type 2 diabetes, compared to walking before a meal or not at all.

HOW IT CAN HELP DIGESTION

Individuals suffering from digestion problems and discomfort may also see some benefits from walking. A small 2008 study found walking increased the rate at which food moved through the stomach. Other research has found that walking after a meal may improve gastric emptying in patients with longstanding diabetes, where food may typically take longer to digest and empty from the stomach.

THE BOTTOM LINE

Walking is one of the most studied forms of exercise, with research demonstrating it’s an ideal activity for improving health and longevity. Try going for a brief walk after a meal (especially in the evening) to help with digestion and blood sugar control.

Amp up your walking in general with these 50 tips to get more steps.

by Sarah Schlichter and myfitnesspal

shared by Dr. Phil McAllister @ Forward Health Guelph

Dr. Phil Shares: All of Us Really Are A Miracle

Sometimes we take our body’s for granted, so I found the illustrations and captions below, put it all into perspective.

Heart
http://en.bcdn.biz/Files/2015/8/27/41a7d347-67ee-4d23-860c-34893d8f2b49.JPG
Cancer
Brain
Stomach
Eyes
Energy
Red Blood Cells
Skin
Hair
Words
Liver
Saliva
Testicles
Kidneys
Hair
Digestion
Regeneration
Final Slide

Shared by Dr. Phil McAllister @ Forward Health Guelph

Thanks to My Mother for sharing this with me.

Dr. Laura: Drugs that affect the microbiome

Drugs are one of the major factors that affect the microbiome. The impacts vary depending on the drug and duration of treatment.

The environmentfoodstress and drugs  all contribute to changes in the microbiome. This is why it is important to recognize and address any contributors that cause troubles.

Clinical intake and tests flushes out root causes and provide clarity. 

Why should I care?

Unique patterns in the microbiome link to different diseases. An unhealthy microbiome links to depression, anxiety, autistic disordersvitamin and mineral status (nutrient absorption)hormone production,  eczemadiabetes, obesity, arthritis and inflammatory bowel psoriasis and other autoimmune, conditions, heart healthcholesterolnon-alcoholic fatty liver disease (NAFLD), diseases.  Research continues to expand this list.  

What is the microbiome?

The human microbiome exists in the gastrointestinal/urogenital tract and the skin. The trillions of cells that make up our microbiome actually out number the human cells that we have in our body by tenfold. Are we microbes having a human experience?

Healthy microbiome?

A healthy regular stool is not always indicative of a healthy microbiome. History of autoimmune conditions, food sensitivity, sugar cravings, gas, pain, bloating, bad breath, candidiasis, brain fog, mood changes, weight issues, skin issues, joint pain, trauma, stress, headaches, use of birth control or other hormones, frequent use of antibiotics and certain drugs can all be factors or indicators of microbiome disruption. 

What drugs affect the microbiome?

Your microbiome may be out of balance if you are currently, or have history of taking, any of the following drugs:

  • Antibiotics
  • Cancer Therapies
  • Antihistamines
  • Antidiabetic drugs
  • Anti-inflammatory drugs
  • GI disorder drugs
  • Non-steroidal Anti-inflammatory drugs
  • Anti-psychotic drugs
  • Anti-coagulants
  • Hormones: estrogen, birth control, thyroid hormone

Find out more…tests available

One helpful test to look at the key players of the microbiome is the comprehensive stool and parasitic analysis. Knowledge of the landscape certainly helps streamline the treatment. 

Food sensitivities often rise when the microbiome is off balance. It is important to recognize the foods that are bothersome. Then remove them for a while and do the work to remove unwanted microbes and replace with healthy ones while repairing the gastrointestinal tract lining. Protocols are patient specific based on the microbiome the lining of gastrointestinal tract and the overall health of the patient. 

Dr. Laura M. Brown ND is a Naturopathic Doctor with a functional medicine approach. She is a Certified Gluten Practitioner, a HeartMath Certified Practitioner and is a graduate of Adapt Level 1 at Kresser Institute of Functional Medicine. Essentially, Dr. Brown helps people better digest their food and the word around them. More at www.naturalaura.ca and  www.forwardhealth.ca

Dr. Phil Shares: 7 Exercises To Avoid

7 Exercises You Should Never Do Again

The next time you go to the gym, take a look around: you’ll probably see all kinds of exercises, some good and some not-so-good.

The unfortunate truth is that not all exercises are created equal. Some are incredibly effective at building muscle and melting fat; others are ineffective and can even do more harm than good. (Worse, the bad ones are sometimes very popular.)

