Nutrition in Midlife for Weight and Metabolic Health | Women's Health

In this CME episode, Marily Oppezzo PhD unpacks the physiology behind midlife weight gain and offers a practical, evidence-informed roadmap for clinicians counseling women in midlife and beyond. Rather than framing weight gain as a simple calorie imbalance, the discussion highlights age-related declines in basal metabolic rate, loss of lean muscle mass, increasing visceral adiposity, and reduced physical activity as central drivers. The conversation emphasizes muscle preservation as a primary therapeutic target, with resistance training and adequate protein intake (approximately 1.4–1.6 g/kg/day) playing a critical role The episode also tackles common dietary patterns and myths, endorsing a Mediterranean-style approach for cardiometabolic health while cautioning against overly restrictive strategies that risk micronutrient deficiencies. Practical pearls include targeting fiber intake (around 35 g/day), prioritizing “food-first” protein sources, and being selective with laboratory testing rather than relying on broad micronutrient panels. Finally, the discussion underscores the behavioral science of adherence—reminding clinicians that sustainable change requires more than knowledge alone and that structured, supportive counseling often determines long-term success. Anthanont P, Jensen MD. Does basal metabolic rate predict weight gain? Am J Clin Nutr. 2016;104(4):959–963. Lamarche, B., Astrup, A., Eckel, R. H., Feeney, E., Givens, I., Krauss, R. M., ... & Kok, F. J. (2025). Regular-fat and low-fat dairy foods and cardiovascular diseases: perspectives for future dietary recommendations. The American Journal of Clinical Nutrition, 121(5), 956-964. Iuliano, S., Hare, D. L., Vogrin, S., Poon, S., Robbins, J., French, C., & Seeman, E. (2024). Consumption of dairy foods to achieve recommended levels for older adults has no deleterious effects on serum lipids. Nutrition, Metabolism and Cardiovascular Diseases, 34(10), 2353-2359. Allen, L. H. (2025). Micronutrients—assessment, requirements, deficiencies, and interventions. New England Journal of Medicine, 392(10), 1006-1016. Parrott J, Frank L, Rabena R, Craggs-Dino L, Isom KA, Greiman L. American Society for Metabolic and Bariatric Surgery Integrated Health Nutritional Guidelines for the Surgical Weight Loss Patient 2016 Update: Micronutrients. Surg Obes Relat Dis. 2017 May;13(5):727-741. doi: 10.1016/j.soard.2016.12.018. Epub 2017 Jan 19. PMID: 28392254. Disclosure and CE info at https://stanford.cloud-cme.com/course... Key moments: 00:00 Introduction to Women's Health Podcast & Dr. Marily Oppezzo PhD 01:10 Weight gain and muscle changes with aging 03:10 Caloric reduction for weight loss 05:18 Protein needs for women in midlife and beyond 07:20 Protein sources and supplements 09:44 Macronutrient distribution 13:17 Fiber goals and sources 15:06 Time-restricted eating and intermittent fasting 17:55 Keto diets - evidence, risks, and LDL concerns 22:35 Plant-based diets - benefits and nutritional concerns 32:03 Nutrition concerns for patients on GLP-1 receptor agonists 34:27 Counseling on Mediterranean diet 37:07 Role and potential harms of multivitamins 42:08 Motivating patients to make dietary changes