One of the most common things my midlife clients struggle with is weight gain. “The things that worked before just don’t work anymore” is the mantra of so many during this phase of life. They visit their healthcare provider with concerns about “waking up in someone else’s body”. The doc runs some tests – thyroid levels, blood sugar studies, and insulin – and all the results come back in the normal range. “Great news!” says their doc. “There’s no problem. You’re just getting older”. End of story.

Many of you who have heard me on various podcasts know that I’m not a fan of the notion that hormone testing reflects the entirety of the Human experience as many “practitioners” would have you believe. The relative insulin resistance of midlife is a perfect example. One does not have to meet the criteria for “pre-diabetes” or metabolic syndrome for there to be real changes for which there are interventions. Isn’t the goal of medical care to prevent these things in the first place rather than just send you away until you actually become diabetic?

One does not need to meet the criteria for “pre-diabetes” or “metabolic syndrome” for there to be changes for which there are interventions. Isn’t the goal of medical care to prevent these things in the first place rather than just send you away until you actually become diabetic?

This is where understanding what’s happening inside your body during the various phases of hormonal life keeps you one step ahead of mainstream medicine. Today we will discuss the phenomenon of relative insulin resistance – the physiologic changes to energy utilization occurring in your body as a result of the normal hormonal changes of midlife – and how to mitigate the effects of these changes so that you can be your healthiest self.

Your Body on Carbs

In a nutshell, carbohydrate is consumed in the diet, digested and absorbed as glucose (among other simple carbohydrates), and utilized as fuel by the tissues in the body. Excess glucose that is not used is stored as glycogen in the liver and muscles, but also as fat. The hormone, “insulin”, is secreted by the pancreas in response to glucose entry into the bloodstream. Insulin drives glucose into the cells so that the cells can use the glucose as fuel to carry out their functions. The “efficiency” of insulin function is impacted by cycling estrogen and estrogen receptors on the surface of cells.

The two bodily systems that use the greatest amount of blood glucose are the brain and skeletal muscle – the voluntary muscles that move our bodies. During midlife, there is a decrease in cycling estrogen and estrogen receptor presence on the surface of skeletal muscle cells. As the ovarian hormonal cycles change and become irregular, there is less circulating estrogen. As a result, muscle mass, strength, and power decline along with the efficiency of the muscle’s ability to utilize blood glucose through insulin-mediated pathways.

A prominent player in cellular and insulin efficiency is an intracellular organelle called the mitochondria: the “batteries” that supply energy to cells. Below is an excerpt from my course Menopause Health and Fitness Specialist Course through MedFit Classroom that explains the science behind how skeletal muscle function is impacted by changes in estrogen and its receptors.

As we just mentioned, when blood glucose is not used as fuel, the excess is stored as fat. When the hormonal changes of midlife reduce the efficiency of glucose utilization by skeletal muscle, the result is a greater excess of unused glucose and increased storage of fat which results in changes in body composition.

Your End-Run Around Relative Insulin Resistance

There are three basic approaches to mitigating the impact of the hormonally-driven changes in how our bodies manage glucose. Resistance training (particularly weight training), nutrition, and neuroendocrine activation.

Resistance Training

If you want your muscles to use more glucose, then you need to increase the activity of those muscles. This looks different for different individuals. If you are sedentary, then starting with walking for 30 minutes 4-5 times per week is a great start! From there, add a weighted backpack, then maybe add some hills or even hiking trails. Simultaneously, engage a personal trainer for 6 weeks and become familiar with weight training. If you are an endurance athlete, make friends with the barbell. If you are a powerlifter, explore different ways to stimulate the muscles that add cardiovascular stimulation like combining running segments with heavy deadlifts. The point is, no matter what your fitness level or expertise, there are new and exciting ways to increase the functional capacity of your skeletal muscle.

Why does this work? The Human body is an amazing machine designed for survival. Mother Nature has programmed redundancies within our physiologic systems to promote longevity. We discussed the impact of our cycling reproductive hormones on how our muscles utilize blood glucose. Fortunately, other physiologic pathways facilitate glucose entry into the muscle cells that depend less on cycling hormones, most notably, the GLUT4 pathway. GLUT4 is a glucose transporter protein that works with muscle contraction to transport glucose into the cells. So when we stimulate muscle contraction through resistance training, this activates the GLUT4 pathway to facilitate the entry of glucose into the cells to be used as fuel, leaving less excess to be stored as fat.

