Intermittent Fasting in Pre and Post Menopausal Women

Suzie Glassman

Think twice before starting this popular weight-loss method

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I’m 43. Menopause is the last thing I want to think about. Yet, perimenopause — the period leading up to “the change” — begins for most women in our 40s.

Ignoring what’s on the horizon doesn’t make it go away. Yet, it’s not a subject that ever comes up with my friends, especially not diet and menopause.

Nearly all women associate this phase with hot flashes, moodiness, and trouble sleeping. Changes in estrogen levels typically bring about weight gain, muscle loss, reduced bone density, and a change in fat cells (meaning fat shifts around the body).

If only we could all age with the grace and beauty of Helen Mirren or Julianne Moore.

Instead, many of us find ourselves in an impossible relationship with food. Can’t live with it; can’t live without it.

Tired, hangry, embarrassed, and confused, we look to popular diet methods to lose weight. While many individuals find success with intermittent fasting, I’ll show why it’s essential for pre- and postmenopausal women to exercise caution when it comes to this particular diet.

Weight Gain

Itstarts without any change in our eating habits. Our 40s frequently mean we are less active just as our metabolic rate beings to slow. Whether it’s increased job responsibilities (sitting at a desk all day), shuttling kids around, or bingeing Netflix at the end of a long day, we are doing a lot more sitting.

Sitting for extended periods means we’re burning far fewer calories. Studies equate sitting with increased mortality (causing some to argue sitting may be the new smoking).

What’s worse? Where we gain weight changes. Perimenopause weight gain shifts from the hips and thighs to the belly. All of a sudden, our jeans won’t button. That’s just cruel.

We also lose muscle with age — called sarcopenia. Inactive people can lose up to 5% of their muscle mass each decade after 30, while active people will lose a little less.

Loss of muscle mass means we burn fewer calories, including at rest. It also makes us more susceptible to falls and broken bones.

Combine weight gain with the stress of midlife, and many of us find ourselves feeling depressed, invisible, self-conscious, and anxious.

Enter the Diet

It’s only natural to fight against the extra pounds. Most of us have dieted in some form another. One poll showed the average adult will diet approximately 126 times in his or her lifetime.

Google’s most-searched diet term in 2019?

Intermittent fasting (IF).

There are several forms — one of the most popular is 16:8. You eat within an 8-hour window and then fast for 16 (the fast includes when you’re asleep).

With only 8 hours to eat, you end up eating fewer calories overall. While no foods are prohibited, the idea is to consume a wide variety of nutrients through protein, fruits, vegetables, and healthy fats.

For example, you choose to forgo breakfast and eat only between noon and 8 p.m. Essentially, you’re limiting yourself to two meals and maybe a few snacks per day. Eating later in the evening keeps you from going to bed hungry, and skipping breakfast doesn’t seem to have negative consequences for most.

Assuming you don’t overeat during your 8-hour window, you should end up in a caloric deficit without feeling miserably hungry — note the word ‘should,’ it doesn’t always go that way.

Here’s where the trouble comes for women our age:

Fasting daily doesn’t support muscle growth or maintenance.

Fasting creates a caloric deficit mentality, which can bring weight loss. Still, it can also bring muscle degradation, which leads to osteopenia (when bones become brittle) and sarcopenia, as mentioned earlier.

Why does that matter? Want to know one of the best predictors of how long you’ll live?

Muscle mass.

Researchers at UCLA found that having higher amounts of muscle mass decreases an adult’s metabolic risk. The greater the amount of muscle an older adult has the less likely they are to experience early mortality.

Why? You are more likely to fall and experience significant injury with the loss of leg strength. Falls are the #1 cause of accidental death in people more than 65 years old.

There are three ways we lose weight — loss of water, fat, or muscle (or a combo of each). The goal of any diet program should be to lose fat and hold on to as much muscle as possible.

How do you know when you’re losing muscle on an IF diet?

  • You’re losing weight too quickly. Your body can only slash a certain amount of fat before it turns to muscle. One study compared severe vs. moderate energy (calorie) restriction and found severe restriction led to more muscle loss than the moderate-restriction group.
  • You’re not eating enough protein. When in a caloric deficit, studies prove protein intake in the order of double the current recommended daily allowance (RDA) (i.e., .7g/lb/d) preserves muscle mass during weight loss. For a 160-lb female, that’s 112g of protein. That can be hard to do with two meals a day.
  • You are not doing any form of resistance exercise. Exercise is an integral part of any health program, especially for someone facing menopause or on the other side. While the health benefits of exercise are numerous, the strongest factor for this age group is keeping bone mass and strength. Low-calorie diets can zap your energy and kill your will to exercise. They can also make you feel like you don’t need to exercise because you are losing weight without it — keep in mind that weight loss includes precious muscle.
  • You are missing out on times when your body could push up muscle protein synthesis (MPS) to build/repair more muscle. For example, by this point, you are exercising and following the 16:8 guidelines. Not eating 16 hours a day makes it more difficult for your body to take the work you just did and translate that to muscle growth. This 2014 study found an even balance of protein intake at breakfast, lunch, and dinner stimulates MPS more effectively than eating the majority of daily protein during an evening meal. Can you fast and gain muscle? Yes, but you are doing it the hard way.

