The Dr Louise Newson Podcast - 290 - Exercise: how to stay active and strong in menopause and beyond, with Matt Roberts

Episode Date: January 7, 2025

Joining Dr Louise on this week’s podcast is Matt Roberts, one of Britain’s foremost fitness experts and personal training pioneer. Matt opened Europe’s first exclusively personal training gym in 1996, is a bestselling author and is responsible for honing some of the most famous physiques in fashion, sport, film, music and politics. In this episode, Matt and Dr Louise discuss the importance of strength training, cardio and mobility exercise for health span, as well as some of the key barriers to exercise during perimenopause and menopause –  and how to overcome them. Finally, Matt offers advice on getting into good habits during menopause, whether you are already active or haven’t exercised for a while. Find out more about Matt at www.mattroberts.co.uk and follow him on Instagram @mattroberts_lifestyle Click here for more about Newson Health.

Hello, I'm Dr Louise Newsom. I'm a GP and menopause specialist and I'm also the founder of the Newsom Health Menopause and wellbeing centre here in Stratford-Pon-Avon. I'm also the founder of the free balance app. Each week on my podcast, join me and my special guests where we discuss all things perimenopause and menopause. We talk about the latest research,

bust myths on menopause symptoms and treatments, and often share moving and always inspirational personal stories. This podcast is brought to you by the News and Health Group, which has clinics across the UK dedicated to providing individualised perimenopause and menopause care for all women. So on my podcast today, I'm delighted to introduce to you Matt Roberts, who some of you will know and some of you might not. I've actually stalked him from afar for many years actually,

watching him a long time ago actually when personal trainers weren't quite such a thing, looking at him in various media sort of newspapers showing how to do very simple exercises, making it look very simple, but very effective as well. And I was very honoured to be introduced to him recently at a longevity event. And so now I've hoiked him onto my podcast. So it's a very exciting day for me. So welcome, Matt. Thanks for coming today.

Well, thank you. It's a pleasure to be on. Likewise, I've kind of watched all the work you've been doing from distance. And it's an area that has a natural follow-on with what I do. And increasing the hormone, health overall, this kind of crossover between what the fitness and the health and training community do or should be doing is sort of quasi-medical, it's more crossover, more understanding. Certainly, I've been doing this a long time.

I've been doing this for 9 and 30 years. I'm 51 years old now. I was my first club when I was 22 years old. And from day one, it was always about data. And there wasn't much data you could gather at that point in time. But it was very much in my core thinking that it needs to be that we could analyze individuals in a really precise way. And I always had teams of doctors, medics that we consulted with and dietitians and

less so hormones, especially at Ray start to say. It was much more of a thing in the last maybe 15, 20 years. We became able to actually really use the data and understanding and a much better. away, whether that was because of us, whether that was because of the general kind of community understanding. I don't know. But where we are now is where I think always envisaged as it should be, is that we have this really interesting, great merging of a whole range of skill sets

with our liver specialists and we have on site and our dietitians on site, and our physio is on site and osteoparts, and we consult with homo specialists like yourself. And it's something which it's a really nice place to be, I think, between what medicine and the fitness world are doing. This isn't in all cases, by the way. is very much, I think, in the upper ends of it, but I do a good job of understanding bodies better.

And I think it's important as well as I stress that, you know, looking at fitness and health, while inevitably fitness is always linked into the body beautiful and building up muscle mass and having a certain shape with being a certain size, it's not how I view it. I mean, I view that as being the good end byproducts of what we do. And what we do is always make sure a body is super healthy. And we focus on the wellness end of things.

I'd say certainly over the last several years in particular, we really have skewed the business towards being a health span business. And I say health span, perhaps as opposed to just longevity. I don't think we can necessarily extend our longevity from what we do per se, lots of other medical interventions can do. What we do is make sure that individuals function in a way that means they can be unbelievably active, whether they are 35 years old or 95 years old. And if for me, being now 51 years old, my goal, well, look, when I turned 30 years old, because you're stupidly when you're in your 20s, you think you're getting older when you're 29 years old. The first is going to hit and you're an old person. And I said, well, I'm going to hit 30, you'll be the same shape and health

