Exercise Lies in Menopause

Hello. Hello, everyone. It's Doctor Sharon Stills welcoming you back to the Mastering the Menopause transition. I am excited to see you all again, and we are going to have such an important conversation today that I am personally super excited for myself because we are talking with the master of exercising and how to do it right and what you're doing wrong, and what you need to know when you're going through perimenopause and menopause.

And so if you are like, I've been gaining weight or I do my exercise and nothing's helping, this is the conversation you're going to want to hear. And to me, it's all about bringing in people who know, like I'm a physician and I make sure women exercise, but I'm going to learn along with you all today.

So this is going to be a good one. And my guest is Deborah Atkinson, who is flippin 50. She is a functional health coach. She's a hormone balancing fitness expert.

She has held 250,000 women, probably more than that. Flip their second half with vitality and energy. I love her tagline, which is the title of her book, You still got it, girl.

That is like the best tagline ever. She's been a TEDx presenter. She just has a long, long list of credentials and accomplishments and just amazingness.

And so welcome Deborah, I am so excited to have you here today. Well thank you. Flattered by that. Okay, totally totally true. Totally from the heart.

I am like, because it's true. Just because you're a physician and you work with women doesn't mean you're an exercise expert. And it's really important that we all kind of have our lane and we learn and from each other.

And so your lane is a really important one. And I guess for starters, I just love for you to maybe tell us your story, how you got into this, why you're doing what you do.

I would love to hear that as well. Okay. So we'll go way back. You know, I never intended growing up to be a fitness professional. And really, you know, if you think back to when we grew up, at least I'm 58.

I mean, fitness professional wasn't really a thing, like, you know, career day. That one was not on the board yet. But I became somebody who was exercising more regularly self-initiated.

Right after high school. And it was the first time, you know, that I'd really, like, gone for a walk or gone for a run, not because a coach said, you have to do this, but because I actually enjoyed it.

And I started started enjoying the benefits far more when I was doing it that way as well, which is a great tip right away because I would just for anybody who's a little reluctant, that's a that's the best place to start or something you enjoy. But I had one put in graphic design for two years and back in 19 that would have been 1980 for everybody in graphic design in the arts, smoked, drank and stayed up all night to do their projects.

And I was like becoming healthier and healthier. And I'm like, I don't fit in here and I don't want to do it this way. And so I flirted a semester with one major and the other, and I by the end, I had some great instructors, and I realized what I wanted was to help a lot of other people feel the way they had made me feel empowered, like I had more energy, like I was more creative to do the other things in my life.

And, you know, so that's really, I think, been my mission all the way along is to help people be a better mom, a better spouse, a better boss, a better employee, a better whatever, and enjoy the ride more themselves while they're doing it, you know, and getting better biceps and going sleeveless.

That's all icing on the cake, but it's not the real thing. And so that's how I landed there, how I landed specifically narrowing down to women that we are talking to right now is a bit of an accident.

Nobody intentionally has a midlife crisis, but I did. And, you know, at 49, I quit my job on purpose. So I created that havoc and that brought with it, you know, things that were happening the same year my son left for college.

So I've got this empty nest now, and he's getting a life, so I needed one. And, you know, I jumped in with both feet. I literally quit everything. I didn't inch my way in.

I said, I'm going to build this online business. And I had no idea what I was doing. I knew fitness, face to face, body to body. I didn't know how to build a course.

I didn't know how to get online, I didn't know anything. And there wasn't all the help that there is today because of the pandemic, certainly. So there was a big learning curve and, a relationship fell apart.

So my soundboard was gone. So, I mean, in about 14 months, I had about eight major life stressors. And I found myself not letting myself away from the computer because this was where my future was.

I was building this course. And so I became somebody who was exercising maybe 20, 30 minutes a day. And I had been somebody who exercised hours a day for the last 30 years.

And about a year later, I realized I was thinner, I was leaner and stronger and healthier looking, and people were asking, what are you doing? And I'm like that my, you know, like, so, you know, that flew against everything that I had learned, you know, exercise more, eat less.

Right. That's certainly not what I was doing. And, you know, so I said, okay, I'm going to dig into this because I had taught for 15 years at Iowa State University in kinesiology.

And I'm like, for years was I saying the wrong thing? You know, I, I because this is not what I was telling people to do. And what I discovered is that only 39% of all exercise in sports medicine research features women at all.

And so if you look at all the hormone phase changes in our lives, you know, we could say that there's seven now, some people go through them more. They have multiple babies, for instance.

Other women don't choose to. Or maybe I'm blessed to go through all of them, but on average, they're seven major hormone changes, and every single one of them demands a unique exercise prescription.

So if we're just exercising, you know, and just going to a program and we're standing in a room with men and with women and with all ages potentially, that exercise prescription for the program wasn't designed for any one individual.

