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Exercise and Nutrition Post-Menopause

Menopause is the natural cessation of a woman’s menstrual cycle. The average age at which this occurs is around 51 years although this varies person to person and can happen much earlier. A woman is post-menopausal after 12 months with no period (not related to other factors such as RED-S, relative energy deficiency in sport). The changes that occur at this time can end up reducing motivation and adherence to exercise. However, maintaining an active lifestyle, plus regular exercise and emphasising a nutritious diet can help to moderate the effects of those changes and help to sustain overall health and well being.

There are many recognised effects of menopause, again this will vary from person to person, including (but not limited to) hot flashes, night sweats, weight gain, hair loss, difficulty concentrating, sleep disorders, mood swings, headaches, incontinence, digestive problems. Less visible but more serious effects of menopause include increased risk of cardiovascular disease, changes to pelvic floor health (incontinence, prolapse, aches and pains), and stress or mental health issues, also, bone disease (osteoporosis). Bone density peaks around the age of 30 then naturally begins to decline. Within the first 7 years of menopause women may lose up to 20% of their bone leaving them at increased risk of breaks or fractures (particularly to the spine, hip, or wrist).

Many women experience weight gain at this time of their life. This is likely due to reduction in daily energy expenditure (general daily activity) which may be stress related or due to sleep disruption causing fatigue and lack of motivation. Changes in the body such as natural decrease in muscle mass reducing baseline metabolic rate, changes to where the body stores fat, and increased insulin resistance (the body is less able to use glucose from the bloodstream for energy) may also result in lower fat oxidation and energy expenditure when exercising.

The benefits of exercise are significant so it is important to find ways to workout regularly. Exercising for 4 hours per week is associated with a 19% lower risk of high blood pressure (compared to 1 hour). Lifting weights 1-3 times per week (1 hour overall) is associated with 70% less chance of heart attack and stroke. It also helps to maintain and/or build muscle mass which supports healthy bones. Exercise can also be very useful in helping to regulate mood and energy levels. The best exercise is something that you enjoy and leaves you feeling energised (even if physically tired) after the session. That could be anything from a Zumba or pilates class, to badminton, working out in the gym or with a personal trainer. Include at least one workout a week that challenges your cardiovascular fitness by pushing the heart rate up and leaving you a little out of breath. When training with weights aim to include exercises that work all the main muscle groups: legs, back, chest, shoulders, arms, core (example here). Walking is also beneficial and many people find it helpful for improving mood. When advising clients I always recommend finding a weekly timetable for exercise that fits in with other responsibilities. Making it part of a routine helps with adherence so on days when motivation is lower there is momentum there to help carry you through.

Nutrition is an important factor in weight management and for overall health. At a simple level body fat percentage is regulated by energy in versus energy out. Gaining body fat is likely due to having increased calories in and a combination of lower activity levels and a natural reduction in baseline metabolic rate. While exercise can help, particularly through resistance training helping to maintain muscle mass, managing calorie intake is going to help most in terms of balancing the equation in terms of reducing or maintaining weight.

Ensure the diet includes plenty of fruits, vegetables, whole grains and protein rich foods. Including 20-30 grams of protein at each meal is important for ensuring the body has what it needs to repair and maintain muscles. It also helps with satiety and feeling full which may be useful in managing portion sizes and reducing snacking. Fish oil may be beneficial for heart health (but check this with a GP as some medications are not compatible). Calcium rich foods support healthy bones and milk is also very good for hydration. When making changes to diet it is sensible to start gradually, for instance switching to a different breakfast or skipping a regular snack, and notice how that affects energy levels and mood. The body needs fuel to perform and food should also be enjoyable so be mindful and consider how any changes you make would work for you long term.

The transition through to post-menopause is different for each person and it may take time to find the right balance of exercise and nutrition that works for you. Remember, the ultimate goal is to improve quality of life over the long term and to support your health and happiness so that you have the energy and enthusiasm for the things you want to do outside the gym.

For individual advice about this topic contact me for a free consultation.

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