by Barbara Berkeley MD
The most frequently accessed posts on this blog are the ones that I've written about weight control after menopause. Clearly, there is enormous frustration and confusion surrounding this topic in my sisters over 50. And why not? The American mainstream becomes disinterested in us women as we get older. We feel invisible. We internalize this cultural meme and fear it. Menopause, while just a biologic event, becomes a huge, nefarious bookmark in our lives. For many women, becoming menopausal is like passing through the gates of oblivion.
Nonsense. Just refuse to be invisible.
To the left, see my mom, age 96. She is utterly visible. But more of her later.
This is Harriet Thompson at age 91. After taking up running at age 76, she broke the speed record for running the marathon in her age group. She ran 26 miles in 7:07:42. Apart from smashing the record, Harriet proved that a 91 year old woman can run for more than seven hours. Can you?
She's not invisible.
Being significantly over 50 myself and having spent most of my professional life working with overweight and obese people, I can assure you that menopause does not have to mean inevitable decline. Nor does it have to mean an inability to control your weight. Yes, we will all get old eventually. We will all lose function in time. But why give up now? Particularly during this incredible era when those of us who have taken care of ourselves will be able to access the new health and life extending technologies that are being developed every day.
I believe that the key to living from 50 onward is to get incredibly smart and creative about how we do it. In other words, don't let it happen to you. Try to direct things!
Life is an obstacle course, but aging can slow your ability to get around the jumps. Many of the women I treat have given up. They simply expect to get slower, fatter, and frankly---dumpier. And there doesn't seem much point to opposing the inevitable. Weight loss and fitness are just two ways to reclaim vitality. There are many others. But in my professional career, I've seen numerous post menopausal women resume active, youthful lives after re-engaging with their health. There is no down side to trying this experiment. If you're on the fence, do it now!
Here are my personal keys to successful weight (and life) control after 50. Essentially, this information can be summed up this way: the same rules apply for everyone at every age, but they must be followed with more passion and determination by those of us past 50.
1. Eat a primal style diet.
That means, avoid all food additives you can. Eat almost all of your foods in an unadulterated, unpackaged way. Eat well-raised animal proteins and seafood and lots of vegetables and fruits. While not strictly paleo, I also encourage eating low fat dairy foods as well. Vastly decrease consumption of the foods that your primal ancestors would have not recognized. This includes sugar and anything sugar-like (honey, high fructose corn syrup, etc), starchy tubers like potatoes and grains, including whole grains. Remember that rice and corn are also grains. Remember too that grain is found in hot and cold cereals, granola and anything made with flour. Do not simply stop eating gluten because gluten is only found in a couple of grains. In addition, gluten-free eaters often fall for gluten free products and these substitute tons of starch in the form of potato and other flours. That's just trading one blood sugar load for another. For more details on Primal or Primarian diet, you can access Primal/Primarian category in the left lower margin. One other thing: if you are healthy and at normal weight while eating a diet that contains grains, you can assume that you tolerate them. Going grain free may not necessarily apply to you. The other features of primal diet (non-processed foods, low sugar, etc.) do.
2. Adopt a strong, passionate belief about how you eat.
That means, you find a healthy, clean diet that works for you and you follow it religiously and every day. What sinks most Americans is their belief that they are "entitled" to dietary exceptions. As we get older, our body is much less forgiving of these excursions. Your body has become intolerant to modern foodstuffs and most particularly to sugars, starches and grains. If you knew that your knee were very damaged and would need surgery if you ran on it, would you feel "entitled" to go our for a five mile jog? You are over 50 years old so time to stop being controlled by a cookie. Been there, done that with cake, cookies, bread, pasta, rice, potatoes, sugar, junk food. You can grow up and eat clean. But once you do it…..DO IT. Don't stop doing it just because it's your dog's birthday.
3. Follow a timed eating pattern.
Recent studies suggest that our bodies do better with food storage when we allow them a decent period of daily fasting. Currently, we sleep about 7 hours and eat the rest of the time. Not enough. You can increase your daily fast by confining all of your food to a 10 to 12 hour eating window. If you're trying to lose weight, you might do better if you stay at the lower end of this range.
4. Avoid unnecessary antibiotics
All of the food we eat must pass through our intestines before it is absorbed. These intestines are complex neighborhoods that are lined with billions of bacteria. We now know, that we are more of an ecology than a single organism. In fact, we carry more bacterial DNA than we do human DNA. We have paid far too little attention to the complex world that we are. Possibly the most dire threat to our internal environment is our constant modern exposure to antibiotics. And not just antibiotics, but super-duper high powered drugs. Used to be a cold would be treated with chicken soup and bed rest. Now you get a Z-Pack. Zithromax is an intense, broad spectrum antibiotic that kills lots of those kindly intestinal bacteria. And we get prescribed drugs like this for things like colds…which are viral and not bacterial, thus don't even respond to antibiotics.
Your intestinal neighbors can be friendly or hostile. Napalming the neighborhood with antibiotics tends to make them hostile. While you will sometimes truly need antibiotics, be sure that you question their use before taking them. Take them for the shortest time that is safely possible. Avoid eating animals that are raised with antibiotics as well.
