Episode 6: Understanding Weight Gain Through Menopause with Jackie McCusker

26 Aug

Healthily | 08/26/20

In this episode I chat to my good friend and colleague Jackie McCusker about the troublesome - and persistent - layer of fat that often appears around the middle as us women transition through the menopause. We discuss the metabolic changes that lead to shifts in body composition, and importantly, what to do about it. We cover hormones, circadian rhythm, stress, the gut, food and more.

TAKEAWAYs

✔️ Hormonal Changes & Body Composition

During perimenopause and menopause, women often experience a shift from a “pear-shaped” body (fat on hips/thighs) to an “apple-shaped” body (fat around the waist).
This central fat accumulation (visceral fat) is metabolically active and associated with increased risk of metabolic syndrome, insulin resistance, and fatty liver.
Mechanism: Decline in estrogen impairs insulin signaling, which can increase fat storage around the abdomen.

✔️ Genetics vs. Lifestyle

Genetics influence how women experience menopause, but lifestyle factors (diet, stress, exercise) significantly modulate outcomes.
Family history (e.g., mother’s menopause experience) can offer clues, but genes aren’t destiny.

✔️ Gut Health & Estrogen

Gut microbiome plays a pivotal role in estrogen metabolism through enzymes like beta-glucuronidase.
Dysbiosis (microbial imbalance) can disrupt estrogen recycling and contribute to hormonal symptoms.
Diet strategies: increase fiber (oats, broccoli), fermented foods (sauerkraut, kimchi), and probiotics to support microbiome diversity.

✔️ Lifestyle Interventions

Stress Management: Chronic stress impacts adrenal estrogen production and worsens menopausal symptoms. Simple breathing exercises (e.g., 4-4-4 breath: inhale 4s, hold 4s, exhale 4s) can activate the parasympathetic nervous system.
Time-Restricted Eating / Intermittent Fasting:
- Helps regulate metabolism and insulin response.
- Typically starts with a 12-hour window (e.g., 7 AM – 7 PM) and can extend to 14–16 hours.
- Benefits include metabolic support, weight management, and autophagy (cellular repair).
- Consider thyroid and energy status before implementing fasting.

✔️ Macronutrient & Meal Strategies

Reduce refined carbs (croissants, white bread), emphasize protein (eggs, oily fish, legumes) and healthy fats (nuts, seeds, avocado, oily fish).
Consolidate meals (3 per day) rather than frequent snacking to reduce insulin spikes.
Pair carbs with protein/fat to lower glycemic impact (e.g., fruit with nut butter).
Align food timing with circadian rhythm: larger meals earlier in the day, lighter meals in the evening.

✔️ Micronutrients & Supplementation

Important nutrients during perimenopause/menopause:
- B vitamins – support blood sugar and mood
- Magnesium – stress, blood sugar, sleep
- Chromium – glucose tolerance
- Selenium – monitor intake (e.g., 1–2 Brazil nuts/day)
Supplementation should be personalized and guided by testing whenever possible.

✔️ Practical Food Recommendations

Vegetables: green leafy and cruciferous (broccoli, Brussels sprouts) support estrogen metabolism.
Protein & fat: eggs, oily fish, nuts (almonds, walnuts), grass-fed meat, organ meats.
Traditional fermented soy (tofu, tempeh, miso) as a plant-based estrogenic support.
Limit alcohol; if consumed, prioritize red wine with meals for polyphenols and lower glycemic load.