Dynamic Dialogue with Danny Matranga - 246: Menopause, Health, Fat-Gain + More!

Episode Date: December 13, 2022

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To get access to this free gift with purchase, scroll down to the show notes and check out using the special link for Dynamic Dialogue listeners. the show notes and check out using the special link for Dynamic Dialogue listeners. Welcome in everybody to another episode of the Dynamic Dialogue podcast. As always, I'm your host, Danny Matranga. And in this episode, we are going to be talking about considerations women ought to make as they transition through perimenopause and into menopause and even into that post-menopausal window when we talk about things from a nutritional, training, longevity, and overall life enhancement perspective. We'll talk about the things that we can change with our health factors, with our health-promoting behaviors, what we ought to look out for, what we need to pay attention to.

promoting behaviors, what we ought to look out for, what we need to pay attention to. We'll go over misconceptions. We'll discuss commonplace tropes associated with menopause, like weight gain, metabolic slowdown, bone density, lifting progress, muscle growth, etc. I'll try to cover this as comprehensively and as scientifically as I can. Also, I think it's important that I outline for you that I've been personal training for 10 years in Sonoma County. Most of that work has been in person. I trained clients in person for three years before I ever started training online, and I've never stopped training in person. So from 2013 to now, I've been working with a variety of clients in person, but the demographic with

whom I've spent the most time working one-on-one are women between the ages of 45 and 60. So this is that kind of prime perimenopausal window. So I will inject some anecdote and some personal reference when and where I think it's appropriate based on what I think can help you. I'll try to let science kind of lead the way with most of this. That way you guys have the best opportunity to kind of, you know, take this in stride and form your own opinions. Because when it comes to physiology, but even more specifically women's physiology, there's so much individual variation and variability, right? That you guys need the information on the front end. I can give you my opinion on the back end and we can go from there. I think the best and probably most reasonable place to start is to just have a basic discussion

about what menopause is. And menopause has anecdotally been referred to as the change. And menopause has anecdotally been referred to as the change. And essentially what happens during menopause is we see a natural decline in women's reproductive hormone production. Usually menopause is going to be a hard line where we can make the definitive statement, definitive statement, we have entered menopause, which the line there would be that it has been 12 months since the last menstruation. So somebody could be perimenopausal and experiencing many menopausal symptoms, but they won't be in menopause from a definition standpoint, until they have gone 12 months since their last menstrual cycle or period. The menopausal transition is going to affect women uniquely and in a lot of different ways. And many women have substantially more challenges than others. And many women have a very easy process when it comes to menopause. Some of the things that can make menopause easier or the

symptoms of menopause less intense are exercise, eating healthfully, maintaining a regular body weight, right? Things that just generally are associated with promoting health. But really, what we see here is a big time change in reproductive hormone availability. Men experience a decrease in sex hormones across the lifespan, but it does seem to be a little bit more gradual. Women experience wild swings throughout reproductive years, right? With their menstrual cycle, where estrogen, progesterone, and luteinizing hormone are bouncing up and down on a semi-regular menstrual cycle. But when menopause begins, or at least perimenopause begins, that's when we can expect to see kind of a extended and consistent decline that is more rapid and a little bit more

steep of a line than when men see hormonal decreases in things like testosterone. So, men will see a slow decrease somewhere around 35 to 40 years old in their testosterone, some as early as 30. If you look at the literature and research emerging now, men already have substantially lower testosterone than any point in human history. But for women, we're looking to see menopause probably start on average, based on the research I've done, the average age for the onset of menopause is about 51 years old. Now, the majority of women will stop having their periods somewhere between the ages of 45 and 55. So we know that on the kind of expedited side of

things, if things were to happen early, you could be between 40 and 45. If things were to happen early, you could be between 40 and 45. If things were to happen late, we'd probably expect that to be closer to 55, with the average woman missing her first full 12 months without a menstrual cycle around the age of 51. And so what we see begin is, again, the decrease in testosterone, of course, but estrogen and progesterone, which are two very, very important hormones. We think about estrogen and progesterone in the body composition world as being bad, but estrogen and progesterone are actually both valuable hormones that play a role in exercise performance, positive body composition, nutrient absorption and assimilation, positive body composition, nutrient absorption and assimilation, heart health.

