Low Energy Availability in Menopause? Eating Too Little to Feel Good or Age Well

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What are you waiting for? Good night. Low energy availability in menopause is a key concern, especially if you're both trying to exercise and combine that with fasting. You could be easily there. In this episode, I'll help you answer whether you're in a state of low energy availability, leaving you with too little energy to feel good during or after menopause, and how it might be damaging you. Under the hood even before the actual feeling and knowing of that crushing fatigue sets in. Exercising too much without results? I also have a reset for you. It's our 5-Day Flip. You can find it at the homepage at flipping50.com. I'm Debra Atkinson and you're listening to Flipping 50. I started this podcast over a decade ago to answer questions about fitness and menopause and beyond, before you knew to ask them. The goal is to help accelerate your results with science in the practical application of proven protocols while living your best life. Not confused. There's no more powerful health influencer in the world than a midlife woman. It's not just you, but it's 3 generations that you influence. My unique 40-year career includes being a university senior lecturer in kinesiology, an industry subject matter expert, and an international speaker, to being the founder of the first and the only exclusively made-for-menopause-and-beyond fitness membership in the world. Every week I interview experts behind the science of optimal hormone balancing, fitness, and longevity, and share answers to our community's questions so you can have the vital energy you want, need, and deserve. In this second half Okay, so let's sum this up. Low energy availability, or LEA as it's written, is not just what you're thinking possibly of adrenal fatigue, although if you live there for too long with low energy availability, which I will describe to you in detail coming up, you could of course do damage to your adrenal system and then result in adrenal insufficiency. And then you've got to unravel the— why did it happen? What was the root cause or causes of this? Because it's never one thing. But let's start there. The definition: low energy availability, or LEA, is a defined and identifiable problem as having limited energy available to support your normal body functions once your energy expended through exercise is subtracted from your total dietary intake. So let's just think math for a moment, and trust me, I spent more time at the dining room table working on math probably than most of you combined. However, here's how it goes. So your total daily intake— so I'm going to walk you through how to do this and find your own, but you wouldn't want to just say, oh, today. You'd want to take an average. So you're going to say, okay, my, my total dietary intake on, on average is X minus how many extra How many calories do I expend? How many— how much energy do I expend in exercise activity? And that, of course, is a wild goose chase, really. But you're going to look at, you know, OK, for a female and my weight, I'm doing this. How many calories am I burning? You know, on a really even much more remedial scale, you'll be able to look up how much energy does walking 3 miles an hour expend? So not even taking into account your body weight, that's not telling you very much on target, but it's a start. You've got to start somewhere. So you'll find tons of apps that'll help you do any of these things. And I personally don't use one. I'm not in the habit of counting steps or calories or points. And there are certain times I believe, let's take a snapshot, that's got value. But doing that ad nauseam on a day and daily basis causes obsession and compulsive disorders and I've helped too many women with too many of those to want to go there and be a part of the problem. So let's do this again, right? So let's take your total dietary intake, that daily caloric intake, minus the exercise caloric output. Now we've got— okay, is this meeting your need? If you live for too long or too often in low energy availability, it's going to negatively impact skeletal muscle. What happens when you decrease skeletal muscle? Decreased metabolism, decreased energy. You're much more content to sit down, stay on the couch. You're more tired. Your blood sugar level is higher. That means you're storing more belly fat. Nothing good, in other words. So it will negatively impact skeletal muscle as well as your bone density, because what happens in the bone— quick lesson— osteoblasts and osteoclasts— so it's blast and clast— they can't properly do their job. So one of them is constantly breaking down and remodeling, and the other one is rebuilding up. And so there will also be more injury in connective tissue. So for those of you who've got plantar fasciitis, you have a constant nagging in the knees or in the hips or your shoulders. Stress fractures, increased risk for osteoporosis and accelerated bone loss if not diagnosed yet as osteoporosis, and the inability to reverse losses. Because your body is not going to naturally just respond to exercise without the fuel available to help it. And in a multitude of things cascade into a big snowball. Low energy availability can also lead to other health disruptions that are commonly blamed on the umbrella of menopause or hormones, and those include irritability, depression, brain fog, poor immune function, low libido, GI issues like constipation and diarrhea, So how do you know if you have low energy availability in menopause? You know, and if you're somebody who diets, you're trying to, you know, not take in as much, you know, you're probably hearing maybe too often, right? The default is you've got to create a caloric deficit, you know. And I think it's a dangerous thing. I think it's a dangerous thing for health professionals, fitness coaches to say that as a blanket statement to everybody, because all too often It's— we're not struggling with weight issues because we eat too much. You know, I wish that were the case, but I think often, you know, powers that be that are not actually working in the front line with a client, with a group of clients, with a community of clients, have not had the opportunity to see that the majority of women are not struggling with metabolism because they're overeating, but because they're under-eating and slowing down their metabolism. And/or maybe they're getting away with that for some unknown reason, and it might be high stress, anxiety. But what they are seeing most likely is very low bone density