So it's been like gambling, if we didn't know to ask was this program designed for me based on women just like me? Chances are no, because most of the research is done on young, athletic males.

They're easy. They're easy to find. They're easy to deal with. They have fewer hormones. And exactly the reason that we're hard to research is the reason we need to research us.

Exactly. Right. But it's and it's slowly coming around because we're we're beginning to demand it. And we're beginning to pointed out that this is this is wrong and it's an injustice and it's not fitting for us.

So functional fitness really has has been a buzzword for a long time. But I would say it's not the word that you think it that it is. It's not the stay off of the machines and only do dumbbells, because I think a machine can be very functional depending on your goal, but functional related to hormones and related to your signs and symptoms and how you feel as opposed to a quota.

That's what flipping 50 is all about, is, yes, there's a better blueprint based on the research of women. But then there's also let's talk about you. And are you feeling like you can do that, or do we need to maybe reset and restore first.

And when you are restored, we can progress. And it's not not at all a time when you need to or have to slow down. If, if anything, we need more intensity in our exercise than we've ever needed before, if we feel good and are able to do it so the the bottom line, the umbrella for me and for flipping 50 is I think there's no more powerful health influencer in the world than a midlife woman.

She's got three different generations looking at her. You know, our young adult kids are looking at us are our friends. I mean, where do you get your advice from for exercise?

Right? You better be me, by the way. But, you know, and your your partners, your spouses and then parents and in-laws, they're looking at that midlife women.

And so whatever you're doing in one way or another, you're influencing good, bad or ugly. It's happening. So that's what keeps me getting up in the morning.

That's just fantastic. So I have so many questions. So seven hormonal changes. So let's talk about the do you want to just maybe talk about them really quickly.

And then we can spend more time on the menopausal change. Yes absolutely. So first of all of course just reaching puberty. Right. So when we're talking and unfortunately right now I mean that happens with fifth graders, you know, I mean younger and younger because of our obesity problem somewhat.

But, you know, let's say you've got an adolescent teen, you know, what you want to do with that teenager is going to be very different than what you do with somebody prenatal or post-menopausal.

We want we want them doing some impact. We want them creating bone density while they can. And although you may not relate that, I mean, that is a hormonal change.

They still have an open door, open window to put deposits for bone in the bank until about 30. So we want to keep having them do things like jump rope.

You know, if you're going to give a gift to a child for exercise, swimming is great. It's great for muscles, but it's not really going to help their bone.

So gymnastics or a jump rope are fantastic things to do with them because it helps build that bone density. So those kinds of things and getting girls comfortable moving and loving their bodies, no matter how they're changing.

I think so very important during that stage that then they're hearing also from those of us older positive statements, positive thoughts about the way we feel about exercise, about the why we exercise.

I think we're we're influencing them by those things as well. So then there's, you know, there's a couple stages here, but there is young adult when we don't want to be pregnant.

Right? I mean, there's that, you know, and then there's prenatal, which also we don't even include this in the seven. A woman who wants to or needs to go through infertility, you know, she's having problems.

That's that's a whole nother animal. And she's going to have more of a roller coaster ride that's going to influence her need to exercise, her desire to exercise what's happening with her body is going to change.

So adjusting to that as well. During pregnancy, obviously we've gotten totally different goals, but exercise is definitely now finally, you know, grasp something that all pregnant women ideally could do.

You can start, you can continue and it should be relative to you and your needs. And of course, then if you've got any special needs, we cater to that postnatal.

You know, if it took a year to build a body, you know, it's going to take you a year to recover from that. And I don't know, I like to say probably mine took 18 years.

I don't know. That was just the sleep deprivation keeps on giving right. But there's that. And then, you know, a lot of women, oddly enough, can be layering there in their in postnatal and they're in perimenopause and at the same time.

So I mean, we've got a double whammy for a lot of women. And then menopause although you know, you know, menopause and I'm preaching to the choir here.

But that's just a blip right. It's 12 months since your last period when I'm talking to fitness professionals, I like to sometimes break it down into perimenopause and menopause, even if it's hindsight or looking at that and post menopause, where menopause is that time, the last two years of perimenopause and then the first 2 or 3 of post menopause, because during that stage in age we know there's a more rapid possibility we lose muscle and lose bone density.

So even if you didn't know you were, you're coming to an end like it's month seven. In this month eight. For some reason, it doesn't happen like that for all women, I've found.

But we do know when it happens. You've got a couple years there when hopefully that wakes you up, that you're not strength training. We need to be strength training.

If you're not addressing your protein needs, probably we need to do that and in conjunction with strength training because the two together really help muscle protein synthesis.

So post menopause, I like to say I remember at first when I began flipping 50, women were like, well, what about flipping 60? Or I'm way past that, so I don't have to worry about that anymore.