GLUT4 is a glucose transporter protein that works with muscle contraction to transport glucose into the cells. So when we stimulate muscle contraction through resistance training, this activates the GLUT4 pathway to facilitate the entry of glucose into the cells to be used as fuel, leaving less excess to be stored as fat.

Nutrition

We have discussed how glucose enters the cells of our tissues through pathways involving insulin and GLUT4 and how unused, excess glucose is stored as fat. In this section, we will discuss the other important part of this equation, which is the load of glucose that enters the bloodstream by way of the foods we eat.

Glycemic Index – The glycemic index is a measure of how much a carbohydrate source will increase blood sugar over 2 hours from the time of consumption. There are low, medium, and high glycemic index foods with a great description in this resource from Healthline. A lower glycemic index reflects lower blood sugar following consumption and a higher index reflects greater increases in blood sugar. This is important because the glycemic index reflects the glucose “load” on the systems (such as insulin and GLUT4) that need to shuttle the glucose into the cells. When the glucose load is greater, the systems can become overloaded, leaving more excess to be stored as fat. When the load is less, insulin and GLUT4 can better “keep up” with transporting glucose into the cells for use as fuel leaving LESS excess to be stored as fat.

By focusing on carbohydrate sources with a lower glycemic index and minimizing those with a higher glycemic index, you can effectively decrease the glucose load that insulin and other glucose transport pathways see and thus more efficiently use carbohydrates as fuel and minimize the excess that is stored as fat.

Neuroendocrine Adaptation

Adaptation is the ability of the body to adjust or “make familiar” movements or tasks that we undertake. This is a coordinated effort by the muscles, joints, metabolic, and endocrine processes all driven by the master puppeteer we know as the Nervous System!

Because Mother Nature designed Humans for survival, our ability to adapt to physical stimuli and physical tasks is powerful! When we stimulate the muscles repetitively in the same way for an extended period of time, the body doesn’t need to work as hard to manage the load or task and effectively switches into “Auto-pilot”. This is great for elite athletes where the tasks that their sports require become second nature through adaptation.

However, from the standpoint of muscle physiology, they crave something more! This is why we train differently in the off-season: to keep the muscles guessing and thus contantly adapting to become fitter, faster and stronger so that we can crush it on game day! To learn more about this incredible phenomenon, check out Neuroendocrine Adaptation: Your End-Run Around the Menopause Transition.

Key Points for Combatting Midlife Relative Insulin Resistance

• Get moving! The first step to using more glucose as fuel and storing less as fat is to move those muscles. For the sedentary, walking, backpacking, and hiking are great ways to start.
• If you have never trained with weights, another great place to start is a group “boot camp” style fitness class. Find one at your local gym and sign up with a friend! My favorite group class for getting started with weights is Les Mills BodyPump.
• Any level of athlete can benefit from a 4-6 week training program with a trainer or strength coach to gain some basic skills and techniques from basic to more advanced movements depending on your fitness level/familiarity.
• Incorporate resistance/weight training at least 2-3x per week.
• No equipment, no problem! Push-ups and their many variations are fantastic for anyone of any fitness level to add mass, strength, and power to the muscles of the upper body.
• Take an inventory of your carbohydrate intake and using the resources in this LINK, identify carbohydrate sources and potential substitutions that can move the needle toward lower glycemic index choices.
• Nutrient timing is a strategy where carbohydrate intake is timed within an hour before training and within an hour after when the muscles are “looking” to fuel movement during the workout and then looking to replenish glycogen stores in the liver following a training session.
• Most importantly, be consistent, but be patient! It’s about progress, not perfection. Every little bit you can do has benefits.

Fit Pros: Offer menopausal and perimenopausal women an individualized approach to training, nutrition and wellness as a Menopause Health and Fitness Specialist.

Dr. Carla DiGirolamo is a double Board-Certified Obstetrician/Gynecologist and Reproductive Endocrinologist who specializes in the care of reproductive age and mid-life women. Carla completed her residency training in Obstetrics and Gynecology at Brown University Medical School/Women and Infants’ Hospital and her Reproductive Endocrinology training at the Massachusetts General Hospital at Harvard Medical School.