And so if these things are going to kind of slowly trickle off until they eventually bottom out, it's important to make lifestyle considerations to put oneself in the best place to be successful. Many women will experience hot flashes or pretty advanced symptoms when they go through menopause that can be offset with lifestyle changes or minimized or mitigated with lifestyle changes. But some women need hormone replacement therapy in the form of estrogen, usually combined with a small amount of testosterone so as to keep the ratios where they ought to be. Now, menopause, like we discussed, is signaled by that 12-month hiatus from having a menstrual cycle. But perimenopause refers to the time period before menopause actually begins.

So there's the menstrual reproductive age. Then there's kind of a transitionary phase known as perimenopause. And then we go into full-blown menopause. And perimenopause is that period right before menopause begins. It's when the body begins its transition, right? And hormone production from the ovaries actually starts declining before we even reach menopause. And so from a training perspective, I have seen clients tend to thrive, female clients tend to thrive with their training and kind of hormone profile, so to speak, from the ages of 20 to about 45. I do see on average around the age of 45, some of those perimenopausal symptoms starting to appear for most women. These can be things like occasional hot flashes, okay? Menstrual irregularity, right? You don't lose the period,

but you begin to see irregularity. I've had women communicate to me about other kind of secondary symptoms associated with these hormone declines, like lethargy, strange changes in appetite, strange changes in cravings, changes in libido and sexual preference, lots of things can change during that window. Because what happens is the ovaries actually begin to reduce the amount of sex hormone they produce. From an evolutionary standpoint, this is likely due to the fact that the more youthful and healthful you are, the likelier it is that you have healthier offspring for most people. So the decline in sex hormones around the perimenopausal window is a signal for women that reproduction at this point in the lifespan is probably suboptimal for a species continuation standpoint.

But what do these reductions really mean for your health? These reductions in hormones, the kind of downward titration of menopause, or I'm sorry, the downward titration of estrogen and progesterone. What does this mean for you as a woman? What does this mean for your physiology? Well, there's a few things that I think we ought to start with. And the first is probably the organ systems. And then we'll talk about things like weight gain and even more macro, I think, framework stuff like metabolism. So let's start with the two organ systems that are probably the most affected by menopause outside of, of course, things like the endocrine system, which is the hormone system. Obviously, that's the biggest kind of bedrock

change. But the organ system probably that you guys are the most aware of changing is bones. Bones do tend to change in terms of their density, right, as women go throughout the aging process. You've probably heard that with each passing decade, bone density drops precipitously for women after the age of about 40. This is due to some of the hormonal changes that occur during menopause, specifically the decline in estrogen production. Estrogen plays a role in calcium absorption so not having enough can cause a significant decrease in bone density if you have a low enough level decrease that you don't kind of trip any alarms you'll probably be okay this is tending this tends to be more common with women who are active in my experience at coaching women, I have not seen

too many women diagnosed with osteopenia or osteoporosis. Most of my clients who exercise regularly come back with very, very high scores from their doctors when they have their annual bone density scans. And I think exercise is a phenomenal way to offset some of these bone loss symptoms associated with estrogen reduction. Now, there's two types of bone loss. There's osteopenia and osteoporosis. The difference there being the severity of bone tissue loss that would kind of dictate which diagnosis you got, right?

