Ernæring og træning til kvinder i overgangsalderen

Ældre træning

 

Overgangsalderen er en periode i kvindens liv, der begynder, når der er gået mere end et år uden menstruation.

Af Montserrat Farré Hernández

De fleste kvinder kommer generelt i overgangsalderen, når de er mellem 45 og 55 år. Kvinden vil blive udsat for en række fysiologiske og hormonelle ændringer, som manifesterer sig i større eller mindre grad med forskellige symptomer.

Hvad sker der med hormonerne i overgangsalderen?

I starten plejer niveauerne af follikelstimulerende (FSH) og luteiniserende (LH) hormoner at være højere end inden overgangsalderen, da de forsøger at inducere follikelproduktion i æggestokkene. Faktisk bliver FSH brugt som en markør til diagnosticering af overgangsalderen. Måske er det naturen, der forsøger at kæmpe for retten til at kunne skabe flere børn? Det ved man ikke.

Østrogener fortsætter et progressivt fald, indtil der opstår en østrogenmangel på grund af æggestokkenes aldring. Men det kan ske, at der kan være nogle sekretioner fra en isoleret follikel, så der kan forekomme udsving i østrogenniveauerne (1).

Den vigtigste kilde til østrogener i overgangsalderen opstår ved at omdanne androgener til østrogener, især i binyrerne, med en proces, man kalder for aromatisering.

Der vil også være en betydelig nedgang for væksthormonniveauer, IGF-1 og IGFBP, der fører til den såkaldte somatopause, som bidrager til reduktion af muskelmasse og knoglemasse, samtidig med at den centrale adipositet øges, hvilket betyder, at det er helt naturligt, at kvinder øger deres fedtlag i denne periode (2).

Fysiske og psykiske ændringer

Næsten alle ændringer finder sted som en konsekvens af østrogen-, androgen- og somatogenmangel, der manifesterer sig på forskellige måder:

  • Huden bliver mere tør og tyndere

  • Humørsvingninger forbundet med stress og angst

  • Mindre libido

  • Tørhed i urinvejs- og vaginalslimhinder, som giver højere modtagelighed for infektioner

  • Svedeture, som er pludselige store varmefølelser i overkroppen, der kan vare mellem 30 sekunder og fem minutter

  • Osteoporose (knogleskørhed). Tabet af knogletæthed som en konsekvens af et progressivt (fremadskridende) tab i mineralisering

Kropskompositionen ændres også. Østrogener var de hormoner, der havde ansvaret for at kontrollere fedtlagring, hovedsageligt på det subkutane niveau, og især omkring hofterne. Og når østrogenniveauet falder, vil fedtsyrerne lagres omkring maven i stedet for at blive fordelt over hele kroppen.

Denne placering af fedtlageret omkring maven fører til en ændring i fedtstofmængden i blodet, som vil øge risikoen for hjerte-karsygdomme. Der sker en stigning i lipoproteiner med lav densitet, såsom VLDL, LDL og triglycerider og et fald i lipoproteiner med høj densitet, såsom HDL. Sagt på helt almindelig dansk vil der være en stigning i det ”dårlige” kolesterol, uden at du har ændret på dine spisevaner. Det er altså udelukkende en hormonel virkning.

En anden konsekvens af aldring er tab af muskelmasse, som er det største metabolisk aktive væv. Det vil også betyde, at den basale metabolisme vil blive nedsat. Du har ganske simpelt sværere ved at tabe dig.

Det bliver sværere at udnytte kulhydraterne i din mad

Der vil ske ændringer i glukosemetabolismen. Det kan skyldes en modstand fra det perifere væv mod optagelse af glukose og/eller et fald i insulinreceptorer. På samme tid sker der en mindre effektiv insulinproduktion.

Evnen til at mobilisere lipider nedsættes, hvilket betyder, at de nemmere samler sig i blodet, fedtvæv og det perifere væv. Alt dette øger risikoen for atherogene processer i blodkarrene (man får problemer med kolesterolet), udvikling af insulinresistens og dermed inflammatoriske processer i kroppen.

Alle ovennævnte ændringer forårsager en stigning i vægten, og hvis der er fysisk inaktivitet, er det forbundet med en øget risiko for metaboliske sygdomme som type II-diabetes eller metabolisk syndrom.