Wonder if your menopause exercise prescription makes a difference? It turns out your hormone ride during menopause deems exercise more necessary than ever. Your hormones reveal more than your likelihood to store belly fat or hot flash.

Research published in the Menopause Journal says your likelihood of being depressed or feeling positive lies in your physical activity level. The study addressed menopause, movement, and mental well-being.

One of 7 levels of physical activity was assigned to each subject:

1. I do not move more than is necessary in my daily routines;
2. I go for casual walks and engage in light outdoor recreation 1 to 2 times a week;
3. I go for casual walks and engage in light outdoor recreation several times a week;
4. Once or twice a week, I engage in brisk physical activity(eg, yard work, walking, cycling) that causes some shortness of breath and sweating;
5. Several times a week (3-5), I engage in brisk physical activity(eg, yard work, walking, cycling) that causes some shortness of breath and sweating;
6. I exercise several times a week in a way that causes rather strong shortness of breath and sweating during the activity;
7. I do competitive sports and maintain my fitness through regular training.

Which level describes you?

Based on that you fall into one of these categories:

• Low (1 to 3)
• Medium (4 and 5)
• High activity (6 to 7)

Subjects in the study with the highest level of activity had the lowest incidence of depression and the greatest sense of well-being.

That’s the bottom line.

What’s most interesting is that researchers measured not only self-reports of depression but hormone levels. So the study was both objective and subjective.

Given we’re in a time when positive mood, attitude, optimism are so important to how we get from day to day, this is just one more message to get moving.

There’s More

Menopause has historically been associated with negative feelings about aging and with greater incidence of depression than in younger women or same age men. The proper menopause exercise prescription, however clearly has the ability to change your well-being.

In fact, many women report that this is a time of great life satisfaction.

Menopause Exercise Rx

The high activity level word descriptions used in this study are exact descriptions of the High Intensity Interval Training and strength training to fatigue that are a necessity for women who want to flip 50 feeling not just well, but outright full of energy and vitality during and beyond COVID19.

Often when I talk about the After 50 Fitness Formula for Women, and a critical part of it — “Less Exercise, More Food” — inevitably an audience member will comment. She may say something like, “I’m so glad you said women over 50 need less exercise.”

I get nervous with that simple statement. Because like a recent podcast I created about “Moderate Exercise,” that is too open to interpretation.

So let me take some real estate in this post to get clear:

• You are not a flower.
• You are not delicate.

You absolutely need to push limits in your workouts – for seconds at a time. That’s true when you’re in good times and when you’re in COVID19.

You need moderate amounts of:

1. High Intensity exercise that gets you breathless
2. High Intensity strength training that takes you to muscular fatigue
3. Fill in with low to moderate exercise that you love

It is #1 and #2 above that have the best opportunity to change your hormones for the better, and in doing so changes your mental well-being, your visceral belly fat, your hot flashes and night sweats, and reverses the effects of 179 genes associated with aging.

Careful Clarification

Advice to do less exercise is often interpreted as advice to do “light” exercise or following a doctor’s vague advice to “walk.” It’s not enough. And walking 3 or 4 miles a day as many women do in an effort to overcome weight or fat gains in menopause only makes matters worse. Greater volume of the same ineffective exercise will not get you better results.

Yes, you want less exercise. Less than you think, and of the right type (of intense exercise).

It’s true that if you’re just beginning you start with habits. We get you hooked and regular first. Yet, yes, you can do interval training when you start. COPD patients and asthma sufferers often do best with intervals. If they can you can. We simply apply a progressive plan for you.

Before you start intervals it may be appropriate for you to “restore before more.” If you’re already exhausted, suffering from mood swings, your first step is to restore yourself with rest, sleep, nutrients and movement, NOT exercise.

Menopause exercise is not a generic prescription for all women in menopause. It should be based on your unique condition now, your current hormone status (assessed by a fitness specialist by your signs & symptoms), and your personal preferences and schedule.

Yet, menopause exercise has the power to make this second half better than the first.

Reprinted from flipping50.com with permission from Debra Atkinson.

