Strictly Comes Dancing Does Perimenopause

Tuesday, 2 November 2021

Strictly Comes Dancing Does Perimenopause

Brain fog & midlife weight gain is so readily attributed to the menopause, why is this? And what can we do about it?

In our 20’s and 30’s the cells of the brain (neurons) & cells of the energy system that drives our metabolism are literally bathed in the natural ebb & flow of oestrogen (O) & progesterone (P) across the menstrual cycle. Oestrogen rising in the follicular phase, a wave of progesterone taking centre stage mid-cycle & both taper off to start the dance all over again, much like an elegant waltz.

Our metabolism relies heavily upon the O+P waltz to maintain an exquisite degree of insulin sensitivity allowing all cells of the body to use blood glucose highly effectively. Achieving this exquisite level of insulin sensitivity establishes a metabolic flexibility at the level of the mitochondria in every cell which serves to fire our neurons, activate anti-inflammatory genes & drives us to be a fat burning machine.

As we enter perimenopause oestrogen levels become erratic: soaring high & plummeting low while progesterone takes an overall nose dive.

The hormone dance changes from an elegant waltz to a more erratic tango, losing first P then O causes a precipitous decline in insulin sensitivity, a shift towards insulin resistance which parallels an increase in weight gain, elevations in LDL cholesterol + triglycerides + inflammatory chemicals. Insulin resistance is like a metabolic brake - slowing the body's ability to burn fat - hello weight gain & an inability to have the flexibility to use ketones (instead of glucose) to fire neurons - hello brain fog & forgetfulness!

Diet & lifestyle strategies can support the nervous system, reverse insulin resistance to adapt to become metabolically flexible - enter the foxtrot!

Physiologically, what becoming a better fat burner is all about is becoming more metabolically flexible. In Perimenopause, due to the erratic fluctuations in oestrogen and progesterone our individual cells' metabolic flexibility diminishes, impairing  the cells energy powerhouse, the mitochondria’s ability to convert glucose for energy!

The availability of energy and our usage of it, changes dramatically across our life stages and day to day activities. We can be sleeping or running; cold or hot; eating or fasting; consuming vegetables, cake, potatoes, or a glass of wine. Our ability to adapt to these conditions depends greatly on the ability of our individual cells to be metabolically flexible.

When metabolic flexibility is impaired, our cells can’t easily switch fuel sources leaving  us unable to respond well to changing conditions. For instance when we ingest carbohydrate, we cannot dispose of blood glucose as quickly as we should. This causes poor glycemic control - wide blood sugar swings and insulin resistance. 

Here are some strategies to help you flex ladies…

  • Optimise Vitamin D Status: Why? Low Vitamin D levels and E2, and increased body fat central mass contribute to insulin resistance. Being low in vitamin D is highly correlated with progression to insulin resistance
  • Move: Why? Movement enhances the cells uptake of glucose and building muscle improves insulin sensitivity even when you are at rest! Lunges, walking, plank, and using resistance bands are all great. Three to four 45-minute sessions of moderately intense aerobic exercise per week, or three 30-minute moderate aerobic sessions and one session of weight training
  • Timing of meals: Why? Ensure you consume some protein by 10am, to stabilise your circadian rhythm and then eat in an 8 hour window, finishing your evening meal by 6pm. Why? Facilitates a healthy state of ketosis which the body switches from burning primarily glucose to burning fat (ketones).
  • Protein: Why? It builds muscle and is highly satiating, so helps to stabilise blood sugar levels. Aim for a serving of protein the size of the palm of your hand or at least 20g of protein per meal.
  • Eliminate refined and processed carbohydrates (and sugars) from the diet entirely