and well-being as when I was 20 years old. And because I was an athlete in my teen years, I was a sprinter. There was lots of data collection that I had. So I could actually quite easy look at some metrics around where I was being 30 compared to being 20. And I was bang on the same. Same number of body fat and blood pressure and the blood data and speed and power and so on. So, you know, Rawford's 10 years got to be in 30-19. Well, I need to be the same shape when I was 40 years when I was 30 and therefore when I was 20. And the same happened at 50 as well. And with all the metrics

that I've got, my data hasn't shifted. I'm within a fraction, the same body fat percentage from the fraction, the same weight. But it's not because things just stay the same. You've got to work on changing as you change and changing as you age. Because no doubt at all, but if you sit in your complacent, you do nothing, you age. It takes consistent work. It takes the understanding of how to use rest and how to understand blood data, how to understand how your VO2 changes and all these things. It takes full diligence in doing it. So I'm like a guinea pig to myself over how to

ensure we can get the best results and for my client base, people that you, like yourself, who see things that I write about in the press and do. I try to take things that have complicated science backgrounds and simplify them. make sure it's a case of, okay, what can we actually do? What's the real things as proper take-hams on this? It's so important, actually. So when I was at medical school many years ago in the late 80s, we didn't really learn much about exercise at all. And I'm active, but I'm not, like, I'm not a runner, I'm not sprinter. I've always cycled. Like, as a student, I cycled everywhere because it was so much cheaper than getting the bus or public transport or whatever. And so I was sort of fit just because

I even was cycling out to nightclubs sometimes because I didn't really drink much. and it was just easy. And then I would do pop aerobics or step aerobics, you know, that was a really big thing in their 80s and 90s. But that was just my choice. But actually, as a medical student undergraduate, I didn't really learn much about muscles. I didn't know muscles produced chemicals that were really beneficial.

I just thought they were there to move our arms and legs. Really, literally, I knew a lot about the anatomy, but not about the physiology of muscles. Knew a little bit about bones, that they're metabolically active. But, you know, fast forward 30 years, obviously my knowledge is very different because I've self-taught. But you're absolutely right, but it's about how we look after ourselves and keep well. And I think I'm fitter now than I was as a medical student in a different way, you know. Just I do a lot of yoga and I'm physically stronger. But actually,

that helps me to be mentally stronger. And, you know, I still can fit into my wedding dress and I've been married 25 years, you know, quite a few people in there. I'm 54, probably can't fit into, and I'm, you know, my wretress was fitting. But it's very important that we think about exercise, I think in very different ways, because I have patients who are extreme athletes, that's fine. I have other people that literally find it very difficult to get up from the sofa, and these are often women in their 70s and 80s that haven't really done much exercise, and it's catching up with them. They have this sarcopenia loss of muscle mass. They might have some osteoporosis.

They have muscle and joint pain. They're more exhausted. They might have some urinary incontinence or urgency. Even just getting out of a chair to go to the toilet is massive. And so I think often when you're young and fit, you could never imagine being that old woman in a chair unable to get out to the toilet. Whereas one of the things that keeps me exercising is like,

I don't want to be that woman. I don't want to run marathons because I'll never be able to, unless I gave up my job and had no time or whatever, but I really, really want to be able to get up without a Zimma Frame, not be in a nursing home. And that's where you're talking about this health span, I think is important because so often you can zone out with personal trainers or extreme athletes thinking,

I'm never going to be that person. And one of the things I've always liked about your work is you simplify it. so you is something for everybody and I think that's really important isn't it? Yeah, it is. I think it's 99.99% of people are never going to be an athlete. So you want to focus the work you're doing not on the 0.1%. Any spirit is focusing on the broad masses of what can we all do to make sure that we have the spirit to stay younger for longer, frankly. That's the goal, isn't it? It's retaining as much of the youth and the vitality and vibrance as you possibly can.