Now, the problem with a decrease in estrogen over the lifespan and a decrease in bone density is it can make women more susceptible to bone breaks and fractures, particularly those of the hip, spine, wrist. We see a lot of hip, wrists just because of where and how people fall. And the problem here is you see accelerated bone loss, oftentimes accelerated muscle loss, which we'll talk about in a minute, and that can lead to falls being a bit more dangerous and recovery being a little bit harder. So falls become particularly dangerous for adults and women specifically after the age of about 60. Balance, muscle mass, body fat mass, bone density tend to put people in a more perilous position after they turn about 60, at which point each time you fall, like year by year, the increase of that fall actually being irrecoverable and even fatal increases exponentially. So it's very, very important for women to maintain as much bone density as they possibly can throughout the aging process. And this is going to be largely initiated during the

perimenopausal window, which is why it's very, very important to begin engaging with weight bearing exercise and nutritional interventions and nutritional tactics, which will help with bone remodeling and bone density preservation. So what can you do, right? We talked about resistance bearing exercise, that's a given, but with regards to maintaining the health of your bones, you want to eat foods with a lot of calcium. So the two foods that have the most calcium are going to be leafy greens and dairy products. Those are probably your two best bets for getting dietary calcium. There's also quite a bit of protein in dairy, which is very beneficial for a variety of reasons.

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your sports supplement needs. Back to the show. What's going on, guys? Coach Danny here, taking a break from the episode to tell you about my coaching company, Core Coaching Method, and more specifically, our one-on-one,

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supports your goals, as well as provides you with the accountability and the expertise you need to succeed, as well as biofeedback monitoring, baked-in accountability support, and all of the stuff that you need from your coach when you check in. We keep our rosters relatively small so that we can make sure you get the best support possible. But you can apply today by going over to corecoachingmethod.com, selecting the online coaching option, and if we have spots available, we'll definitely reach out to you to see if you're a good candidate. And if we have spots available, we'll definitely reach out to you to see if you're a good candidate. And if we don't put you on a waiting list, but we'll be sure to give you the best shot at the best coaching in the industry. So head over to corecoachingmethod.com and apply

for one-on-one coaching with me and my team today. Hey, everybody, I have a favor to ask you. If you're a regular listener or somebody who gets value out of this podcast, somebody who's learning from me on your health and fitness journey, whether you're a trainer, a high-level athlete, or you're just getting started, other people need this kind of advice. And the best way for you to help me grow the podcast is to take a little bit of time, literally one to two minutes max, to leave a rating and review on the app that you listen to your podcasts on. The majority of you probably listen on an iPhone and you probably listen on Apple podcasts, but many of you listen on Spotify. Both platforms allow you to leave a quick, easy review. And if you could leave me a

five-star review plus a short one to two sentence blurb about what you like, not only will it help more people reach the podcast, it will help me to continue to refine what blurb about what you like. Not only will it help more people reach the podcast, it will help me to continue to refine what it is I bring you each and every week. Thanks so much for doing this. It means the world to me. It helps me achieve my dream of helping more people live a healthier life. Enjoy the episode. Most specifically, the preservation of muscle. Another thing you can do to help with bone density is to avoid habits that can actually enhance the rate at which we lose bone, like excessive alcohol consumption and smoking. There are also a variety of pharmaceutical interventions

that you might be able to speak to your doctor about to enhance bone density. A client of mine who's in her mid-80s, I believe has a once annual bone density scan. And depending on how she trends with that scan, she may or may not have an injectable form of bone density medication administered to her. That is the only client that I know of personally that has used these medications. I just know that they exist. So let's talk about the next organ system most likely to be affected by menopause and how this will affect your health as you age. And this will be a really nice segue to, I think, the discussing weight gain and metabolism, which are definitely the two biggest questions I get from women as it pertains

to what the heck happens to me and what can I expect when I go through menopause? Am I doomed? Am I screwed, right? And so muscle is inextricably connected to bone, no pun intended, but quite literally connected to bone. But these are the two tissues that change the most. And one of the things we see with women when they go through menopause and we see that reduction in those oh-so-important sex hormones is it becomes harder to preserve muscle mass. Muscle mass is very tightly correlated with strength, balance, metabolism, blood sugar regulation. These things are very, very important. And they're probably no more important for any demographic in the way that they are as important for women. We already talked about falls. We already talked about bone density. We already