Debra Atkinson is the #youstillgotitgirl who is flipping 50 and changing the way thousands of women think about their second half. She’s the host of the Flipping 50 TV Show and the Flipping 50 podcast. As a master personal trainer, strength and wellness coach with over 30 years fitness industry experience, she works with women who are pro-aging with vitality and energy. She is an international fitness presenter, author of hundreds of articles and multiple books. Visit her website, flippingfifty.com

Reference:

https://journals.lww.com/menopausejournal/fulltext/2020/04000/the_role_of_physical_activity_in_the_link_between.6.aspx

The Perfect Pandemic Storm? 

The average weight gain during the pandemic was 1.5 pounds per month, according to a recent study in the Journal of the American Medical Association. As of May 2021, that’s 20 lbs. The results were gathered by monitoring smart scale users with Bluetooth technology. Subjects were male and female smart scale owners with a mean age of 51.

What Happened? 

Shelter in place (SIP) orders combined with stockpiles of pantry items, ample take-out and door-to-door delivery. Additionally, many found themselves with either a household of varied food wants and needs, serving up a daily meal dilemma, or in isolation lending to depression and anxiety. Neither scenario made it easy to adopt or stick to routine healthy dietary habits.

Researcher Suggestions

From the results, researchers suggest a need to mitigate our present post-pandemic conditions with dietary interventions and physical activity.

As aforementioned, the study included both men and women. Women at age 51, however, have another challenge. Women reach menopause at the average age of 51.3. During the latter stages of perimenopause and early postmenopause, there is an accelerated rate of loss of both muscle and bone. The loss is experienced when there is a sharp decline of estrogen and a corresponding increase of cortisol.

Show Me the Muscle

While average weight gain was the reported data in this study, changes in body composition weren’t included. This author suggests we may safely assume this was fat weight and not muscle. There is a need for both exercise and nutrition interventions.

There is also a potential need to identify solutions to sleep disruption and stress (as cortisol can have a negative impact on fat storage and muscle breakdown). Sleep disruption is common for women in menopause and often accompanies stress or anxiety, of which the pandemic provided an abundance.

Hormonal Contributing Factors

Testosterone and growth hormone also decline with age and levels will suffer more in women who experience unresolved insomnia during menopause. These two hormones are produced in the greatest amounts during deep sleep cycles, which menopausal women may reach with less frequency or for shorter durations. 

Women who were in late-stage perimenopause, early-stage post menopause window during the pandemic have the greatest potential for devastating disability. This is especially true if they weren’t strength training with adequate intensity. We may see these effects in a decade if losses of muscle and bone are not mitigated. 

Sarcopenia, a significant loss of muscle and strength, is experienced by 42% of women by the time they reach 65. This is true in normal times, without a 14+ month decrease in adequate exercise stimulus. Sarcopenia results in frailty, greater risk of falls, and with bone loss also occurring at accelerated rates during menopause, fracture risk is higher. 

Compounding Problems

Pre-existing obesity or that stemming from weight gain during the pandemic coupled with sarcopenia provides an even more severe condition known as sarcopenic obesity. Both obesity and sarcopenia are independent risks for disability. In adults diagnosed with both, there is a 2.5-fold increased risk of disability. 

Inadequate Stimulus

When hormone levels offered a stimulus for muscle decline, there must be some other stimulus to replace it. 

Remember the shortage of dumbbells early in the pandemic? While Peleton sales skyrocketed and walking increased for many, access to the type of anaerobic strength training that has the biggest pro-aging benefits for women in midlife required creativity. For those not familiar with strength training, or not online due to connectivity or comfort, muscle and bone loss awareness and solutions are warranted.

The Perfect Storm for Fitness Professionals

For personal trainers and fitness pros, this truly is a perfect storm. It’s an opportunity for a legacy of impact on a female demographic that touches three generations. Her young adult children, friends and life partners, and parents & in-laws. Household decisions and health habits are influenced most by her. No one else has as much influence on health as she does. 

The unnecessary devastating disability that could result for those who’ve gained and sustained significant weight during the pandemic can be avoided. Fitness pros who take proactive measures to educate, publicize, and offer positive solutions for behavior change can be a part of reversing this significant health risk.