and very poor quality of bone if they're not having issues with bone density. Absolutely. And those things will add up still to frailty. You know, I mean, in a sense, with low energy availability, if you're skating on that, you could be what appears to be fit while actually under the hood being very frail. Let that sit in for a moment. You could appear on the outside to look very fit. People could envy you. You could be complimented all the time. And yet, under the hood, those bones potentially don't look all that good. Something to think about. Okay, so low energy availability. I mean, if I read these things again— irritability, depression, brain fog, poor immune function, low libido, and GI issues like constipation and diarrhea— hold the horses, right? Does that or does that not sound like a, a list, a partial list of signs and symptoms of menopause? Yeah, so we have to ask what comes first, the chicken or the egg? Are we, you know, a generation— and I say that not meaning those of us who were born as baby boomers or the next gen, but those who are passing through the 60 or the 40 to 60 year old age range— are we just finally— life is catching up with us, the chronic dieting, you know, eat less, exercise more kind of thing where we've tried to shrink our entire adult lives? Is that catching up with us, you know, or is it actually symptoms of menopause? Or are we in part responsible, not intentionally, for causing some of this chaos? And/or if that's true, there should be a little hope there that we can turn it around. So here's how you would know if you have a low energy availability. It is the math, so I'm going to bring you back to that. So think about this, the simple equation for figuring out EA, or energy availability. So let's not, let's not conclude before, before we know you're guilty that you have low energy availability. Your energy availability equals your energy intake—that's your calories per day—minus your exercise energy expenditure, just your exercise energy expenditure, divided by your fat-free mass. So if I help you figure out each of these, let's go like this. Dietary intake would be this. Number 1, I want you to plug, plug all of your— I, I ate this, I ate this, and I ate this— in for 3 to 5 days and then average that. Because, you know, the ideal recommendation always used to be do, do at least, at least, uh, 2 weekdays and a weekend day so you get a good average picture. And, you know, you could do 3 and 2 if you wanted to do more, but do about 3 to 5 days and then take those totals, divide by the number of days you actually did that for, and you have a pretty good estimate. Now, if you're totally on vacation that week, probably not a great snapshot, but, um, do this because it's really the only way to get a really true and accurate idea. We— and I would suggest we— either overestimate or underestimate depending on who you are. What we're taking in. And we probably think— most women think— we take— we are taking in tons of calories, you know, and, and maybe surprised to find you're only taking in 1,200, 1,500. And listen, that— unless you're, you know, teeny tiny and 5'0", you know, 5'0" and you don't do very much, you know, maybe you can get by with that. But for the majority of us, that is just not enough. And you have a basal metabolic rate that is probably at least that. So if you're exercising on top of it— I know we all think, I'm gonna win the game then because I'm, you know, don't— I'm gonna exercise for 500 calories every day and then I'll be in a caloric deficit and I'll gain lean muscle because I'm exercising. It won't necessarily work that way if you're messing up your hormones, and we will. So you're going to take that dietary intake, figure that out. That'll take you a few days to actually do it unless you do this on a daily basis. Okay, I know you're out there. And then you're going to go to an app again, could be the same one depending on what you're using, but go to another app and/or look it up and just say, okay, I am walking the dog for 3 miles every day. Even if you're doing it every day, that's still additional exercise that is over and above, say, just daily living, washing the clothes, up and down your stairs, you know, your heart beating, getting you up and out of bed, breathing. That's your basal metabolism, right? But exercise on purpose, going for a walk, maybe you do HIIT, maybe you do strength training, those kinds of things you're going to calculate and plug that in each day. So you're getting, okay, now, and if you feel the need, you could do that and average as well. You could look at what's my average caloric expenditure from exercise over 3 to 5 days. If you really want to get nitty-gritty on this and, and have a real, real carefully targeted average, it's probably a great idea. Okay, so you're going to take that dietary intake minus your exercise energy expenditure, take that answer and divide it by your fat-free mass in kilograms. Now let's calculate that, your fat-free mass. So if you have a smart scale, it will at least tell you percent body fat. So you have your weight and your body fat. Then all you need to know is take your weight in pounds times your percent body fat. So let's say you're 25% body fat. So if you weighed 130 pounds, you take 130 times 0.25. You all remember how to multiply percentage, right? So that's going to give you your fat weight. So you're going to subtract the fat weight from your pounds, total pounds. So whatever that number was, it'd be, you know, 130 is now my weight, and I'm taking that minus my fat weight equals— now that is your fat-free mass. It includes everything else, like it includes your muscle, your bone, and your organs, and those are not going to change that much. So that fat-free mass. But that's what you have to sustain— your heart, your lungs, your breathing, all of it— and sustaining your muscle, sustaining your bones. And that's why we're dividing by it. So doing that math, once you've got the numbers, that number is what we use to gauge. Anything less than 30 calories per kilogram— so the last thing actually I left you, uh, lurching— so you're— you also have to change that fat-free mass in pounds to kilograms. Remember, that's a divide by 2.2, and all of this will be in the show notes, by the way, if you need to see it. I certainly would. But anything less than 30 calories per kilogram of fat-free mass is considered low energy availability and puts you at risk for real health concerns, actually within days, because your body is not functioning well and something is going to give. So I highly recommend you track your calorie