and within that then you feel well. And we have to remember that when someone starts to exercise, whether they have done something before or have not, the percentage growth they can get in muscle size, strength, strength in particular, is the same. So if someone has the same input in relative terms to their fitness ability, the return they get on their time investment is the same percentage change. So this idea that maybe it's too late for me or I can't do it now. I'm too old. I've never done it before is wrong. Whether you do, you gain. And in fact,

actually, there's more chances if you're gaining a higher percentage when you haven't done something before. You start from a lower base. Now, clearly, the strength changes as percentages are different if you've got high strength to start with or low strength to start with, the percentage are the difference. You're going to feel the difference irrespective. And with that difference, with that change in the strength, you get an absolutely linear response in terms of your mobility. So you're right to say people struggle to get out of their chair. And that's a horrifying thought that you actually unaided can't stand up because that's when things are starting to slow down dramatically

and you start to get then secondary illnesses and various issues alongside that. So we've got to have that raw basic of what are the functional patterns and movements that you need in your life to not be at risk. And as someone gets older, the problem with sarcopenia is something which is not to do with the size or anything else, is to do with the risk. of falling. So if you haven't got muscle strength in your glutes, in your hips, and your mobility is poor, you stiffen up because you sat down for too long, the chance of tripping, falling, damaging the bones is much higher, combined, of course, with the effects for a female of the

menopause on bone health, the effect of not exercising on reduced bone density and health, all the things that we do that are strength-based are all positive for making sure you've got greater mobility, greater stability, greater stability, greater bone, density and the risk someone having an issue when they're 65 and that break of the hip where the mortality rate just goes, styrocheting, goes away. And it's really about what can you do? And it's very much that person who sat in their chair can't get up. Well, just put four or five cushions, or two cushions on the edge of the chair and just stand up and just literally bend your knees so you can just touch your cushion. So your knees aren't going to go fully down and do it multiple

time, small range of motion squats as an example, and doing that for 12, 15, whatever the number might be, 20, 25 reps, it gives you that chance of re-engaging those muscles. And these are basic, basics that can be done. You get the butt to be stronger, the quads, the thighs to be stronger, and the amount of stability and strength gives you in the core key areas is massive. And if that kind of thing, it's just, you haven't got to be going to the gym necessarily. Great if you can and you do. But what can you do around your environment to make sure you've got the tests that you need. We have to keep testing. And like I say, with myself, as time goes by, what's noticeable with anybody, everybody, is it takes the same amount of work to get the same game because I haven't slipped back

as anywhere. But the rate of which can fall backwards increases. So your retention of muscle strength goes more quickly. It takes an ongoing, diligent approach to ensure you stay on top of it. So it can be done. And it can be simple. And it does take just this idea of, I am the person that can do this. Do you actually think we lose track of the idea of it's not me. That's not what I am. Well, imagine that you are. Imagine that is you.

Imagine you are that person who can do the activities. Imagine that you are the person who's active. And then you have that mindset of I can actually feel as though I've got control of me of my life. It's so easy. I think you're right to be on that slippery slope. So I've had a viral infection over the weekend. And so I haven't done any yoga for three days. And for me, that's quite a long time.

At the weekend, I tend to do a longer practice as well. but I just haven't felt and it was probably the right thing to rest my body. But it would be very easy to forget that I've ever done yoga and not do it. But I know that if I left it a longer period of time, it would just be so much harder to get back into. And I end my yoga practice with a headstand. And I'm very proud of being able to do headstands. But I do sometimes think, God, if I didn't keep doing it most days, I wonder how long it would take for me to not be able to do a headstand. And it's a bit of an internal sort of thing.

But that's just a mark of anything, like just doing, bending down and touching my toes. I can do that very easily because I do it a lot. But it wouldn't take long at 54 to stiffen up. And that's where it's so easy or it's easy to continue. But then there's people my age who go, well, that's ridiculous. Louise, I will never be able to do a headset. I will never be able to touch my toes. No, but you will be able to walk up the stairs a bit quicker.

You will be able to run for the bus. you will be able to walk up the escalator rather than just waiting for it to take you up. And it's harder, isn't it, to start, I think, when you've let bad habits sort of slip and not do as much exercise? It's human nature to find a shortcut. It's human nature to find a work around.