Read on for our list of the worst exercises — the ones you should avoid at all costs. If you currently have them in your exercise routine, try our alternatives, which are far more effective and take your body to the next level.

1. SITUPS AND CRUNCHES

Situps and crunches are as old-school as it gets: You see them in PE class, boot camps and military training around the world. But get ready for some big news because these tummy exercises aren’t effective or good for you.

Your core — which consists of your rectus abdominis, external and internal obliques, transverse abdominis, pelvic floor, etc. — is designed to help your body stabilize and brace against twisting and bending (not generate it).

Situps and crunches, however, eliminate the bracing and put your body into bad positions: You pull your neck forward, round your shoulders, flex your spine and put a lot of stress on your lower back. (It also goes without saying that you should avoid the situp machine too for those reasons.)

Instead, choose ab exercises that help you maintain a good posture throughout the exercise. If you want to take your core strength to the next level and get washboard abs, try our super effective 14-day plank challenge: It uses many different variations to blast your midsection from different angles to test your muscles (and your mind).

2. SMITH MACHINE EXERCISES

With the exception of the inverted row, avoid all exercises on the Smith machine. It seems safe because the bar has a lock that activates when you let go, but it puts your body in unnatural positions because the bar only moves in a straight, rigid line, which is not how you move in real life.

Also, because the bar follows a straight path, you don’t get to improve your stability or balance and you won’t get the same muscle gains you’d like. Researchers found that free-weight squatsand free-weight bench presses activated more muscles than doing the same exercise on a Smith machine.

Stick to the free-weight version of your exercise: barbell squat, dumbbell bench press, etc. You’ll get more overall benefits and build more muscle and strength.

3. SEATED TWIST MACHINE

Remember what we said about how the core is supposed to move? Well, the vertebrae of your spine at your lower back can only twist 13 degrees in each direction, which is tinier than one hour on a clock. But the seated twist machines actually crank your body well beyond that range-of-motion.

If you want to improve your rotational strength, try the kneeling Palloff press. Get on both knees and set a cable handle to chest height. Facing perpendicular to the cable, bring the handle to your chest, and push it straight forward. Do it facing both ways. You have to brace your trunk to resist twisting and turning, which fires your core and keeps your spine in a safe position.

4. SUPERMANS

You might see these done in gyms or even physical therapy centers in an effort to “strengthen” your lower back. But the problem is it cranks your lower back into hyperextension while putting tremendous load and compression onto your lumbar spine. (Most people have a lower back that’s already too extended, which creates something called “lordosis.”)

Substitute supermans with another exercise if it’s a part of your current fitness program. Instead of directly targeting your lower back, focus on strengthening your entire trunk — back, abs, obliques, etc. — with core exercises where you maintain great posture throughout.

Try the single-arm farmers carry: Grab a heavy dumbbell in one hand, keep your chest up and shoulder blades squeezed, then walk. Maintain a neutral lower back and don’t arch excessively.

5. BACK EXTENSIONS

The back extension machine tries to strengthen your lower back by repeatedly flexing and extending it, which can cause problems. Worse, a lot of people hold a weight plate behind their head or at their chest, which further increases the stress on your spine.


READ MORE > 10 ESSENTIAL BODYWEIGHT EXERCISES 


6. UPRIGHT ROW

This popular exercise targets your shoulders and traps. Unfortunately, it’s one of the worst exercises you can do for your shoulders because it impinges your shoulder joints. The upright row actually forces you to internally rotate your shoulders and pull a heavy weight while in a poor position, which can lead to all kinds of problems.

Instead, to build strong and wide shoulders, replace upright rows with the dumbbell overhead press. It targets your upper body without adding unnecessary (and impinging) stress to your shoulder joint.

7. BEHIND-THE-NECK LAT PULLDOWNS OR BEHIND-THE-NECK PRESSES

Avoid any upper-body exercise where you pull or push from behind your neck because it puts tremendous strain on your shoulders. In a behind-the-neck position, your shoulders are almost at their maximal limit on extension in those positions — throwing weight on top of it just adds more strain to a fragile area.

Always do lat pulldowns, chin-ups, pullups, etc. toward your collar bones; if you’re going to press a weight overhead, start with the barbell at your collar bone or use dumbbells or kettlebells.

Shared by Dr. Phil McAllister @ Forward Health Guelph

Thanks to My Fitness Pal

Dr. Phil Shares:5 Science-Backed Solutions For a Healthy Lifestyle

 

5 Science-Backed Solutions For a Healthy Lifestyle

If you feel overwhelmed trying to build a healthier life for yourself, stop stressing. You can perform the simplest tasks and still create a more active, flourishing life. Plus, executing such small activities can put you on a path toward accomplishing your larger health and fitness goals.

