Staying Ahead of Midlife Weight Gain

Those extra pounds were assumed inevitable, but what we are learning about microbiome and energy metabolism says that may not be so

Bigger rises on the scale during the prime of life are linked to more chronic disease including heart disease as we march on in life.

It’s not simply your weight, wherever that tell-all dial lands on the scale, but the amount of weight you gain from your twenties onward that impacts your health. Large prospective surveys tracking what Nurses and Health Professionals reported they ate over their lifetimes are helping scientists unravel the impact of putting on weight in midlife.

Midlife is a dynamic period when most weight gets put on, peaking at about 65–70 years. With further aging, weight tends to reverse as lean muscle mass declines. Weight and the stress posed on the workings of the body seem to accelerate risks of what scientists dub “inflammaging,” increasing oxidative stress posed by lifestyle choices like diet. Weight gains from adolescence onward seem to drive up the risk of developing colon cancer in men. In women, the link is more complicated… weight gain before but not after menopause increases colon cancer risk. The differences between the sexes underscore the way metabolism, hormones, genes, and our defenses against inflammation interact with our gains. Body mass is linked to higher risk of breast cancer in some studies, but most significantly in women who have a family history of cancer. Women who gain more than 35 pounds from their early twenties to their forties have higher risk of kidney stones. Why not men?

Women tend to put on weight in the hips and thighs while men see expansion around their midsection. That’s the case until menopause sets in when women’s weight gain patterns become more apple than pear-shaped, more similar to men’s. That weight gain around the abdomen is also a hallmark of insulin resistance, the precursor condition that leads to obesity, diabetes, and cardiac and other diseases linked to thwarted metabolism.

Putting on midlife pounds may not be as inevitable as previously thought. The science behind what makes us fat is emerging to reveal how what we eat drives appetite, inflammation, and the rate we burn energy. Here are some strategies to help optimize midlife diets…

Nurture Your Microbiome

To a large extent, our diet choices have effects on the trillions of bacteria living in our gut, our microbiome, which is increasingly linked to rising obesity. Numerous studies have shown that intestinal microbiota, the bacteria that inhabit our guts, are key to America’s obesity epidemic. Gut changes with menopause also likely foster women’s later life weight gain. 

What we habitually eat can cause fluctuations in the richness and diversity of gut bacteria important to health. We rely on them to absorb essential nutrients , to maintain gut integrity, reduce inflammation, and to regulate insulin and metabolism.

Diets high in fiber exert a protective effect on the gut’s mucosal barrier fending off pathogens and reduce obesity. For ideas on how to supercharge your fiber, read here and great 25+ great snacking ideas here. Also, avoid unnecessary use of antibiotics as they are increasingly understood to cause perturbations in gut bacteria with consequences to weight maintenance.

If You Are Parenting, Take Note How Early Life Impacts Lifelong Weight

Set good habits early, so the eaters you are raising can recognize which foods are packed with high value from good fats, antioxidants, and fiber. Focus less on restricting “unhealthy” foods and more on promoting “good” foods to build intuitive skills about what constitutes healthy choices. Be sure to offer a variety of fresh fruits and vegetables daily to message how to incorporate these into favorite meals and snacks. Early life diets have impact on the microbiome that can endure a lifetime.

Fulfill Your Protein and Calcium Needs

Particularly for women after menopause, body weight changes tend to stem from increasing fat as muscle mass declines. That’s why it’s important to adapt to aging by increasing daily exercise which in itself builds bone and muscle mass. Keep up with protein and fiber-rich meals. Just because the nest may be empty, it’s not a time to skimp on dinner or simply graze. Adequate protein can be found in yogurts and kefir, cheeses, dairy, soy, and nut milks; tofu, beans, chickpeas, lentils, fish, shellfish, nuts, seeds, and lean meats like poultry and lean cuts of beef, lamb, and pork. To get 1000-1200 mg of calcium daily, you’ll need three servings of dairy, calcium-fortified plant milks and juices, yogurt, labne or kefir, or sardines and salmon. Foods like beans, kale, and broccoli will add calcium, but not enough in the quantities most people eat.

