When it comes to weight, it seems to be more of an issue in our later years…especially after our 60’s. Having a negative body image occurs for over half of women in their 60’s. Men are no exception. In a small Canadian study, half of men ages 60-83 said they felt unattractive because of their weight. Body dissatisfaction is associated with a higher risk of depression, poorer sleep and sub-optimal self care. Many people struggle with controlling those extra pounds that tend to deposit themselves around the middle while losing important muscle mass. Visceral fat is the fat that surrounds internal organs and is hidden in your abdominal cavity. What we have learned since the mid-1990’s, is that the fat cell is an endocrine organ, secreting hormones and other molecules that have far-reaching effects on other tissues. There are a host of chemicals that link visceral fat to a wide variety of diseases. This combination can lead to health problems such as high blood pressure and cholesterol, type 2 diabetes, sleep apnea and a decline in physical function. Your weight is one indicator of your health, but it matters where you carry those extra pounds. Here are some things to know about late life weight gain.
Visceral fat makes more of the proteins called cytokines, which triggers low lying inflammation and is a risk factor for heart disease and other chronic conditions.
Aging is an inflammatory process. The uncomfortable fact is that the fat you gained in your 50’s may continue in your 60’s. There is a natural increase in body fat until your 80’s!! While subcutaneous fat produces a higher proportion of beneficial chemicals, visceral fat produces chemicals that are far more harmful. Visceral fat makes more of the proteins called cytokines, which triggers low lying inflammation and is a risk factor for heart disease and other chronic conditions.
There is also a hormonal mechanism that perpetuates middle age weight gain (obesity) through eating high glycemic foods. Foods that have a high glycemic index pack alot of sugar into a small package. High glycemic foods cause a fast rise in blood sugar resulting in insulin release. Highly processed refined carbohydrates are absorbed quickly, increasing insulin levels that can result in rebound hypoglycemia and insulin resistance. These mechanisms increase insulin sensitivity in adipose tissue but create insulin resistance in muscle and brain. Your body continues to make more and more insulin which leads to metabolic dysfunction, inflammation, weight gain, fatty liver and plaque development. Weight gain has been said to be nothing more than your body’s chemical reaction to foods. It comes down to 2 things: hormones and inflammation.
A 2022 meta analysis described the metabolic consequences of partial sleep restriction. Out of 26 randomized clinical trials, 400 adults were studied under controlled laboratory conditions. It concluded that insufficient sleep results in a clinically significant decrease in whole body insulin sensitivity. This condition can lead to obesity and diabetes. This present study was the first to assess the impact of sleep restriction in post-menopausal women. The proportion of adults with chronic insufficient sleep (< 6 hours/night) is around 30%. And 41.5% of adults ages 60 and older are obese according to the Centers of Disease Control and Prevention. So getting enough sleep is important. At least 7 hours is ideal because sleeping less has been shown to elevate the hormone Ghrelin that signals us to eat. So less sleep= more hunger and calories.
We may want to eat as we did in our 20’s and 30’s but our metabolism slows down significantly as we age. Your body requires fewer calories to keep it working (calories needed for our lungs to breath and our heart to pump). Less muscle mass also contributes to this slower metabolism. We lose lean muscle as we age. So just walking those 10,000 steps is not enough. We need to fit in some weight resistance (weight lifting, push-ups, planks, etc) at least twice per week while consuming abut 25 percent of our calories from protein. Aerobic exercise like walking, biking, jogging or swimming are still important, but our muscles need protection and strength. You lose as much as 3% of overall muscle strength every year in your 60’s. Men hold on to more of their muscle power than women.
Menopause and it’s decline in estrogen also contributes to weight gain. By the time a woman is postmenopausal, 15-20% of her body fat is visceral fat, compared to 5-8% when she was premenopausal. Estrogen has direct actions in pancreatic islet beta-cells in regulating insulin secretion, nutrient homeostasis and in promoting fat burning. When estrogen falls during menopause, it is thought to reduce a women’s ability to use fat as an energy source leading to weight gain, high blood pressure and cholesterol, type 2 diabetes and inflammation. Estrogen replacement therapy may increase a woman’s resting metabolic rate.
Another common killer that becomes more common as we age is our risk for cancer. One reason according to the NIH is the decline in the immune system’s ability to detect and correct cell defects. Obesity is linked to at least 13 types of cancer. Some are hormone related. Obesity creates inflammation which disrupts the immune system and causes dysregulation of the endocrine system. Fat cells increase estrogen and other hormone levels that lead to an increase in cancer: breast, endometrial, thyroid and pancreas to name a few. Losing weight can reduce this risk.