Debra Atkinson is the #youstillgotitgirl who is flipping 50 and changing the way thousands of women think about their second half. She’s the host of the Flipping 50 TV Show and the Flipping 50 podcast. As a master personal trainer, strength and wellness coach with over 30 years fitness industry experience, she works with women who are pro-aging with vitality and energy. She serves on the MedFit Education Foundation Advisory Board, is an international fitness presenter, and author of hundreds of articles and multiple books. Visit her website, flippingfifty.com

References

• Lin AL, Vittinghoff E, Olgin JE, Pletcher MJ, Marcus GM. Body Weight Changes During Pandemic-Related Shelter-in-Place in a Longitudinal Cohort Study. JAMA Netw Open. 2021;4(3):e212536. doi:10.1001/jamanetworkopen.2021.2536
• Front. Endocrinol., 21 May 2020 | https://doi.org/10.3389/fendo.2020.00332

During menopause, you’re more susceptible to negative effects of stress. Avoid the wrong exercise (that will worsen stress) and do the right exercise and you can reduce or eliminate symptoms of menopause. There are at least 84 symptoms associated with menopause. This short list of 13 pesky symptoms can be supported by the right exercise.

Hot Flashes (and Night Sweats)

Hot Flashes are potentially the most well-known and most-associated signs of menopause, affecting approximately 50% of menopausal women. They are a sudden sensation of feverish heat that spreads through your body.

Why they occur for some women and not for others, or why they may happen occasionally or for a time and then be gone, is not clearly understood. Vasomotor control is the reason behind why you might experience them when a girlfriend doesn’t when both your hormones may fluctuate.

Night Sweats are excessive sweat that occur during the night. They can contribute to sleep disruption and daytime fatigue or anxiety. That of course, is not the jackpot you want. Both hot flashes and night sweats are believed in part due to fluctuating or low estrogen levels.

Exercise can help this menopause symptom if it’s the right exercise. 

Women who are more fit, with better body composition, and who exercise with adequate intensity experience up to 62% less frequent and or intense hot flashes. What you need to beware of is your tendency to jump to conclusions about how to reach higher fitness levels. Longer and “more” exercise is not the answer. Due to this fast-paced life and your midlife status, the rules have changed.

In midlife, in 2021 and beyond, if you’re still playing the exercise game according to 1980 rules, you will lose.

Will You?

The variability of progesterone related to amount of estradiol had the greatest correlation with hot flash occurrence in more than one study. Increased progesterone variability was associated with decreased hot flashes. Though there’s not much that can be done to influence the variability in your progesterone levels. However, you can exercise to optimize your natural progesterone. Namely, keep stress (cortisol) in check.

Simply start with a smart plan according to your status right now. (More tips below). Ultimately,  include high-intensity intervals at the duration, frequency, and time of day that supports you instead of throwing you under the bus.

Did you know that if the only time you can exercise is late day and you push through high intensity, instead of losing weight you could set off a cascade of events that cause you to gain? The right exercise at the right time of day is a must.

Fatigue

Fatigue is that sluggish, always-tired feeling doesn’t go away with a good night’s sleep. You feel unproductive, moody and this fatigue can cause what’s known as wired-and-tired feeling. You desperately want to get a good night’s sleep and shake it but can’t. For some women, this is like period week fatigue only it doesn’t go away.

Extended periods of fatigue can be signs you’ve just been pushing through, using caffeine or sugar or both to serve you short term. If you rely on external substances too long, that false energy you borrow is going to catch up to you in the end and you will pay back that debt.

If you rely on external substances too long, that false energy you borrow is going to catch up to you in the end and you will pay back that debt.

So, what do you do when menopause fatigue hits and your calendar says HIIT? Or Long run? You rest. You can’t build fitness on a false foundation. Fake it till you make it doesn’t work with your midlife fitness. Plan the work. Work the plan. Override the calendar and rest if your workouts or your sleep, appetite, mood, or digestion is suffering.

An entire chapter in You Still Got It, Girl! Is dedicated to Rest & Recovery. Oh, there are chapters on exercise and on sleep too but Rest & Recovery is something few of us learned to do well. Now? We have to pay attention.

The right exercise when you’re fatigued could be no exercise. We need to remember what it’s like to just move more and rest well.

