Flashes and body composition and age, oh my! What’s the relationship?
For some time now, experts have made the connection between body mass index (BM() and hot flashes during menopause, theorizing that body fat offer protection against hot flashes since androgen hormones are actually converted into estrogens in body fat. On the flip side? Women with lower BMI should have more frequent hot flashes. However, this hypothesis — formally known as the “thin hypothesis” – has recently been questioned, especially among researchers whose studies have shown the opposite: that a higher BMI leads to more hot flashes because the fat acts to insulate the body and prevent heat dissipation. In the middle of this argument are women, overweight, underweight, normal weight, who may have an opportunity to prevent hot flashes before they worsen or at least ameliorate them.
To more thoroughly tease out the underlying causes of hot flashes as they relate to body composition, researchers evaluated a subset of 52 women participating in the larger Study of Women’s Health Across the Nation (SWAN, an ongoing trial at seven sites across US that are examining women’s health in middle age). These women were African-American or non-Hispanic Caucasians between the ages of 54 and 63, mostly overweight, in menopause and reported experiencing hot flashes or night sweats. None were taking hormones or antidepressants, and still had their uterus.
In the study, published online in the Journal of Clinical Endocrinology and Metabolism, broad measures of central abdominal fat/total percentage of body fat, BMI and waist circumference and blood hormones were taken. Over two, 48-hour periods, participants also wore a monitor to evaluate the frequency and severity of hot flashes and were asked to both complete electronic diaries and press buttons on their monitors that would notate when they were experiencing symptoms.
The result? A higher percentage of body fat, BMI and waist circumference were associated with a reduction in the frequency of hot flashes only in women who were 59 or older. Moreover, this association was restricted to Caucasian women in the study compared to their Black peers. However, in so far as the interaction between estrogen levels (and sex hormone-binding globulin) and body composition, researchers found that higher levels reduced but did not fully eliminate the distinctions in hot flashes and age.
So, why the differences compared to other studies? Others have looked as self-reported hot flashes via questionnaires while this one actually took physiological measures of hot flashes via the monitors that the women were wearing. The researchers also looked specifically at the link between size, weight and proportions of the women and hot flashes rather than risk factors of any or no hot flashes.
Importantly, data are starting to emerge that show how BMI/adipose fat and the relationship to reproductive hormones varies by age and menopause status, with higher estrogen levels related to older, menopausal women and lower to younger women. What’s more, while body fat may act to produce estrogen in older women to play a role in regulating body heat and dissipation, it seems to play a different role in younger, overweight women, predisposing them to hot flashes. Finally, wellbeing also appears to play a role in symptoms: in this case, women who were anxious reported more hot flashes and hot flashes tended to increase anxiety.
Should you care?
Although the sample size is small, the is first time that researchers have considered how age and race affect the way that obesity may affect hot flash frequency. It’s worthwhile filing it under “useful information,” especially when it comes to perimenopause and preparing to deal with full blown symptoms as you enter menopause.
A special thanks to my pal Ivan Oransky, executive editor of Reuters Health and author of Retraction Watch for giving me a heads up on this study. Thanks Ivan!
Read MoreWednesday Bubble: Are you invisible?
Early last year, I wrote a post for Women Grow Business based on an interview I had conducted with the incredible Author/Chef Mollie Katzen. Entitled “The Incredible Disappearing Woman: Lessons on Dealing with Ageism,” the post focused on ageism in our culture and the fact that as women age, they often undergo a culturally-driven disappearing act in both their personal and professional lives.
During our interview, Mollie discussed a five-step strategy to insure that women continue to matter, a strategy that is self-respectful, empowering and focuses on playing up one’s strengths without resorting to smoke and mirrors. Hence, I was a bit dismayed to run across a post on Talent Zoo the other day that addresses a similar theme but in less empowering vein. Mind you, I was not dismayed because of the topic but rather, because of the content, which for the most part, encourages women to play up their sexy and physical appearance while mostly ignoring their inner core. A few examples:
1) Expand your group of friends…by hanging out with people who with different perspectives.
That’s great advice, right? However, the author offers “because different perspectives will make you a more interesting person, and that’s sexy, which always gets noticed.” Hmmm, “sexy always gets noticed.”
2) Become friends “with a bit of lycra in your fabrics and dresses that need nothing more than a cool scarf to be a complete outfit.”
While you’re at it, since 40+ is obviously old and over the hill and subject to gravity, why not grab that Spanx and corset? Just sayin’.
3) “Innocently flirt.”
Flirting, the author says, makes others feel good about themselves and you should practice this even on people you don’t find especially attractive.
4) Be a real grownup in order to embrace “cool confidence.”
Okay, admittedly, I don’t even know what this one means.