talked about the importance of having good and robust metabolism. Muscle helps with all of that. But as people age, something that's not often talked about, and you see this a lot when you work with people who are older, is independence. Being able to do things, being able to lift things, being able to contribute around the household or do things independently. Being able to do the things you did when you were younger is very important to people. And you lose the ability to do that very quickly if you do not maintain a certain amount of strength and capability with your body and with your physique. a certain amount of strength and capability with your body and with your physique. And I think for women in particular, they can feel very vulnerable when physically they begin to show signs of decline and they need to ask for help. This can be substantially more noticeable

depending on your living and familial situation. So if you are somebody who is living alone, a loss of independence can be crippling. And resistance training and regular exercise with weights can be a phenomenal way to not only enhance muscle growth, maintain muscle, continue to regulate blood sugar, can help tremendously with bone mass. It can also maintain coordination, increase strength, and massively increase your ability to maintain independence while your body changes. Additionally, a lot of the subjective menopausal symptoms that women feel that can really vary from mood irregularity to hot flashes can be actually positively mitigated by exercise,

meaning a regular exercise program not only sets you up to better help that oh so important muscular system make this transition through menopause, and not only sets you up to have better strength, to have better balance, to have the better or the best likelihood of maintaining your independence, it also will help you with some of these secondary symptoms and help you with things like mood regulation and making symptoms like hot flashes not so bad. So those are the two things that I think you can expect to see the most change directly correlated with menopause. Of course, during that perimenopause to menopausal window, your skin's going to change, your hair's going to change, your wrinkles are

going to change because there's aging going on. But I don't think that those hormonal fluctuations are as tightly associated with those signs of aging. The third system I felt was worth talking about was actually the cardiovascular system because of the role estrogen plays in cardiovascular health. And so to keep things briefed and succinct, I think the best thing that you can do to maintain your cardiorespiratory fitness during the menopausal change and to maintain the health of your heart, lungs, and vessels more generally is to do some zone two aerobic work, some low intensity, steady state cardiovascular work to the tune of about 90 minutes a week. Weight training, cardiovascular exercise will probably give you the best bet and the best opportunity to offset a lot of the problems associated with physiological changes with

menopause. Now, we talked about bone density and what you can do nutritionally to help your bones. From a nutritional standpoint to help your heart and your muscles, remember your heart is also a muscle, I think the big thing that we can discuss is probably protein intake. It's very important that most people who plan to be active and maintain as much muscle mass and independence as possible, we want to make sure that you have what you need from a raw material standpoint to actually build and hold on to muscle. So that's going to be protein. You want to make sure that you are getting your protein in. Somewhere between 0.6 to 1 grams per pound of body weight is a great place to start, but you can spread that out into multiple

small protein feedings across the day. And even if you get half a gram per pound of body weight, that can make a really big difference. There is one supplement that I think might be worth considering in this situation. We might recommend vitamin D for bone health, for example, and I would recommend creatine monohydrate in a five gram dosage taken on training days or a two to five gram dosage taken every day, depending on body mass, is a great way to improve muscularity and enhance the kind of robustness of the muscular system while making it easier to recover and perform during your workouts. Because I think it's important to work out during this change. And this is a great segue to the next piece,

which of course is weight gain and menopause. And this is one of the things that I have been told ad nauseum from women as they age, which is that, you know what, ever since I hit a certain age, ever since I went through menopause after I had kids, weight gain just became extremely challenging. I couldn't keep the weight off. Nothing that I do is working anymore and things get a heck of a lot harder. And so you've probably heard this from friends, family, and loved ones. I've heard it forever. Sometimes it seems true. Sometimes it doesn't. So I wanted to dive into the research