If you struggle with any of these issues, try incorporating these easy actions into your daily life and you should begin noticing encouraging changes:

If you’re ever feeling unproductive, a power nap could help. In a study published by Sleep, researchers found a nap lasting as little as 10 minutes mitigated short-term performance impairment. “What’s surprising is how little sleep is necessary for better focus,” says Martin Rawls-Meehan, CEO of Reverie, an organization that creates sleep systems. Plus, he says a nap can reduce your body’s levels of cortisol — a stress hormone responsible “for a lot of the negative physiological effects.”

If you’re ever lacked the motivation to work out, spend a moment thinking of friends and family. In a study published by the Proceedings of the National Academy of Sciences, researchers asked 220 sedentary adults to complete one of two self-transcendence tasks: reflect on what matters most to them (such as friends and family) or make repeated positive wishes for both strangers and people they know. A control group reflected on what mattered least to them. Then, everyone viewed health messages encouraging physical activity. Results showed those who thought of others decreased their overall sedentary behavior versus those who did not think of others.

Researchers looked at data from almost 92,000 middle-aged people and found that those with disturbed sleep patterns were more likely to experience depression or bipolar disorder. Worse yet, one of the culprits of bad sleep was something completely within people’s control: scrolling the internet in the middle of the night on their cellphones, according to a study published in The Lancet Psychiatry. To negate the negative effects of disrupted sleep, Rawls-Meehan suggests using an old-fashioned alarm clock and charging your phone overnight in the kitchen — completely out of reach.

Feeling sluggish and bloated? Dr. Brian Levine, the founding partner and practice director of CCRM New York, says to avoid foods like white rice and white sugar that cause inflammation. Although you might crave these foods, swapping them for a healthier alternative just one meal per week can help you begin a healthy diet transformation — you don’t need to make sweeping food changes right away.

For example, instead of chicken and rice, try chicken with cauliflower. You can pulse the vegetable in a food processor until it resembles the consistency of rice, say Jessica Jones, RD, and Wendy Lopez, RD, of Food Heaven Made Easy. Or, swap one cup of white sugar for a half a cup of honey. According to a review published in Pharmacognosy Research, “honey can act as a natural therapeutic agent for various medicinal purposes” such as diabetes and cardiovascular and respiratory diseases.

You don’t need meditation experience to begin a compassionate meditation practice. In fact, all participants in a study published in Frontiers of Human Neuroscience had no background in meditation. But in 20 minutes a day for two months, researchers found people who practiced compassionate meditation increased their social support, felt more purpose in life, decreased illness symptoms and enhanced their life satisfaction. To start such a practice, simply sit with your eyes closed, concentrate on your breathing and think of someone you love. As you get more comfortable, expand your thoughts to more people you know, then on to strangers and on to the world. Although you will still hear bad world news, you should start to achieve a healthier ability to digest negative information.

BY JENNIFER PURDIE JANUARY 5, 2019 NO COMMENTSSHARE IT:

Shared by Dr. Phil McAllister @ Forward Health Guelph

Dr. Phil Shares: 5 Rules For Better Planks and a Stronger Core

 

5 Rules For Better Planks and a Stronger Core

Planks are one of the hardest exercises to get right. Yet, most of us incorporate planks into our workouts, whether it’s running, lifting or doing bootcamp. What many of us don’t realize is we’re planking all wrong.

“Planking is the gold standard exercise for core strength and stability,” explains Shana Verstegen, fitness director at Supreme Health and Fitness in Wisconsin. Doing them properly has real benefits. “They will make you a better athlete, help prevent/reduce back pain and allow you to move better in life.”

Here, learn how to maximize the perks of this exercise staple.

Most exercises can benefit from a bit of glute engagement, and planks are no exception. “Squeezing your glutes causes a bit of a stretch in your hip flexors, which transfers more of the workload to the abdominal muscles,” explains Greg Pignataro, certified strength and conditioning coach at Grindset Fitness. And your abdominal muscles are what you’re trying to work, right? “Additionally, contracting the glutes will reduce strain on your lumbar spine by preventing your lower back from sagging,” Pignataro adds.

Seriously. “Dr. Stuart McGill, a professor from the university of Waterloo who has spent 30+ years researching the spine and back pain, touts groundbreaking research about core ‘stiffness,’” Verstegen notes. “Holding planks for 10 seconds at high tension followed by a brief rest period before the next rep creates a much stronger core with fewer injuries.