5) “Work out with weights,” and, “lift a lot more than you think you can” since “nothing will get you fit faster and give you more body confidence than some muscle tone, and that means lifting real weights way past your comfort level.”
Wow. Just wow!
Let’s try this one again, shall we? Mollie-style:
From a social perspective:
- Posture! The first sign of “older” is often stooped shoulders. Standing tall conveys confidence and strength. “Anyone who is not attracted to that is someone you don’t need in your life.”
- Keep a focused gaze. “Looking sharp sharpens, Mollie explains. “Glazing over glazes you over.”
- “A smile is the best and cheapest face lift. Especially when it is genuine; your smile, not theirs.”
- Breathe deeply. Then speak. “When you do speak, let your voice come from your abdomen and be fueled by that deep breath.” (This isn’t easy, btw.)
- “Don’t ask your sentences unless they are questions.” (Remember Valley Girl by Frank Zappa?)
- “Try to find the love in all situations.” Mollie explains that in most cases, this needs to come from within. “Recognize that sometimes that love can take the form of putting up a boundary. Recognize also, that putting up that boundary can be cloaked in warmth and humor, even while you are being assertive.” She adds that “true personal power can be a warming and loving representation.
- Develop your own centeredness and use that for balance.
And, in business:
- Stay centered in your “standard,” meaning you should anticipate what other’s need and provide it. The customer matters as much as you do.
- Don’t drink the Kool-Aid. Buck societal aversion to age by avoiding dogma and overcoming prejudice. Rather than giving in, evolve your business in ways that positions you for longevity.
- Leverage your power to empower. The more that women are able to embrace and not tear down, play up one another’s strengths and share wisdom, the likelier the total universe of women is to be empowered and enabled.
- Look in the mirror…often. This is what you look like at 40, 50, 60 and that image is not based on preconceived notions. In other words, the buck stops at your insecurity and no one elses’.
At the age of 40, I felt better than ever — more self assured, comfortable in my own skin and comfortable in my career. I hardly felt invisible. At the age of 50, I am realizing that I don’t care as much anymore, that I’ve worked hard to earn my rite of passage. And that in some ways, I look and feel better than ever.
Trust me, you don’t need the tricks to stay in the any game. Use your knowledge, self-worth and inner beauty to solidify, maintain and stay visible.
Read MoreMidlife metamorphosis: for da guyz
Yes, this one if for da guyz. Who may or may not be dealing with their own aging issues. Who says that Flashfree isn’t an equal opportunist when it comes to gender issues?
This one’s a redux. Because men? You’re worth it.
[Used with permission. Dan Collins. http://www.dancollinscartoons.com]
In Laura A. Munson’s poignant “Modern Love” post, ‘Those aren’t fighting words, dear” she writes about the crisis of self that may seem familiar to many in midlife who are watching or have watched their husbands or partners implode. In the post, (which I highly recommend if you’ve not read it) Laura writes:
And I saw what had been missing: pride. He’d lost pride in himself. Maybe that’s what happens when our egos take a hit in midlife and we realize we’re not as young and golden anymore. When life’s knocked us around. And our childhood myths reveal themselves to be just that. The truth feels like the biggest sucker-punch of them all: it’s not a spouse or land or a job or money that brings us happiness…
The premise that happiness comes from within is not a new one. However, the midlife spin on it can be a wake-up call of epic proportions, when we start reaching for a gold ring that actually resides out of sight. Yet, why are we yearning for what was rather than what is to be? Aren’t life’s many transitions, including the one that our partners and each of us are facing, movements into the next phase of productivity or change or growth, rather than a loss of self?
I’ve had many conversations with women who are facing or have faced situations that are similar to Laura’s. Overwhelmingly, they say that women tend to themselves a little at a time so that the crises never quite reach the precipice. That many women are able to deal with their physical and emotional changes incrementally so that the ultimate metamorphosis — who they are during and at the end of their lives — is not a monumental shock.
Dick Roth, in his wonderful book “No, It’s Not Hot in Here,’ devotes a chapter to men in midlfe. He says that men should repeatedly ask themselves three questions:
- What won’t pass away when my youth does?
- Who will I be after my career is over?
- Who would I be if everything else was gone but my mind and feelings?
Referencing the book The Diving Bell and the Butterfly, Roth adds that the protagonist’s lack of self-pity and ability to cherish his soul provided him with the foundation to overcome his physical confinement (the author, who was completely paralyzed by a stroke except for a single eyelid, was only able to communicate by blinking this one eye).
Cherish your soul. Sounds a lot simpler than it is. Or does it?
As much as we expect our partners to understand what we are going through as hormonal changes wreak havoc on our psyches and our bodies, we must also be willing to offer the reverse, to acknowledge the changes and struggles that our partners are going through, their self-confinement, and perhaps their inability to cherish or tap into their souls.