Aldring er uundgåelig, da det er en fysiologisk proces, der forekommer naturligt i kroppen som en konsekvens af alle de processer, der finder sted kontinuerligt. Vi skal ikke nægte eller bekæmpe denne naturlige proces. Det bedste vi kan gøre er at forstå, erkende og acceptere det på en positiv måde, så vi kan gøre det til en mere harmonisk og behagelig proces og en udvikling af vores liv. En tilpasset kost og træning vil hjælpe dig og gøre en stor positiv forskel i denne periode.

Kost i overgangsalderen

Da der er et fald i det basale stofskifte og mange gange mindre aktivitet, vil energibehovet falde. Nogle forskere estimerer en reduktion på fem procent pr. årti.

Proteinindtagelse

Proteiner vil være det vigtigste næringsstof på grund af deres strukturelle funktion. Proteinindtag i denne periode øges for at kompensere tabet af muskelmasse, nedsat absorption (optagelse) og genbrug af aminosyrer.

Indtagelse af 1,5 g/kg/dag (3) har vist sig at være gavnlig for at opretholde muskelmasse, der skaber en forbedring i den fysiske funktion. Endvidere viser nogle undersøgelser, at det højere forbrug af protein, D-vitamin og calcium har en synergistisk effekt på absorptionen af ​​calcium i knoglen, hvilket reducerede tabet af knoglemineralisering (4). Med andre ord: Spis flere proteiner, træn mere, og sørg for, at du får nok D-vitamin, så du kan få tilstrækkeligt kalk ind i knoglerne.

Kulhydratindtagelse

Det anbefales, at kulhydratindtagelse er minimum 130 g/dag (5).

Gode kilder til kulhydrater til denne periode er især grøntsager, frugter og bælgfrugter. Disse er grove kulhydrater og vil give en langsommere tømning af maven, som giver en længere følelse af mæthed, stabile insulinniveauer og har et godt indhold af kostfibre, der vil kompensere for nedsat tarmmotilitet.

Ud over det er disse fødevarer rige på vitaminer, mineraler og antioxidanter, som alle er til gavn for din organisme.

Fedtindtagelse

Fedtstofanbefalinger er 30-35 pct. af det daglie kalorieindtag. Men vi er interesseret i de gode fedtstoffer, hvor der er et højt indhold af essentielle fedtsyrer, især omega-3, men også omega-6 i en god balance.

Indtagelsen af ​​disse essentielle fedtsyrer i en god balance vil hjælpe mod de inflammatoriske tilstande, støtte hormonsystemet og forbedre lipidprofilen.

Med hensyn til fødevarerne er det en god idé at vælge dem, som forebygger og hjælper til at nedsætte den højere risiko i denne periode for hjerte-karsygdomme, metabolisk syndrom, stigning i vægt, knogleskørhed og humørsvigninger.

Fødevarer, som er interessante

Alle friske frugter og grøntsager, især grønbladede grøntsager om foråret og sommeren og rodfrugter til efterår og vinter. De er alle meget rige på vitaminer, mineraler og antioxidanter.

Gode fedtstoffer, især ekstra jomfru olivenolie, koldpresset rapsolie, nødder, frø, fede fisk, som støtter hormonsystemet, og især omega-3 plejer karvæggene. Dem finder du flest af i fisk og omega-3-produkter baseret på alger.

Sesamfrø, mandler, sardiner i olivenolie, broccoli, grønkål, hvide bønner, kikærter, som alle er gode kilder til calcium.

Fuldkornsprodukter, som havre, bælgfrugter og nogle frø, såsom chia og hørfrø, er alle rige på opløselige fibre, som begrænser reabsorptionen af kolesterol udskilt med galden og derved fremmer en bedre anvendelse af endogent kolesterol til syntesen af ny galde.

Fødevarer rige på phytoøstrogener, såsom sesamfrø, soja, bønner, kålfamilie, jordbær, abrikoser, grønne ærter. Phytoøstrogener har en lignende molekylær struktur til kvindens naturlige østrogener og kan derfor hæfte sig til østrogenreceptorer i kroppen. På den måde hjælper de til at balancere og kompensere på det naturlige fald i østrogener i overgangsalderen.