Low Libido

Libido is your overall sexual drive or desire for sexual activity. It’s influenced by biological, psychological, and social factors. It’s not just that you may feel dry and a lack of interest thanks to hormone shifts. If you’re experiencing fatigue and other menopause symptoms like weight gain and belly fat, you don’t feel sexy or want to be seen or touched.

One of my first Flipping 50 TV episodes was dedicated to low libido and what you can do about it. It’s partially due to changing hormones. But a lot of midlife women don’t realize that the exercise they’re doing (or not doing) is also destroying libido.

The right exercise will boost your testosterone. The wrong exercise kills it and the mood, girlfriend. Simply said, from the boardroom to bedroom this hormone is important. Last, exercise that gets your hips moving increases blood flow there and so it’s not all intense. Whether it’s dancing for you or it’s Pilates or Yoga is up to you.

Make this flip: Stop the endurance exercise and get on the short, intense train. Plus? If your partner snores? You may need to just have play dates together and sleep separately or the libido will keep being a problem. Sleep deprived and sexy don’t belong in the same sentence.

Sleep Disorders & Insomnia

Sleep disorders & Insomnia are often brought on by night sweats. Anxiety & Depression (below) can also be to blame. If your mind just won’t shut down and quiet when your body is crying for relief from fatigue, there are things you can do. If you think of your symptoms as little messengers something isn’t quite right, it may not just be hormones. Or it may be that your hormones will be helped by some gentle shifts.

It may be a micronutrient deficiency showing up. After all, at midlife, several things may be catching up to you. Have you had a less-than-5-star diet? Are you pretty passionate about your coffee and your wine both? Have you neglected your exercise? Just review your last month and get honest. If “busy” got in the way of you exercising and your regular routine is now a random one, get back on it if only for sleep. Truth is just 10 minutes of exercise can boost sleep by 33% according to a poll by National Sleep Foundation.

It could also be exposure to EMFs (too many screens, electronics) in your lifetime or at least right now. Our bodies weren’t made to handle all of this.

There are about 20 different things you can do (and stop doing) to support sleep. Try them sequentially, not randomly and adjusting until you’ve eliminated each one or find it works is something most of us struggle to do on our own. “I’ve tried everything,” too often means I’ve randomly tried this and that for a while.

The right exercise to help with sleep depends on how you’re currently sleeping.

The Short List

Menopause Symptoms Lessened or Eliminated by (Proper) Exercise

• Hot flashes
• Fatigue
• Night Sweats
• Libido
• Sleep Disorders
• Weight Gain
• Incontinence
• Muscle Tension
• Osteoporosis
• Insomnia
• Anxiety
• Depression
• Belly fat

Weight Gain

If you’ve experienced weight gain, I have good and bad news for you. First, you can do something about it. Second, menopause is not to blame. Hormone fluctuation may have caused sudden weight gain. But often at a deeper level there is some behavior change that either did or needs to happen.

You may, as I did, find yourself in a perfect storm. Everything that happened for me in 2019 put me in a place of toxin exposure (hormone disruption), physical and emotional stress (hormone imbalance x 2), and related time and financial stress (hormone disruption). By the end of the year I’d gained 10 lbs. Now, at first glance, it’s possibly reasonable. However, I was training for an Ironman (that’s 140.2 miles of swimming, biking, and running in a day).

Endurance activity has the potential to throw women in midlife (and others) under the bus with adrenal fatigue and it certainly did me. I’d successfully trained for 7 prior to it, with excellent health (albeit, I modified my protocol intentionally for optimum training as opposed to volume).

During menopause, what you’ve been able to get away with until then, you may not.

Depression & Anxiety

Depression & anxiety are mood disorders more common among women than men. Dropping estrogen can negatively influence production of neurotransmitters (brain hormones) like dopamine and serotonin that regulate mood. Combined declining levels of progesterone and estrogen make it hard to restore happiness after incidence of sadness or anxiety.

During the pandemic if you’ve had a little more struggle with this, though perfectly natural and normal with a decrease in our social connections, as a woman in midlife you may struggle a bit more than you would have going through this say 10 years ago.

What can you do? Mood boosting exercise is a big part. Get outdoors and move and lift weights. Both are associated with increase in serotonin, and reductions in anxiety & depression.