Midlife doesn’t have to be a four-letter word. What rings true for women, also rings true for men.
Seize it.
Read MoreUse it or lose it – more on osteoporosis
Bone health and osteoporosis. Yes, I know I keep writing about it. The reason is simple: you ARE at risk of losing your bone density and strength, especially if you are a woman over the age of 35. And if you are 50 or older? You have as much as a 40% risk of suffering a fracture due to osteoporosis during the rest of your lifetime. Moreover, during the first five years after menopause, women can experience as much as a 30% loss of bone density.
I can’t emphasize it enough. The risk is there. It is inevitable. However, you can reduce your risk a little bit by incorporating the following message into your life:
Use it. Or lose it.
In other words, you need to move.
The latest news out of the esteemed Cochrane Collaboration (an international organization that extensively reviews medical research) is that exercise specifically designed to promote bone growth and preserve existing bone mass, namely the type that places mechanical stress on the body, is necessary. The newly-published review of 43, scientifically sound (i.e. randomized, controlled studies) is an update of a review that appeared in 2000. Of the 4,320 postmenopausal women included in the reviewed trials:
- Those who engaged in any form of exercise had slightly less (0.85%) bone loss than women who did not.
- Those who performed combinations of exercise types, i.e. walking, jogging, dancing, progressive resistance training, vibration platform had, on average, as much as 3.2% less bone loss than those who did not exercise.
- Non-weight bearing exercise, such as progressive resistance strength training targeting the lower limbs, was shown to slightly preserve bone mineral density at the hip, while the combination of exercise, per above, was most beneficial for slightly preserving bone mineral density at the spine. (Did you know that spine and hip fractures are the most common among women with osteoporosis?)
The conclusions are pretty clear: long periods of inactivity lead to reduced bone mass.However, here is a simple way to mitigate some of this loss, albeit slightly, and even help reduce the costly effects of osteoporosis: Exercise.
The best exercises? Those that stress or mechanically load the bones, meaning the type that make the bones support body weight or resist movement, such as aerobic or strength training, walking, or Tai Chi.
Ultimately, your goal is prevent osteoporosis from occurring in the first place. While some amount of bone loss is part and parcel with aging, resistance training is critical.
Move it or lose it.
Read MoreWednesday Bubble: Got symptoms? Got milk? An udder disaster…
Got milk?!
Milk is being touted as the next best thing, that is, when it comes to hormonal symptoms. In fact, a new campaign sponsored by the California Milk Processor Board centers around the claim that milk can help reduce the symptoms of PMS. EverythingIdoiswrong.com offers global gauges of PMS symptoms, packaged apologies for men who feel victimized by PMS and even analyzes or verifies their mistakes so that they can avoid them during the next cycle. In a piece about the marketing effort in the Washington Post, Executive Director of the California Milk Processor Board, Steve James, is quoted as saying that the strategy is to “disarm the situation surrounding PMS and its effects,” both for women and individuals around them who are suffering from their mood swings and other symptoms.
Say what?!!!
Is this advertising for milk or a drug claim?
According to the website, the claims about milk are derived from a review that appeared in the year 2000 in the Journal of the American College of Nutrition. In the review, the authors discuss the potential links between altered calcium balance and affective disorders, such as depression and anxiety. Because women with PMS reportedly have calcium fluctuations that interfere with hormonal balance, some researchers have hypothesized that this imbalance can lead to both mood and other features of PMS. In these studies, however, participants obtained their calcium through supplements and not through dietary means; this enabled the researchers to control and standardize intakes (which averaged as much as 1300 mg calcium daily). Translated into daily milk consumption, this means that a person would have to drink more than 4, 8 oz glasses of milk daily to achieve the level of calcium used in clinical studies.
Honestly, do you know anyone over the age of “tween” who consumes that much milk?
Regardless of the studies cited, the claims about milk are exaggerated and inconclusive. Many of the studies were poorly designed or relied upon recall. However, one has to wonder if the milk-PMS claims will set off a cascade of others that stretch to the other end of the hormonal spectrum –menopause — where too much calcium is believed to be too much of a good thing: although calcium may offer protection against osteoporosis, it may also increase the risk for heart disease in some women.
Let’s get away from the hard science for a moment and take a closer look at the campaign. The inference:
- Women: your PMS causes undue suffering to people around you, especially your male partners
- Men: humor the woman in your life. If you want to save your relationship, friendship, partnership, etc, create a photo with puppy eyes, film a video apology or better yet, make fun of her. Oh, and have her drink milk.
Don’t know about you but this one is so absurd it may not even be bubble-worthy. Hey California Milk Processor Board – you may want to add a few women to your marketing team. This one’s an udder disaster.
Hat tip to Reuters Health Executive Editor, Ivan Oransky for the campaign heads up. (I tried to milk it Ivan – how’d I do?!!)
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