IF can create a disordered relationship with food

Possibly the most common theme I see in women my age group is a fear of food. And why not? The same amount of food we could eat in our 20s and 30s now makes us gain weight.

However, not providing your body with a sufficient amount of fuel can have adverse effects. Caloric suppression can slow down your metabolic rate, cause fatigue, nutrient deficiencies, lower immunity, and weaken bones.

Fasting can also set you up for a dangerous cycle of bingeing, feeling guilty, and restricting even harder — only to binge again. Remember, the diet works if you maintain a caloric deficit. But ignoring your hunger cues day in and day out can lead you to overeat whenever your fasting period expires.

Hormonal shifts, pressure to lose weight, and changes in life circumstances drive some women to eating disorders midlife.

35% of “occasional dieters” progress into pathological dieting, (disordered eating) and as many as 25%, advance to full-blown eating disorders

Of course, not all women who use fasting as a technique to lose weight will go too far with the restriction aspect. However, if you find yourself going down a dark hole where you’re obsessing over what you will eat as soon as the fast ends, you may want to reconsider.

What Now

Long-term research on the benefits or drawbacks of IF is mostly unavailable at this point. Short-term, the diet is just as effective as any other weight loss method.

IF includes other forms of fasting. The 5:2 method encourages eating 500–600 calories two days a week and then normal the other 5. Alternate day fasting promotes eating very little one day — normal the next. The Eat. Stop. Eat. method dictates a more prolonged fast (18–24 hours) once or twice a week.

The same caveats outlined earlier apply to each form.

Fasting is an added form of stress that can increase cortisol levels. Chronic elevation of cortisol can lead to weight gain — precisely what you are trying to fight against.

Keep in mind that even though it feels like the rest of the world has jumped on this bandwagon, it may not be right for you. The hanger is real and can be downright unmanageable if you are living through a highly stressful situation (like a pandemic).

What’s a girl to do?

Start with exercise. Exercise can help mitigate the effects of estrogen deficiency. While hormone replacement therapy can help attenuate changes in body composition and fat distribution, it has no effect on preserving resting energy expenditure — meaning it doesn’t help maintain or increase the number of calories you burn at rest in the way that having more muscle can.

Research indicates that postmenopausal women who engage in the comprehensive exercise program, benefit by maintaining a healthy body, bone density levels, and good mental health.

It is never too late to start exercising. Start slowly and focus on what you enjoy. Regular walking helps with Vitamin D exposure and overall wellbeing. Simply move fast enough to get the heart pumping.

If you’ve never set foot in a weight room, start with a group class, or have a trainer show you the ropes. I know it can be intimidating.

Focus on nutrition. Eating well is your best defense. You don’t have to count calories or obsess about tracking every last morsel. Start with getting enough protein. Aim for 30g with each meal. Here’s a great list of high protein foods.

It’s also essential to get a wide variety of nutrients to protect our bones and organs. Of course, fruits and vegetables are on that list. Fatty fish like tuna and salmon provide an excellent source of Omega 3 fatty acids, which are linked to improved mood and heart health. You can consider a fish oil supplement if you’re like me and don’t like salmon.

Most of all, don’t restrict your diet too much. Aim for a moderate caloric-deficit of around 300–500 calories per day.

Stephan Guyenet, Ph.D., author of The Hungry Brain, says severe restriction induces a classic starvation response. Your brain responds by upping hunger, making high-fat, sugar-laden foods impossible to resist.

Perimenopause and postmenopause are times where training and nutrition become more important than ever. Make it a priority to maintain lean mass and not gain excess body fat.

There are 20 million American women between the ages of 40 and 60. It’s time we started talking about this phase of our lives. The diet industry would like us to think we are at fault. If only we could just eat less and follow some unspoken set of rules about how to age gracefully.

The truth is the change of life is hard.

Intermittent fasting is simply one tool at your disposal. There is no shame in passing on this way of eating.

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I write about health and fitness with the goal to help you live a healthier, happier life.

Denver, CO
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