“Pavel Tsatsouline, most famous for popularizing kettlebell training, agrees. He designed the ‘RKC’ plank around this philosophy of full-body stiffness and also promotes shorter, stronger plank holds.” Try doing a set of 3–10-second holds with maximum contraction for the best core strength gains.

Just as every body is different, every perfect plank setup is different, too. “Due to individual differences in body size and limb length, the ideal position is probably slightly different for every single person,” notes Pignataro. “This is important, because planks should challenge your core musculature, not hurt your elbows or shoulders. Experiment by moving your elbows and feet a few inches inward, outward, backward or forward until you find your sweet spot!”

Some people struggle to feel their abs firing during planks. If that sounds familiar, try this: “Once in plank position, pretend you are looking over a fence by pulling your elbows down so you can get your head and neck to feel taller,” recommends Brian Nguyen, CEO of Elementally Strong. “This will pull your hips and shoulders into alignment and you should feel more where you want it … abs, baby!”

“To make your planks count, every muscle needed to stabilize your spine is firing at a maximal effort,” says Kari Woodall, owner of BLAZE.

Doing so can even even help with your preferred method of exercise. “If I want to crush my deadlifts, I need the requisite core strength to pick up something heavy. If my body doesn’t understand what a maximal contraction feels like, then I am not only limiting how much I can lift, but I’m increasing my risk of injury if I do pick up something heavy,” she explains.

Not feeling the burn? “Squeeze your armpits like you have million-dollar bills tucked underneath each one, and you get to keep the money if no one can rip them away from you,” Woodall adds.

BY JULIA MALACOFF FEBRUARY 4, 2019 4 COMMENTSSHARE IT:

Shared by Dr. Phil McAllister @ Forward Health Guelph

Dr. Phil Shares: Prevent Winter Slip Ups!

Stay Standing This Winter!

Falling on ice can leave you red-faced with embarrassment, or far more seriously, hurt badly from taking a knee to the ice or falling awkwardly on icy snow. Slippery sidewalks, driveways and icy parking lots can be risk factors for falls in winter. Avoid a bad fall with these top tips!

Walk like a penguin

  • The penguin waddle helps you keep a center of gravity over the front leg as you step, instead of split between the legs. Short strides also help keep your center of gravity, which help avoid falls. When walking, extend your arms out from your sides to increase your centre of gravity. Don’t keep your hands in your pockets!  Walk slowly, with short strides and try to land your steps with a flat foot.

Keep walkways clear

  • Shovel snow and scrape ice as soon as possible. Liberally sprinkle ice melt product or sand onto walkways to provide foot traction and to make sure surfaces don’t turn to ice. This not only protects you and your family, but also postal carriers and others when they’re walking around your property. Where possible install or use handrails for extra support.

Take all precautions

  • Be extra cautious walking after a storm. Tap your foot on potentially icy areas to see if it is slippery. Hold a railing while walking on icy steps. Stay steady by wearing proper winter footwear. Lightweight boots with a thick, non-slip tread sole will provide good traction on ice. If a sidewalk is icy down the middle, walk on the snow beside it to avoid slips.

Lighten your load

  • Carry fewer bags on snow days, since excess baggage can throw off your balance and make it tougher to regain your balance once you lose it. Keep your hands free by putting away your phone while walking – you may need to catch yourself!

Boost balance with exercise

  • You can’t control the weather, but you can improve your balance through regular exercise. Exercise is an ideal way to help you stay safely on your feet because it helps improve balance, flexibility and strength. Talk to a chiropractor about ways to improve your balance and strength in order to prevent falls.

Visit your chiropractor

  • Don’t let a fall get you down. If you do take a tumble, visit your chiropractor. They’ll get you back to doing the things you love to do and will work with the rest of your care team to help prevent future falls.

Dr. Phil Shares: Not Taking a Multivitamin? Here Are the Top 5 Reasons You Should Be

You try to eat well to feel good and stay healthy. While it’s optimal to get your nutritional needs from the foods you eat, it’s not always possible. There is conflicting information out there on the benefits of supplements, but the Dietary Guidelines for Americans 2015-20201 say that supplements may be useful for providing the nutrients you may be lacking from diet alone.

Still on the fence? Consider these top five reasons to add a multivitamin to your daily regimen.

