Starting at this time of year and continuing through February, I tend to get more-than-usual questions about diet. Some women are anticipating upcoming holiday-eating challenges; others are thinking through resolutions for the new year.
Before I address diet and weight during menopause, let me make this public service announcement: If you’re just entering menopause—or just becoming conscious that menopause is in your future—know this: Women who enter menopause close to their ideal weight improve their chances of maintaining it. Women who tend to yo-yo or who have a hard time maintaining a healthy weight tend to end up at the high end of their range. Now is the time to cement healthy movement and eating habits!
And now back to our regular programming: During menopause, weight is easy to gain (in fact, some weight gain is almost inevitable) and hard to lose, for a number of reasons: metabolic change, loss of muscle mass, hormonal change, sleep deprivation, and stress. As you enter your 50s and 60s, you’ve lost about 20 percent of your muscle mass and you need about 200 fewer calories per day.
The good news is that the best weight management strategy—the one that will work for the long haul—will also keep you stronger, more flexible, healthier, and capable of maintaining an active lifestyle for far longer. You’ll be able to travel, garden, play with the grandkids, get up off the floor, carry heavier loads, and remain generally pain-free.
The bad news is that it’s hard. A realistic and effective strategy to maintain a healthy weight requires self-discipline and lifestyle change. For the rest of your life. As you’ve probably guessed, you have to get serious about exercise and your diet—how much and what kind of food you put in your mouth. And without lifestyle change, you’ll put weight right back on and then some. Only now, at midlife, you’re more vulnerable to a host of serious, life-altering ailments, such as joint problems, diabetes, and cardiovascular trouble.
So let’s talk about ways of eating that work for older women. First, focus on fresh, real, homemade food. You need to consume fewer calories, but they need to be high-quality, nutritious calories. Think whole grains, fresh fruit and vegetables, nuts, and legumes. I like Michael Pollan’s quote: “Don’t eat anything your great-grandmother would not recognize as food.”
Don’t go crazy on low- and non-fat foods, which are unhealthy in hidden ways. Instead, go for the unsaturated fats in olive or sesame oils, avocados, nuts, and salmon or tuna. “…[nutrient-rich, unsaturated fat] keeps your skin supple and your body from drying out. Basically, it’s like putting lotion on your body but from the inside out,” says Dr. Christine Gerbstadt in her article, “Flourishing at Age 50 and Beyond.”
Speaking of calories, a sedentary older woman in her 50s and 60s should consume about 1600 calories per day. If you’re more active, bump that up to 1800 calories. To lose a pound per week, you need a daily 500-calorie deficit, either through diet or exercise.
Protein is important to replace muscle and protect bones—5 to 6 ounces of lean protein per day, such as that in dairy products, poultry, and fish. Avoid sugar, but don’t be obsessive about it. If you’re too rigorous, you just may set yourself up for a binge. An occasional treat is a nod to mental health. Alcohol (even in red wine) is not your friend. Alcoholic drinks are full of sugar and high in calories. One 4-ounce (half-cup) wine or beer per day is the limit, with 1.5 ounces for spirits.
The best diets for older women are the Mediterranean diet and the low-carb diet. Plant-based diets are easy to find right now, and vegan and vegetarian diets are both good for weight loss and have been linked to greater longevity. As Dr. Connie Newman said in our conversation about weight, though, “It’s not the diet [that matters]. It’s the diet that's adhered to that works.” Don’t agonize about which diet is “best,” that is; as long as the diet you’re evaluating is aligned with good nutritional practices, choose the one that suits you best.
If you slip up, start fresh at dinner time, or tomorrow! It takes time to redesign our relationships with food. Staying fit and a weight you’re comfortable with after menopause is no picnic, but feeling healthy, capable, and in control of your life is worth every uneaten donut.
Dr. Barb DePree, M.D., has been a gynecologist and women’s health provider for almost 30 years and a menopause care specialist for the past ten.