Women begin perimenopause sometime after age 40 and gain, on average, a pound every year during menopause unless they change their exercise and eating patterns. Weight distribution changes, too, shifting to the belly area and creating the dreaded “menopot.”

Women begin perimenopause sometime after age 40 and gain, on average, a pound every year during menopause unless they change their exercise and eating patterns. Weight distribution changes, too, shifting to the belly area and creating the dreaded “menopot.”

The good news is that with knowledge and hard work, you can beat this trend.

In perimenopause, even without weight gain, clothes may not fit like they used to because fat redistributes from the limbs to the abdomen. A higher level of testosterone promotes this, rather than lower estrogen, according to recent research from Rush University Medical Center. A good core workout like pilates can help. But when the scale starts to move up, your calorie intake and physical activity are out of balance and a different strategy is needed.

Belly fat is not only unsightly, it can produce metabolic changes that increase the risk of heart disease, diabetes and stroke. Adding 20 pounds during menopause also increases the risk of breast cancer. But this, too, can be reversed.

Know your risk of disease by measuring your waist circumference – at the belly button on exhale. Less than 35 inches is desirable.

Women get frustrated when cutting back their diet doesn’t work to shed pounds like it used to. This is related to two factors: age and body composition. Typical sedentary people lose muscle when they age. This slows metabolism because muscle cells require more energy (calories) to function and when lost, overall calorie needs decrease and weight is gained even with a marginal diet. Add the hormonal changes in menopause and you have the perfect storm for belly bulge.

To combat this, start a strength training program of at least two 20-minute sessions per week.

Overall activity is also important. Recently, the Nurses’ Health Study, which tracks women through menopause, found that only women who did an hour of moderate exercise daily, like brisk walking, cycling, or swimming, avoided menopausal weight gain. Yes, you read it right – at least one hour a day! So if you are not moving now, get moving to burn belly fat. If you have always been active, say three days per week, you may need to step it up to five or six; 30 minutes of an intense workout is the equivalent of one hour of moderate.

With fat storage shifted to the abdominal area, insulin may not work as well and linger in the blood stream, creating inflammation and making it more challenging to lose weight. To minimize this, limit or avoid simple carbohydrates such as white bread, pasta, crackers, soda, juices, sweetened coffees, cookies and others. Replace them with anti-inflammatory foods such as whole fruits, vegetables, oatmeal and other whole grains, cinnamon, small amounts of nuts, and lean proteins such as fish and chicken.

Try having a 100-calorie-pack of almonds one hour before meals to quell appetite and then skip the starch and pile on the non-starchy vegetables such as broccoli, asparagus or green beans to accompany a lean protein.

The average woman will need to lower her calorie intake by 200 to adjust to a slower metabolism due to age. This does not spell starvation diet but requires a commitment to planning nutritious meals and snacks, and an awareness of lowering portions to what your body needs as you get older.

Massachusetts-based Joan Endyke is a registered dietitian with a master's degree in nutrition and food science, and a certified personal trainer.