But I like to say, I mean, it's till death do us part, right? I mean, we're going to be impacted by our hormonal changes until death, and we certainly have hormones until death.

So cortisol and insulin are always going to be there. Okay. So you mentioned strength training. You mentioned protein needs. Do you have like formula for the women listening.

Is there some kind of average of how you should think about how much protein you get? Is or are all proteins made equal or what are your type of recommendations in that area?

Yeah. Great question. So this is I know this is a little bit of a bumpy road. It's a little bit of, you know I feel like I need to say a disclaimer. It's not my job to persuade anybody.

And I'm not going to judge any way that you might be eating. So I think no matter how, if you're plant based, if you're animal based, that's not the the concept.

But what we know is that, you know, animal protein is different than plant protein or, beef, for instance, or bison or elk or venison is different than the quality of the essential amino acid profile in, say, turkey or chicken.

So it all varies slightly. And what you're looking for is I like to think of a New York skyline, you know. And then there's me. I'm from a super small town in the Midwest, and the skyline just is not there, you know?

And so you're looking for a protein profile, something that offers you New York skylines, where everything is high and all the essential amino acids in it are high.

Instead of that Midwestern small town, you know, there's barely a bank in a store in a bar, you know that or that I'm making a skyline and they're not very tall.

And that's the difference, you know, if we can use that analogy. So what's important about protein is, yes, choosing the right quality. And for a lot of my plant based, followers, what they will often do.

And we agreed that, you know, at a certain point, especially a plant based, because so many protein sources are high in fiber, we get to a point where you're so full, you actually can't eat all of the protein.

You know, that the the RDA, many of us believe are antiquated. And there's been research out since the 90s that still isn't mainstream. It's I think there are a lot of influencers now talking about it, but it's still not something that everybody in your family, if you sat around the table and said this, would believe that your body weighed in pounds, ideally.

And if you need to lose weight, it may be closer to your your ideal or your lean body weight in pounds in grams of protein per day. But it's like a bottle of penicillin.

If your doctor said you need to take this, they're going to say you need to take this three times a day and this dose at each of those three times. And that's what we know about protein as well.

And that even distribution throughout the day over the course of meals, not just one big uncle Buck steak at dinner time, you know, or skipping throughout the day.

It works best if you get that dose multiple times, especially as we get older. So if we're over 50, that's true. But as we get to be 70 and 80, it's going to be even more true that we need that pickup at those different points during the day.

And so the irony is also this, that the more active you are, the better you are at using or synthesizing protein for the benefit of your muscle, for gaining strength and keeping that muscle mass so you have better metabolism, but the less active you are, the worse your muscle protein synthesis.

So it might be the opposite. If you thought, well, I'm not an athlete, so I don't need that. In fact, you know, aging older adults who are sedentary potentially need it more because they don't actually digest and break down those proteins for the use of their body as well as an athlete, athlete or athletic person.

If you exercise intentionally, we're just going to call you an athlete today, okay? Yeah, yeah, I will own that. Yeah. Feels good I love it. So that's so just to repeat it was your weight.

So if you're 125 pounds and it's 125oz, a protein in divided doses throughout the day and animal proteins are superior. Yes. And so if you, and I learned this the hard way, I was one of these, like, crazy vegans in my early 20s.

And I'm blood type O. And so we really need protein. We are like the carnivore blood type. And I never felt good as a vegan. I was always sick. My periods were messed up and but I was just so righteous about not eating anything with a face.

And then finally I had this moment where I thought, you know, I want to be impacting in this society and participating and giving my gifts and helping people.

And if I don't feel good, then does it really matter if I'm not eating animals? And so I started to eat meat and it like, changed my life on health wise on every level.

And I do my best. You know, for those listening, I'm conscious. I give thanks to the animal. I eat grass fed, I eat organic, but sometimes if we're doing something and we're not doing and it's hurting our health, sometimes we just have to take a look at our reasons as why we're doing that.

And I do have patients who are vegans and we work, you know, we work together, but sometimes it's like hurting yourself when you're trying to do something good, but you're hurting your own health.

Yeah, I love that. And I think that, you know, backing up to where we started, you know, it's not my not my intention or job to persuade anybody, but I what I think anybody should be doing is, you know, looking at the numbers like how is it impacting you?

And of course, yes, you know, how you feel. There's that and how you're sleeping and your libido and those kinds of things. But the way I want people to look is, you know, measure, but not just on the scale.

Measure your percent body fat, measure the amount of lean muscle you have. And especially after 50, we want to watch that. We want to guard it and we want to hold on to it.

We certainly don't want it to to to go down. So we want to be doing the strength training and eating in the way that helps us either maintain our muscle or gain our muscle.