and see what I can find. And what I found most interesting was data from the CDC. And these findings show that women gain the most weight during their 30s, not their 40s, not their 50s, not their 60s. But the decade in which women consistently gain the most weight is very much premenopausal. It's during their 30s. Tends to be the year where women have the most children. So some of that could be associated with childbirth, sure. But what we don't see is massive upticks in weight between 40 to 60 during that perimenopause and menopausal range, right? We do see increases, right? Weight actually comes down a little bit in women's 40s based on this data. but really what we're looking at is weight changes

most before menopause. And a lot of the weight changes and body composition changes women discuss or they worry about or they report when they go through menopause aren't related to the age necessarily or the change itself, but the change plus the lifestyle changes that go together, right? So this would be in my 30s, I didn't gain a ton of weight. Let's say, but I gained the most weight I did during any decade, but I also had children and that changed my lifestyle a lot. And I also spent more time with them and more time preparing their food and more time eating a little bit of their food. And all of these lifestyle changes that occur are substantially more likely to be the cause of the weight gain than the aging itself. Now, one of the biggest rebukes you might hear

about this is that we actually see changes in metabolism. My metabolism is so much different. I have so much less energy. I can't even look at the food I used to eat. And that is not entirely true either. In fact, a study from Herman Ponser found, and this is one of the most referenced studies you'll find as it pertains to aging. This was a headline maker, I think maybe a year ago, maybe a year and a half ago when it hit the Journal of Science. But essentially, what this study shows is that what we've been led to believe about that kind of robust, youthful metabolism versus that kind of deflated, wimpy, old lady metabolism that you often hear people complain

about, that's not really there, right? Metabolism only declines about 1% per year after the age of 60, and it remains pretty damn stable from the age of 20 all the way to 60. And if you do some of the stuff we've discussed to maintain the health of your bone tissue and to maintain the health of your cardiovascular tissue and to maintain the health of your muscle tissue, tissues that are all closely and tightly correlated with metabolism, you'll do even better, right? So there's lots of physiological changes that happen when we get older, right? Or as we age, we've got puberty, right? We've got perimenopause, menopause. We have the reduction in testosterone for men. We see a lot of changes

that occur across the lifespan. But what's interesting is we don't see massive metabolic swings, at least in the evidence, right? That we see reported by women and that kind of persist in the public conscious. And what I can tell you as a trainer is I've been able to help women be successful and lose weight at pretty much any age, depending on how tightly bound they are to the notion that they can or they cannot. When women think that they cannot because they're a certain age or that it will be harder because they are a certain age, they generally don't do as well. Now, if I tell somebody what I just reported to you guys on this podcast, which is that we see the greatest weight gain during the 30s, not the 40s, not the 50s,

not the 60s, and that metabolism remains fairly stable all the way from your 20s into the 30s, not the 40s, not the 50s, not the 60s, and that metabolism remains fairly stable all the way from your 20s into your 60s, and only then does it start declining at a relatively low amount. Meaning if it's only around 1% a year and you live from 60 to 80, your metabolism might only be 20% decreased from where it was when you were 20 when you're 80. That's not the huge drop, people report. And that's not a big enough drop to preclude you from seeing results with your exercise and maintaining a body physique that you're proud of. And more importantly, maintaining your health. And so another big question I get is, am I going to be able to make progress in the gym when going through menopause? Am I going to

be able to recover? Do I have to make any adjustments? And I looked at a study from Romero Parra et al. that was published in 2021 titled, Exercised Induced Muscle Damage in Post-Menopausal Well-Trained Women. So this was looking at women who've already gone through menopause. So we can assume they have the lowest availability of hormones to help them succeed with their training. And what they did in this study was they looked at pre-menopausal and post-menopausal women, both of whom were trained. That's important. They did a 10-set protocol, 60% of their one rep max for 10 sets of 10 with the barbell squat. What they found was that not only, well, let's talk about first what they checked for. They

were checking for muscle function, markers of muscle damage and inflammation two hours after training, 24 hours after training, and 48 hours after training to see, do you recover better? And what we can garner from that is if you recover better, you can train harder. Do you recover better? And can you train harder depending on your age and depending on whether you're pre or postmenopausal? And what was shown when we looked at markers of muscle function, markers of muscle damage and markers of inflammation is that the changes are pretty similar regardless of whether you're pre-menopausal or post-menopausal. So for me as a coach, what that means is I get the opportunity to relax a little bit knowing that recovery rates are going to slow down at some