Æg og fede fisk indeholder lidt D-vitamin, men den primære kilde er solen. D-vitamin er vigtig for calciumoptagelsen, inmunforsvaret og humøret.

Råvarer, der passer godt på leveren, som bitre urter og grøntsager, såsom rucula, julesalat, mælkebøtte og dem, som er rige på svovl, såsom løg. Leveren er ansvarlig for den største del af østrogenudskillelsen og for lipidprofilen, altså fedtsammensætningen i blod og væv.

Det, der skal undgås

Især transfedtsyrer, som øger risiko for hjerte-karsygdomme. De findes især i forarbejdede produkter såsom kiks, kager, færdigretter, osv. Tjek altid ingredienslisten, når du køber ind, men de er heldigvis forbudt i Danmark i dag. Men det er stadig de dårligst tænkelige fedtstoffer, der bliver brugt næsten overalt i færdigretter.

Sodavand og alle sukkerholdige læskedrikke, da de indeholder fosfor og sukker, som øger udskillelsen af calcium.

Raffineret sukker, af samme grund.

Pas på salt, da for meget salt øger blodtrykket og dermed øger risiko for hjerte-karsygdomme.

Alkohol og rygning, som ikke er gavnligt for kroppen og belaster den.

Raffinerede produkter, da de ikke indeholder nogen af de interessante næringsstoffer, vi har beskrevet ovenfor.

Eksempel på en dagskostplan

Morgenmad

Grøntsagsjuice med en gulerod, granny smith æble og citron (ingefær, hvis du kan lide det)

2 skiver koldhævet fuldkornsspeltbrød med avokado, tomat og et blødkogt æg

1 appelsin

Frokost

Stor salat med frisk rucola, julesalat, løg, afkølede kogte kartofler, valnødder, belugalinser eller hvide bønner, kapers, rosiner, grønne oliven. Dressing af ekstra jomfru olivenolie, æbleciddereddike og en lille smule sennep. Spis så meget rucola og julesalat, som du har lyst til.

1 æble

Husk vand

Aftensmad

Squash og gulerodsuppe med sesamfrø

Dampet laks med asparges

Yoghurt naturel uden tilsat sukker

Husk vand

To go-snacks

Frisk frugt eller grøntsager

En håndfuld mandler

Grøn te eller urtete

Fysisk aktivitet og træning

Fysisk aktivitet og træning er uden tvivl nødvendigt og har mange fordele:

Forebyggelse af knogleskørhed: Styrketræning favoriserer en tilstrækkelig mineralisering af knoglen og gør den mere modstandsdygtig over for knoglebrud, da den stimulerer knoglen til at forblive aktiv og med en stærkere knogletæthed (6).

  • Både konditionstræning og styrketræning favoriserer tab af visceralt fedt og reducerer risiko for hjerte-karsygdomme. Dette gøres gennem forskellige metaboliske ruter, som på den ene side forbedrer lipidprofilen (forøgelse af HDL og faldende LDL), og på den anden side sænkes den inflammatoriske tilstand. Med alt dette vil blodtrykket også sænkes, en sygdom, der ofte findes hos kvinder over 50 år, som også er en vigtig risikofaktor for hjerte-karsygdomme.
  • Forbedrer den metaboliske aktivitet: Fysisk træning medfører en række fysiologiske og metaboliske tilpasninger, der øger det oxidative potentiale, som favoriserer stofskiftet for fedtstoffer og kulhydrater.
  • Det forbedrer insulinfølsomheden, da det perifere væv, især muskler, har brug for en tilførsel af glukose for at få energi. Af denne grund øges følsomheden af ​​insulinreceptorer og dermed en bedre optagelse af glukose ind i cellerne (7).
  • Forebyggelse og forbedring af urininkontinens: Øvelser i bækkenbunden har vist sig at forstærke bækkebundsmuskulaturen, der er direkte involveret i kontrolprocesser i blærens sammentrækning.
  • Træning øger niveauer af endorfiner, dopamin og serotonin, to neurotransmittere, som vil give dig en følelse af velvære. Når du træner, føler du samtidig, at du gør noget godt for dig selv, og det vil give dig glæde og en mental pause i de daglige tanker.

Hvilken styrketræning?

