Menopause and Weight Gain
Now, here are a few basic facts about menopause and how it can have an impact upon your weight. Besides genetics, it is hormonal changes that occur during a woman’s life cycle that are the principal trigger for weight gain. Principal hormonal changes take place in adolescence, pregnancy and menopause. All of you have experienced adolescence and the associated weight gain from the rounding out of hips, breasts and thighs. The resulting body image and associated weight consciousness was for many the beginning of a lifetime struggle. Next, many of you experienced the major hormonal shifts of pregnancy with its inevitable weight gain. The final hormonal shift takes places during menopause, where again many women feel its effects.

This may come as a surprise, but the link between menopause and weight gain is not clearly understood. There are several reasonable theories, but nothing conclusive to date. However, we do know why women’s traditional “pear” shape, with weight distribution around the bottom, hips and thighs, shifts to the more prevalent male “apple” shape with the middle (read beer belly!) carrying the weight. This is because the female hormone, estrogen, was responsible for the development of your female shape during adolescence. During menopause estrogen production in your ovaries drops, so your body shape redistributes and you accumulate more fat around your abdomen. It’s this increase in abdominal fat that has serious implications for your health, especially heart disease, stroke and diabetes.

The likely causes of weight gain during menopause are a combination of both hormonal and age-related factors. Here’s what we do know:

• Estrogen/progesterone: Both estrogen and progesterone hormones become depleted during menopause and this interferes with appetite control. In one research program, some HRT (hormone therapy replacement) users showed less weight gain and less redistribution of weight, though those prone to weight gain did not appear to benefit.
• Metabolism: This is the rate at which your body burns calories. During and post-menopause your metabolic rate drops. So if you burn calories more slowly then you need fewer calories. This change in metabolic rate is partly due to the natural aging process. Remember, burning fewer calories without reducing your calorie input inevitably leads to weight gain.
• Muscle mass: Muscles are the body’s largest calorie consumers and we start losing muscle mass from the age of 20. This muscle loss really accelerates during post-menopause (for men it’s post 60 years) which means again you’re burning fewer calories and therefore putting on the pounds if you haven’t adjusted your calorie consumption.
• Physical activity: As we approach our fifties (average North American menopause age is 51 years) many of us become less active. Child rearing and its associated activity are largely over. Exercise becomes more of an effort and we become more conscious of the wear and tear on our bodies along with the inevitable aches and pains. Less exercise means fewer calories burned – and we know where the surplus calories are being stored!
• Lifestyle: As many of us now have fewer family-raising responsibilities and are entering our peak earnings years, we tend to eat out and travel more. Eating out tends to be a calorie-rich experience.

So, as you can see, while hormonal changes are somewhat responsible for weight gain during menopause, the aging process itself also has a substantial impact. The two are inextricably linked.

The one common element in all the factors I’ve mentioned is calorie intake and expenditure. The two must be brought into balance – and that is what the G.I. Diet is all about. I will show you how to reduce your calorie intake painlessly and without going hungry or feeling deprived. The traffic-light coding means you never have to count calories or points, or weigh and measure your food. The G.I. Diet is a nutritious, balanced diet that will keep you healthy and reduce your risk of major diseases, including most cancers (including breast cancer) heart disease, stroke, diabetes and dementia. The evidence that food is the most important controllable risk factor in our health is overwhelming. While exercise is important for overall good health, it is a poor tool when it comes to losing weight. As you will read later, losing weight is 90 percent diet and 10 percent exercise. However, when you reach your target weight, exercise is essential to help you maintain that weight and improve your health.

How to Read a Food Label
When reading a food label, there are six factors to consider when making the best green-light choice:

Serving Size
Is the serving size realistic, or has the manufacturer lowered it to make the calories and fat levels look better than the competition’s? When comparing brands, ensure that you are comparing the same serving size.
Calories
The product with the least amount of calories is obviously the best choice. Some products flagged as “low-fat” still have plenty of calories, so don’t be fooled by the diet-friendly slogans. Calories are calories, whether they come from fat or sugar.
Fat
Look at the amount of fat, which is often expressed as a percentage, say 2 percent (good) or 20 percent (forget it). Then check to see what sort of fat it is. You want foods that are low-fat, with minimal or no saturated fats and trans fats. Remember that trans fats are often called “hydrogenated oils” or “partially hydrogenated oils.”
Fibre
Foods with lots of fibre have a low G.I., so this is an important component. When comparing brands, choose the one with higher fibre.
Sugar
Choose products that are low in sugar. Again, watch for products advertised as “low-fat.” Companies will sometimes quietly bump up the sugar content to make up for any perceived loss of taste. This often happens with yogurts and cereals.