It's human nature to go for the comfy option. And we are very guilty of that now because we have the ability to make our lives become very comfortable, very warm, very cozy and not have to exert very much at all. remember what the boy is designed to do. The slip-off rate, if someone stops doing something per your point, is that if you do nothing, nothing, nothing for two weeks, nothing really changes, you don't lose anything at all. It's a minimal percentage drop in your strength,

growing your V-O-2 capacity, your half-lung capacity and strength. Four weeks, it starts to slide. You might lose maybe 5 to 10%. After eight weeks, you drop off a cliff, and you pretty much lose all that you've done in the previous six months. All of your fitness work, all effort that you put into it, you lose all of it in eight weeks. So you've got to stay on it and you have this window. You can get away with getting the virus and being a well, it doesn't make any difference. You feel like it has been in reality, you're okay. You can get away with being on a business trip somewhere because you have no time to exercise for a few days, not a problem. If you decide suddenly, just because you forget you need to, but you lose that urge to exercise

and move and be healthy eight weeks and you're back to where you were at the very start of your program. But the longer you've been active for over many years, you might get a bit of an increase in duration of that, but you still have a huge drop in your capacity and your fitness. So we've got to, yes, got to stay very, very consistently on it. Consistency is the key. It's not necessarily about hitting the high, just being consistent all the time. If there was one thing, I mean, effectively there's one facet of fitness, which is probably the most important thing that anybody must be focusing on.

And it's the one that for most, for a lot of females, they tend to avoid the most, which is strength work. Strength work is the mainstay of our hormone health. It's the mainstay of our bone health. It's the mainstay of our ability to actually physically function and move without muscle strength. Our skeleton can't hold up. It's the mainstay of all that we are as a being. Without that, we wouldn't be anything at all. Increasing your strength. I do mean strength rather than size. There's two very different elements of how we train muscle. We don't want mass. What we want is highly activated, very strong tissue.

which is functioning and able to keep you doing all that you need to do and more. And that's the high metabolizing tissue as well. That will burn energy. That should be the one thing you must, must do. The second thing is probably quite equal, second, first in a way, is doing Zone 2 cardio training. So Zone 2 cardio is that thing you must do every other day, four days a week, of constant pace. it's for most people a fast walk or it's a sat in a bike

at your gym ticking along for 40 minutes and it needs to be one speed one intensity, one pace and it should feel like as though we're having conversation now and it's fine. It should go so we can have this conversation but we'd be just pressing ourselves a bit harder,

a bit breathless, heart rates about roughly 70% of your maximum capability so it's definitely overloading you, but you're getting slightly sweaty but you're not exhausted and it's sustainable for that 40 minutes The reason why that's important is what we're looking for always is really good mitochondrial health. So our mitochondria, they decide on how our cells kind of use energy in a way.

So they decide on how we utilize fatty acids, fats, how we utilize glycogen, sugar. And if they're functioning badly, we tend to have a tendency towards using up, burning up more glycogen or sugars, then we do fatty acids. These are marginal differences. But our insulin resistance then gets tweaked and adjusted, and that causes also some other problems. and we've got to train our bodies to become very efficient. And Zone 2 cardio, this sustained 40-minute spell without changing the intensity, whether it's walking or biking. Viking's great because it's very sustainable.

It gives you very rapidly, very strong, healthy, mitochondrial capabilities, and your body gets very efficient. It starts being able to just really get used to that and burn away and much more fatty acid as an energy source than it does sugar. So you've got to do those two things in your main. days to focus on. There's a whole bunch of other things as well actually, but those are the two things that you want to get right. And how we use cardiovascular training, how we bear using cardio work to create cardio strength is different again. That's interval training. How we give you

muscle size if you want it is different again. That's a very specific training program and eating programs to gain mass. In the main, it's about giving you exercises that give you direct strength. And, you know, off the back to you and I do in the numbers with this one, someone's going to the gym or being workouts at home, the amount of reps that you do defines your intensity. So if you can do an exercise that you can do for around really eight to 12 reps, that's in the strength gain zone. You're unlikely to build up a whole lot of size doing that kind of range, eight reps somewhere there. You get really, therefore, high loading to be heavy enough that you couldn't lift it more than eight times. That's a heavy weight. We don't want a weight that's light that's light that you do 12,

