Muscle Makeover: Why Resistance Training is Essential in Menopause

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What are you waiting for? Good night.

It may sound like I'm repeating myself. In a very recent episode, I talked about essential exercise in menopause.

Today I'm really going to harp on this again, so yes, pardon my sermon. This is about why resistance training is essential in menopause, particularly as it lends itself to bone density. And I'm going to quote studies. So today I'm really breaking down a 2023 study, something very recent, and just want to point out what they found to be most beneficial. Now, many of you know we just completed the What, When, and Why to Exercise for Women 40+.

That was the 2.0.

In 2023, we did the first summit where we shared even more protocols about how to gain lean muscle, how to optimize body composition. So yes, lower, probably for many of us, but optimizing it, not too low. You've got to have something in reserve and you got to be able to function, have great energy. You might need some of that fat for a little libido action. What I'm going to do today though is really go into some of the recent research that isn't exactly what you've from some of our experts like Belinda Beck, who talked about resistance training and some of the research that they're doing that I think is groundbreaking. At least it is for me. So imagine in 1995, I'm leaving my infant son with my husband the first time to go teach an adult education class. It's why it's so vivid.

You know, I was—

I'm sure I went over all the drills, like how to put him to bed and how to do all the things more than he needed to hear them.

And it was such freedom to be back and speaking to adults again. So that adult education course, I think, was spring of 1995, and I had to explain what is osteoporosis, what is osteopenia.

It was not then a household word. And of course, now that's not the case. Case. And we know that young men as well as young women can be prone to osteoporosis or low bone density.

It's not just women.

But what I want to point out is, you know, back then we thought once you're diagnosed, okay, put you in bubble wrap. We could have you lifting weights, but you should be on machines where you're safe, you're protected. Women thought they should not rotate You know, so nobody thought about— guess what happens when you get out of bed in the morning?

That's how complex that movement is.

Because what happens when you get in and out of a car? And people still unfortunately have this lingering thing that they should not be rotating and not realizing they're doing that every day. So potentially maybe we should learn how to move better so that we can do it more safely. But I'm going to leave that alone for now. Those of you that are fearful of regular everyday movements, I'm going to have you rethink that a little bit. Remember, if it gets posted on the internet, it may live there forever and yet not be the most up-to-date science that you've heard. So there is that. So for this podcast, I want you to Stay tuned. I want you to realize we're really going to talk about 2023 science. And for those of you that feel that you can't go as heavy as Belinda Beck's new science, 5 sets, 5 repetitions, or don't want to, this one has great news for you.

I'm Debra Atkinson. You're listening to Flipping 50. I started this podcast over a decade ago to answer questions about fitness in menopause and beyond before you knew to ask them. The goal: to help accelerate your results with science and the practical application of proven protocols while living your best life. There's no more powerful health influencer in the world than a midlife woman. And it's not just about you, but the 3 generations that you influence. My unique 40-year career, including being a university senior lecturer in kinesiology, an industry subject matter expert, and an international speaker, to 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 scenes and the science of optimal hormone balancing, fitness, and longevity, and share answers to our community's questions so you can have the vitality and the energy that you want, need, and deserve.