  1. Healthy aging. As we get older, our bodies have a harder time absorbing nutrients from food. The National Institute on Aging notes that starting around age 50, people begin to require increased amounts of certain vitamins and minerals.1 In fact, according to a study published in the June 2009 issue of the American Journal of Clinical Nutrition, researchers found that taking a daily multivitamin & mineral supplement may help improve micronutrient deficiencies associated with aging.3
  2. Making up for eliminated food groups. While some people have to cut certain foods like nuts or gluten out of their diets due to allergies, many eliminate particular foods or food groups from their diet voluntarily. This can cause vitamin deficiencies that would be helped with a multivitamin.
    Trying a paleo diet? You might risk a shortage of calcium or vitamin D by eliminating dairy or grains. Cutting back on red meat? A multivitamin will replace the iron and B12 you would normally get from diet.
  1. Getting the RDAs you’re not getting from food.You’ve probably heard that the typical Western diet doesn’t include nearly enough daily fruits and vegetables. As part of that, you don’t always get the vitamins those natural foods supply. Supplementing with a multivitamin containing phytonutrients from fruit- and vegetable-derived ingredients may help. In addition, it’s important to keep in mind that RDA levels are set to prevent nutrient deficiencies. But there’s a wide range between taking enough vitamin C to avoid scurvy and the optimal amount you can benefit from.
  2. Getting that extra energy to get through the day. In today’s “go-go-go” society, one of the top complaints is a general lack of energy. Instead of reaching for that third cup of coffee, remember that your cells require certain vitamins and minerals to power your busy life; especially if you’re not getting a full eight hours of sleep or eating a balanced diet, a multivitamin can help provide the nutrients you need to feel energetic throughout the day.4
  3. Managing stress. Daily life stressing you out? You’re not alone. But vitamins and micronutrients play a significant biochemical role in improving your brain’s cognitive processes, and studies have shown that a daily multivitamin—particularly one with high doses of B vitamins—can help to reduce stress and support a healthy mood.5

Ready to add a daily multivitamin to your diet? Be sure to check with your healthcare practitioner to see if he or she has a recommendation and to ensure that any medications you’re currently on won’t interfere with their effectiveness.

Shared by Dr. Phil McAllister @ Forward Health Guelph

Dr. Phil Shares: Menopause Belly: Why Fat Accumulates & How to Tackle It?

 

Many women notice after age 45 that fat seems to accumulate readily at the waist. There are even terms for it, like menopause belly, muffin top, or “meno-pot.” What does the science tell us about menopausal belly fat and how to get rid of it? What are the hormonal drivers and are they amenable to change with personalized lifestyle medicine? Certainly belly fat, specifically subcutaneous and visceral abdominal fat, increases during menopause,1-3 when the changing hormonal environment can bring with it a remodeling of fat storage patterns. Abdominal fat, especially visceral fat, is biochemically different and more metabolically active than fat stored in other areas, secreting more pro-inflammatory cytokines and adipokines.4 That means preventing or reversing belly fat is not just a vanity project, it’s a meaningful step in managing a woman’s overall health, as abdominal fat has been consistently linked with insulin resistance, impaired glucose control, and overall higher cardiometabolic and breast cancer risk. Practitioners are often asked ‘How can I get rid of menopausal belly fat?’, and it is important to remember that effective management is multifaceted – encompassing an understanding how changes in sex steroids interact with other endocrine systems and also with lifestyle choices, and recognizing the best time to implement a lifestyle medicine approach is in the years before a woman’s final menstrual period.

The changing hormonal environment

A robust understanding of the hormonal changes associated with perimenopause and menopause can guide women toward effective intervention. Here are the top five hormonal changes associated with the menopausal transition.

  • Changes in estrogen and estrogen dominance: Menopause is often framed simply as the loss of estrogen, but the road from pre- to post-menopausal estrogen levels is not necessarily smooth. Although loss of estrogen itself is linked with increasing abdominal fat,2,3 paradoxically the estrogen dominance that occurs in perimenopause and that may continue into menopause is seen clinically as a culprit in expanding abdominal fat mass.5 Between age 35 and 45, most women are beginning to run low on ripe eggs and experience hormonal changes linked with advancing reproductive age.6 During this time reduced progesterone coupled with high and erratic estrogen occurs.6,7 Estrogen declines but is in relative excess to progesterone. This is the definition of estrogen dominance: having a progesterone level that’s less than 100X the level of estrogen, creating an imbalance in the estrogen-progesterone partnership and essentially an inadequate level of progesterone to keep estrogen in check. Local estrogen production in adipose tissue can also contribute to estrogen dominance during this time. For example, aromatase enzymes, responsible for converting androgens to estrogens, are more active in visceral adipose tissue of post-menopausal women in response to cortisol.8

 