5. Keep your body as drug free as possible
One of the most shocking aspects of medical practice is the drug lists that patients bring in. The advent of modern medicine and its many medications has been a boon, but it has also gone way too far. Remember that the body is a complex web of interactions. It is impossibly convoluted and difficult to understand. Every time we take a drug, we are changing something, and that change means that something else will be affected. A great many of the conditions we treat with medicines can be ameliorated by eating clean, staying at lower weights, and keeping fit and flexible. Examples? Reflux, muscle pain, blood sugar elevations, blood pressure, high cholesterol, arthritis pain, anxiety, mild depression, sleeplessness. Medicines like cholesterol lowering drugs, blood pressure drugs and insulin can be lifesaving, but please review all of your medicines with your doctor to make sure that they make sense and are needed. Make sure you are not taking a bunch of stuff because one doctor has given you one thing and another has given you something else. One person needs to have an overview of your whole medication plan. If you have lost weight, re-evaluate your medication list. If you have a doctor who wants to throw a pill at every little problem you describe,consider switching doctors.
6. Exercise until you love it
If you don't crave physical activity, you're not doing it right. You will need at least five days a week of physical activity to stay healthy and at a good weight. Not just in the summer, by the way, but all year round. For me, the thing that separates my healthy patients and friends from those that are less so, is their ability and desire to exercise. This becomes more of a creative challenge when physical limitations set in, but with the advent of yoga, spinning, swimming and other non-weight bearing exercises, it has become easier to circumvent this problem.
Your key going forward is to find something that calls to you and that you simply love doing. One of my friends recently became a runner. She didn't love it at first, but she liked it enough that she kept on going. Now she is running half marathons all over the country. I, on the other hand, have tried to love running and simply can't. Instead I got sucked in by tennis, a sport that has an endless improvement curve and the extra allure of competition. I also love dancing. Hip-hop anyone?
My advice is always the same. Exercise does not mean a gym. Only do the gym thing if that's what you love. Personally, I find it hard to connect with mechanical objects like treadmills and weight machines.
7. Remake yourself every five years
Your time is more precious now and the way you fit in the world is different. Are you still wearing your hair the same way? Is your personal style a version of what you sported in 1982? Do you have some vague idea of wanting to learn Japanese that you've never acted on? After 50, we should be assessing our health, our style, and our goals more frequently. This is the creative part of the exercise. To avoid invisibility, we must be doing something that is stimulating and that stimulates those who know us. Don't be fearful. A nice part of being over 50 is that no one cares if you're outrageous.
8. Forget perfection. Substitute achievement.
If you are continuing to measure yourself by how much cellulite you have on your thighs, you'll be pretty unhappy after 50. Give it up already. Instead, measure yourself by a "cool" index. When you look at other people of the same age, how cool are you? If, along with being strong and healthy, you can say that you're kind of cool, you're doing it right.
9. Find a spiritual space
What we all learn about the over 50 life is that there is a lot more loss to experience. The things and people that we believed to be permanent turn out to be…..not. How heartbreaking. So I think that having some sort of spiritual nidus is really key. If we look at all of the people who preceded us on this earth, they always sought some sort of way to explain life through a spiritual lens. There are multiple roads, some as simple as communing with nature. Very personal, but just a thought.
10. Get on the internet
If you're over 50 you are unlikely to be as fluent in technology as those born in the 1990s and beyond. But there is an endless support network and world of ideas on the internet. It's a great place for staying visible and for living creatively. I have found a whole new world through blogging, and you can too. My mother had her own blog for awhile during her mid 90s. You can also use the internet to epublish the book you've always wanted to write. You can find exercise instruction, chat rooms, and digital books on any topic. Recently I've been suggesting that my patients take up walking while listening to the 12 episodes of Serial, a podcast from NPR. Serial is a spin off of the popular NPR show "This American Life". It became hugely popular and chronicles a reporter's investigation into the murder of a young high school girl, ostensibly by her jilted boyfriend. Podcasts are downloadable pieces of the internet that can help fuel your exercise. For those of you who want to run your first 5K, try downloading the app called Get Running, a great guide to take you from couch potato to athlete in 11 weeks.
11. Become visible.
Your desire to be healthy and stay fit and flexible will be supported by the sense that you are visible. By visible, of course, I'm referring to the feeling that you continue to interact with the world in a way that makes you interesting. I know three people who are fortunate enough to be able to travel extensively. They are fascinating to talk to and their worldly knowledge makes them very "visible". My sister parlayed her high school hobby (playing the harmonica) into becoming a full scale blues harmonica player in the past ten years. She's "visible". My childhood friend Susie has published several ebooks which all sell on Amazon. She's found a voice and is quite "visible". The women on my 65 and over tennis team play through injuries and often with multiple bandages and braces. They have gone deep into the playoffs a number of times. They are self-effacing, indomitable and "visible". My mother is 96 and until recently, maintained her own blog about life in the nineties. She stays "visible" in the world by continuing to engage with it and by continuing to care for all the members of her extended family. Every single one receives Facebook greetings on birthdays and anniversaries and long, heartfelt emails if something is going on in his or her life. Visibility does not mean fame. It means relevance and a high "cool" index.
You may know the apocryphal story about Michaelangelo that I often share with my patients. The sculptor was said to be in conversation with an admirer. "How do you sculpt something as transcendent as The David out of a plain block of marble?", the admirer asked. Michaelangelo replied, "I don't sculpt it at all. The David is already in the marble. I just take away what's around him."
In America, we spend too much time trying to shrink ourselves and too little time trying to figure out what's inside the marble block that is us. Once we have a clear idea of what we want to release, we can work toward creating a masterpiece. Weight and health may be a part of that, but without the greater vision, they are unlikely to bring satisfaction or lasting result.
For other posts about life and weight after 50, click on "Menopause/After 50" in the Categories section in the left hand margin.