As I age, my body shape is changing. Lower estrogen levels mean I carry more weight in higher-risk areas, such as around my organs (I am transitioning from being a pear to an apple!).
Men under 50 suffer from heart disease at a greater rate than women (2-5 times more), but when women reach menopause, the statistics even out. Estrogen has a protective effect on women, supporting healthy cholesterol levels, blood vessels and blood pressure. As women go through perimenopause and menopause, their heart disease risk rises sharply and changes can also occur in cholesterol, visceral fat accumulation (fat around your organs) and insulin resistance. By the time women are through menopause, their risk of heart disease and associated diseases can match men’s. This is a critical window of time for women to prevent disease.
I have been burrowing down a few rabbit holes in my exploration of this, particularly the connection between the gut microbiome and insulin (which I will write about next time).
Is it just about Calories?
I grew up as a ‘margarine kid.’ My dad, the medical doctor, told us that fat was bad for us and margarine pushed butter out of the fridge. Mum would sneak real butter onto our new potatoes, earning a look of disapproval. Dad’s disapproval was based on the medical thinking of the time. Fats were shunned and weight loss required a simple focus on calorie counting.
Nowadays, this simple model of ‘calories in, calories out’ has shifted because we recognise that calories from different food sources are not metabolically equal.
- 200 calories of sugar will spike blood glucose and insulin far more than 200 calories of nuts or legumes.
Insulin is important; it’s the traffic controller of metabolic health:
- It determines whether energy is stored (in the form of fat) or used (as fuel).
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Repeated glucose spikes → chronic high insulin → insulin resistance.
- Insulin resistance is at the root of obesity, diabetes, cardiovascular disease, and fatty liver and it accelerates ageing-related inflammation.
Chronic insulin spikes, not fat alone, drive fat storage, metabolic dysfunction, inflammation, and disease.
I am not diabetic, nor do I have high blood pressure or known heart disease; however, I am overweight and my visceral fat has increased. To gain a deeper understanding of my body’s insulin levels and my response to food, stress, and sleep, I am trialling a Continuous Glucose Monitor (CGM) for a month (listen to Episode 25 of our podcast to learn more about using CGMs for preventative health).
By wearing a CGM, I will be able to monitor my responses and learn how to manage my insulin levels (flatten the spikes) to support my metabolic health and reduce visceral fat.
The truth is, for me and many others, menopause changes the rules, but it doesn’t take us out of the game. By understanding insulin, visceral fat and eating for a healthy microbiome, we can play smarter, longer and stronger.