15, 20 times, if you're looking to try and create strength, it gives you probably some strength and endurance, but that's different. We're looking for direct pure strength. Now, that means doing a pretty heavy loading when you're doing a squat with some weights in your hands at the side, maybe you're a bar on your shoulders or a leg press machine in the gym. It means working up to a level. I wouldn't say jump straight into this by the way. You've got to work up to that level over some time. And at that level where you're doing 8, 10 reps, you build such a huge degree strength and you test the muscles and therefore the tendons on the muscles and the tendons attach to the bones, you create really good bone density build. And this gives everyone phenomenal

abilities to burn away calories. It gives you a really amazing change in your glitone usage and your insulin resistance. It gives you a far better use of sugar and your chances are becoming pre-diabescal lessened if your muscles get stronger and utilize that program more quickly. So it's a must-go-to. It's a thing that you have to do to ensure we have functional strength. We've got therefore hormonal strength for guys who are listening as well, if you want to get some testosterone gain. And this is a big problem. You know, the data on testosterone in males is horrifying. The levels of this generation are less than their fathers before and less of their fathers before them, which I think is horrifying, staggering. We're seeing that with male sperm

counts as well, you know, 50% drop in some studies over a 40-year period. I mean, bad data. This is all based on us as human beings, not challenging ourselves in the same ways we need to. And females absolutely need to be physically challenged, need to be pushed. I think that we've got to focus on having a box ticking exercise. So in the course of a week in your programming, what do you need to do? We've got to work on fundamentally strength first, cardio fitness second equal first mobility within that mix as well and some way of calming the system too so within that what are you going to choose to do so for the strength side you kind of got to go to the gym or you've got to have some weights at home and do some really big overload the cardio you can work

into a program and think about if you're going to do cardio how does that work you've got a dog what you're doing already you're walking the dog are you walking fast enough with the dog to get your heart's level it needs to you can check it out you can find out you can do a manual check or get a wearable I wear a whoop device on my wrist and look at your data. With the mobility work, you do yoga. Yoga's great example of a thing which is very, very good for us in lots of ways, mobility, for flexibility, good mentally as well. We won't take the box on the strength or on the cardio side.

And all data shows that as well. We need to do lots of stretching mobility work. But again, it's not going to give you what you need in the strength. So if you're choosing your week of workouts, and I sort of would point towards people perhaps who focus on doing politeness sessions and yoga sessions and so on, and they're working out. It's great, but it's not enough. We need to test you and challenge you and do those things because they're also great,

but they're not the mainstay. So how you construct you a week is about let's get the box ticking done over, we have to do these things over here, and the rest you can enjoy, because you might not enjoy the weight training, but if you don't enjoy it, say, well, enjoy, I'm not going to do it. That's fine, but you are going to probably have some issues with the bones and with the hormones and with the muscle structure and shape as time goes by. So there's a degree of, let's find the things that you like to do.

Let's make sure we take the boxes on. Did you do the things you had to do as well? Yeah, it's so important. And actually, a lot of it doesn't take that much time. You know, I've got free weights at home, which makes it a lot easier. So I don't have to factor in. If I factored in going to a gym coming home from a gym, that's probably as long as it is to actually do the exercise. And so it's very easy to take, make the excuses.

You know, depending on, you know, I'm quite happy exercising on my own. I don't need to be surrounded by other people, whereas other people do need that motivation. But it's having something that definitely is varied that's right for you. And, you know, one of the things I see a lot in the clinic is women who are fit and active, but then their fitness falls off a cliff because their hormones drop. And it's very easy to say to a hormonal woman, oh, you just need to exercise and then you'll be better. Well, actually, these women, and I found eight years ago when I was perimenopausal, I stopped

exercising because I had such bad muscle and joint pain. I had reduced stamina. I had loss of muscle strength as well and I knew I was putting on weight, especially in my midline. And so to tell me, oh, of course, just exercise. Actually, I couldn't physically. I found it really hard. But we know that all three hormones, estrogen, progesterine, testosterone, build our muscle as well as our bones. But I'm very interested in mitochondrial function. So as you've already mentioned, the mitochondria, the powerhouse of all our cells. We have receptors for eustodil, which is a nice form of oestrogen, progesterone, testosterone, on every single mitochondria. There's a good study showing that our mitochondria work better, especially with respect to sarcopenia and bone strength in the

presence of hormones. And so it's a combination. Obviously, our muscles will produce hormones as well as our brain and our ovaries. But it's that whole thing. So often people are told, well, if you exercise, you'll feel better, but they're not addressing the hormones. And, you know, hormone prescribing is half of what it was 20 years ago. And no wonder that people are less fit, more obese, because, you know, it's trying to run a car without diesel or oil or whatever.

It doesn't matter. Or electricity, depending on your car. But it's very hard. you've got to be looking and, you know, you mentioned about what we eat is crucially important. So many women I speak to aren't having enough protein. They think they're eating well, but they're not. And then they haven't got hormones, but they're still trying to exercise. And then they end up feeling like failures, and it's no surprise.

And that's where your work is so important as well, because it's looking throughout. It's looking at every single factor. Whereas I think so often you can just be siloed thinking hormones are going to control everything, or exercise is going to improve everything. And of course it's not. It's a combination, isn't that? Yeah. So a few points to absolutely.

I think that firstly, with the point of when someone is going through paramedopause, menopause and don't feel like being physically active, damn right you do. I mean, it's something which is, as a male, it's only an understanding looking at how someone gives me symptomatic feedback. You can see why someone would not feel like doing a great deal. And the answer to that is you go to pick and choose your moments because some days are better than others. On those days when you feel good, fine, use that day. That's great.

On the days when you just don't feel like that, there's no way you can push yourself. You go choose the things on those days. It will make you feel a sense of personal well-being, personal satisfaction, feeling whether you want to get some increase in vitality, get some calm, find some time. Whatever the thing might be, you find your exercise and your routine to suit that thing. But on those days when you can do something, then you'll make the most of that moment. But it might be there one in ten. It could be one in two.

And that would vary enormously. The prescription of hormones, it's a minefield. I think something which you're a huge expert in this area. And one thing from a point of view of me working with clients who go to sea specialists is there's still a great deal of uncertainty over people wait and can I do it without, can I sort of find another way, is there a way to do it naturally? And the answer in, I think most cases is there's not. I think that there needs to be intervention.

And that's where the regular testing, the regular consultation, the regular update, symptomatic checks are vital. And there needs to be constant adjustments. I think that from my point of view, a way to keep on to microadjusting over extended periods seems to make absolute sense in response to symptoms, in response to things that we see with performance in people, their ability to be energized in their workouts in their life, how they're sleeping, all these things, you just see things out clearly and you can't do anything, you're not good. So the intervention with hormones is vital for males

as well as for females. Females obviously have much more time with. Males, you know, TRT is without question, it's a huge and positive intervention for lots of males. We're seeing some data on males, as we know, personally in our testing in the clubs, but broadly is poor. So we have to have that. And then

combined with that right now, the issue we have increasingly with females, males who are going through the menopause is the concern over the weight gain. That's important point where they're using a Zempec and Wegevian and Manjaro to try to lose weight. And it's just fighting with the wrong tool. I think they're an interesting medication. I think they have a place clearly. I think they have some great upsides.

When used phenomenally tightly within a brief at a low dose, there's a good chance it gives people weight loss only if they're doing a very specific strength. program, and only if, as you said, their protein intake is high enough to sustain themselves and their muscle. Otherwise, it's a one-way street downwards. And I suspect, and I'd love to get your feedback on how much that increased use of the GLP-1 agitators, which these products are, is affecting hormone health. It must be, surely. Yeah, I actually don't prescribe them. And I'm too concerned about their long-term risks, actually, that I wouldn't be rushing and prescribing them. They probably do have a role, but I'm more concerned about or more interested in prevention, actually.

But also a lot of women, when they have their hormones optimized, all three hormones actually, can really make a difference because obviously menopause is a cardiometabolic problem, people's metabolism changes. But a lot of people, if they don't have adequate estrogen, the active, nice form of estrogen, they'll produce more estrogen in their body. And the fat cells produce estrogen as well as all sorts of other. inflammatory cytokines, chemicals. And, you know, Eastern is not good, but it's made in fat cells to people then put on weight because they're producing more fat. And so I'll often work very hard with patients to optimize their hormones properly in a physiological way. Think about how they exercise, really look at their nutrition, even, you know, looking at

their sleep, their mental health, because that can make a difference to their metabolism as well. and then wait because it can take three to six months to really have an effect. Rather than rushing into these drugs, which someone told me a few days ago actually, I'm not going to mention names, of course, but a menopause specialist. She had seen, she's absolutely, you wouldn't look at her and think she was overweight, which said, I've got a bit of belly fat and I went to see this doctor, and they said, oh, we could just give you a low dose of, you know, one of these drugs. And I'm like, hang on, no, they shouldn't be used first line.