Okay, let me dive into this. I'm just going to unpack this. The name of the study that I'm referring to here is The Comparative Efficacy of Different Resistance Training Protocols on Bone Mineral Density in Postmenopausal Women. It's a systematic review and network meta-analysis. Now that last part is potentially more than you want, but But again, it's 2023. It's examining various resistance training regimens. So here's a quick synopsis of what happened. I mean, the objective was to look at what's the optimal protocol. One thing you and I have to keep in mind is in a very specific and guided study, they're not studying like all across every possible protocol. So they took 2 and 3, and they took certain levels of frequency and intensity. So they were looking at some very specific things— exercise intensity and the frequency— and in the variables that they played with. And I think that's a really important distinction. This doesn't mean that something else doesn't work as well, because in the last 5, 6 years we've seen high-impact and high-intensity resistance training, meaning heavy weight, fewer repetitions, actually also do very well with minimal risk of injury. There were zero dropouts, high adherence rates. Actually, participants seemed to like it more, and that's something that surprised researchers. It wasn't something they were looking for, but it's something that emerged, that the women actually responded better and differently than they had to prior studies. So something to keep in mind. So the study here aims to identify the most effective resistance training protocols to combat osteoporosis by improving bone mineral density. Specifically, subjects were postmenopausal women, so definitely we love that. So what are those variables? They were categorized by exercise intensity. High, moderate, and low. Frequency is high frequency of 3 days per week, and low frequency was 2 days per week. So the overall effectiveness found resistance training is definitely beneficial in increasing bone mineral density in women, particularly at the lumbar, your lower back, and your femoral neck, that's at your hip. Intensity and frequency Moderate intensity training. So what they labeled this moderate intensity was 65% to 80% of a one-rep max. Now you're going to say, what is that? And I hope that you never do a one-rep max test because that's like taking the final exam on the first day of class, and that would be a bad idea if you were at risk at all. But what I can tell you is that the This is according to the National Strength and Conditioning Association, you know, and I've recited this ad lib for, you know, since 1998 when I first took that certification exam. But 10 repetitions is the equate to 80% of a one rep max. If you choose a weight heavy enough to fatigue at 10 repetitions, you're doing about 80% of your one rep max. That's what they're labeling in this study as moderate intensity. That's the highest range. 65, just to give you a good idea, is about 16 repetitions. So 65 to 80% doing moderate intensity performed 3 times a week was most effective in improving bone mineral density. Now keep in mind That's based on what they looked at in this study. Again, it doesn't mean that doing 5 sets of 5 repetitions, so that's significantly heavier weight, isn't also effective. But with this particular study, this was the most as they were looking at variables and plugging them in that provided a balance that was intense enough to stimulate bone density improvements without the risks often associated with high-intensity training. Now, what would be deemed higher intensity by these researchers? Also really important details, right? The interpretation of these would be any repetition range lower than 10. So that means the weight is higher, and I know this inverse relationship gets tricky We have women who are in our membership and they've been there for a long time, and yet they're confused when they look at it on paper. Because when you're looking at exercise on paper, it seems like, why would, after weeks period of time, the number of repetitions go down? It would seem, if you just at a glance look at that, that the workload then goes down. But that's not true. The thing is heavier. You can't lift it any more than 5 times. That's much more heavy than something you can lift 20 times just fine. Okay, makes sense. So keep the perspective here. So the comparison of the protocols in this study, it revealed that while all the resistance training positively— so whether it was low or moderate or high intensity or high frequency of 3 times a week, what they deemed low frequency of twice weekly, it all helped. It all had a positive impact on bone mineral density. The— but the moderate intensity at a higher frequency provided the most significant benefits, and I'm going to come back to that. So statistically, the results suggest that moderate intensity, high frequency training was superior to other combinations in improving bone mineral density. That meaning lower frequency, higher intensity may or may not work as well for bone density. Okay, but— and inclusive, let's be inclusive and say— and so for postmenopausal women, resistance training at moderate intensity, meaning 16 or 10 to 16 repetitions, 3 times a week offers the best outcomes for increasing bone mineral density. Now, that's post-menopause, and often they're studied— if we're talking bone density now, I should say they're not often studied, but they should be more often. And it's more significant because in perimenopause, they may not quite be at that sudden drop of estrogen that negatively impacts bone mineral density. Most. So they're really looking at— this is a group that we should really be concerned about, and what are we doing to help them increase their bone density? So let me give you a suggestion here. So in our groups, we often in our programs will do twice weekly, and there's a reason behind that. So if we do a workout, yes, we're juggling the ideal and the bone density benefits with the boost in metabolism that comes from lean muscle mass. We're also dealing with bodies that may have been on the planet for 50 or 60 or more years and have had a little wear and tear. We've lived a good life, some of us. We've had a car accident, we've fallen, we've gone down the ski slope wrong. You know, let's say it that way. Things have happened and we just have to honor that as well. But the other thing that we have to honor is the endocrine system. Now, generally when we're in post-menopause, our endocrine system has settled down a little. It's not as volatile as when we're in perimenopause. That's a good thing. So we can potentially much more easily increase the frequency. We have programs within our membership for women who are post-menopause. We often will suggest you could add a third time a week. For women in perimenopause, I often recommend don't add that, certainly not yet. If you're doing twice weekly, you're reaching muscular fatigue, you're completely recovered between sessions, you're sleeping really well, there is no moodiness or up and down or blood sugar issues, then you might want to try 3. You can get away with it. But for the majority of women in perimenopause, doing less But making it work is actually best. And then you can dial that up as we get into post-menopause, and we need to— we need intensity more, we need more stimulus of the muscle, we may need more protein in order to have the same muscle protein stimulus. And we want muscle protein stimulus as well as bone because the muscle pulling on the bone from each end is also a part of that growing the bone density and improving it. So it's not just the force of, say, you hitting on the ground, jumping, or of you pushing on the weight hard, but it is also the pulling and pushing and strengthening of the muscle. Now, to pull on the bone increases that bone mineral density as well. So my suggestion might be doing this. So remember the range that is working. Between 65 and 80. Now, if you're a reluctant exerciser, you might be thinking 65%, while I as a trainer am optimized to think 80%, right? So it's kind of like hiring somebody. If you say, here's the salary range, they're thinking here, you're thinking, let's start here, right? So we've got to get this right. But I would suggest that if you're doing 3 times a week, you know, in order to do that just for organization-wise in our head, Monday, Wednesday, Friday makes it easy right now. Remember the endocrine system, and I'm going to come back to that. There may or may not be enough recovery time if you're doing Monday, Wednesday, Friday, if you did every one of them equally as hard. So giving that some variety may make more sense. Monday and Friday, where you hit that 80%, you hit that 10 repetitions. And notoriously, back in 1995, 2000, 2005, the research talking about bone density then showed that some of the best results occurred at least when you hit that threshold of 10 repetitions or fewer. Had the most impact on the bone.

