Training and Nutrition Considerations for Menopause
There are few things women like to talk about less than menopause. But to optimize your health and fitness results during this critical time, you need to think, and yes, talk about it. Your body is going through many drastic changes that, among other things, will have an effect on your ability to train and the results you can expect from that training.
As a man, I have never and will never go through menopause. However, my experience with numerous clients experiencing menopause has given me insight into what to expect from your training. While I cannot speak to the daily realities of navigating menopause, I offer guidance for understanding how these changes affect your fitness and weight-loss journey.
Regardless of your age or gender, the quickest way to derail your training motivation is to compare yourself to others. Comparison leads nowhere but to discouragement or false pride, depending on who you choose to compare and how you each perform on a given day. Both options are meaningless. If you are approaching or experiencing menopause, you have probably discovered the futility of comparing yourself to the younger women in class, let alone the men. However, it is easy to fall into the trap of comparing yourself to your direct peers, especially close friends at a similar stage in life.
Know that menopause is like puberty; it is simply a broad term that we use to describe a whole set of physiological changes. Everyone will experience these changes at different times, in different ways, and to drastically varying degrees. We find several universals, but menopause is much more defined by the immense differences and unpredictability than by the similarities.
All women begin menopause at different ages, and the symptoms and severity vary widely. Your personal genetic makeup and reproductive history play key roles. For instance, women who have many children tend to enter menopause younger, and women of Asian descent tend to experience less frequent and less severe hot flashes (although many studies credit this to dietary factors; more on that to come). Your lifestyle and diet also play critical roles in how and when you experience menopause. This article aims to offer guidance for understanding how you can adjust your habits and practices to optimize your health and happiness as you navigate this transitional period.
How Menopause Effects Your Fitness and Nutrition
Insulin Sensitivity and Carbohydrate Tolerance
Many women experience significant and seemingly unexplained weight gain during menopause, while others do not. Many factors could explain this, but decreased insulin sensitivity is a likely culprit. This is a complex process but essentially, insulin is the hormone that instructs your body what to do with blood glucose. Our bodies produce insulin to communicate to our cells to take up blood glucose to use as fuel or store as glycogen.
Decreased insulin sensitivity (also referred to as insulin resistance) means that your body is less sensitive to the effects of insulin. This means that your cells will not take up blood glucose as effectively, leaving higher amounts of glucose in circulation eventually to be stored as fat. While this occurs naturally with aging (in men also), it seems to become especially noticeable during and after menopause. Your relationship with food becomes ever more important as you move into this period of your life.
Related to your insulin sensitivity, carbohydrate tolerance describes your body’s ability to utilize carbohydrates. Carbohydrate tolerance describes roughly how many carbohydrates you need in a day, at one time, and at which times throughout the day.
Your carbohydrate tolerance and insulin sensitivity vary with the hormonal environment in your body. In addition to during and post-menopause, you become much more susceptible to storing body fat and feeling low energy from stresses such as alcohol, insufficient sleep, and a stressful lifestyle.
If you have an established nutritional plan but notice that your body is responding differently as you move into menopause, you probably need to re-examine your carbohydrate intake. Avoid high carbohydrate meals at all times except post-exercise. Prioritize non-starchy vegetables and proteins for these meals.
Use the following guideline as a starting point for how to fill your plate:
- Fill more than half your plate with vegetables. Seek a wide variety, but avoid starchy vegetables such as potatoes, yams, etc.
- Fill about a quarter of your plate with a protein source: red meat, chicken, eggs, or seafood from humane and natural sources, or a vegetarian source such as beans/legumes.
- Use healthy fats to reach satiety. Fill the rest of your plate with healthy fat sources; as much as you need to feel satisfied but not full. Seek roughly an even one-third split between monounsaturated (most nuts, olive oil, avocado), polyunsaturated (fish oil and most seeds like flax, hemp, and chia), and saturated fats (coconut oil, palm oil, and animal sources).
For post-exercise meals, make a few tweaks:
- Up your protein portion to roughly half of your plate.
- Make an allowance for starchy vegetables and grains.
These guidelines will help you to mitigate the fat-storing effects of decreased insulin sensitivity and ensure that you get sufficient dietary fat. Do not be afraid of dietary fat; your body requires it for many key functions, especially during menopause. Saturated fat will aid in the manufacture and balance of your hormones. Dietary fat also helps absorb and transport fat soluble vitamins, many of which aid in mineral allocation. This is a key function for building and maintaining bone density, perhaps the more prominent physical effect of menopause.
During menopause, deepen your relationship with your body and increase your commitment to health and wellness. [Photo credit: J Perez Imagery]
Nutrition for Bone Density
You will likely lose bone density during menopause. This is perhaps the most universal symptom of menopause. Fortunately, you can mitigate or forestall this effect with some adjustments to your nutrition and training.
Peri- and post-menopausal women lose bone density because their calcium absorption drops drastically during this time: as much as 50% from when they were an adolescent. Before you run out and buy calcium supplements, understand the root cause. Quite often the shortage of calcium is a problem of absorption and allocation rather than of insufficient intake. It is possible that you are not consuming sufficient calcium, but it is far most likely that the calcium you do eat fails to reach your bones.
To ensure optimal calcium absorption and usage, prioritize vitamin D. Natural, unfiltered sunlight remains the absolute best source of vitamin D. To produce vitamin D, we need UVB rays to directly contact our skin. Note that glass and sunscreen can block as much as 99% of UVB, rendering the sunlight you absorb through these media virtually useless for vitamin D production. Get outside and soak up those rays! As little as 20 minutes of unfiltered sunlight can provide sufficient vitamin D each day (this depends on your skin tone, time of year, and location on the Earth).