Recognize Calorie Counting and Restrictive Diets as Outdated

There was a time patients were told to cut 300 cal/day from soda and sweets in order to lose 30 pounds, but body weight is regulated by negative feedback loops that drive appetite and more food intake. Those using restrictive diets, especially “all or nothing” approaches, end up in cyclic yoyo dieting without sustained weight loss over time.  As more weight is lost, biology makes it harder and harder to feel full and slows metabolism. To fight back, eat plenty of fiber and, judiciously, good fats from nuts and seeds to feel satisfied. Say snack on popcorn, hummus and crudités, or a handful of nuts a day. Eat whole foods unrestricted taking cues from a Mediterranean or DASH-style diet…most will lose 10 percent of body weight if shifting from a convenience-food rich diet. These foods will fill you up with more staying power. Include

soy products (edamame, tofu,) chickpeas, fava, pistachios, and peanuts rich in isoflavonesas well as lentils, beans, cereals, and flaxseeds that provide lignans and coumestans. Diets rich in these are associated with lower body weight and lower rates of metabolic disease.

Beware of Very High Salt Foods

Salt overload has been shown to override appetite signals that let a diner feel satisfied and full enough to stop eating. In mice fed to become obese, high salt elevates leptin, a hormone essential for appetite regulation, which in turn promotes leptin resistance. Excess sodium has also been shown to drive up ghrelin, the gastric-derived peptide signaler that stimulates appetite to ensure we eat enough to meet energy needs. This is one area of research that is developing in order to better understand the relationship between high salt intake and rising rates of obesity.

Make Exercise Part of Each Day

Increase your exercise to increase energy expenditure through at least 150 to 300 minutes a week of moderate-intensity or 75 to 150 minutes a week of vigorous-intensity aerobic activity. Include muscle-strengthening 2 or more days a week in your workout to help counteract the loss of lean muscle mass.

The Last Advice is Simple…Cook More At Home

The foods you buy for convenience at the deli counter or in restaurants add sugar and salt to ensure you will return to buy more. These foods drive appetite up with their hidden sugars and sodium. Prepared and grocery convenience options are less likely to contain perishables like the greens and fiber you need to fight “inflammaging.” Learn a repertoire of recipes and stock your pantry to make cooking at home easy and enjoyable. When you take control over what goes into your food, it’s an investment with great returns.

Have a strategy to fend off midlife weight gain? Write to me and tell me about your successes!

Roasted Beets with Labne and Pistachios

Labne, a Middle Eastern strained yogurt, can be purchased in most markets or made by straining Greek yogurt in cheesecloth. I have a handy, cheap device called a “Yogurt Cheese Strainer” that I purchased on Amazon. It amounts to a fine sieve suspended in a box that stores in the fridge. I simply fill it with 2% or 5% Greek yogurt and 2 hours later I have a thickened, creamy labne to top shakshuka, spread on a bagel, or use for my favorite beet and pistachio salad. The beets offer good fiber for low calorie investment, the labne calcium and protein, and the pistachios are rich in isoflavones. No matter…it’s a beautiful summer starter!

1 bunch red beets, tops trimmed, approximately 3-4 large beets 0r 6-8 medium

3/4 cup shelled pistachio

6 ounces labne

3 tablespoons extra-virgin olive oil

Preheat oven to 400 degrees.

Trim the bottom root from each beet. Do not attempt to peel beet as you prepare them. Wrap each beet individually in a well-sealed foil packet. Place on a foil-lined baking sheet as the beets tend to omit a staining liquid.

Roast for 45-55 minutes. Test each beet for tenderness by ensuring the tines of a fork will readily pierce each. Remove from heat and let cool to room temperature.

Open the foilpackets and peel the beets. You may wish to protect your hands from staining by using a plastic bag or food-safe glove. Quarter the beets and cut each quarter again half.

Using a sharp knife, medium chop the pistachios. Alternatively, place them in a sealed sandwhich bag and crush with a meat tenderizer taking care not to pulverize them to a paste.

Plate the beets in a single layer on a platter. Follow with several tablespoon-size dollops of labne evenly over the beets. Drizzle good quality olive oil evenly among the beets.

Dress with the chopped pistachios and serve.