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Lifestyle changes may not always be enough to control biologically driven body changes.

You spend hours in the gym every day. You eat nothing but grilled chicken, fish, and salads. Yet the numbers on the scale don't budge � or worse, they slowly creep up, along with your waist measurement.

Welcome to menopause.

"The change" actually does bring changes for many women, including weight gain that can resist even the most diligent efforts to reverse it, says Dr. Fatima Cody Stanford, instructor in medicine at Harvard Medical School.

In the journals

Spending just 20 minutes connecting with nature can help lower stress hormone levels, according to a study in the April 4, 2019, Frontiers in Psychology. Previous research has shown that interacting with nature reduces stress, but it is not clear how long and how often the engagement needs to be, or even what kind of nature experience is best.

Here, researchers asked 36 people to spend 10 minutes or longer, three days a week for eight weeks, in an outdoor place where they could interact with nature. The settings varied from yards to public parks to green areas near their place of work. They also either walked or sat during their nature time.

Ask the doctor

Q. What causes high blood pressure?

A. My answer is going to start in your back yard; stay with me. You're holding a hose, you turn on the water, and it shoots through the hose and out the nozzle. The water is moving because it's under pressure. Similarly, when your heart beats it creates pressure that enables your blood to "water" your body with the nutrients that are in your blood.

Three things affect the amount of pressure that pushes blood through your body: how forcefully the heart pumps, how much blood there is, and how narrow the smallest blood vessels are. That last one may need some explanation. When you're watering plants, and you want the stream of water to go farther, what do you do? You make the nozzle smaller. Narrowing the opening through which the water flows increases the pressure, and the water then is able to reach the distant flowerbed.

Managing emotionally driven weight gain requires planning ahead.

How much and when you eat isn't driven just by hunger, which you likely already know if you've ever found yourself hunched over a bowl of ice cream after having a particularly stressful day. Stress can set off a cascade of physical reactions in your body that may not only drive you to eat more and make you crave less nutritious, fattening comfort foods, but also help you pack on extra pounds much more easily.

"Stress drives up levels of a hormone called cortisol in the blood," says Dr. Fatima Cody Stanford, an instructor in medicine at Harvard Medical School. Cortisol is a hormone produced by the adrenal gland that helps to regulate your metabolism. It also plays a role in blood sugar management and memory. When levels of cortisol rise, it can promote inflammation and may spur the body to start stockpiling fat around the midsection. "Stress might also disrupt sleep and drive people to seek out food when they wouldn't normally � such as in the middle of the night," says Dr. Stanford.

Learning to "belly breathe" helps ease your body's response to stress and tension.

The average person takes between 17,000 and 23,000 breaths per day, but there is a good chance we don't always breathe the right way. Chalk it up to how we deal with stress.

"When we feel something as a threat, our fight-or-flight response automatically kicks in," says Dr. Katherine Rosa, with the Harvard-affiliated Benson-Henry Institute for Mind Body Medicine. "Our breathing becomes more rapid and shallow and our hearts beat faster, all of which prepares us to run away from the threat."

In addition to boosting fitness and easing stress, yoga may also help you embrace a healthier lifestyle.

Many people think of yoga mainly as an activity that promotes flexibility and balance. But this ancient tradition also includes breathing exercises, relaxation, and meditation. Together, these practices can lead to measurable improvements in factors connected with cardiovascular health, such as lower blood pressure, better sleep, and less artery-damaging inflammation.

"There are four distinct but interconnected areas in which yoga has specific benefits, not just for heart disease but any disease," says yoga researcher and neuroscientist Dr. Sat Bir Singh Khalsa, assistant professor of medicine at Harvard Medical School. Following are summaries of the four areas.

Dealing with the emotional effects from a physical setback can be a challenge. These three strategies can help.

The physical repercussions of a major health issue, like surgery, an injury, or a heart attack, are tough enough without having to also confront the stress, anxiety, and depression that often accompanies it. Yet managing your mental health is just as important as your physical health when it comes to making a full recovery.

"There is no question that your state of mind can dictate how quickly you can return from a physical setback," says Dr. Jeff Huffman, director of the cardiac psychiatry research program at Harvard-affiliated Massachusetts General Hospital.