And that is possible at any age. It's been proven. I find that, some of my plant based people will do supplements. They'll take amino acid supplements in order to give them that extra bump.

And I'm a I'm a huge advocate of food first, because we need the other micronutrients from the food. You're not going to get those in a pill, but then you get yourself as far as you can.

And then when you need a little help, then the supplement, I think is there. When it's when it's called for. So. So we love you vegans. We love you vegetarians.

But we're we're just saying there's lots of different ways to think of it. And options. Yeah. Just to keep it clear here. So you mentioned measuring. So is there.

So should we throw out our scales. Should we have a certain kind of scale. Let's have the scale conversation. Yeah. So throw out your old scale potentially. Yes.

Or if. Yeah you're right now it's not in the budget. Hang on to that scale. But also then make sure that you get a tape measure and you're measuring your inches.

So I call that the poor women's, you know, body composition and scale. Because if you're weighed on, the scale is not changing. However, your inches are positively changing.

And for some of you, I think it's unfair to assume everybody here needs to lose weight. Some of you probably feel you need to gain weight. Maybe you're on the frail side and we don't want that to happen either.

When we're in our 50s and 60s, because 20 and 30 years from now, that doesn't look good, right? So whatever it is that you need, but you're seeing those changes happen.

And for some it's not a huge loss or gain in total, but it's a change where maybe you're losing it around the belly where you need to. If it was gaining and you were at risk, because that's where we carry risk for heart disease and other diseases as well.

So I love the smart scale for anybody who can, you know, budget for that and afford it. They're actually very affordable now. But a smart scale will measure for you right at home in the comfort of your own bathroom in the bath.

You can do this any morning you want to measure for you your body composition. And we should be clear here that body fat percent is not the same as what you're familiar with.

As BMI. Body mass index is just. You can tell me that by looking it up. It's it's your height, your weight. So we need to know is that BMI full of muscle or is that full of fat.

Because your health is very different based on that. And you know, worst example probably here I can't think of a female that Arnold Schwarzenegger, you know, you can imagine him.

He was very short, right. And stout. But he was Arnold, right? He was no. And he would have a terrible BMI, although he was like 100% muscle, you know, back in the day.

And his example is that although his BMI is probably just off the charts terrible, he was very healthy. No, based on lean muscle mass to fat ratio. So you want to be sure that when you go to your doctor, your doctor still does use generally BMI as a measure and it has some degree of help.

The body composition is really what you want. And if you can go deeper, we can do the math ourselves. Your total weight minus your fat weight. We'll know what your lean is.

That'll include your bone in your organs and your muscles. But we know your bone in your organs are probably not going to change much. If we see change, we're going to see it in your muscle.

So knowing that is really a great benchmark. For what impact are your habits, your exercise habits, your nutritional habits, sleep habits, even having on your lean muscle mass.

Okay. So the smart scale it's smart scales. So let's talk. You mentioned strength training but I sure I mean I'm included in this as a postmenopausal 54 year old.

Am I doing the right exercise. What kind of exercise should I be doing. You said it changes. Should I have been doing different things in perimenopause or now that I'm post menopause, like what's the scoop? So great question.

So so in general, if I can give you a general blueprint, let's talk about if you if you aren't feeling really good, you're you're going through a rollercoaster and perimenopause and you're not sleeping.

We wouldn't want to say just do this. This is what you do no matter what. Feel good, feel bad. We wouldn't say that, right? So it does need to change.

If you're not feeling good, here's how we'll change. We'll talk about that. But here's what we know from the research for women's, specifically in menopause as they're studied.

And this goes for a little bit broader men and women. But I think we can add to it. And I'll have you vouch for this. So you you see a lot of midlife women, we know that it's even more true for them.

There's no difference at all between the benefit of getting 2 or 3 times a week strength training. So that said, what's everybody's biggest objection?

Time generally. Right. I don't have time to do that. I don't have time to exercise two supports a little bit less time. We have to do that. But women that I meet who want to get fit want to feel better, maybe feel like I am.

I've got this stubborn body fat that I can't get rid of, almost always are already tired before they come asking for that exercise program. So to pile on more stressors because even exercise of a positive kind for good health is a stressor.

Your body likes to be on the couch, right? So yeah, and we need to keep that stress low. So by doing twice a week, what we allow is adequate recovery.

And that's the one thing that probably in the last 30 to 40 years of our adult lives, we have negated. We've always been told more exercise is less food, or the more you move, the more the better it is.

And that's the American way. So we may have an international crowd here, but I don't know about you. That's the way it is over here. And so we're looking at, you know, twice a week instead of say, Monday and Wednesday and Friday, the way most of us used to exercise Monday and Thursday allows you two full days between.