Sugars are sometimes listed as dextrose, glucose, fructose or sucrose; regardless of the form, it’s sugar.

Sodium
Sodium (salt) increases water retention, which doesn’t help when you are trying to lose weight. It also contributes to premenstrual bloating in women and is a factor in hypertension (high blood pressure). Combine high blood pressure with excess weight and you move up to the front of the risk line for heart disease and stroke. Low-sodium products are therefore preferable.

The Recommended Dietary Allowance (RDA) for sodium is 2,500 mg, but this is generally regarded as too high. The U.S. National Academy of Science’s new recommendation of 1,500 mg makes more sense. Since the average North American consumption of sodium per person per day is over 3,000 mg, it goes without saying that most of us could stand to cut back. However, if you have a BMI over 30 and have any blood pressure, circulation or heart problems, you need to be even more vigilant about seeking out low-sodium brands. Canned foods such as soups are often very high in sodium, as are many fast foods and processed foods.

You’ve talked to your doctor, decided there’s no better time than the present to lose weight and get healthy, set your weight-loss target, cleared your kitchen of fat-building foods, and restocked your pantry with delicious green-light choices. Now all you have to do is eat green-light meals and snacks each day and you’re well on your way to your new trim self. In the next section, you’ll find a week-by-week guide to all the challenges and issues that will come up as you follow the G.I. Diet for the first thirteen weeks. By the end of it you will know everything there is to know to achieve your weight-loss dreams, and you’ll have lost a significant amount of weight along the way!

Fast Food
Most of the leading fast-food restaurants have introduced menu items that are lower in fat and calories. However, the amount of sodium (salt) that is often added to offset any perceived flavour loss is a concern. Remember, salt retains liquid, which is the last thing you need when you’re trying to lose weight, yet alone trying to keep your blood pressure down. If you are not sure about salt levels, ask your server for a nutritional information sheet, which most family and fast food restaurant chains carry.

A couple of ground rules:
1. Always eat burgers and sandwiches opened-faced, throwing away the top slice of bread or bun.
2. Use at most, one-third of the salad dressing normally provided in a sachet as it contains far more than you would ever need, and only adds unnecessary calories and salt to your meal. Choose the light or vinaigrette dressings over creamy ones.
Here is a more detailed rundown of your best choices at some of the larger fast-food chains:

Subway
This chain has been a pacesetter in the fast-food industry in reducing fat and calories in its meals. Subway’s 6-inch/6g fat subs on whole wheat or honey oat bread are your best choices. Just be careful not to load on those high-fat/-calorie extras such as cheese, bacon and high-sugar sauces. Mr. Sub and other similar sandwich chains are following this lead.

McDonald’s
McDonald’s grilled chicken salads are a good bet with a low-fat dressings. You can even go for a Fruit ’n’ Yogurt Parfait dessert (hold the granola).

Burger King
Again, grilled chicken salads, or a chicken sandwich with garden salad, are your best options. You also may consider a Veggie Burger (without mayo) and a garden salad.
Wendy’s
Grilled chicken sandwich or salads are acceptable along with low-fat dressings. You might consider a large chili with side salad.
Pizza Hut
Normally I recommend avoiding pizza restaurants so I am delighted to see that Pizza Hut has made a real effort to improve its offerings. Your best bet is Thin ’N’ Crispy Pizzas and Fit ’n Delicious Pizzas (2 slices maximum) with garden salads and light dressings.
Taco Bell
Their line of Fresco tacos and burritos are acceptable green-light choices but are very high in sodium. Steer clear of the rest of the menu except the side salads.

KFC
Until just recently, KFC was a place to avoid. Stick to salads and chicken if you must eat here, and get the chicken without skin, grilled not fried.