Styrketræning er især anbefalet, da den udgør den mest intensive og effektive metode til at opnå alle de fordele, som er beskrevet ovenfor.

Ifølge nylige undersøgelser som Ball et al. 2016 (8) anbefales minimum 150 minutters fysisk aktivitet om ugen for at opnå en beskyttelse mod hjerte-karsygdomme, da det viser væsentlige forbedringer i lipidprofilen, kropskomposition og blodtrykket (9).

Der er også studier, som viser, at styrketræning hos menopausale og postmenopausale kvinder med relativt høje belastninger og en hurtig hastighed i den koncentriske fase viste signifikante forbedringer i osteopeni-markører, dvs. de viste en forbedret mineralisering og knogletæthed såvel som knoglebrudsresistens (10).

Det anbefales at arbejde med relativt høje belastninger (> 65 pct. 1RM eller højst 12 gentagelser pr. serie) og udføre løft med maksimal hastighed for at opnå den højeste effekt. Hver femte til ottende uge er det en god ide at bruge én uge til at give den maksimal gas på al træning og derefter arbejde med lavere belastninger de andre uger, omkring 50 pct. 1RM.

Tal med en træner om at få målt din 1RM.

Styrketræning træner også din kondition, da det hårde arbejde kræver rigtig godt med ilttilførsel til alle muskelcellerne.


Yderligere inspiration til din træning

Vi er nyligt blevet kontaktet af VeloChicks.
VeloChicks specialiserer sig i cykeltøj og udstyr til kvinder, og har hertil enormt stor fokus på at guide kvinder i den rigtige retning, når det kommer til en sund livsstil med nemme muligheder for træning.

De har udarbejdet en guide til cykeltræning for kvinder:
LÆS MERE HER


Konklusion

Overgangsalderen er en helt naturlig periode i kvindens liv, hvor der er nogle fysiske og psykiske ændringer. Med accept af og forståelse for, hvad der sker i kroppen og tilpas med kost og træning, kan du støtte din krop og psyke, så denne proces foregår mere harmonisk, og de forskellige problemer nedsættes.

Referencer

(1) Buckler, H. M., & Anderson, D. C. (1994). The perimenopausal state and incipient ovarian failure. Treatment of the postmenopausal woman, 11-23.

(2) Corpas, E., Harman, S. M., & Blackman, M. R. (1993). Human growth hormone and human aging. Endocrine reviews, 14(1), 20-39.

(3) Wolfe, R. R., Miller, S. L., & Miller, K. B. (2008). Optimal protein intake in the elderly. Clinical Nutrition, 27(5), 675-684.

(4) Tang, B. M., Eslick, G. D., Nowson, C., Smith, C., & Bensoussan, A. (2007). Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. The Lancet, 370(9588), 657-666.

(5) Bates, C. J., Benton, D., Biesalski, H. K., Staehelin, H. B., Van Staveren, W., Stehle, P., … & Wolfram, G. (2001). Nutrition and aging: a consensus statement. The journal of nutrition, health & aging, 6(2), 103-116.

(6) Bar-Or, O., & Rowland, T. W. (2004). Pediatric exercise medicine: from physiologic principles to health care application. Human Kinetics.

(7) Warburton, D. E., Nicol, C. W., & Bredin, S. S. (2006). Health benefits of physical activity: the evidence. Canadian medical association journal, 174(6), 801-809.

(8) Ball, C., Abdelmoneim, S. S., Huang, R., Eifert-Rain, S., Mantovani, F., Wilansky, S., & Mulvagh, S. L. (2016). Changes in Exercise Patterns in Menopausal Women at Low–Intermediate Risk for Cardiovascular Disease: A Prospective Survey Study. Journal of Women’s Health.

(9) Rosen, S. E., & Mieres, J. H. (2016). Exercise and Strength Training in Postmenopausal Women at Risk for Cardiovascular Disease: Need for Strategies to Improve Adherence.

(10) Stengel, S. V., Kemmler, W., Pintag, R., Beeskow, C., Weineck, J., Lauber, D., … & Engelke, K. (2005). Power training is more effective than strength training for maintaining bone mineral density in postmenopausal women. Journal of applied physiology, 99(1), 181-188.

391 thoughts on “Ernæring og træning til kvinder i overgangsalderen

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