So that's about 72 hours. And what many studies find is that the older we get, the more we probably get more fit by taking that additional recovery between us.

So I'm not saying to anybody, slow down because you're too soft and you're not resilient, but we're saying if you want to get in better shape, you will actually just put more time between your high quality workouts because our muscles need to repair and we're just not quite as good at it now as we were 20 years ago.

So we need a little bit more time. We can do it, but we need that a little, little more time. So twice a week, strength training. In those strength training workouts, you want to do the whole thing your upper body, your lower body.

So it's total body. So you're all done. You're not going to do a little of this on Monday and a little of that muscle group on Tuesday. You get eight times the results doing total body as you do if you were doing in that split routine is what it's called.

When you do your chest and your triceps on Monday and you do your legs on Tuesday, because most of us don't have that, that amount of time for every single day or four days a week to be strength training.

And if you are only going to do a smaller muscle group, you need to do more exercises. So you're adding a lot more time duration wise. So now you're talking.

You've got to exercise or do strength training for at least four hours or 5 or 6 hours a week, as opposed to get two high quality workouts. And it might take 30 or 45 minutes.

Maybe it takes an hour if you have it, but it's all about quality. Not really. Or not really quantity like it? It's not the minutes. So twice a week strength training, two muscle fatigue.

So this is a big one and we can't skip it. So a lot of people will do 15 repetitions because that's how many we're supposed to do. And then put the weights down and go on to the next exercise.

But if you are that perky after 15, something is wrong. You know? So we need to get to that last few feeling like, I don't know if I can do this one. You know, feeling like it's getting sloppy, like I'm starting to cheat with other muscles.

That's a good sign. This is the only place in the world where failure is success. So we actually want to read, just temporarily. That muscle is done, not in the third set.

If you're doing three in set one and in set two and in set three. So they all need to really count. So if you're not reaching that point, then would you be increasing the weight to a higher pound or would you be doing more reps or which is the way to go?

Great question. And then it depends a little bit on you. So we could say it depends on you your needs your status or it also depends on to your body type and your goal then what it is you want.

So we have to start with status number one. For a beginner generally the the number that you do, the number of repetitions in a set will be a little bit higher.

So we might want a beginner to do maybe 20 or even 25 repetitions because that's going to mean it's a lighter weight. And so we're going to not just condition the muscle, but we're going to let the connective tissue around the joint adapt.

And even when your mind and your muscle feel like I lift more, that connective tissue is like your foundation and you would never skip building a foundation and letting it solidify in a house.

And you don't want to do that in your body either. So you can't rush to fitness, because then you'll probably look back and say, oh, that's why I got that injury right?

Yeah. So in taking it slow, if you're a beginner or if you have arthritis, you're doing a few more repetitions. Not so many that we're doing now wear and tear, but so we don't have that heavy weight stress on the joint.

So we'd probably keep you there and finding a way where, yes, you were choosing slightly heavier weight, so you're reaching fatigue, but you at a higher repetition range.

If you were somebody who had more experience, you are someone who's lifted weights regularly and fairly intensely. You came close to fatigue most of the time.

But you said, my number one goal right now is bone density. What we know is, you know, getting off the couch and doing something is, is more bone density building than than lying on the couch.

Right? Then then lifting light weight is better than that, but lifting heavier weights the heaviest you're able to. And if you're able to do ten or fewer repetitions, that is most closely associated with bone density benefits.

So not everybody can do that. It becomes a dance between bone density and arthritis or osteoarthritis potentially. And we have to abide by where's the risk.

We don't need to cause risk. We'll do the best we can taking care of that. So there's no pain and we get the benefits we can or we do. The other thing so heavier is best if bone density or if metabolism is a big goal.

Because we know that for weight loss boosting lean muscle, lean muscle mass, it's more metabolically active tissue. So we're going to get a bigger boost that way as well.

So heavier weight if you're not fatiguing at 15 if you can. And if you're a beginner yes. Then I would increase the repetitions instead. So I have so many questions.

So six is someone is 60 listening and has never really lifted weights. Is the window lost for building bone density or I have great question. So it may be but here's the benefit.

Stopping the loss is still there right. That's going to be there for good. And you know I don't know how how we want to get into supplements. But I will throw this out.

And this may be something you want to research or add your $0.02 about. What I have had is success with women in their late 50s. So I can't say 60, which is the example you gave, but starting to strength train they hadn't before.

But of course that's how it happens. You go to the doctor, they have you do this scan and you get that diagnosis. And and so it's like okay I need to, I need to lift weights.

I've been hearing that now I know, now I know I do. And what we found is that the weight lifting plus a supplement called algae count okay. Yeah. Yep. Has support added gains for a couple of my private clients and a couple of our group members have also had good results doing it.