Vitamin D supplements (both D2 and D3) prove effective for those who cannot produce enough naturally. The recommended amounts vary significantly by individual and supplementing in excess can have ill effects. For accurate dosing consult your doctor, but general recommendations can be found here.
Now that you have ensured optimal vitamin D, we can talk about calcium itself. As with vitamin D and every other nutrient, the Earth-grown forms are best. Seek foods naturally high in calcium such as leafy greens, legumes, nuts, and seeds. Perfect, these are already on your plate from moderating your carbohydrate intake! Calcium supplements can help those with very low absorption but most everyone can fill their calcium need through natural sources.
The final and most critical method to maintain your bone density comes through avoiding a net-acidic diet. Meats and grains have a net acidic effect as we break them down, while fruits and vegetables have a net basic or alkaline (the opposite of acidic) effect. Your body has an amazing ability to balance the acidity of your nutritional intake to create the level it requires. Unfortunately, to balance acidity your body uses its stores of minerals, the most abundant of which is your bones. Your body will actually draw calcium and other minerals from your bones to use in neutralizing an acid diet. Prioritize significant portions of fruits and vegetables to balance the acid/base ratio so your body does not need to use minerals to do it for you. Also, avoid large quantities of pro-acidic foods like meats and grains.
Exercise for Bone Density
Many women nearing menopausal age have an established regimen of yoga and cardio-focused classes. I would never advise removing classes or exercises that you enjoy. However, if you fall into the category of women who do not incorporate any resistance training into their program, you are doing nothing to mitigate the almost certain loss of lean mass and bone density. Sorry, those 5lb dumbbells and 10lb kettlebells from your cardio classes do not provide enough resistance or loading.
You need heavy resistance training to maintain and improve your bone density. Understand heavy as heavy relative to your size and strength. Know that you do not need to lift tons of weights or bulk up. You simply need to test the limits of your physical strength. Use movements like the following to safely apply heavy loading to your system. Prioritize using the heaviest load you can handle safely. These movements are all about full engagement and time under tension.
- Deadlifts: If you feel comfortable and confident, use the barbell deadlift. For a safer option try suitcase deadlifts with a heavy kettlebell or dumbbell (or bag of groceries or jug of milk) in each hand. You can make these safer still by starting with the weights elevated on a small box. Move slowly and even add a long pause at the top to increase your time under tension.
- Farmer’s Carries: Pick up a heavy weight in each hand (suitcase deadlift) and carry them. This will add stability challenges to your heavy loading.
- Yoke Holds or Walks: Stand or walk with a barbell or yoke on your shoulders. As with the farmer’s carries, walking provides a great challenge to your balance, focus, and stability. For safer loading, skip the walk and just bear the weight and stand. Focus on your posture and position. Simply being under heavy load will stimulate increases in connective tissue strength and bone density.
- Sleds: Push or pull a heavy sled. You can do this fast or slow as long as the primary focus remains on work capacity.
Your body might naturally be losing bone density, but you do not need to accept this as a sentence of osteoporosis or frailty. With a few adjustments to your habits, you can maintain strong bone health late into life.
Maintain and Build Lean Mass
Like bone density, most women begin to experience losses in lean muscle mass as they enter menopause. Also as with bone density, this does not have to mean an automatic sentence. Maintaining a strong (not to mean huge or bulky) amount of lean mass helps optimize health for everyone regardless of age or gender. Mid-life and menopause both typically lead to significant loses in lean mass. Maintaining and building lean mass is now more important than ever.
Muscle mass is not only important to maintain your strength and vitality. Muscle tissue demands fuel and will take up blood glucose when instructed to. Building and maintaining lean mass are great ways to stave off the effects of decrease insulin sensitivity. This in turn supports a healthy level of body fat.
Incorporate heavy resistance into functional movements to get the greatest benefit in building and maintaining your muscle mass. Favor movements that support your everyday activities. Some of the best options are:
- Weighted Lunges: Walking lunges provide the best challenge to your stability. Scale with stationary lunges (split squats) to progress toward walking lunges.
- Push Ups: Full range of motion push ups with chest to the floor. Scale these by elevating your hands on a box or wall or performing them from your knees, rather than shortening range of motion.
- Ring or TRX Rows: These offer an infinitely adjustable scale for pull ups. You can walk your feet forward and back to adjust the difficulty. Add a static hold at the top and a slow decent to increase the muscle-building benefit.
With a few tweaks or additions to your exercise program, you can maintain and even increase your lean muscle mass during menopause.
The Final Piece: Stress
Controlling stress will help mitigate the other emotional and physiological symptoms like insomnia, irritability, and hot flashes. It is more important than ever to eliminate (or at least moderate) the stressors in your life. Avoid high amounts of caffeine and alcohol. Avoid foods that cause inflammation like sugar, grains, and dairy. Get plenty of sleep, and take up stress relieving activities like walking, meditation, or yoga.
Layered Strategies for Compounding Effects
Remember that your experience of menopause will be entirely unique. Understand what types of symptoms you can expect, and the patterns you can change or introduce to mitigate them.
Most of the recommendations herein are interrelated. For example, if you adjust for increased insulin resistance by eliminating starches, sugars, and grains and prioritizing vegetables, these habits will also help to maintain bone density by providing more dietary calcium and reducing the net acidity of your diet. Taking a walk outside is both stress-relieving and an opportunity to catch some rays to up your vitamin D production.
Menopause means many big changes for your body. But menopause also offers the opportunity to deepen your relationship with your body and bring your commitment to health and wellness to an all-time high.
You don't have to be along for the ride: