Menopausal Medicine: “Your Mother Was Right” – Healthy Lifestyle Choices and Longevity

Did you know that women in their 50′s who are overweight, do not exercise, and eat a poor diet are three times more likely to die of a heart attack and nearly two times more likely to die of cancer before they reach age 75? This is five to ten times the risk of heart disease and breast cancer reported in the WHI study that made everyone quit taking estrogens!

This information is widely available, but it is not talked about and few women do anything about it!

Menopause marks a life crossroads that offers women the opportunity to think about their health and make good decisions that will benefit them for decades to come. While comfort and caring for menopausal symptoms is important, there is so much more to consider. Our real goal is to address your entire health picture. If you have good genes you should enjoy a active and vital life into your eighties. Why not try to be a healthy 100?

To to make this a reality we must get our priorities straight. Americans obsess over medications. But they often forget to take care of their health.

Yet heart disease and cancer are exactly what waits if you eat poorly, are overweight, and do not exercise. A study of over 77,000 women found that more than 40% of deaths between ages 50 and 75 we due to poor health habits. These deaths could have been avoided without pills or treatments – just a little attention to diet and exercise.

Likewise: breast cancer scares women to death. But most women don’t know that obesity nearly doubles your chances of getting breast cancer. This tragic disease may not be preventable – but you can sure get the odds in your favor.

So it turns out that your mother was right: eating well and exercising are the foundation of good health and happiness. And it is never too late to make these lifestyle changes. Many chronic medical problems (diabetes, high blood pressure, heart disease) can be slowed or reversed – even in middle life – with a careful program of diet and exercise.

From a medical perspective we want to address several common medical issues as part of our program of improving with your menopausal health in conjunction with your hormone replacement therapy, including:

• diabetes and “metabolic syndrome”
• atherosclerotic heart disease
• hypertension

These are the most common illnesses that eventually lead to death in the last third of life. They each have something in common: they cause blood vessel damage that over the long term lead to early death from heart attacks, stroke, and kidney failure.

Another thing that they have in common is that each of these diseases – and the damage to the blood vessels – can be prevented or slowed by weight loss and moderate exercise.

We recommend that women who are not in good physical condition work with a dietitian and a personal trainer to establish a program of improved nutrition, exercise, and weight loss.

Our goal is to help patients achieve slow but steady weight loss – perhaps a half of a pound to a pound a week. The target goal is to reach a “normal” body mass index (BMI) of 25 to 27. This translates out a weight of 148 to 160 for a 5’5″ person. Reaching this target with weigh loss over three to twelve months can dramatically reduce blood pressure and diabetes.

There are many different diets that may be effective. In terms of weight loss it doesn’t matter which diet you choose, so long as you reduce the number of calories that you are eating. Having said that, we find that a “low carbohydrate/high protein diet” such as the South Beach Diet is often effective at both helping patients lose weight and eat healthier foods. One of the nice things about the South Beach Diet is that it doesn’t restrict the amount of food that you can eat; rather it features foods that keep you from feeling hungry. The South Beach Diet approach is a “anti-insulin” diet. It reduces the production of the hormone insulin that both makes you hungry between meals and puts food into your fat cells.

We also advocate a “Mediterranean” style diet. These diets are high healthy oils and unsaturated fats. Your nutritionist will help you select a diet meets you specific health needs.

Exercise is the other key part of your health program. A regular exercise program both makes it easier to lose weight and has health benefits on its own. In particular, regular exercise strengthens the heart, reduces the inflammation that damages blood vessels, and can help reduce blood pressure.

The news here isn’t bad. You don’t need to be a slave to the gym. Studies show that as little as 30 minutes of moderate exercise five times a week – walking will do – improves longevity. 50 minutes of exercise five times a week markedly reduces your chances of dying from all causes.

Please be careful not to get off the couch and try to run a mile or a marathon on your first day out. You can hurt yourself by trying to do too much too fast. We suggest that you begin by working with a personal trainer to set up a safe and realistic exercise program, with gradual increases as your conditioning improves.

Yours, Dr. Midlife