So at a woman who just before the pandemic started, came to me. We met once in person and then the pandemic hit. And so she went online. She was doing digital programed, but I had told her about algae kale and said, yeah, if I were going to recommend something to my mother or myself, this is what I do.

You do your due diligence. So, you know, and, so she did. Nine months later, she called back and she said, I'm ecstatic. She said, I had my second bone scan and it's better.

It improved. And she said, my doctor's thrilled. Yeah, yeah. So. So there's always, there's always opportunity to improve or slow down, which is, which is helpful.

So you talked about twice a week strength training which is really exciting. That like you get to rest more. That's so much more digestible. And speaking of digestion, I just wanted to throw in when we were talking about protein.

It's really important that I see this a lot in patients who are eating a lot of protein, but they're not absorbing it. And so it's really important to evaluate your hydrochloric acid levels and make sure you're chewing and eating slowly so that if you are eating a lot of protein, you're actually utilizing it.

Because I can't tell you how often I see that where women are like, but I eat so much protein and I look at their diet diaries, I'm like, but you're not absorbing it.

We don't have we don't have the stomach acid in the digestive capabilities. So so we talked about the strength training. What about cardio? Yeah. So you mentioned recovery right.

So there is a lot of recovery between the strength training. But we do want you to be active on those other day. So let's talk cardio and then break up with cardio as we know it.

All right. So mostly hardy. Most of us here grew up in the time when you know, you got your heart rate up and then you're going to keep it there and cruise, and then you're going to bring it down and cool down that steady state cardio we called it.

So that died 1980 called and wants it back. Then. I just have visions of like Jane Fonda and Lucille Roberts and. So short periods of that are okay. But it's.

If you could think of this and see if I have a pyramid around here. I don't. But if you can think of like a pyramid. All right. And if we could divide that with two lines.

So we've got three sections in it. Ideally what we want to do is have we've got low intensity exercise or movement. You go for a walk not even for a heart rate or for a distance or a speed, but you go for a walk and you enjoy it.

That's movement. That's low level, kind of the base of the triangle. And we should spend quite a bit of exercise time there moving to counter. I mean, I don't know about you, but I'm sitting down.

Are you sitting down? I am, I know. Right. So we sit so much and you know, we need to counter that because life didn't used to be like that. And nobody back when it wasn't needed a gym the way they do today.

Right. So we need to just move and don't don't don't think of your your exercise or your walking necessarily as exercise, but do find ways to do it. So while I say walking I throw that as a blanket.

Statements to any of you of who like to garden all day or like to golf and, and are willing to walk a little bit more than just ride and who like to go stand up, paddle boarding or like to be moving throughout your day.

That's what you're doing, is looking for activities and maybe sports, but really things you can do for extended periods of time and not be sedentary, that's the goal.

And then the high is that's where we do interval training. So that's where we do the kind of interval training where you actually get breathless and of the cardio that you're going to do.

Those two kinds are most related to longevity, most related to maintaining lean muscle mass, and most related to decreasing cortisol or stress levels and cortisol.

We all know you know, as a stress hormone, cortisol bad. But cortisol breaks down muscle. So you may be doing all of this activity to gain muscle and eating the protein.

But if you're under a great deal of stress or you're trying to exercise more and more, you may be adding to that cortisol, which is causing actually muscle wasting the opposite of what we want.

So you may be amazed to find less exercise, but more movement actually is the key. So we got our strength training on Monday and Thursday. Do you recommend we be moving every other day?

And I recommend, yeah, I recommend movement every day. I mean, some kind of movement. I mean maybe on one day it's yoga, but most days it's walking or it's it's version of walking.

So maybe it's golf and gardening and in a walk or if you have a dog you're walking every day and that's probably a good thing for both you and the dog.

But then you can punctuate with high intensity interval training. And how often are you doing the high intensity every day or just a couple of those days?

Yeah, that's such a great question. So I'm going to be talking a little bit more about something called high intensity repetition training as the time rolls on, but we're kind of just looking at the tip of the iceberg.

Traditionally, though, high intensity interval training is maybe bursts of 30s and recovery of 30s or a minute so you can recover longer so you feel ready to go again.

But you're literally getting breathless. So if you're outside going for a walk, you could pick it up and go faster with walking. Or you could find a hill and you could walk up that hill.

Try not to lose your pace, turn around, come back down, slowly, recover and do it again. So those repeats, maybe four times, maybe six times, and then finish with a you've started with a warm up, you end with a cool down and that whole thing can take 20 minutes and then you're done warm up to cool down the whole thing.

So if you want to continue, it probably wasn't high intensity, right? Okay. So it's okay to do is that okay to do every day the little hill. So what what we've seen is at a point about six years ago when there was enough research, we'd all been doing it right.

High intensity wasn't just for athletes anymore. Everybody had been doing it. There was enough data to show that injury rates went up about sitting down right, 544%.