Belly Fat

Belly fat didn’t make many “common symptom lists.” For over 90% of the women I’ve worked with belly fat is a big complaint, whether or not they’ve gained weight. Fat deposits tend to favor the belly.

There are two types of belly fat, visceral fat and muffin top or the pinch-an-inch type.

Visceral belly fat is internal around your organs. Muffin top is that spare tire, often in front and back for women.

The two types of fat respond to exercise differently. The right exercise for targeting menopausal visceral belly fat is high intensity interval training. Altering exercise to include high intensity intervals a few times a week can be enough. However, the muffin top requires more. You’ve got to do intervals and cut out your extra-curricular carb intake.

Osteoporosis

Osteoporosis and osteopenia (less than optimal but not quite to the 2.5 Standard Deviations from optimal bone that is osteoporosis) are both growing concerns for midlife and older women.

For good reason. Bone loss on average can be between 1-3% of total bone density per year if you’re not doing something about it.[Resistance weight training has the greatest positive influence on bone density. High impact weight-bearing exercise is second. The emergence of vibration therapy also contributes to bone density. However, vibrational therapy has to be combined with function stability movement for optimal prevention of falls and fractures.]

During the 3-5 years around a woman’s menopause bone losses can accelerate to 3-5% loss annually.

What’s the answer, or rather, what’s the answer while you’re at home, opting not to go to the gym during the pandemic? At the gym using the leg press, chest press, and seated row for strength will help most to load your hips, wrists, and spine. At home focus on squats, lunges, bent over row and chest press.

You’ve been conditioned to believe any exercise is better than no exercise. During menopause the right exercise for each woman is unique.

Reprinted from flipping50.com with permission from Debra Atkinson.

Debra Atkinson is the #youstillgotitgirl who is flipping 50 and changing the way thousands of women think about their second half. She’s the host of the Flipping 50 TV Show and the Flipping 50 podcast. As a master personal trainer, strength and wellness coach with over 30 years fitness industry experience, she works with women who are pro-aging with vitality and energy. She is an international fitness presenter, author of hundreds of articles and multiple books. Visit her website, flippingfifty.com

References

https://pubmed.ncbi.nlm.nih.gov/30502745/

https://pubmed.ncbi.nlm.nih.gov/22409782/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459070/

https://journals.lww.com/menopausejournal/Abstract/9000/Depression,_anxiety,_and_fear_of_death_in.97144.aspx

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2018853/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3568069/

https://pubmed.ncbi.nlm.nih.gov/19211823/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3858421/

https://pubmed.ncbi.nlm.nih.gov/26676059/

Women’s fitness in menopause is a hot topic. This is what I shared in a recent post when I began to spread the word about my TEDx talk:

I think I just threw up a little bit.

That’s how I titled my post. Here’s why.

My TEDx Talk Story

Let me tell you what happens when you get accepted to do a TEDx talk… and have less than 4 weeks to prepare it.

While you’re training for an Ironman happening two weeks after. And the weekend before you’re at a Thursday-Sunday conference knocking out a huge block of time you needed to prepare.

Then you do the talk and walk off stage feeling like you just had an out-of-body experience. You have no idea if you even said all the important things that made you do this, on your own dime and time.

Then you wait, and wait, and wait… for 7 months to it to be published (almost unheard of). And it risks getting banned because it’s controversial and in spite of a dozen+ research studies quoted and the basis of it: it flies against tradition.

It’s released… exactly what you wanted… except then you have to watch yourself and your midget mindset says, “what will people think?” You wonder if you’ve done the women whose stories you told justice. You wonder how many fitness pros will hate it because, well, they’d rather keep doing what they’re doing than accept we might be wrong.

(and of course, I’m human… I think while watching… I definitely look like I had gained that 10 lbs in 2019 I hinted at – ugh!) Keep reading beyond the video to learn more.

Well, hence the original subject line. I opened with. My TEDx talk is wayyyyyy harder to share than I anticipated.

I’ve been talking about women’s fitness for 3 1/2 decades. I’ve been diving deep into the research and protocols on exclusively women’s fitness in menopause for 10-14 hours a day for eight years. And still…

The Resistance

Somehow in my head it went different, you know? It was going to be a huge celebration and something I couldn’t wait to share.

