New research from Cancer Research UK, published in May, suggested that if current trends continue, seven in ten Britons will be classified as overweight or obese by 2040 — and it’s particularly a problem as we move into middle age and beyond. And a recent study in Finland found that piling on the pounds in midlife ages you before your time – with obese 55-year-olds having health problems that don’t usually show up until their 70s. However, according to the Health Survey for England 2019, only 13 per cent of 16 to 24-year-olds are obese, compared with 33 per cent of 45 to 54-year-olds. Weight peaks between 65 and 74, with 36 percent obese and an additional 39 percent overweight. After 75, things change slightly, with 45% overweight and 26% obese. This trend has devastating health effects, increasing the risk of cancer, type 2 diabetes, depression and dementia. According to the Health Survey for England 2019, only 13 per cent of 16 to 24-year-olds are obese, compared with 33 per cent of 45 to 54-year-olds But why do we gain weight in middle age? For years, it was thought that a slowing metabolism was the culprit — but new research shows that’s not the case. Metabolism is the term for the chemical processes that help us use the energy from food for vital functions such as breathing, pumping blood, and powering our organs. There are two types of metabolic measurement. Your resting metabolic rate is the minimum amount of energy or calories needed to stay alive while you are at rest and fasting. while total energy expenditure is the combination of your resting metabolic rate plus the energy used for physical activity and digesting food. For sedentary adults, resting metabolic rate accounts for about 50 to 70 percent of total energy use, digestion for ten to 15 percent, and physical activity for the remaining 20 to 30 percent. In a groundbreaking study last year, scientists measured the metabolic rates of 6,400 people aged eight days to 95 years and found that metabolism does indeed change with age – but not when you think it does. The study revealed that our metabolism – the amount of calories we burn for our size – peaks when we’re just 12 months old. After that, it slows by about 3 percent each year until we reach our 20s, when it reaches a new normal and remains “steady” until our 60s. This means that a woman of 50 will burn calories as efficiently as a woman of 20. Professor John Speakman, a biologist at the Institute of Biological and Environmental Sciences at the University of Aberdeen, one of the authors of this study, published in the journal Science, told Good Health: “One surprising thing was that there was no drop in metabolic rate in the middle age. . In a groundbreaking study last year, scientists measured the metabolic rates of 6,400 people aged eight days to 95 years and found that metabolism does indeed change with age – but not when you think it does. “So if you’re experiencing a middle-aged spread, you can no longer blame it on a lowered metabolic rate. “It used to be thought that our metabolism accelerated during the teenage years and dropped in middle age, but the study found that, in fact, the rate at which we burn calories remains remarkably constant.” After 60, our resting metabolic rate declines by about 0.7 percent a year until, at age 90, our metabolism is 26 percent lower. Co-researcher Herman Pontzer, associate professor of evolutionary anthropology at Duke University in the US, said: “Our work further supports the view that our metabolism is hard to shake. Our bodies follow a programmed course throughout our lives and there’s not much we can do to change the energy we burn during the day.’ Professor Speakman admits that, despite this fact, “many people struggle with weight in their 40s”. So what’s going on? The unpleasant truth seems to be that we gain weight because we consume too many calories — but often we just don’t realize it. “People are really poor at estimating their food intake, so they probably felt that their intake was unchanged,” says Professor Speakman. “This myth has been created that the spread of middle age is due to decreased metabolism — potentially contributing to reduced physical activity and/or altered resting metabolic rate,” he explains. “But we now know that’s not true.” This is in line with the findings of a study published last week in the journal Cell, which found that physically thin people are not more active than the rest of the population: they just eat less. And the spread of middle age, it seems, is a simple process of accumulation. As Professor Speakman explains: “The amount you need to overeat every day to gain 20kg (44lb) over 15 years is not a lot.” The process begins, he says, as we “eat and drink more” as we “get wealthier and have more disposable income” and that “increased alcohol consumption could be another factor.” What seems to encourage weight gain in middle age, however, is menopause. Studies show that while menopause doesn’t actually increase overall weight, it does affect the amount of fat relative to lean tissue a woman has—and where that fat is stored. In a five-year study of women aged 46 to 57 (published in the journal Climacteric in 1999), menopause appeared to cause an increase in total body fat and especially abdominal (or visceral) fat. Postmenopausal women have more visceral fat regardless of age, meaning menopause was the likely reason, according to Dr Sarah Berry, associate professor of nutritional sciences at King’s College London and chief nutritionist at health sciences company ZOE. Her findings (published in The Lancet) were based on a study of metabolism in 1,002 women who were premenopausal, perimenopausal, or actually going through menopause. One reason may be that menopausal women ate more sugary foods and, according to Dr Berry’s research, menopause changes the way the body handles sugar and fat. Previous studies have linked these changes to a drop in estrogen, a hormone that regulates fat distribution and insulin sensitivity. Genetics also play a role. Identical twins weigh almost the same as adults, even if they are separated at birth. Dr Giles Yeo, a neuroscientist at the University of Cambridge who studies the links between obesity and genes, says genes can affect our appetite – meaning some of us are more likely to crave fattening food. He told Good Health that more than 1,000 genes are linked to obesity and that our brains need to be sensitive to how full we are, so any gene mutation that causes a slight numbness could make it harder to say no to temptation. So what can we do if we’re piling on the pounds? Sally Norton, an NHS gastro-intestinal surgeon, says her key recommendation is to remove ‘chemical foods’ from our diets. Highly processed foods such as mass-produced bread, ice cream, processed meat (even some vegan meat substitutes), crisps, some ready meals, cereals, cookies and carbonated drinks together contribute 56.8 percent of calories in the UK diet. A seminal study from the US National Institutes of Health in 2019 found that people who ate highly processed foods consumed an average of 500 more calories per day than those on a diet of unprocessed foods. In two weeks, those who ate highly processed foods gained 2 pounds, while those who ate natural foods lost 2 pounds. Dr. Yeo says, “To lose weight, we need to eat less — and the easiest way to do that is to eat food that makes us feel fuller.” Sleep is also important, says Sally Norton, as sleep regulates the balance of hormones that affect hunger. He recommends aiming for seven hours a night. A study at King’s College London in 2016 found that sleep-deprived people ate 385 more calories per day. When forced to go about their day after less than five and a half hours of sleep, they were more tempted by unhealthy food. Exercise like running can help, but you have to work hard, as studies show that to avoid weight gain in middle age, runners need to increase their weekly distance by about 1.4 miles a year. So someone who runs ten miles a week at 30 needs to run 24 miles a week by 40 to stay lean. Meanwhile, US research shows that one to two hours a week of weight training reduces the risk of obesity over the next six years by 30 per cent in both men and women. The bottom line is that if you want to keep your bottom in check in middle age, stop blaming your metabolism.
Historical case notes
The old medical practices are still relevant today. This week: Using the arts as therapy The Ancient Theater of Epidaurus in Greece was not just a place of entertainment. Epidaurus was surrounded by a sanctuary, where the sick came to be healed—and part of that involved “purging,” defined as the experience of emotion in response to music, poetry, and tragedies. The idea that our emotions affect health is now well established. “We experience psychological pain in the same part of the brain as we feel physical pain, which triggers the release of endorphins,” explains Dr Robin Dunbar, a psychologist from the University of Oxford who led the study. And he adds: “Endorphins are 30 times more powerful than morphine.”