At the same time, that interval training started to increase. So we know injury rates are there and prevalence. So it's choose wisely what activity you're going to do.

And I find I can point to research on this. But I can find when I sit down with other medical exercise specialists or other, even physical therapist friends of mine, when we talk about midlife women, we there is a correlation between the increase of injury and a midlife woman.

There's more plantar fasciitis, there's more tendinitis, there's more bursitis. And and so we know there must be a hormonal contingent, but we don't research hasn't come up with anything to say.

This is it. This is why. So I would choose wisely. And what I like to say is, if you're going to do interval training, think of it as you have 45 minutes in your interval training bank for the week.

So we don't need to start with that. But you might do three sessions of 15 minutes of interval training a week, or you might do two of 20 minutes a week, and that would be spending your allotment and knowing that, okay, I'm still below that curve where injury risk goes up.

And it doesn't mean that you couldn't get away with more, but I think that's a good guideline for realizing, you know, things get muddy when we just start doing more.

Unfortunately, your intensity probably will come down right. And the longer you do something more you do something. The more sloppy we will get. So if you keep it short, you do a few really good high intensity intervals.

Call it a day because you've done all the good you can. You can't do more good. You just done good. This is like good news, ladies. Like less is more.

Who knew it is okay to walk away feeling good? Yeah, I love it, I love it. So 10,000 steps a day. Is that a fallacy? Is that something we should strive for?

You know, it is not necessarily, proven. So I mean, it's a it's a guideline, but here's the statistic that is true, that, one of the risks of losing muscle.

And so we know bone loss is osteoporosis. So your audience may or may not know muscle loss. Significant muscle loss is called sarcopenia. So one of the three risks of muscle loss significant enough to be qualified is sarcopenia.

One of them is step count. So for adults who are closer to like a thousand steps a day, they were much more at risk for sarcopenia than adults who got 6000 or more a day.

So I think you've got to look at your overall activity. So yes, I think step count for some people is very helpful because we're a little competitive with ourselves.

And so like after dinner, if it's not there, maybe you're going to be more or less go around the block, okay. But I also think if you're somebody who lifts weights and you you swim some laps, I mean, that step count might not be there that day, but you've been pretty active.

So don't wear yourself out or beat yourself up for the sake of the step. So look. Look at the whole picture I love I love my wear an aura ring which counts steps and it also lets me know, hey, you need to get up and move.

If you're like, if I'm sitting at my desk too long, which I love those little reminders. I think those things can be helpful because sometimes we all get busy and you're really involved in something and you can forget, obviously, like getting a stand up.

But that's on my to do list. I want to get one of those stand up, sit down desks, so then you can be going up and down and moving your body. Yeah. Not being an issue for so long. Yeah.

So I have a couple more questions before we finish up. Otherwise I'll keep you here for hours and hours and hours. So is there do you recommend what do you recommend before you work out as opposed to after?

When do you eat? Should you do a protein shake? Are there any tips you can give? Yes. So great question. And that kind of circles back. So thank you for doing that because we talked about muscle protein synthesis.

And as we age we're not as good at using the protein that we eat to the benefit of our muscles. So it takes more protein than it did for us when we were 20.

So if you and your kids are fighting over that last hamburger, you take it. You go, you got say no. Okay. But and then we know you're not likely to do that, but ideally the the sweet spot for muscle protein synthesis when you pair the high protein meal, which boosts your muscle protein synthesis with your strength training which also boosts it.

But if we can marry the two of them, then really get a boost from 90 minutes after a high intensity strength training workout. And I would say this would apply to if you're doing high intensity intervals and you can time this right.

But that's the sweet spot for muscle protein synthesis. So it's about your perfect time to, you know, if you do for breakfast then at 90 minutes or at do for lunch or do for dinner, perfect.

You know, if not, you know, maybe a smoothie or a shake. Another way to get that. And so you've got 30 or more grams of protein at that meal. That is kind of threshold for getting the adequate essential amino acids that you want.

So I just want to make sure I understood when you're done working out, you wait 90 minutes. Like what if you're hungry, you have to reset. Well, and let's let's address that.

So to those who number one, if you exercise in a fasted state and I'm just going to say that personally I'm not a fan. And professionally we just I just did a masterclass recently on this that there is no difference in fat burning after exercise in a fasted or in a fed state.

So for women who are already more susceptible to negative effects of stress and cortisol more likely to be in muscle breakdown at midlife in May behoove you to eat something to stop that cortisol breakdown before you go into an exercise, which is also breaking down muscle.

So realize that healthy exercise is breaks down muscle. It's between the exercise that the fitness happens not during, but between when those muscles repair themselves.

