Middle aged and want to lose weight?

     There, I got your attention didn’t I?  But I do have practical advice that can work for you, so stay with me.  Let’s start by discussing what is probably the most ‘in your face diagnosis’ of the next ten years for most middle aged adults: diabetes.  As an aside, we can argue the definition of middle aged, but I am going to use 40-64 years of age for this label.  It is not pretty, I know; “middle age is my age plus ten” was my mantra for years.  Nonetheless, I’d recommend that we all get familiar with the “OK, I really am middle-aged” concept. 

     There are near one million new cases of diabetes in the U.S. per year in this age range.  And that doesn’t count the many who remain undiagnosed, or those who are told they are ‘prediabetic’ (translation: you’re diabetic).  Or…the many millions of us who are well down that ever so gentle road to diabetes also known as insulin resistance.  And what is one of the major, if not #1 warning signs of insulin resistance?  That’s right…ever increasing problems with losing weight.

     “I used to be able to drop five to ten pounds pretty easy, just a few weeks of focus and discipline”.  Remember being able to say that?  You had the same genes and ethnicity back then; what changed?  The main problem is that average Americans give their cells more sugar than they burn, day in and day out.  The pancreas responds by putting out more insulin to get that sugar out of the bloodstream.  As time goes by, several bad things start to happen.  Your cells lose their sensitivity to insulin, so that your calories end up being stored, rather than being burned.  The excess insulin inhibits fat burning enzymes, so that once a calorie is stored, it is far harder to get it out.  It not only gets stored in fat, both under the skin and in the gut, but also in the liver.  A fatty liver is more prone to inflammation, and can’t detoxify as well.  Some of the other negatives of too much insulin include :

-salt and water retention.

-its effects on neurotransmitters, promoting sleep disorders where you make too much cortisol…which in excess is a fat storing hormone.

-it is the primary contributor to both high levels of triglycerides, low levels of good HDL cholesterol and an excess of pro-inflammatory LDL cholesterol. And that’s bad for circulation, which serves to deliver the oxygen that enables you to burn the calories.

     A recent study in the New England Journal of Medicine found that losing 5-7 percent of your body weight can slow the development of type 2 diabetes.  It wasn’t just the being lighter part that did the trick as much as how they got lighter.  Ah, you say, finally on to the bottom line.  I’m not going to give you the old “you need to burn more than you eat” line, although one can’t deny the simple arithmetic there. Instead, here are ten you can do this strategies to resist the mid-life trend toward insulin resistance:

Keep moving.  Sure, it’s good to get that 45 minute aerobic and strength training session in.  And you will make faster progress when you ramp up muscle fitness.  But small and consistent activities that challenge major muscle groups all add up.  Consider getting a pedometer or even one of the newer activity monitors.  A useful entry level device is the Pivotal Tracker 1, which has many of the higher end functions at only $12 per year, and its app works with your Apple or Android smartphone.  Use 10,000 steps as a general goal for daily activity.  Despite that ‘busy schedule’, most of us get far less steps per day than we would like to think!  If you’re only at 5000 steps by 5 PM, it might just be time for a brisk walk.

Spend as much time on strength training as you do on cardio.  Women in general short the strength work in their routines, which study after study shows more calorie burning benefit 7/24 than an equal amount of cardio.  Muscle is the engine where we burn most of our calories, and it is the tissue best suited to the enhancement of insulin sensitivity.  And, as one patient told me about toning her triceps ‘bat-wings’:  “Not only is there less fat there, but it sure hangs better”.

Increase your non-exercise activity by:

-parking farther away at work or when shopping.  I have to laugh when
someone who was just at the gym is now circling the grocery parking lot to get that ‘close in’ parking spot, and then realizing that person is me.

-instead of sitting; stand or pace while taking phone calls at home or work.

-skip the elevator and take the stairs.  The rule should be that you don’t take the elevator unless it’s more than two (or three) stories up or four down.

-if it’s less than two blocks, don’t drive around the corner to the store—walk!  OK, unless it’s pouring out there…

Drink more water.   Dehydration can masquerade as food cravings.  It can also slow your metabolic efficiency.  Have a water bottle with you when out of the house, and have a fresh glass of water on your desk at work.  Try not to go more than 20-30 minutes without meaningful (4-8 oz.) of water intake.  I know, I know…more restroom breaks, but think of the extra steps toward that daily 10,000 goal!

Looking for a carb fix?  If you want a carb reward, save it for right after a workout, when you are depleted of glucose and muscle glycogen.  That’s when fresh fruits, bread and cereals will work to your best advantage in post workout recovery.

Eat high volume.  Choose that are high in volume but not calories.  That is, nutrient-dense but not calorie-dense.  Cabbage, spinach, lettuce, and broccoli are great choices that you can eat in high volume without pushing your calorie quota.  Another pair of simple tricks along this line that works for smoothies is to: 1) add a heaping teaspoon of ground flax/chia seed to a serving, which is both a great source of omega-3s and also adds volume, which helps your stomach make you feel full longer, and 2) blend any meal replacement smoothies longer to amp the air volume.  One study showed that this simple maneuver reduced calorie intake at the next meal by 12% and that adds up, or rather, subtracts down.

Portion control (repeat three times) Almost everyone underestimates the volume they eat.  You would have guessed 200 cals…and it was 450.  “Healthy snacks” can be a stealthy surprise as well.  “Those nuts were only 162 calories per serving, and I had…three servings”…oops!  Consider prepackaging ‘to go’ foods as 100-150 calorie portions in a small baggie.  For unsalted almonds that would be ~14-21 per baggie.  Read those labels (even when you don’t want to!)  I know that feeling.  “If I read that label, I’ll have to choose more wisely, and right now…I don’t care”.  So read and portion, well before the point where craving insanity hits you.

Get your sleep.   Getting insufficient restorative sleep is a nightmare for fat loss. A lack of deep restorative sleep disrupts fat-loss and hunger hormones, which can sabotage everything you’re doing.  At mid-life, hormonal disruption can play a significant role, even well before you get to menopause.  I’ve often said that if I could fix just one thing about menopausal transition symptoms, it would be to ensure a deep night’s sleep.  If you are having sleep problems associated with menopause, please consult a physician familiar with bio-identical hormone support therapy.  Two good resources are at: www.bioidenticaldoctors.com or the  www.acam.org ‘Doctor Locator’ page.

Take a multivitamin that covers the most important insulin resistance fighting nutrients.   While Dr. Oz’s ‘fat buster of the month’ may have some potential benefits, focus on the nutrients that are already part of your essential fat burning biochemistry.  Look for these key ingredients, and you may need to add additional if your multi is short on:

-a full measure of magnesium, ~300 to 600 mg a day as a critical co-factor in glucose metabolism.  Preferably a citrate or a chelated version.

-chromium in the 400-800 mcg range to activate insulin

-Vitamins C and E, at least 400 mg and 400 IU respectively

-fish oil: 1,000 to 4,000 mg per day improves insulin sensitivity.  If you use the ground flax/chia seed in your smoothie, as I mentioned previously, it will cover most of this amount.

-B-complex vitamins such as B6 50 to 150 mg/day and B12 1,000 to 2,000 mcg/day are especially helpful.

-biotin 2,000 to 4,000 mcg/day also enhances insulin sensitivity.

Consider taking metformin.  This prescription medication is a useful ‘entry level’ therapy for those with blood sugars nearing the diabetic threshold.  If you need medical strength therapy, this is often a reasonable first step to discuss with your physician.

Reducing insulin resistance is the key to mid-life weight loss.  Put these pieces into play and start seeing results!