  • Cortisol: Dysregulation of the HPA axis and cortisol excess can manifest as increased central and visceral fat mass and metabolic disturbances such as insulin resistance.9,10 Increased production of cortisol,11 and conversion of cortisone (inactive) to cortisol (active) has been described in post-menopausal women,12 indicating that increased cortisol synthesis and conversion could contribute to metabolic dysfunction in these women. Cortisol is regulated in part by sex steroids, and estrogen down-regulates the expression and activity 11β-HSD1, the enzyme involved in converting inactive cortisone to active cortisol13 – so higher estrogen, lower 11β-HSD1 and less active cortisol formed. Declining estrogen levels during menopause can have a knock-on effect on cortisol formation, and 11β-HSD1 has been shown to be upregulated particularly in visceral fat in post-menopausal compared with pre-menopausal women. 1,11,12 As well as contributing directly metabolic dysfunction, higher cortisol can feed back to hormonal environment and contribute to estrogen dominance occurring at this time through cortisol-induced aromatase activity.8,14

 

  • Insulin: Fat cells accumulating in the abdomen is linked with insulin resistance. The pro-inflammatory cytokines produced by abdominal fat interferes with insulin signaling.15 This results in insulin resistance where cell response to insulin is lost, which creates a cycle where greater production of insulin is required to manage blood glucose levels. Insulin is a gatekeeper of metabolism, and rising insulin levels can set off a chain reaction that ultimately leads to a cycle of weight and abdominal fat gain. Insulin can lower production of sex hormone binding globulin (SHBG) in the liver.16,17 Lower SHBG results in greater free androgens and estrogens in circulation, and is linked with visceral fat and insulin resistance in menopausal women.18,19 In addition, insulin resistance can have a knock-on effect on leptin, insulin’s cousin.

 

  • Leptin: Leptin is the put-down-your-fork hormone, the one that tells you when you are full.20 Elevated insulin levels eventually lead to elevated leptin, which despite what you may think, does not mean you are more likely to put down your fork and stop eating. Instead, consistently elevated leptin levels lead to a dysfunction of leptin receptors and they stop sending signals to the brain to tell you to stop eating – this is called leptin resistance.21 The mechanisms driving leptin-resistance are complex, but high intakes of refined carbohydrates have linked with its development.22

 

  • Thyroid hormones: Thyroid hormones, which regulate how quickly we burn calories and maintains our metabolism, can becomes unbalanced with age, a trend that has been labeled ‘thyropause’. If the thyroid becomes underactive, this can lead to symptoms including weakness, fatigue, and weight gain.23

What can be done?

One of the biggest myths in women’s health is that once hormones change with menopause, abdominal adiposity is immovable – however addressing modifiable hormones such as cortisol and insulin in the following ways can have an impact.

  • Make foundational changes to dietary intake. When evaluating diet, consider factors that influence insulin levels, such as high carbohydrate intakes or intake of refined carbohydrates which require greater insulin response to manage spikes in plasma glucose. Remove inflammatory or trigger foods, as inflammation can contribute to insulin resistance.31 Add in foods rich in antioxidants which promote detoxification. Eliminate alcohol which robs you of deep sleep and lowers metabolism by more than 70% for 24 hours. Choosing when to eat during the day can also make a positive impact to insulin levels and insulin sensitivity. Time-restricted feeding (TRF) protocols, a type of intermittent fasting, where food is consumed during a limited number of hours per day (often 6 or 8) has been shown to reduce body weight and abdominal fat32 and improve insulin sensitivity even without weight loss.33

 

  • Add more movement to the day. Sitting is like the new smoking. Approximately 35 chronic diseases and conditions are associated with sedentariness, and sedentary behavior makes people more prone to gain body fat.24 High intensity interval training (HIIT) is effective at reducing abdominal and visceral adiposity, as well as improving insulin sensitivity and building muscle.25,26 Studies in post-menopausal women show that HIIT training results in greater abdominal and visceral fat mass loss compared to continuous exercise programs (where heart rate was maintained at a constant level)27,28 showing that HIIT is a time-efficient strategy for improving central obesity in this population. In addition to HIIT programs, practicing yoga can be recommended for menopausal women, showing significant reductions in menopausal symptoms.29 In broader populations, interventions that included yoga asanas were associated with reduced evening and waking cortisol levels, as well as improved metabolic symptoms.30

 