intake for 3 to 5 days to get an average. I think it would be great for you to track your average energy expenditure from exercise over 3 to 5 days. You're going to get a good indication because, right, some days you're going to do strength training, which is super valuable but burns fewer calories during, right? And some days you're going to do HIIT or go for a longer walk and you're going to get a big difference. So an average there would also be great. You're going to arrive at your body weight minus your fat-free weight and make sure that's then switched to kilograms. And you will do this calculation. So all things count. Playing pickleball, you don't have to be breaking a sweat. Playing badminton, count that as exercise. You worked out weight-wise for 45 minutes, count it. You walked 30 minutes at a 3.0, count it. At that speed, right? Not walk 3 miles, probably, because that's— that wouldn't work. All right, so it's easier than you think to check. And I did this. Interestingly enough, during the period of time that I was looking at, my average intake was 2,100 calories. My average exercise expenditure was 400. So I'm left at 1,700 calories. Divided by what I found as my fat-free mass. And remember, you've got to change that to kilograms. Um, so what I got was 36.7. I'm on the low side, ideally, right? So 45 is a pretty good number, and this is according to the research, and the research is listed in this, uh, podcast as well for Prove It to Me Girls. I got— yeah, but 45 is a good number to aim for. Or if you're training really hard regularly, say you were going to train for an event, and so you've got a really pretty regimented plan, you know, day in and day out, you know, every week for 8 weeks, 6 weeks, or whatever it might be, you know, 50 would be a better number for you in terms of that energy availability. So I'm not training for something, you know, and some days honestly I'm much less active than I like to be. But we have to remember that we may be slowing our metabolism by eating too little and compromising our abilities to regulate thyroid, proper immune function, metabolic function, your mood, and more. So your exercise may or may not be affected. That's an interesting thing. So if you're just waiting to lean into— well, I work out just fine, I have plenty of energy to work out— but I hear that all the time, even from some of you who have adrenal insufficiency. And then it's it's after the exercise you feel like you've got to be on the couch, or you're really for 3 or 4 days just down and out, you know, not wanting to do much. And then you think, okay, now I'm going to work out again because I'm trying to get fit. That's not going to work. It's not going to work, right? So it's important that you realize that you might get through the workout not feeling like there's anything wrong. Your body is putting all the energy into And it is that, you know, partially it's just doing it because you're geared up. Maybe it's habit, maybe it's mindset, maybe your endorphins kicked in so it feels good during. But there is probably some suffering, and people notice it. People who know you well notice this isn't typically you. So if this was helpful, right, I'd love for you to share this with a friend. Do the math you do yours, have them do theirs. Low energy availability isn't something talked about openly enough. Instead, we're bragging about how long we're fasting or how much we're doing HIIT. Potentially, we're contributing to the problem, keeping the score, you know, in the wrong game. And that you have to be really careful of. If you are an athlete, performance will most likely be negatively impacted because you're at probably just a different level. And you are also— most athletes have really good body awareness and high expectations about how they should perform. So the rest of your life and your physical function probably will suffer first for the rest of us. It might be happening at such a low level you don't notice it until there is that cumulative effect setting in. So there are other experts who also talk about this topic, and because it is shared so very little, I'm sharing them with you. So when Dr. Stacy Sims talks about this quite a bit. Now, her history is that she's worked with endurance athletes. She herself was a triathlete, and, and that's where we see this most often, right? We see women who are getting into endurance events. They're thinking, if I do a marathon, I'll surely lose weight. Actually, it couldn't be further from the truth. If you're trying to lose weight, you're going to suffer a great deal— your performance, but also the long-term damage to your body is there. Not a great thing. You need to eat more. You're probably not going to lose weight. You may gain more lean muscle, and you certainly should support your VO2 max. But Dr. Stacy Sims, she's a doctor of science and studies in exercise physiology, so great resource there. Steph, uh, Gaudreau is also somebody that you can find online. She is, I believe, in her early, maybe mid 40s. She's been talking about this for a long time. She's got a background in nutrition and, you know, talks a lot about lifting heavy, Olympic lifting, and that's just a certain small battery of lifts like, you know, snatches, cleans, and jerks and those types of things. And Betty Rocker is also somebody great to follow who was very aware of this. In fact, the last time I spoke with Betty Rocker You know, huge nod to her and huge respect. I mean, she has very strong boundaries. I mean, one of the things she, she doesn't or didn't talk about— it's been a minute, but really didn't talk about intermittent fasting for this reason. I think that it's just a delicate topic. Doesn't— it really doesn't work the same for everybody. And where women tend to eat too little, cut back, you know, many of us who've been in this industry for a very long time working in the front lines with people And in, in one-on-one and in groups, we see too often most people are eating too little, not too much. And that becomes the issue even for those who struggle with weight loss. And by the time they've gotten there, often the people who've struggled with weight loss— I hope this has been helpful. You can find the show notes for today at low energy availability in menopause. And again, I really would help— it would really help if you shared it with friends or somebody that you know. Thank you so much for listening. To listen to a decade of episodes and get the show notes, visit Flipping50.com where you'll be able to find all of the previous episodes. 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