Obesity is also a risk factor for autoimmune disease, a problem more common in women and as we age. This is when the immune system starts to attack the body’s own healthy tissues. People with rheumatoid arthritis in particular have premature aging. Researchers have found that their immune age is about 25 years older than their actual age.
Obesity, especially when there’s lots of visceral fat is a risk factor for faster brain aging and Alzheimer’s disease according to Howard Fillit, M.D. cofounder and chief science officer at the Alzheimer’s Drug Discovery Foundation. Belly fat can: reduce blood flow to the brain, shrink brain volume (up to 4%- 8%) and reduce cognitive function.
Think about monitoring your weight, BMI (body mass index- an estimate of your body fat based on your height and weight, aarp.org/bmi) and waist measurement as important as monitoring your cholesterol, blood pressure and blood sugar levels. A healthy BMI is 18.5-24.9 and 25-29.9 is considered overweight. A waist measurement (place a tape measure above your hip bones) above 35 inches for women or above 40 inches for men means you are at higher risk for heart disease or type 2 diabetes according to the National Institutes of health (NIH). Also if your waist size is more than half your height, you might be at greater risk.
Our immune systems can be re-set and inflammation significantly reduced with weight loss. Here are some tips:
- Increase your protein intake..especially in the morning. Eating 25-30 grams of protein with each meal helps maintain muscle mass and reduces fat gain.
- Choose fresh farm food over processed food. Consider following the MIND diet (a combination of the Mediterranean and DASH -low sodium diet).
- Move at least 30 minutes/day for cardiovascular fitness and add weight resistance at least twice per week for muscle strength. Exercise is the best thing you can do to prevent Alzheimer’s disease!
- Cut down on simple carbs, especially sugar. This includes alcohol too which is a toxin to the brain and destroys sleep. Simple carbs also retain fluid.
- Get some sleep…at least 7 hours. Avoid late night food and alcohol. Stop eating at 7 PM as it stores more body fat since you are not burning it off.
- Sunlight, especially in the morning even if it is overcast. It helps elevate Cortisol in the morning which you need for energy and resets your circadian rhythm for better sleep at night by increasing melatonin in the evening.
- Social connection is important. Remember that hormones are involved in weight gain and the more we can reduce high levels of cortisol throughout the day, the less insulin gets produced to allow fat to be stored. When you are connecting and having fun, it lowers cortisol and raises serotonin and oxytocin which help us relax, digest better and utilize glucose for energy more efficiently. Meditation, deep breathing and prayer are also important.
- Consider getting a food allergy test. Learn to avoid “trigger foods” (foods you are reacting to) so that inflammation and insulin subside and weight loss can begin. Reactive calories will put on weight.
- Get your thyroid level checked. It’s a major player when it comes to hormone health since it stimulates metabolism.
- Drink water. It is essential to drink approximately half your body weight in ounces. For every 16 ounces less than your body needs, it will hold onto half a pound! When you are dehydrated, your body has to extract water from your food and holds on to it in your tissues. When you drink enough, the body can let go of the extra water it’s been holding on to, and the numbers on the scale go down.
References: Mauvais-Jarvis, F, et al. The Role of Estrogens in Control of Energy Balance and Glucose Homeostasis. NIH: Nation Library of Medicine. Endocrine Review, 2013 June; 34 (3): 309-338.
Cauter, E. and Spiegel, K. Effect of sleep restriction on insulin sensitivity and energy metabolism in postmenopausal women. Obesity, Metabolic Syndrome and Prediabetes. May 9, 2023. Practiceupdate.com.
Stuart, A. Menopause, Weight Gain, and Exercise Tips. WebMD. March 17, 2023.
Migala, J. The Weight Issue. AARP, the magazine. April/May 2023. pp 52-57.
Genet-Recitas, L. “The Plan”. Grand Central Publishing, 2013.
Healthline.com/nutrition/mind-diet. The MIND diet: A detailed guide for beginners.
even if you continue to have healthy eating habits and exercise. When women are struggling with night sweats, hot flushes, lack of sleep, fatigue and mood swings, it tends to exacerbate the problem. Offering bio-identical hormones not only helps symptoms but can assist in weight management. Again, hormone replacement therapy does NOT cause weight gain! That is, if hormones are started less than 10 years after starting menopause.