Every women wants to be healthy & fit Optimum weight is one of the important component of health & fitness Here in this Slide share Dr. Laxmi Shrikhande shares some important points about Weight management in Menopause.

1. A Step by Step Guide to
Menopausal Hormone Therapy
– Dr. Laxmi Shrikhande
– Consultant - Shrikhande Hospital, Nagpur
https://facebook.com/laxmi.shrikhande | https://.linkedin.com/in/dr-laxmi-agrawal-shrikhande

2. Dr. Laxmi Shrikhande - MD; FICOG; FICMU;FICMCH
– Medical Director-Shrikhande Fertility
Clinic, Nagpur
– Chairperson Designate Indian College of
OB/GY ICOG
– National Corresponding Editor-The
Journal of Obstetrics &Gynecology of
India
– Senior Vice President FOGSI 2012
– Patron & President -Vidarbha Chapter
ISOPARB
– Received Nagpur Ratan Award at the
hands of Union Minister Shri Nitinji
Gadkari
– Chairperson-HIV/AIDS Committee, FOGSI
(2007-09)
– President Nagpur OB/GY Society 2005-06
– Immediate Past President Menopause
Society, Nagpur
– Associate member of RCOG & ESHRE
– Member of European Society of Human
Reproduction
– Visited 96 FOGSI Societies as invited
faculty
– Delivered 11 orations and 450 guest
lectures

3. • Medical Director-Shrikhande Fertility Clinic, Nagpur
• Chairperson Designate ICOG 2020
• National Corresponding Editor-Journal of OB/GY of India JOGI
• Past Senior Vice President FOGSI
• Founder Patron & President –ISOPARB Vidarbha Chapter
• Received Nagpur Ratan Award at the hands of Union Minister
Shri Nitinji Gadkari
• Received Bharat excellence Award for women’s health
• Received Mehroo Dara Hansotia Best Committee Award for her
work as Chairperson HIV/AIDS Committee, FOGSI
• Immediate Past President Menopause Society, Nagpur
• Past president Nagpur OB/GY Society
• Visited 96 FOGSI Societies as invited faculty
• Delivered 11 orations and 450 guest lectures
• Publications-Twenty National & Eleven International
• Sensitized 2 lakh adolescent boys and girls on Do’s & Dont’s
Dr. Laxmi Shrikhande
Nagpur

4. Weight Management in
Menopause
DR LAXMI SHRIKHANDE
NAGPUR

5. Why to talk on this subject ?
Every women wants to be healthy & fit
Optimum weight is one of the important
component of health & fitness

6. What is Health ?
Health is much more than just the absence of disease or
disability.
It is a state of physical, emotional and social well-being.

7. What is Fitness ?
Fitness is defined as the ability to perform moderate-
to-vigorous levels of physical activity without undue
fatigue and
the capability of maintaining this capacity
throughout life.

8. Why there is weight gain during
menopause?
High caloric intake-probably, because of too much fat and sugar. As
the age advances ,the calorie requirement decreases by about 10%,
with every decade, after the age of 30 yrs.
Reduced physical activity-This further widens the gap between the
energy intake and expenditure.
Physical and mental disruption- anxiety and depression results in
snacking habit which leads to excessive calories.
Low BMR- low thyroid activity( if hypothyroidism remains
uncontrolled )- increases weight.

9. J Midlife Health. 2019 Oct-Dec; 10(4): 165–172.
Mechanism for development of obesity during menopausal transition

10. can prevent and control many diseases in
midlife.
If you are obese, you are at HIGHER RISK
of developing CAD, hypertension, type 2
diabetes, gallstones, breathing problems,
and certain cancers
Maintain Healthy Weight

11. Some Physical Activity or Targeted Exercise
Correct Diet & Nutrition
Avoid alcohol, tobacco
Stress reducing strategies
Meditation, Paced respiration
Emotional stability
Positive attitude
Family involvement
Spiritual attitude
 Adequate Sleep
Therapeutic Lifestyle Management in Midlife – General
Recommendations

12. Dietary Prescriptions –
Calories count: Should be decided according to the individual’s body weight and
height. Distribution of calories: 60% carbohydrates; 20% protein and 20% fat.
Protien: Moderate, because activity level decreases, body building is not there,
0.8 gm/kg body weight taking normal values for height should be sufficient. .
Carbohydrate: Complex carbohydrates which include fibre, natural forms of
sugar, like whole cereals, brans, kidney beans, pulses, barley, etc.
Fat: 20-25 gram/day. It is important to use combination of fats everyday for a
good supply of essential fatty acids.

