One day Mark came to me and said that he wanted to talk to me about helping him lose weight. It was a good time, because he was ready to listen and follow my advice. He was eating about 4,000 calories per day, and drinking a tremendous amount of milk, eating a lot of sandwiches and desserts, he was eating very little vegetables and fruits. Even though he did not have junk food at home, he was getting hold of it outside the house.
Now that Mark was interested in losing weight, I finally was able to put him on a proper diet. I started him off on a 2,400 calories diet. I also put him on a beginner exercise program, as he was not very athletic; just would occasionally play some recreational basketball with his friends. The exercise program included some resistive and aerobic exercise. It was 6 days a week aerobic exercise and resistive exercise 2 to 3 days per week. In just 3 months he lost the excess body fat and reduced two sizes. After 6 months his waist size dropped from 36 to 28 inches. He also grew 3 inches during this period. Now Mark is maintaining a good lean body, and following a healthy diet and exercise program. I also noticed that he improved in his school work and he is playing terrific basketball.
CHAPTER 4
MENOPAUSE FACTORS RELATED TO EXCESS BODY FAT AND FAT LOSS
Menopause is a stage of life where hormonal changes usually occur, in particular changes of the sex hormone, estrogen. But other hormonal changes can occur that contribute to changing body composition and can be harmful to health, as illustrated in Figure 1, for example increased cortisol and aldosterone, and decreased levels of Vitamin D, DHEA, and Growth Hormone. These hormonal changes can cause your body to accumulate excess body fat, and reduce muscle, bone, and other lean body mass tissues. They can also make you more susceptible to diseases, such as cardiovascular diseases and osteoporosis.
As part of a body fat reduction and weight management program, it is important to be aware that the hormonal changes associated with menopause can therefore complicate a fat loss program, even when a person is following the personalized Body-Profile Type Nutrition and Exercise programs. So, after 3 weeks of following the Body-Profile Type Fat Loss Program, if you are not losing body fat and are in the menopause age group (as discussed below), this indicates that the hormonal imbalances may be interfering with the ability to lose body fat.
The following information presents an overview of the main hormones related to Menopause.
HORMONES
Hormonal changes that occur during aging also enhance the accumulation of body fat, reduction of FFM (Fat Free Mass or lean body mass), and energy balance. Environment and behavioral abnormalities causes a cascade of hormonal changes. Hormonal changes coming from aging and behavioral abnormalities have the same effect, causing:
Excessive fat gain
Reduction of Fat Free Mass
Hormone Changes with Aging
Aging is associated with decreased Growth Hormone, Testosterone, 17 B-Estradiol, DHEA, Melatonin, as well as decreased responsiveness to thyroid hormone and resistance to leptin and insulin. The importance of hormone balance when it comes to aging management and the quest for a long and healthy life cannot be overstated. The following Figure, Hormone Changes with Aging, summaries these hormonal changes. In addition to the health implications, for people who are trying to reduce their excess body fat content, imbalances in these hormones may present another challenge, in addition to the other hormones, such as leptin, ghrelin, and adiponectin. Therefore, for people who are 40 years of age and older, if you find that your fat loss progress is slow while following the recommended nutrition, supplements, and exercise programs based on your Body-Profile Type Evaluation, then it may be necessary to discuss with your doctor the possibility of some medical intervention to help to restore the levels of one or more of these hormones that naturally declined with aging, with the exception of cortisol, which would need to be reduced if found to be higher than normal.
Figure 1. Hormone Changes That Occur With Aging, Which Can Effect Fat Gain and Fat Loss.
Menopause Hormonal Summary
Growth Hormone (GH, also referred to as Human Growth Hormone (HGH) and Somatotropin). Decline in GH and Testosterone Production decreases lean body mass (muscle, bone, etc.) and increases body fat mass. Thyroid hormone induced thermogenesis is blunted with aging. Resistance to Leptin could result in a decreased ability to down-regulate appetite. GH production reaches its maximum around 20 years of age. GH concentration starts to decline in twenties and continues to decline 14% per decade throughout life. However Pituitary GH reserve remains intact during ongoing aging with no change in the amplitude of GH response to appropriate stimulation. Ghrelin which is produced in our stomach is a strong Growth Hormone secretagogue (increases the production of Growth Hormone). But in obesity the Ghrelin level is decreased and the stimulation of Growth Hormone secretion is decreased. So we produce less Growth Hormone when we have excess body fat. Growth Hormone by itself has a direct effect on tissues, organs, including muscle, brain, skin, bone and immune system. GH gets converted within the liver to active form called IGF-1 (Insulin like growth factor). GH increases anabolic activity which builds more muscle, denser bone and thicker skin. Increases fat burning and improves brain function and immune system. GH repairs muscle damage. About 80% of GH is secreted during slow wave (deep) sleep, particularly between 11:00PM – 1:00AM. The other 20% is secreted just after rigorous exercise. Patients with severe GH deficiency due to pituitary gland damage often suffer from sarcopenia (muscle loss), increased abdominal obesity, and the body composition changes usually observed with aging. GH replacement therapy in these patients significantly changes body composition by reducing fat mass and increasing lean body mass. Exercise increases GH secretion. When we lose excess body fat and increase lean body mass with Body-Profile Type nutrition and exercise, Ghrelin production increases in our stomach, and this increases the secretion of GH.
Melatonin. Melatonin is secreted from the Pineal gland (located in the brain). Its secretion is stimulated by darkness; it controls the daily (circadian) rhythms of sleeping and wakefulness with cortisol. Melatonin helps us sleep and is active at nighttime; Cortisol awakens us and is active in the daytime. Melatonin is a potent antioxidant and protects DNA from free-radical damage. When melatonin is not secreted enough we have trouble falling asleep. When we have less melatonin secretion and do not sleep well, this causes the body to produce less GH during sleep, which is essential for repair of your body’s cells, DNA, and tissues. Lack of sleep increases the production of cortisol, the stress hormone reviewed below. It is interesting to note that breast cancer patients respond better to chemotherapy and radiation therapy when they take melatonin.
Cortisol. Cortisol is an age accelerating hormone (stress hormone). In contrast to DHEA secretion by the adrenal gland, cortisol secretion does not decline with aging. Circulating cortisol levels do not change significantly but because the enzyme 11beta-HSD-1 activity is increased in fat cells which convert inactive cortisone into active cortisol in fat cells, increasing cortisol level the tissues. Inflammatory cytokines increases the effect of 11beta-HSD-1. As fat mass increases with obesity and aging, we have more production of inflammatory cytokines in fat cells, and this excess production increases the 11beta-HSD-1 activity and causes more cortisol production. Stress increases cortisol, elevated cortisol is related to breakdown of collagen and elastin in skin (causing wrinkles) and in joints, muscles, bones (causing pain). Cortisol has inhibiting effects on sex hormones, DHEA, Thyroid and HGH. High levels of cortisol damages in the thymic tissue and causes decreased T-Helper cells. (T-helper cells protect us from infections.) DHEA and Cortisol have opposite effects on T-helper cells balance. DHEA protects the thymus gland, because DHEA decreases the activity of 11-BHSD-1 enzyme and decreases