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As we move through peri-menopause and into menopause I often hear females talk about changes in fat storage. Where once they were unhappy for extra fat on their thighs they then become unhappy that it´s moved from there and seems to settle around the midsection. So what´s going on? It could be many factors, but lets have a look at one influence upon extra fat storage.

With the menopause transition, first progesterone, then oestrogen drops away while androgens slightly increase before resuming their gradual decline with age (as happens in both men and women). The menopausal situation of relatively high testosterone (an androgen) paired with relatively low oestrogen and progesterone causes a profound shift in fat distribution from gynoid (hourglass) to android (thicker waist and heavier upper body).

Androgen excess in women and androgen deficiency in men result in the same metabolic phenotype, characterized by abdominal adiposity, adipose tissue dysfunction, insulin resistance and metabolic disturbances.

Premenopausal women have less visceral white adipose tissue (fat around organs) and more fat accumulation in subcutaneous fat (under the skin) in the glute/thigh regions. Subcutaneous fat appears to be metabolically protective, whereas visceral fat contributes to metabolic dysregulation. With the hormonal changes that naturally occur as we move through perimenopause and into post menopause, fat metabolism changes. Body fat increases are seen in both truncal (more weight above the waistline) and subcutaneous fat tissue, with the greatest change seen in intra-abdominal fat mass. In some women, this change in body fat around the middle has been reported to increase by as much as 20% to 44%.

Studies in women both pre- and post-menopause, demonstrate that female oestrogens, strongly regulate adipose fat accumulation in women. Decline in circulating oestrogen levels during menopause are associated with distinct changes in adipose distribution patterns, leading to visceral adiposity.

With changing hormones fat tends to move from the bum/thigh area to the middle part of the body, so from a pear to an apple shape. Post-menopausal women tend to have lower levels of the beneficial oestrogen and low progesterone, this means they might distribute more fat mass around the middle region. The changes to fat mass tend to occur for the first 2 years post menopause and then stabilise (see diagram)

Metabolic changes of menopause, such as the increase in white adipose tissue, are associated with chronic low grade inflammation and oxidative stress.

A central or android fat distribution can increase the likelihood of narrowed artery walls; high blood pressure; and abnormal blood lipids, glucose, and insulin. This is why exercise, good nutrition (especially balancing blood sugar levels) are KEY to optimising health in peri to post menopause.

The natural shift to lower oestradiol in menopause impairs the mitochondrial cells ability to convert glucose into energy causing a temporary energy crisis. This is partly due to the reduced ability to convert energy from foods into metabolic energy (ATP) to drive the mitochondria (metabolic flexibility). Oestradiol also affects weight regulation by impacting thermogenesis. Thermogenesis is the regulation of energy through heat production. This increased energy expenditure contributes to weight loss.

Visceral fat has been strongly associated with metabolic dysregulation, due to what´s called: adipocyte (fat cell) hypertrophy.

Adipocyte (fat cell) hypertrophy is the swelling of existing fat cells with more fat and storage of excess nutrients as triglycerides. White adipose tissue expansion by adipocyte hypertrophy is considered metabolically unhealthy.
When hypertrophy happens these very large fat cells then produce more new fat cells which are metabolically inactive.
Changes in adipocyte (fat cells) endocrine (hormone) function in response to hypertrophy have considerable effects on appetite, glucose metabolism, lipid uptake, thermogenesis (body heat regulation).

High or low levels of oestradiol can both lead increased insulin resistance in the brain and other body tissues. This means that insulin resistance (lack of cell sensitivity) may be more likely to develop during high-oestrogenic periods of a woman’s life. Such periods include adolescence, pregnancy and the perimenopause. Therefore, women may be more at risk of weight gain during these stages.

If this is your concern, eating low glycemic carbohydrates, good levels of protein and healthy fats will help minimise insulin imbalances. If you are still having a period, eat foods with more glucose (such as rice, sweet potatoes, carrots and other beets, in the second half of your cycle).

There is more on this on pages 13, 48-50 of your E book.

Going a little deeper:

The accumulation of central abdominal fat is associated with a decline in circulating adiponectin. Adiponectin, is a protein hormone produced by our fat cells which enhances the response of cells to the hormone called insulin, so it´s role is to increase insulin sensitivity by promoting fat oxidation in liver and muscle tissue.

Those with low serum (blood) adiponectin levels are at higher risk of insulin resistance (IR) and the metabolic syndrome, and the decline in adiponectin with intra-abdominal weight gain at menopause is believed to have an important role in the development of IR in menopause.

Insulin-like growth factor (IGF-1) and growth hormone (GH) regulate adiponectin release in the fat cells. Leptin also has a role to play in adiponectin regulation.

Don´t be scared of fats:

The mono saturated fats found in fish oil and olive oil play a big role in supporting adiponectin levels. Other good sources are: avocados, olives, nuts. These should replace the fats that are not so beneficial at this stage of life for most:

  • Fatty meats, salami/sausages, and whole fat dairy products.
  • Herbs/Spices help too: fennel, sage, ginger
  • Exercising 30 minutes a day has also shown to be supportive of supporting adiponectin levels.
  • Short sharp sessions to raise heart rate are great to help stimulate growth hormone (up hill walking, skipping, faster biking, some mountain climbers etc)

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