13. Micronutrients:
Micronutrients should be from 2-3 servings of fruits and vegetables.
Milk and milk products, for calcium1000-1500mg of calcium/ day is
recommended .
Dark green leafy vegetables to be included at least once a day to
ensure required amount of folic acid, zinc, calcium, and iron.
Fat soluble vitamins A, D, E, and K should be taken.

14. • Salt 1.5tsp or 3-5 gms/day
• Oil 2 level tbs /day
• Fruit- 100 gms/day
• Vegetables- 300 gms/day
• Drink 8 glasses of water every day
• Add powdered flaxseed, cinnamon, fenugreek, saunf in salads and
curds
Diet

15. Avoid more than 200 mg/day of caffeine
Limit intake of tea and coffee to 3 cups a day
1 cup (150 mL) of brewed coffee is equal to 120 mg of caffeine
65 mg for 1 cup of instant coffee and tea
Consume a minimum of 500–600 mL of milk or curds (low fat) to build on
calcium bank in bones
Support it with lots of vitamin – C rich fruits or vegetables to favour calcium
absorption
Tea, Coffee And Diary Products

16.  best defined as the level of drinking
that poses a low risk of alcohol-related
problems.
 “defined as the consumption of up to
one drink a day for women and up to
two drinks a day for men.”
Drink in moderation

17. Watch your Sugar Intake
Start with taking a lesser amount of sugar than usual and
work towards cutting your sugar intake on a regular basis.
Carbonated soft drinks contribute to a huge percentage of
sugar intake, resulting in massive weight gain.
No to sugar

18. Boosting Your Fibre Intake
Make sure to consume a fair amount of fibre each day, as it
will not only make you feel full, but will not lead to any extra
calorie intake.
Boost your fibre Intake

19. Weight= Calorie intake vs calorie expenditure
Rebound weight gain
No good for health in long turn
No to Crash Diets

21. Eat an enjoyable and varied diet
Watch your weight and stay active
Eat plenty of fruit and veg
Opt for healthier fats
Eat plenty of fibre
Reduce your salt intake
Eat calcium-rich foods
Boost B vitamins through a varied diet
Keep well hydrated
Look after your teeth
A little sunshine is good for you
Go easy on alcohol
Don’t smoke
Get enough sleep
Keep your brain stimulated
Use it or lose it – keep active!
Tips on healthy Eating in midlife

22. Physical activity is any bodily movement, produced by your muscles
Exercise is a type of physical activity that is planned, structured,
repetitive and purposeful to improve or maintain some component
of your fitness or health
Both are important for good health
Physical Activity Vs. Exercise

23. Physical Activity should be maintained
Exercise—Aerobic—CVS
Strengthening, Resistance training—Muscle
Flexibility, Range of motion— Muscle, Joints
Balance and Posture - prevention of falls
Breathing—Respiratory system
Kegels—pelvis
Counselling On physical activity and exercise

24. Exercise should include aerobic, muscle strengthening, breathing and balance
30 minutes of moderate-intensity physical activity mostly 5 days a week
Muscle-strengthening activities should be included at least 2 days/week
30 minutes/day – For fitness and reduced risk of chronic disease
60 minutes/day – For prevention of weight gain
60–90 minutes/day – To avoid regain of weight loss
Recommendations for Physical activity and Exercise

25. One of the most beneficial exercises is something humans have
been doing for centuries: walking.
Simple modifications to your routine, like parking further away and
walking the extra distance or taking the stairs instead of the
elevator, can really add up to boost your overall health.
For an even greater benefit, take brisk walks that get your heart
rate up.
Walking

26. Dancing is one of those activities that doesn't feel like
working out, but is an incredible aerobic exercise.
It's a good option for those who want more physical
activity but don't like the gym or in the winter when it's
harder to get outdoors.
Dancing

27. Weight training
The other aspect of training is strength , and is best achieved by resistance training
,which translates to “lifting weights” .
 Contrary to popular belief, you do not need to be young to engage in, and benefit from
resistance training .
The greatest benefits may be experienced by post- menopausal women, in whom
osteoporosis is a major problem.
Resistance training helps by strengthening the bones , and has shown to positively
influence “quality of life measures” ,in various studies. For health benefits you should
do one set of 8-10 exercises. And for the major muscle groups 2-3 days per week.
One of the simplest ways to start weight training is to lift a one litre bottle , filled with
water-it becomes a 1 kg weight.