Absolutely. I think it's so easy to just do this, whereas actually you want to put in habits that are sustainable that are going to really make a difference. And also you want to build muscle and you still need fat, as in good fat as well. Whereas I worry about some of these drugs, what they're doing to bone density, what they're doing with fat in the brain and the cells as well. And what they're doing to hormones, actually, are they having a negative effect on hormones in men and women? so much we don't know. And if we don't know, then it's actually better to think about the basics. And actually, it's interesting when people say they want to manage their menopause naturally,

because it is actually more natural to have hormones than not. It's not actually natural to live without hormones. So we just need to think, and even for men, testosterone's been labelled or mislabeled because sadly a lot of men are using testosterone that are synthetic, which are chemically altered, which are not the same, they're anabolic steroids. whereas the pure testosterone, of course, it isn't an anabolic steroid. It is a natural hormone that we produce. And a lot of men don't have it as they age for all sorts of reasons. So there's a lot we need to think about.

But I think the big message of this podcast, Matt, is about individualisation. And that's certainly, for me as a doctor, every patient's different, everybody's journey's different. And when you're thinking about exercise, everybody's coming from different beginnings, but also they've got different endpoints. And so making sure everything's tailored is crucial. So it's the new year. People are thinking hopefully more about exercise, movement, being healthier. So just before we end, three tips for those people that might be sitting here thinking it's all very well for them to talk like that, but what am I going to do? So what are the three things that they could do that's going to start for them to continue? Well, very simply, I mean, the one thing you should

definitely be doing fundamentally because it's very easy to do, is going to doing that zone two cardio we touched upon. So if you can make a goal for yourself, that each week, don't look it too onerous. Make it that three days in the next week and thereafter. You're going to do a 40-minute long, fast-paced walk with your level being about that seven out of ten. So you've got that slightly puffy feeling and do that.

That's one for sure. Anyone can do that, that's straightforward. Always to think about as well, making sure we build on that strength. So let's choose to do four or five key exercises. simple ones. So probably a squat, probably a lunge, maybe a step up, possibly a form of a press-up. They can make the easy versions. It can be on the edge of a table. It can be on the edge of a bench in the park, anything you like, and some form of a pull test. Now, that could be ideally some form

of a pull-up exercise. If it's in the gym, it's a pull-down exercise. Choose four or five things for the big muscle groups. And when you're doing those, think as we discussed before, the intensity, are you doing a level where going to about 10 reps roughly is a struggle? Is that where you're at? If you're starting from fresh, different, fine, but if you're into this already a little bit, are you doing that degree of overload for four or five sets of that? So high volume, the four or five sets, ten reps, and the last two reps you're thinking, I can just about do this.

And that should be your second go-to, those things, easy, twice a week. So all I want. If you can do more, great do more, but twice a week. And I want to then focus as well on mobility. And the mobility section is straightforward. You want to choose just probably three or four key exercises. If you only stretch out your thighs and your hamstrings and use some spinal flexion lying on your back,

pulling your knees towards your chest, and some rotation where you put your knees to one side lying on your back, those four stretches alone, give some spinal mobility some stretching in towards the limbs in the quads and hamstrings, and those alone give you a good start. So you've got a little bit of strength work in there, your cardio work in there, and your mobility in there. And those are the simplest ways you can do something. Beyond that, you can do much, much more. If you do in the next week, the cardio three times, the strength work twice, and mobility three times, perhaps post the walking,

then you're doing a pretty good start to your year if you're doing nothing else. Perfect. Great advice. And actually, hopefully, achievable. So thank you ever so much for your time, Matt. It's been a great pleasure having you on my podcast. My pleasure. Thanks for you inviting me. Great to see you. You can find out more about Newsome Health Group by visiting www.newsonhealth.com. And you can download the free balance app on the App Store or Google Play.