Mayo Clinic study finds explanation for postmenopausal belly fat

Star Tribune (Minneapolis)May 14, 2013 

Weight was never a concern for Stephanie Brondani, 52, of Minnetonka, Minn. Until last year, when she hit menopause.

Suddenly, she noticed her midsection thickening. "I think everybody feels (like), 'I'm eating the same way I always have been and yet I'm getting this roll.' What is that about?" she said.

Scientists have long known that lower estrogen levels after menopause can cause fat storage to shift from the hips and thighs to the abdomen. Now, a groundbreaking study, co-authored by the Mayo Clinic, has determined why: Proteins, revved up by the estrogen drop, cause fat cells to store fat more efficiently.

The study also revealed a double whammy: These cellular changes also slow down fat burning by the body.

Even though the research doesn't provide weight-loss solutions, it might bring a sense of relief to millions of middle-age women who have been fighting an often losing battle against the dreaded "postmeno belly."

"It doesn't mean you're absolutely doomed," said Dr. Michael Jensen, an endocrinologist at the Mayo Clinic and one of the study's authors, "but it does mean it's going to be harder probably" to lose weight.

That comes as welcome news to Brondani, who has tried a new exercise program, wears a pedometer and has cut back on sugar and junk food.

"There's that sense of, 'Oh, this is just normal,'" she said. "While you don't have to just lay down and take it, you know you're not doing anything wrong. At least you feel like it's OK, everybody is going through this. Not just me."

More than 50 million women in the United States are 50 or older; and 75 percent of women age 50 to 55 are postmenopausal, according to the Menopause Center of Minnesota. Most — if not all — will have to confront postmenopausal weight gain.

According to a 2010 study in the International Journal of Obesity, women gain an average of 12 pounds within eight years after menopause. But even women who maintain the same weight say they notice their waistline expanding.

Cassandra Chapman-Clay started putting on the pounds soon after she entered menopause a few years ago. Before she knew it, she was 10 pounds heavier. "It just happens," she said. "You just blow up like a balloon."

Chapman-Clay, who lives in Scottsdale, Ariz., is one of 24 women who participated in the five-year Mayo study, the results of which were published recently. The group included women who were pre- and postmenopausal. They were all the same age — 49 to 50 — and had the same levels of body fat, Jensen said.

Weight gain, especially around the abdomen, is one of the top complaints women have when they come to the Menopause Center of Minnesota, said director Sandy Greenquist.

But beyond vanity, there are health risks associated with having an extra layer of padding around the waist.

Belly fat is a sign of visceral fat around vital organs and increases the risk for obesity-related illnesses. According to the Mayo Clinic, a waist of 35 inches or more can lead to a greater risk of problems such as heart disease, high blood pressure and diabetes.

That's why medical professionals focus on the health issues related to weight gain.

Said Greenquist, "We do a lot of counseling with our patients about nutrition and exercise.

"We tend to overindulge on carbohydrates and not get nearly enough protein. Those two conditions contribute to fat on their bodies. I give them some basics on changes that could be helpful. Exercise needs to be muscle-building exercise — doing things that will increase their metabolism."

The Mayo research might lead to other strategies for maintaining a healthy weight after menopause. For example, Jensen said it raises questions about the kinds of dietary changes doctors might suggest. It also raises questions about whether hormone replacement therapy might play a role in offsetting weight gain.

"Those kinds of questions we weren't able to address with this study," he said, "but that's something we'll have to consider in the future."

Sylvia Santosa, an assistant professor of nutrition science at Concordia University in Montreal, Quebec and the study's co-author, added that while science doesn't offer any fixes for the postmeno belly, the findings shed much-needed light on the issue. "It puts us one more step toward understanding how estrogen affects how and where we store fat," she said.

Mary Rossi, 64, of Minneapolis, used to take pride in her "marked waist."

Since menopause, she's watched her midsection grow five inches, even though she eats less and is still active. She's healthy and her body is proportionate, but she says, "I've given up trying to go back to the waist I had when I was 50."

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