  • Support reparative sleep. A primary step to losing belly fat is to get enough sleep and to make it quality sleep. Epidemiological studies have repeatedly shown links between sleep duration and the risk of obesity and central adiposity.34 People sleeping 7-8 hours/night night have been shown to accumulate less visceral fat mass than those sleeping for ≤6 hours/night.35 Sleep debt leads to changes in leptin and other hormones related to satiety, greater feelings of hunger, dietary indiscretion and poor food choices, as well as reduced physical activity and insulin resistance.34 In other words, getting that solid sleep needs to be a priority. As well as sleep quantity, sleep quality has to be considered, as poorer sleep quality is associated with higher visceral fat mass.36 Subjective poor sleep quality is linked with altered cortisol response37 and insulin resistance in postmenopausal women.38

by Sara Gottfried, MD and Annalouise O’Connor, PhD

Shared by Dr. Phil McAllister @ Forward Health Guelph

Citations

  1. Yamatani H et al. Association of estrogen with glucocorticoid levels in visceral fat in postmenopausal women. Menopause. 2013;20(4):437-442.
  2. Shen W et al. Sexual dimorphism of adipose tissue distribution across the lifespan: a cross-sectional whole-body magnetic resonance imaging study. Nutr Metab (Lond). 2009;6:17.
  3. Lovejoy JC et al. Increased visceral fat and decreased energy expenditure during the menopausal transition. Int J Obes (Lond). 2008;32(6):949-958.
  4. de Heredia FP et al. Obesity, inflammation and the immune system. Proc Nutr Soc. 2012;71(2):332-338.
  5. Prior JC. Progesterone for symptomatic perimenopause treatment – progesterone politics, physiology and potential for perimenopause. Facts Views Vis Obgyn. 2011;3(2):109-120.
  6. Hale GE et al. Hormonal changes and biomarkers in late reproductive age, menopausal transition and menopause. Best Pract Res Clin Obstet Gynaecol. 2009;23(1):7-23.
  7. Hale GE et al. Endocrine features of menstrual cycles in middle and late reproductive age and the menopausal transition classified according to the Staging of Reproductive Aging Workshop (STRAW) staging system. J Clin Endocrinol Metab. 2007;92(8):3060-3067.
  8. McTernan PG et al. Glucocorticoid regulation of p450 aromatase acitivty in human adipose tissue: gender and site differences. J Clin Endocrinol Metab. 2002;87(3):1327-1336.
  9. Paredes S et al. Cortisol: the villain in metabolic syndrome? Rev Assoc Med Bras (1992). 2014;60(1):84-92.
  10. Incollingo Rodriguez AC et al. Hypothalamic-pituitary-adrenal axis dysregulation and cortisol activity in obesity: a systematic review. Psychoneuroendocrinology. 2015;62:301-318.
  11. Li S et al. Effects of menopause on hepatic 11β-hydroxysteroid dehydrogenase type 1 actvity and adrenal sensitivity to adrenocorticotropin in healthy non-obese women. Gynecol Endocrinol. 2011;27(10):794-799.
  12. Andersson T et al. Tissue-specific increases in 11β-hydroxysteroid dehydrogenase type 1 in normal weight postmenopausal women. PLoS One. 2009;4(12):e8475.
  13. Andersson T et al. Estrogen reduces 11β-hydroxysteroid dehydrogenase type 1 in liver and visceral, but not subcutaneous, adipose tissue in rats. Obesity (Silver Spring). 2010;18(3):470-475.
  14. McTernan PG et al. Gender differences in the regulation of P450 aromatase expression and activity in human adipose tissue. Int J Obes Relat Metab Disord. 2000;24(7):875-881.
  15. Castro AV et al. Obesity, insulin resistance and comorbidities? Mechanisms of association. Arq Bras Endocrinol Metabol. 2014;58(6):600-609.
  16. Plymate SR et al. Inhibition of sex hormone-binding globulin production in the human hepatoma (Hep G2) cell line by insulin and prolactin. J Clin Endocrinol Metab. 1988;67(3):460-464.
  17. Loukovaara M et al. Regulation of production and secretion of sex hormone-binding globulin in HepG2 cell cultures by hormones and growth factors. J Clin Endocrinol Metab. 1995;80(1):160-164.
  18. Davis SR et al. The contribution of SHBG to the variation in HOMA-IR is not dependent on endogenous oestrogen or androgen levels in postmenopausal women. Clin Endocrinol (Oxf). 2012;77(4):541-547.
  19. Janssen I et al. Testosterone and visceral fat in midlife women: the Study of Women’s Health Across the Nation (SWAN) fat patterning study. Obesity (Silver Spring). 2010;18(3):604-610.
  20. Klok MD et al. The role of leptin and ghrelin in the regulation of food intake and body weight in humans: a review. Obes Rev. 2007;8(1):21-34.
  21. Engin A. Diet-induced obesity and the mechanism of leptin resistance. Adv Exp Med Biol. 2017;960:381-397.
  22. Harris RBS. Development of leptin resistance in sucrose drinking rats is assocated with consuming carbohydrate-containing solutions and not calorie-free sweet solution. Appetite. 2018;132:114-121.
  23. Diamanti-Kandarakis E et al. Mechanisms in endocrinology: aging and anti-aging: a combo-endocrinology overview Eur J Endocrinol. 2017;176(6):R283-R308.
  24. Levine JA. Sick of sitting. Diabetologia. 2015;58(8):1751-1758.
  25. Boutcher SH. High-intensity intermittent exercise and fat loss. J Obes. 2011;2011:868305.
  26. Maillard F et al. Effect of high-intensity interval training on total, abdominal and visceral fat mass: a meta-analysis. Sports Med. 2018;48(2):269-288.
  27. Maillard F et al. High-intensity interval training reduces abdominal fat mass in postmenopausal women with type 2 diabetes. Diabetes Metab. 2016;42(6):433-441.
  28. Nunes PRP et al. Effect of high-intensity interval training on body composition and inflammatory markers in obese postmenopausal women: a randomized controlled trial. Menopause. 2018;Oct 1.
  29. Cramer H et al. Yoga for menopausal symptoms-a systematic review and meta-analysis. Maturitas. 2018;109:13-25.
  30. Pascoe MC et al. Yoga, mindfulness-based stress reduction and stress-related physiological measures: a meta-analysis. Psychoneuroendocrinology. 2017;86:152-168.
  31. Caputo T et al. From chronic overnutrition to metainflammation and insulin resistance: adipose tissue and liver contributions. FEBS Lett. 2017;591(19):3061-3088.
  32. Gabel K et al. Effects of 8-hour time restricted feeding on body weight and metabolic disease risk factors in obese adults: a pilot study. Nutr Healthy Aging. 2018;4(4):345-353.
  33. Sutton EF et al. Early time-restricted feeding improves insulin sensitivity, blood pressure, and oxidative stress even without weight loss in men with prediabetes. Cell Metab. 2018;27(6):1212-1221.e3.
  34. Koren D et al. Role of sleep quality in the metabolic syndrome. Diabetes Metab Syndr Obes. 2016;9:281-310.
  35. Chaput JP et al. Change in sleep duration and visceral fat accumulation over 6 years in adults. Obesity (Silver Spring). 2014;22(5):E9-12.
  36. Sweatt SK et al. Sleep quality is differentially related to adiposity in adults. Psychoneuroendocrinology. 2018;98:46-51.
  37. Huang T et al. Habitual sleep quality and diurnal rhythms of salivary cortisol and dehydroepiandrosterone in postmenopausal women. Psychoneuroendocrinology. 2017;84:172-180.
  38. Kline CE et al. Poor sleep quality is associated with insulin resistance in postmenopausal women with and without metabolic syndrome. Metab Syndr Relat Disord. 2018;16(4):183-189.