So yes, I'm a fan of eating something before, and I think that to to midlife women who are a little bit more sensitive to carbohydrates, you need to play an experiment for yourself and see what you're doing.

The body tends to want to burn on carbohydrates and will digest that easier. When you're doing high intensity things like running or jumping, you got a lot more gut activity and you're jostling it, so you want to make sure is easy to digest.

It doesn't have to be a lot, but a half a banana smear of nut butter may be okay, but if you can do nuts and seeds or your fat adapted and or some protein, a simple smoothie, you know, which is maybe it's almond milk in your protein shake before so it's liquid or a little digest a little bit easier.

Something in your system prior to can be helpful, especially to strength training. For those women who struggled to gain lean muscle. And when you say prior, are you talking right before or 30 to 60 minutes before?

The timing is really the individual, so it has a little bit more to do with your stomach. I mean, obviously the closer you get to the exercise, the lighter you want it to be now.

And just to take the edge off of hunger or being distracted by that and, and give you a little bit of blood sugar, but not not such a huge rise that you're going to come up and crash down.

We don't want to puking right now. The reason was that. And then you mentioned the word time. Is there a better time to exercise? Doesn't matter. Morning, afternoon evening.

Yeah. So I'm so glad you asked that. So the mantra we use at flipping 50 is intense early and light late. So that so that a woman is working with her natural cortisol levels.

Because later in the day, you know, generally as cortisol is coming down, cortisol is the energy hormone we use for for exercise. So that still all of hormones that should make us rest and relax and sleep better later.

That pregnant alone maybe converted to cortisol. If you're a somebody who tries to exercise at 530 and you're trying to do your high intensity intervals at that time, you may get done and say, Deborah, I'm fine.

I just did it fine. And potentially you could. But later you may not get the quality or the quantity, sleep and rest that you should, because you've kind of written checks from that account tomorrow for the cortisol energy you didn't have.

So I'd much rather see somebody do high intensity early and light late, even if because I know this will happen. You meant to do your high intensity workout this morning and it just didn't happen.

Don't be thinking you need to pay that back tonight. Push it to tomorrow and instead tonight go for a walk or do yoga if you want to do. That's such good permission. Thank you.

And before I ask you where everyone can find you. Because I want to know what we can do. I'm just so it's a personal question, but rather than ask you off air, I figured, you know, there's probably women listening, so I am really into hot yoga.

And hot yoga is a lot of muscle. Like, we're doing push ups. We're, you know, we're using our own body. And I'm curious, is, does that mean you don't need to do the strength training?

What do you think of the more hot power? Yoga is not just like a half a chill yoga, but one way you're really you're working hard. Yeah. So I mean, it is in a sense, you're right.

It is resistance training in that you're moving your own body, but you're not actually reaching that point of muscular fatigue, just total muscle fatigue at each of your major muscle groups.

So I would suggest, yes, to balance that to sure strength training workouts. And maybe because you're doing that, those are a little bit shorter. Your sessions of strength training picking up heavy weights are shorter, but you're still doing those to round things out.

So I'm asked that quite a lot. And I remember sitting through my I'm a 200 hour yoga instructor, and I was sitting through the training and I remember they were going through here's all the benefits.

And he was just kind of reading them, and he was in bone density. And I'm like, just a minute here. I type. Okay. Good to know. Good to know. So wow. Well we are at our time and I guess the last thing is, I'm sure there are a lot of women who are saying to themselves right now, where do I get started?

What do I do? What? How can we follow you? How can we learn from you? So what do you got for us? Well we are. I am at flipping 50.com and that's all spelled out words, no numbers.

And then on all things social it's flipping five zero TV. So we're on Instagram, lots of YouTube videos, and we have a large Facebook group and activity as well.

Awesome, awesome. Well you are just such a treasure and such a wealth of information. So everyone go follow her, go learn from her. I follow her on Instagram and her videos are awesome.

And of course, before you engage in any new physical journey, make sure you check with your physician. I'm a physician. I'm not your physician, so make sure you get cleared.

We don't want you getting hurt, but this has just been so valuable and such an important piece. And the just inspiring, empowering that it doesn't matter if you've never exercised or you feel like you've lost that opportunity, you can rocket it.

You still got it, girl. You can get this going. You can be an athlete because I am now an athlete, Deborah said. I'm an athlete, so I am, I'm I'm owning that.

So thank you so much for being here and everyone else, you there was so many good, important nuggets. I hope you're taking notes, and I know you're going to want to listen to this one again.

And so there's just so much hope and inspiration here. And, and in the solid methodology that it's not just something you go out and do that. There's really, as Deborah was saying, there's research.

And the best take home is less is more. You don't have to be hours a day every day. So that's fantastic. So thank you so much and we'll look forward to seeing you in the next interview everyone.

Thank you. Thank.