Over the last 30 years, the Fitness industry has evolved from the gym being mostly for “muscle heads” – and certainly not a place for a teenage girl – to a more inclusive environment – over all age groups and across genders. Today there are so many more fitness options to choose from, whether it be Zumba, Spin, Bar, Yoga or Crossfit, just to name a few, and today’s gym is most certainly a place for male and female high school and college athletes. But one of the fastest-growing demographics seeking to improve their physical fitness is the 40+ year-old woman.
This month I had the opportunity to take a course called “Menopause for Athletes” by Dr. Stacy Sims, exercise physiologist and nutrition scientist. I have spent 15 years of my career taking care of women in all phases of reproductive life, as well as becoming a Crossfit Trainer and Nutrition Coach. But this course was able to tie it all together.
Why is the 40+ woman special? Well, we have seen quite a bit of life, maybe raised children, solidified our careers, taken our “bumps” and celebrated some victories. As a result, we are wiser, more centered, care less about the “status quo” and are ready to conquer the next half of our lifetime! But in the midst of all this empowerment, our bodies are changing. But what I learned in this course and in my experience taking care of women, is that these changes are not the end of us; they are actually the beginning, and present new opportunity to embrace change and conquer it to make us better, stronger, faster and fitter!
So what is changing and how do we deal with it? Here are some tips!
Insulin is a hormone secreted by the pancreas that helps move glucose (sugar) into our tissues. When insulin is not working properly, more glucose is stored as fat. From age 40 and beyond, our hormones are transitioning after a long reproductive life. As a result of greater hormonal fluctuations during this time, our bodies become more resistant to insulin. This is why we get that little “pooch” around our middles and feel more “squishy”. So what do we do?
- Be mindful of refined sugar intake (a.k.a “added sugar”, sweets, breads, pasta) and reduce this intake.
- Work those muscles!! Your muscles are one of the greatest utilizers of glucose in the body (next to the brain), so much so that they have a second metabolic pathway for moving glucose into the tissue – the Glut4 pathway – which is independent of insulin. The more you move and work your muscles, the Glut 4 pathway kick’s in and moves that glucose to a place that can use it rather than store it as fat, taking some of the load off of your insulin!
- Focus carbohydrate intake around physical activity – within 1-2 hours before and within 1-2 hours after. During these periods, the body is either prepping for glucose utilization or recovering and thus using glucose, again, instead of storing it as fat. That does not mean restrict carbohydrate only to these times (that wouldn’t be healthy), just move some of your daily carbohydrate intake around activity, and have a little less during times of rest.
Decline in Bone Density and Muscle Mass
Estrogen is the dominant female hormone during our reproductive life. When we are having regular menstrual cycles, the estrogen exposure helps to build and maintain our muscle mass and bone density. Once estrogen declines as it does in our 40’s and beyond 50, our bone density and muscle mass decline with it. So what do we do?
- LHS – Lift Heavy Stuff! Resistance training is one of THE greatest things we can do to maintain our bone density! When the stimulus to build bone and muscle declines with less estrogen around, we can compensate for that stimulus with a new stimulus, and that is weight training.
- Plyometrics – The key here is multi-directional: running, box jumps, jump rope, sports – incorporating a variety of plyometric exercises provides another stimulus for bone-building and maintenance.
- Vitamin D and Calcium intake. They go hand in hand to build and maintain bone density. It is recommended that women in most age groups consume 1200mg of Calcium daily. Dietary sources are best but calcium carbonate or calcium citrate supplements are good too. Always check with your doctor. Vitamin D supplementation recommendations depend on sun exposure – here in New England, we all need it during the winter months! 1000-2000 IU per day is typically a safe range.
- Protein intake. Always include a variety of sources including plant, animal, nuts, seeds, tofu, and dairy as tolerated. As we need to work a little harder to maintain our muscle mass as estrogen declines, we need to ensure that we have the building blocks to do that. There are some studies that suggest 2-2.3g of protein/kg body weight works well for maintaining muscle mass in the in active, exercising peri/post-menopausal woman.
Ever wonder how the little 70 year-old lady tears her rotator cuff carrying groceries? As we age, the absence of estrogen leads to more laxity in our tendons and ligaments (they have estrogen receptors too!). Coupled with declining muscle mass, this can lead to less stability within our joints and increase our risk of injury. The operative word here is “can” – because it doesn’t have to be this way! What can we do?
- Core Stabilization Exercises: Focus a portion of exercise time on core stabilization work. Rotator cuff exercises (Crossover Symmetry is my fav!), planks, oblique twists, situ ups, back extensions – just to name a few; and LHS – “Lifting heavy stuff” requires tremendous core stability and is all the more reason to make it part of your exercise routine.
- Yoga. Incorporating Yoga practice into your wellness routine builds and maintains core strength and stability, balance, body control and mindfulness; all strengths and skills that become critically important for our vitality as we age.
A Word About Stress
Stress reduction is important during our entire lives to remain healthy, happy, and to be good partners and parents to our children. But as we age, the negative impact of stress can become even more problematic for our health. Cortisol is a hormone that is secreted under times of stress – this could be physical stress or mental stress. We all experience stress in short bursts. This is healthy and our bodies are designed to adapt to this and recover to be stronger. But prolonged stress – and thus prolonged exposure to Cortisol due to overtraining or ongoing life stressors – can result in insulin resistance, an inability to recover, and suppression of our immune system. Our 40’s and beyond is a time of our lives where we become a little more insulin resistant and recovery/sleep become a little more challenging to achieve. So stress reduction is paramount to keeping us balanced, healthy and happy!
Our forties and beyond is a time to celebrate our accomplishments, our strength and our wisdom – and also our ever-changing physical selves! So ladies, join me in kicking 2020 to the curb and saying “Bring it, 2021!”
Carla DiGirolamo is Board Certified in Obstetrics and Gynecology and Reproductive Endocrinology and Infertility specializing in the care of women through all stages of life. She was named among the Top Doctors in the Boston area by Boston Magazine in 2019, 2020 and 2021. She is also a Crossfit Level 1 Trainer and member of Crossfit Health, Les Mills BodyCombat/BodyPump Instructor and Certified Precision Nutrition Level 1 Coach.