28. • Helps to maintain a healthy weight
• Increases BMR
• Improves bone density
• Improves Coordination and balance
• Improves Muscle strength and joint mobility
• Improves lipid profiles, reduces CVD risk
• Improves genitourinary problems
• Relieves depression
• Induces sleep
• Improves quality of life
Benefits Of Exercise at midlife

29. Precautions during exercise are:
Warm up is a must
Person should be well hydrated
Exercise room should be comfortable.
Frequency of exercise should be 4-6 days a week.
Its recommended that one should take a brisk walk of 30 minutes, at
least 4 times a week.
If you have never exercised before, it is important to start slowly,
and gradually build up your capacity over several weeks.

30. Precautions during exercise are:
One should exercise between 55-90% of your maximum heart rate.
Your maximum heart rate is 220 minus your age.
 If you do not want to actually measure your heart rate, a simple
way of monitoring exercise intensity is the ‘the take test; If you are
too breathless to carry on a conversation with someone beside you
,then you are probably working too hard and need to slow down.

31. Before starting exercising:
If one has any of the following symptoms then mild to moderate exercise should
be prescribed after investigations:
Dizziness or shortness of breath
Chest pain ,should be investigated
An infection or fever ,start exercise when fever or infection is cured.
Unplanned weight loss
Acute arthritis should subside
A bleeding or detached retina, eye surgery, or laser treatment

32. Stress-Reducing Techniques
Exercise
Stretching
Yoga
Meditation
Vacation
Calling a friend
Attacking your goal with
enthusiasm and focus
 Slowly indulging in one portion
of a favorite food
 9. Spending time with a loved
one
 10. Spending time with a pet
 11. Taking a break
 12. Making a schedule
 13. Watching a funny TV show

33. Women centric weight management module
Step I: Assessment
Clinical and lifestyle history: Elicit clinical history of risk factors of obesity and its related comorbidities, psychological distress, and severity of
menopausal symptoms. Lifestyle-related factors leading to weight gain should be highlighted
Anthropometric measurement: Height, weight, body mass index, waist circumference, and bioelectric impedance (if available) should be
measured
Biochemical assessment: Biological factors such as lipid profile, HbA1c, kidney function test, liver function test, blood pressure, thyroid-
stimulating hormone and fasting blood glucose. Further laboratory test can be initiated for patient-specific indications
Dietary and physical activity assessment: Assess current caloric intake and overall physical activity status
Step II: Prescription: Medical, dietary, and activity advice
Medical prescription: Prescribe the required medication on indication of metabolic or adverse menopausal symptoms
HRT is recommended in adverse menopausal symptoms
Low-dose HRT - 0.3 mg CEE/1 mg estradiol and MPA 1.5 mg
Nonoral route - Patches, gel, vaginal cream, and implants or tibolone
Dietary advice
Balanced hypocaloric diet (deficit 500 kcal), rich in Fe, Ca, and phytoestrogen
Incorporate 5 servings of fruits and vegetables and high fiber (nuts, oilseeds, whole cereal, and pulses)
Small and frequent meals with optimum portion size
Limit processed foods rich in fat (saturated and cholesterol) food, sugar, and salt intake
Physical activity
Activity plan of 150 min/week as a combination of aerobics, strength training, balance, and flexibility should be planned
Advice to maintain overall active status: Walk-in office, take stairs, commute via public transport, walk the dog, etc.
Behavioral advice
Use strategies like self-monitoring (food and activity log), goal setting (5%-10% weight loss), eating behavior (EatWell Plate, Food label
reading), problem solving (discuss maladaptive eating behavior) and stimulus control (use distraction to avoid excessive eating)

34. Summary
All peri & postmenopausal females should initiate or
continue regular physical activity and improve nutrition.
A balanced diet, regular exercise & Yoga play a vital role in
weight management and also helps in prevention of chronic
problems.
Aerobic exercises definitely has beneficial effects on
cardiovascular disease, cancer, obesity, diabetes and
depression, It also improves lipid profiles & insulin
resistance

35. Take Home Message
Balanced Diet +
Physical activity & exercise +
Stress reducing techniques =
Optimum Weight & Health

36. My World of
sharing happiness!
shrikhandedrlaxmi@gmail.com
Dr. Laxmi Shrikhande
Shrikhande Fertility Clinic
Ph-8805577600 / 8805677600

37. Questions

38. The Art of Living
Anything that helps
you to become
unconditionally
happy and loving is
what is called
spirituality.
H. H. Sri Sri Ravishakar