Restaurants
As it’s impossible to list restaurants by name, I’ve provided a quick rundown of different types of restaurants instead.
All-You-Can-Eat Buffets
This can be your worst or best option depending on your level of self-control. Best to do a quick reconnaissance of the whole buffet before you start to fill your plate. This way you can pick out your best green-light choices ahead of time.
Italian
Start with a good bean and vegetable soup such as minestrone. For the main course your best option is grilled, roasted or braised fish, chicken or veal. You may order pasta as a side dish if you wish, though you would be better off with an extra serving of vegetables.
Greek
Grilled or baked seafood is an excellent choice as well as the classic chicken souvlaki. Just watch your serving sizes. Instead of the potatoes, which are frequently served along with rice, order double vegetables. You must ask for both your salad dressing and feta to be served on the side so you can control your servings.
Chinese
This type of food can present some real challenges. Much of the food is deep-fried with sweet sauces. Sodium levels are usually astronomic and the rice is glutinous and red-light (short-grain rice has a much higher G.I. than long-grain rice such as basmati). Though you can make do with steamed or stir-fried vegetables, it’s probably not worth the effort. This kind of restaurant would be my last resort when eating out.

Indian/South Asian
This is one of your best restaurant choices because of the cuisine’s focus on vegetables, legumes and long-grain rice. Servings of meat, poultry or fish tend to be modest. However, make sure that food is not fried, particularly not in “ghee” or clarified butter, which is a highly saturated fat. Also be cautious with the side dishes such as mangoes/papayas, raisins and coconut slices as they have a higher G.I. and can pack a lot of calories if you aren’t careful.
Mexican/Latin American
Tex-Mex dishes can be heavy on cheese, refried beans and sour cream, which are all red-light. Your best bet is to look for grilled seafood, chicken or meat, as well as dishes made with beans (not refried). Vegetable-based soups such as gazpacho are an excellent choice.
Thai
Thai restaurants tend to be heavy on red-light sauces, often using full-fat coconut milk. Here it’s best to stick with a starter such as lemongrass soup, green mango salad, or mussels in a lemongrass broth. Follow this with a Thai beef salad or stir-fry with chicken and vegetables. Skip the peanut sauce.
Japanese
This is a good green-light choice once you get beyond the sushi and tempura. Sushi is red-light because of the glutinous rice it is made with. Order the sashimi instead. Watch the quantity of soy sauce, which should be thought of as liquid salt! The beef and vegetable stir-frys and grilled fish are excellent choices. You might try Nabemono, a healthy fondue with broth rather than oil as the cooking medium.

Top Ten Dining Tips

1. Just before you go out, have a small bowl of high-fibre, green-light cold cereal (such as All Bran) with skim milk and sweetener. I often add a couple of spoonfuls of fruit yogurt (fat-free with sweetener). This will take the edge off your appetite and get some fibre into your digestive system, which will help reduce the G.I. of your upcoming meal.
2. Once seated in the restaurant, drink a glass of water. It will help you feel fuller.
3. Remember to eat slowly to allow your brain the time it needs to realize you are full. Put your fork down between mouthfuls and savour your meal.
4. Once the basket of rolls or bread – which you will ignore – has been passed around the table, ask the server to remove it. The longer it sits, the more tempted you will be to dig in.
5. Order a soup or salad first and tell the server you would like this as soon as possible. This will keep you from sitting there hungry while others are filling up on bread. For soups, go for vegetable or bean-based, the chunkier the better. Avoid any that are cream-based, such as vichyssoise. For salads, keep the dressing on the side. Then you can use a fraction of what the restaurant would normally pour over your greens. Avoid Caesar salads, which come predressed and often pack as many calories as a burger.
6. Since you probably won’t get boiled new potatoes and can’t be sure of what kind of rice is being served, ask for a double serving of vegetables instead. I have yet to find a restaurant that won’t oblige.
7. Stick with low-fat cuts of meat or poultry. If necessary, you can remove the skin. Duck is usually too high in fat. Fish and shellfish are excellent choices but shouldn’t be breaded, battered or fried. Tempura is more fat and flour than filling. Remember that servings tend to be generous in restaurants, so eat only 4 to 6 ounces (the size of a pack of cards) and leave the rest.
8. As with salads, ask for any sauces to be served on the side.
9. For dessert, fresh fruit and berries – without the ice cream – are your best choice. Most other desserts are a dietary disaster. My advice to you is to avoid dessert. If a birthday cake is being passed around, share your piece with someone. A couple of forkfuls with your coffee should get you off the hook with minimal dietary damage!
10. Order only decaffeinated coffee. Skim-milk decaf cappuccino is our family’s favorite choice.