 

Sara Gottfried, MD

Sara Gottfried, MD is a board-certified gynecologist and physician scientist. She graduated from Harvard Medical School and the Massachusetts Institute of Technology and completed residency at the University of California at San Francisco. Over the past two decades, Dr. Gottfried has seen more than 25,000 patients and specializes in identifying the underlying cause of her patients’ conditions to achieve true and lasting health transformations, not just symptom management.

Dr. Gottfried is the President of Metagenics Institute, which is dedicated to transforming healthcare by educating, inspiring, and mobilizing practitioners and patients to learn about and adopt personalized lifestyle medicine. Dr. Gottfried is a global keynote speaker who practices evidence-based integrative, precision, and Functional Medicine. She has written three New York Times bestselling books: The Hormone Cure, The Hormone Reset Diet, and her latest, Younger: A Breakthrough Program to Reset Your Genes, Reverse Aging, and Turn Back the Clock 10 Years.

Annalouise O’Connor, PhD, RD

Dr. Annalouise O’Connor is the R&D Manager for Therapeutic Platforms and Lead for Cardiometabolic and Obesity platforms at Metagenics. Her role involves research coordination, as well as developing formulas for targeted nutrition solutions and programs to assist practitioners in the optimal management of their patients’ health. Annalouise trained as an RD and worked in clinical and public health settings. Dr. O’Connor completed her PhD in the Nutrigenomics Research Group at University College Dublin (Ireland) and postdoctoral work at the UNC Chapel Hill Nutrition Research Institute.