Positive Health Online

At the age of 43, and with a lifelong tendency to pile on the pounds, this title was speaking to me. I think by now we all know that most successful weight loss regimes involve eating less and being more active. In the final analysis this book gives that same message. But for most people who have tried losing weight and failed time and again, what becomes important is how that message is conveyed and whether you are motivated to make the required changes. This is where this book is certainly likely to make an impact for women in the peri-menopause stage of their lives (the time leading up to the menopause when hormone levels begin to change and when the dial on the scales creeps up for many). Dr Peeke warns us that "if you have continued to consume the same amount of calories as you did when you were twenty until the age of forty-five, you can expect to be at least thirty to fifty pounds heavier".

Dr Peeke's clinical work has centred on the effects of stress on fat deposition. She divides us into three groups: Stress-Resilient (healthy eaters), Stress Overeaters and Stress Undereaters. Most of the dietary advice in the book is aimed at what is called 'regrouping' to turn the reader into a stress-resilient person.

Women who are exposed to long term stress over many years will, she says be more likely to lay down fat in and around their abdomen which she calls 'stress fat' and which builds up 'toxic weight'. This results from levels of the stress hormone cortisol being raised over time. You can then add to this what she calls the 'menopot', or increased pinch-an-inch type of fat.

She includes some pretty convincing pictures of scans that provide a graphic illustration of this phenomenon. This stress leads to cravings for carbohydrates and fatty foods in excessive quantities that, she says, is behaviour even demonstrated by stressed experimental rats.

She rather neatly illustrates how we respond dietarily to what she calls the CortiZone. This is the time of day, from about 3pm onwards, when our cortisol stress hormones naturally fall and we unwittingly respond by trying to keep the levels boosted by snacking on inappropriate foods and indulging in higher calorie meals just to sustain ourselves. This will ring familiar bells with many people. In essence, she then recommends inverting the eating pyramid so that the bigger meals are eaten earlier in the day and that carbohydrate and fat rich meals are avoided in the evening. She also advises not eating after 8pm. The old adage 'breakfast like a king, lunch like a prince and dinner like a pauper' springs to mind, but she also advises regular snacking which includes low fat proteins. It is worth pointing out that this is not a low carbohydrate approach to eating which has become popular in many quarters and Dr Peeke says it is undesirable to become phobic about carbohydrates. What is more important is to eat carbohydrates and proteins in tune with the rhythms of the natural daily fluctuations of cortisol, to avoid the effects that this hormone can have on adding to fat.

In other words eating with the CortiZone in mind. She illustrates how our hormones can push us to eat up to 3500 calories daily, but if we master our hormonal response by paying attention to how we eat, we can get that down to the 1300 calorie range that is needed to lose weight (though some people would argue that this may be too low a level).

The other way to affect the way that hormones work in relation to body fat is to exercise regularly. Dr Peeke devotes more than one-third of the book to this issue "there is no way of flunking out of it", as far as she is concerned, "if you want to boost your mid-life metabolisms. You've got to move to lose weight."

Dr Peeke has an easy style which conveys information in a usable way. She talks about Dashboard Dining (eating in the car), keeping an Eating Emergency Kit (for when you are likely to be caught out) and eating Women Food Portions (in restaurants who gear up portions to men). She provides lots of 'What If' situations and manageable 'Then You' answers. Rather than piling on the guilt when you don't get it all quite right, she talks about being flexible and accepting that life doesn't always go according to plan, about regular regrouping, about what to do if you relapse and about self-care and balanced care-giving (i.e. not being a martyr). All sound advice from a stress expert who acknowledges that the very process of dieting can be yet another stress.

Many women will find the advice in this book sensible and manageable and it will undoubtedly fill a need for many 40+ women.