So if I tell you when it all goes peachy and smooth, I have to tell you when it’s a sh#* storm for me.

That’s just personal doubt coming up. And I have it too. So it is fair for me to tell you, when you think maybe something won’t work for you or you can’t do this, these feelings are going to come up.

This resistance is harder than any weight you will ever lift.

So, I’ve got to say to you and to I both… lift the damn thing anyway.

We have to honor what’s happening for us at the moment we’re in no matter what that includes.

Now, a humble ask.

Will you watch my TEDx talk? 

It may help you know you’re not doing anything wrong. It may help you realize you’re doing more than you need to right now. Fitness in menopause is tricky.

Will you share it if it will benefit a friend or a health coach or trainer? 

We need to have some change in the way we think about women’s fitness in menopause order to change women’s fitness and health for the better. You deserve energy and vitality and you’re not going to get there by starving or exercise that causes extreme fatigue.

You can share the link from my website, flippingfifty.com/tedx (scroll below the video and see share buttons to put it directly on your favorite social media site) or from the TED YouTube channel directly.

And know, I appreciate it so much.

Here’s News I Haven’t Shared

Literally, the day after my TEDx talk went live, while I was still pulling up my big girl panties to share it and stop second-thoughts, I got my body fat tested. Here are the results.

Pretty amazing for a woman in post menopause at 56. From walking…. And 2 20-minute interval sessions (start to end) and 2 strength training sessions (about 30 minutes each) AT HOME during COVID19.

Now, if I changed that sentence:

Pretty amazing for a woman in post menopause at 56. From walking…. And 2 20-minute interval sessions (start to end) and 2 strength training sessions (about 30 minutes each) AT HOME during COVID19

Still true.

If I change it again:

Pretty amazing for a woman in post menopause at 56. From walking…. And 2 20-minute interval sessions (start to end) and 2 strength training sessions (about 30 minutes each) AT HOME during COVID19

Still true. (even at gym where you might think it’s easier)

So…You Need to Know

Listen, girlfriend. Please do not let that nasty, second-thought voice inside your head say you’re too old, you can’t get results, or it takes time and effort you don’t have or don’t want to put in.

Women’s fitness in menopause, and let’s get personal, your fitness in menopause may come from far less exercise than you’ve been led to believe.

Had you seen the BEFORE numbers… back in December of 2018 when I tested before beginning Ironman training … I was at 127, 24% body fat. So now… the negative impact of a year full of cortisol elevating stressors – including endurance training – become much more apparent. At my highest weight just before the Ironman I saw 139 on the scale. A number I’ve only ever seen before this when I was when pregnant. On a 5’4” frame that’s not healthy, and it’s mysterious given the exercise I was doing and high quality diet I have. Or so you might think!

Endurance exercise… causes a spike in cortisol.

You add that with many more major life stressors (I clearly got in the wrong line at some point in 2019) and you will GAIN weight. Add hitting menopause mid-year and you’ve got a perfect storm.

And no, many blessings to those who said, oh it’s muscle. Honey, um no. A girl knows. Muscle is more compact, not bulky. You can see the increase in body fat percent… 27% is not bad… just not something that makes sense with my lifestyle.

You Don’t Have to Go That Far (Please Don’t!)

I did an experiment in extremes here. You don’t have to be doing Ironman triathlon training to gain weight with too much exercise.

Please check your default thought pattern that more exercise is better.

Better exercise is better. Like walking…. Walking … for a woman used to running 3 hours, biking 4 and 5 hours… swimming for 1-1.5 hours … could also make you lose weight if it is the right Exercise is Medicine dose for you right now.

There will be a time when I can do some more of the endurance I love again. We have to listen to our bodies, adjust the exercise, as you would medication if your status changed.

Reprinted from flipping50.com with permission from Debra Atkinson.

Debra Atkinson is the #youstillgotitgirl who is flipping 50 and changing the way thousands of women think about their second half. She’s the host of the Flipping 50 TV Show and the Flipping 50 podcast. As a master personal trainer, strength and wellness coach with over 30 years fitness industry experience, she works with women who are pro-aging with vitality and energy. She is an international fitness presenter, author of hundreds of articles and multiple books. Visit her website, flippingfifty.com