5 steps by Dr. Jennifer Pearlmann
As we age, the extra pounds aren’t just about
calories. It becomes a tidal wave of risk factors for obesity and metabolic problems and cardiovascular disease that can wreak havoc on our physiology and contribute to the aging phenomenon.
Our evolving understanding of risk factors are shedding light on the question of why calorie-restricted diets,
regardless of regimen, don’t work, or may seem to work only temporarily but are
inevitably followed by rebound weight gain. This vicious cycle of weight loss
and gain is hazardous to our health. Recent research suggests that yo-yo
dieting redistributes toxins from fat tissue exposing the brain to their
harmful effects.
So if calorie counting doesn’t work,
what can we do about age-related weight gain? The first step is redefining the
problem and moving away from a quantitative approach and toward a qualitative
framework. We encourage focusing on food quality (not calories) and body
composition (not simply pounds on the scale). There are no cookie-cutter
solutions, but by understanding an individual’s metabolic, inflammatory,
hormonal and psychological status along with their habits and lifestyle a
comprehensive plan may be born.
Preventing age-related weight gain
requires an individualized, multifaceted approach as diets alone are doomed to
fail. The following five steps target the metabolic, hormonal, psychological, environmental
and lifestyle factors contributing to weight gain.
1) Reset
insulin sensitivity
By the time we’re 50, our ability to
effectively metabolize dietary carbohydrates has plummeted to about 50 per cent
of our level as teenagers. We acquire a varying degree of insulin resistance
that makes us more prone to elevated insulin levels even in the setting of
normal blood sugar. So while we are not yet diabetic, an unfavourable metabolic
cascade is at play with faulty insulin signaling and inflammation. As a result,
we become adept at converting the carbs we eat to deep stores of body fat,
especially in the belly. Cutting back on grains and highly processed food along
with increasing aerobic exercise can improve insulin sensitivity and stop the
mid-waist drift.
2) Restore
hormone balance
Declining estrogen and progesterone in
women and testosterone in men produces changes in body composition with
redistribution and accumulation of deep fat stores coupled with a loss of lean
body tissues such as bone and muscle. The role of hormone therapy is well
established for maintenance of lean body mass while its role in preventing
weight gain is less clear. The decision to initiate hormone therapy must be a
highly individualized one between a patient and their qualified physician that
considers the total risk-reward profile. While hormone therapy may not be right
for all, an easily accessible first step is to reduce harmful environmental
exposures. Common household products like skin care and cleaning agents may
contain hormone-disrupting or estrogenic chemicals known as “xenoestrogens”
that can interfere with hormone balance and increase risk of breast cancer.
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3) Repair
the gut
Overgrowth of unfavourable gut bacteria
can adversely affect human health and metabolism. New science has shown that
the typical Western diet fosters gut bacteria that are more efficient at harvesting
energy from food. These gut bugs are much better able to convert the food we
eat into calories – literally delivering an even faster version of fast food to
our cells with the extra energy being stored as fat. To keep the microbiome
thriving, a plant-based, high-fibre diet is preferred as it increases transit
time and supports favourable flora. Fermented foods like kimchi and sauerkraut
may have an edge on a store-bought probiotic pill as these traditional “germy”
foods contain a naturally derived symbiotic blend of both the necessary
pre-biotic substances and probiotic organisms. So at once we can live clean and
eat dirty to better balance the gut.
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4) Rethink
calories
Be mindful of portion size but think
mostly in terms of quality, not calories. An energy-equivalent portion of kale
and processed fast foods are not equivalent in any other way, as the
cruciferous kale is akin to a warehouse of nutrition with anti-inflammatory,
anti-oxidative and anti-carcinogenic health benefits. Get more nutritional punch
with each bite by loading up on cruciferous vegetables like kale and broccoli
instead of starchy ones like potatoes and avoiding processed foods that often
have hidden calories.
5) Reboost
brain controls
Sleeplessness and stress are both
strongly associated with weight gain and poor dietary choices. Chronic stress
produces a state of elevated cortisol, which in turn can lead to insulin
resistance. Psychological stress has been shown to alter levels of the satiety
hormone, leptin, leading to overconsumption of comfort foods that are high in
fat and sugar. Mindfulness-based interventions and stress-management techniques
such as tai chi, stretching, yoga, massage, deep breathing, and exercise have been proven to be effective in
keeping stress at bay and improving sleep.
Dr.
Jennifer Pearlman is a physician focused on women’s health and wellness and a
staff physician at the Menopause Clinic at Mount Sinai Hospital in Toronto, and
medical director of PearlMDRejuvenation, a women’s health and wellness
facility.
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