Menopause Medley - Redux

I received a few questions about nutrition and exercise recently, which I attribute to our cultural custom of "New Year's resolutions." I picked a couple that are representative.

1. "I've read your blogs on nutrition, but I doubt I'll ever measure my amount of protein and carbohydrate intake. Are there shortcut rule-of-thumbs I can use to try to do the right thing."

Absolutely! Science suggests that active menopausal women should aim for 2.2-2.4 grams of protein per kilogram per day. But, who really knows what a gram of protein looks like or how many kilograms you weigh, right? Here's a simple trick - include a palm-sized portion of lean meat, chicken, or fish in every meal. You can also incorporate eggs, dairy products, beans, lentils, other legumes, nuts, seeds, and quality protein powders and bars. By including protein in each meal, you're on the right track.

Science recommends 2-3.5 grams of carbohydrates per kilogram of body weight for menopausal women. Here's an easy approach - consume 5 servings of fruits and vegetables daily and 3 servings of whole grains. Add red peppers to your breakfast eggs, toss blueberries into your snack yogurt, and incorporate spinach into your pasta sauce. Start your day with oatmeal, snack on whole wheat crackers, and swap white rice for quinoa at dinner. Once you develop the habit, it becomes effortless. Instead of fixating on numbers, focus on enhancing your diet with simple adjustments. However, for those who love numbers and aspire to optimize your diet, feel free to grab your calculator and dive into it. You can read more about nutrition for menopause here, here, and here.

2. "Can I combine my plyometrics and HIIT workouts instead of doing them separately. I'm curious if something like squat jumps done in the HIIT pattern ticks both boxes? And also, should I add flexibility activities like yoga and endurance sports like running or cycling or is strength training, HIIT, and plyometrics sufficient."

Thank you for your question. I'll echo my earlier sentiments - the best answer is to make the changes, whether nutrition or exercise or stress management, that you can consistently maintain. That being said, science offers insights into optimizing exercise during menopause. A complete exercise plan for menopausal women should emphasize power, flexibility, balance, and cardiovascular endurance.

Addressing the decline in power associated with aging is crucial. Plyometric exercises, such as jump squats, box jumps, lateral hops, and more, enhance muscular strength, balance, bone health, and overall quality of life in older adults. Begin with one set of 8-10 repetitions per week, gradually progressing to 3 sets twice a week. Focus on doing the movement correctly instead of speed. Adding plyometrics to your exercise routine should add only 5-20 minutes per week to your total weekly workout time. Technically, you can do plyometrics as a HIIT workout, but both workout types are quite challenging so I'd advise combining them only after you have good mastery of both.

The best type of high-intensity interval training (HIIT) for menopausal women is short, high energy, sprint-style intervals (SITs) lasting 30 seconds or less. These brief, intense workouts improve insulin sensitivity, mitochondrial strength, fat burning, and growth hormone release. Limit SIT workouts to twice a week, starting with once a week if you're new to high-intensity exercises. Pick your favorite exercise (e.g., running, biking, push-ups, rowing, swimming, burpees, mountain climbers, jumping rope), warm up well, then go as hard as you can for 20 seconds. Rest for 10 seconds and repeat 6-8 times. As you get used to the workout, add 2-3 more sets with 5 minutes rest between them. You can do this workout at the end of a cardio workout since you'll already be warmed up. Adding SIT workouts to your routine should only add 5-20 minutes to your weekly schedule.

Lifting heavy weights (as much weight as you can safely for 6-8 reps) helps counter muscle loss that's common to menopausal women. Heavy lifting also helps to keep bones strong, improve balance, and promote fat burning. Choose compound exercises that use multiple big muscle groups. Safety is key with these workouts. Get familiar with the movement before adding weight. Schedule a session with a professional trainer if you have questions. And when your form starts to suffer, stop. Aim for 2 workouts per week with 4-5 exercises, each with 3 sets of 6-8 repetitions. Squats, deadlifts, bench press, overhead should press, lunges, and rows are good options. These workouts shouldn't take more than 30 minutes each which adds an additional hour to your weekly workout time.

Menopausal women need to add a stretching routine to maintain flexibility, promote relaxation, reduce injury risk, and improve posture. Light stretching, yoga, and pilates are good options, but keep the intensity level low since you need to keep your cortisol low during this workout.

Finally, prioritize cardiovascular endurance with at least 150 minutes of moderate-intensity activity per week, equivalent to 30 minutes, 5 times weekly. Adjust intensity to maintain conversation without resorting to sentence fragments or grunts. Save high-intensity efforts for specific SIT days to manage cortisol effectively.

And that brings us to cardiovascular endurance. The Physical Activity Guidelines issued by the U.S. HHS recommend that all adults get at least 150 minutes per week of moderate-intensity physical activity, which is basically 30 minutes, 5 times per week. If you have the time, try 50 minutes, 3 times per week or 75 mins, 2 times per week, or even 150 minutes, 1 time per week.. You can do almost any activity to meet this goal - brisk walking, running, swimming, cycling, rowing, dancing, etc. You get even more benefit if you can increase your endurance workout time to 300 minutes per week. But importantly, let's talk about the intensity of these workouts - they must be low to moderate intensity. As a rule of thumb, you should be able to talk in full sentences but not able to sing aloud. If you need to resort to sentence fragments, single words, or grunts, you are working too hard! Working hard or "kinda hard" will raise your cortisol, and menopausal women do not manage cortisol well. For those who use RPE, stay below 5. This is harder than you think since most women who have been active their whole lives are more used to exercising at RPE 6-8. Leave those days behind you. Seriously. Menopausal women must be strategic about when to exercise more intensely - leave it for the SIT days.

Keep those questions coming!