point, right? Like when I train my clients in their 80s, I don't expect them to recover as well as my clients in their 60s. But it means that my clients in their 60s can actually train pretty hard and pretty intensely, and they're not going to have as much of a reduction in their ability to recover as we might assume. Now, I think that's a really, really big deal, right? And so lastly, guys, I want to leave you with some lifestyle tweaks. I should say, lastly, girls, because quite frankly, most of you listening are either coaching women or you're going to be helping women implement these or you are women. So what would my menopause toolbox be for making the most of this transition and positioning yourself to be as healthy, fit, and kind of have a great trajectory for graceful aging and lifetime independence.

I have a number of tips here. I would recommend lifting three to five times per week with resistance, focusing on compound movements and progressive resistance. Those sessions can be anywhere from 20 to an hour plus long. They don't have to be powerlifting, but they need to be progressive in nature. They have to train through a full range of motion whenever possible so as to optimize mobility, muscularity, muscle retention, et cetera. I would aim for 10,000 steps a day to offset the general lifestyle changes associated with aging. The older people get, the more they sit, the more sedentary they become. So offset some of that. I would aim

for 90 minutes a week of zone two cardio to protect your heart and maintain the robustness of your aerobic system. I would eat a diverse array of plants, especially leafy greens to load up on nutrients that are good for your whole body, but specifically calcium. I would also focus on getting a good amount of dairy protein, particularly fermented dairy protein, as it contains probiotics that can be valuable for the gut when paired with the fiber and the leafy greens, and a ton of protein and calcium to help with muscle and bone. I would find a variety of protein sources in addition to dairy, if you can tolerate it, that you can sprinkle in across your day with the hopes of getting all the way up to

0.5 to one gram per pound of body weight to help maintain muscle and keep you full. I would find a good multivitamin specifically formulated for women. I like Legion's Triumph, but find a good multivitamin specifically formulated for women so you can fill any nutritional deficiencies you might have. You might also consider supplementing with vitamin D3 and creatine monohydrate. The last two tips I have for you are to focus on sleep, aiming for six to eight hours per night, seven to nine being ideal, six to eight being kind of the low end range and continue to find active hobbies that keep you enthusiastic and engaged with physical activity. As that does seem to be the biggest change, non-hormonal change, that would be the biggest lifestyle change

that can contribute, right? That can contribute to some of that stuff you hear out of the public consciousness about metabolic slowdown. Oh, it just doesn't work the way it used to be. A lot of that is driven by lifestyle. So hopefully that gives you some tips and tools to how you can better manage menopause and better manage the change in your body with lifestyle intervention in the form of exercise, selecting some certain foods. I've worked with a lot of menopausal women over the years who are in the form of exercise, selecting some certain foods. I've worked with a

lot of menopausal women over the years who are in the best shape of their life post-menopause, after menopause. So I would not be discouraged that just because your body is going through some very natural changes that you're somehow doomed to not liking the way you look, being weak, not having the fitness you'd like, and losing valuable markers of health and independence. There's a lot you can do to make this transition as seamless as possible. But remember, it's different for everyone. I'm certainly not a doctor, and you should speak with your physician before you implement any of the things we discussed on this podcast. If you enjoyed this, it would mean the world to me if you shared it with somebody,

particularly somebody who could benefit from it. And leave me a written review on Apple Podcasts and Spotify. Five-star written reviews help podcasts grow like crazy. And podcasts are something that, honestly, you have many options when it comes to what podcasts you want to consume. And you sat here and just consumed mine, which means the world to me. So if you could help more people find it and help me continue to grow and spread my message of health, fitness, and longevity, it would make a big difference. Thanks so much for tuning in, and I'll catch you on the next one.