Like many women of various ages, I have an old pair of jeans in my closet that no longer fits. Why I haven’t donated them to some anonymous, younger, lithe woman who shops at the Goodwill store is complicated, and not entirely clear even to myself. But I think it has something to do with a belief, or hope, that I’ll be able to fit into them again, no problem, with just a subtle tweaking of my activity level and eating habits.
But the scientific research tells me something different. I may need to make more significant changes. Even though I happen to be one of those lucky people who, by virtue of genes (the other kind) and a generally active lifestyle, has never really needed to worry about my weight, I suddenly find myself, at the age of forty-eight, unable to indulge in those cookies that a patient brings into my office, or that bowl of ice cream at night once the kids are in bed. Not without consequences anyway. The scale and the fit of my clothes tell me that I have put on a few extra pounds over the last year, even though I’ve been trying to watch what I eat. So what exactly is going on?
As a pediatrician, physiologic changes in middle aged women is not my area of expertise, so I asked my friend, Yanna Karabatos, M.D., an ob-gyn doc in Hartford who takes care of lots of mid-life mothers, to clarify what happens. She tells me that most women begin peri-menopause, the period during which subtle hormonal shifts start to take place, at about age forty-five. Our ovaries start to make less estrogen, but our bodies also start to make less testosterone, the hormone which helps to create muscle. Because of this, we start to slowly lose muscle mass. If muscle mass isn’t retained, we not only lose strength, our metabolic rate also declines, and we begin to burn fewer calories on a daily basis. So we put on a few pounds, which begin to add up over a number of years.
There is also the issue of how this weight is distributed. Before peri-menopause, women typically gain weight in their hips, buttocks and thighs, but as we get older, we tend to put on extra weight in the abdominal area. This is a bad thing. Abdominal fat, or “visceral fat”, is associated with an increased risk of hypercholesterolemia, hypertension, Type 2 Diabetes, heart disease and stroke. In younger days, you may have had a hard time believing that there were things worse than having a big butt, but there you have it. Having a big belly is far worse.
So what can we do to ward off the consequences of these metabolic changes? The short answer is: we need to do more and eat less than we would/could have a few years ago. And the type of activity that we engage in should include strength training to preserve muscle mass and bone density, which requires a more conscious effort. For those of us who are hitting this stage of life while still taking care of young children, this can be particularly challenging. While many of our same aged peers can feel comfortable leaving their teenagers unsupervised (for a short period of time anyway) while they go to the gym or out for a run, carving out the time to do this may be a little more complicated for us; complicated, but not impossible. There are a few good websites that help women figure out the specifics of what to do in terms of aerobic activity and strength training: the Mayo Clinic website, www.mayoclinic.com and www.healthywomen.org are two good places to start.
Maybe I need to get rid of those old jeans. Or maybe I need to keep them hanging in my closet as a reminder that my body is different now, and requires more of my attention, in order to be the healthy mother I need to be.