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And bone also, by the way, needs a break. So it does need that time for remodeling in between. But if Monday and Friday you go with that 10-repetition range, and sometimes maybe you only get to 9, sometimes maybe you get 11, you're right there in the ballpark. That's what you're looking for, that sweet spot. You'll know if you get 11, 12 too many times in a row, it's time to increase that weight if possible, or slow yourself down. So time under tension makes it feel heavier. But then on Wednesday, when you're working on getting that third session a week in, you do 16 repetitions. That's still within that 65 to 80% range, and yet You're not stressing yourself quite so much. So you have to think not just about the long bones that you want bone density in, but you have to think about the joints, the ligaments, the connective tissue, all of those little pieces that have to be involved. And are they resilient enough to handle additional stress? Well, maybe two big boluses of stress, but still stimulus that is adequate and in a different way. So I would put a workout that was much more functional, single leg work. If I'm doing a squat and I'm doing it on two legs, I can do a lot more weight if I'm using just— I'm using both legs to do a squat, just down and up, versus I'm on one leg now and I've got to now maintain balance and I'm going down and up. I'm probably not going to go as deep. I'm going to fatigue with less weight, and I'm probably going to be able to do a few more repetitions. But if you're positioned right, you'll still reach muscle fatigue at a higher rep range, and you're not stressing your system quite so much. And that's where the endocrine system comes in. So if we are striving to— I'm going to get those 3 times a week, and I'm gonna go all in on my bone density and you're exhausted and you're on the couch in between, it's not working. So stress is also a disruptor for your bone density. And this is— nobody's talking about that. We can't talk about ideal and optimal protocols without saying, but how do you feel? Because if you feel like bleep, it's not probably going to work. You should feel good. So we should be able to slowly, gradually ramp that up, making sure we're staying in that I'm sleeping really well, my energy is really well. You're not forgetting and skipping to fuel. When you move more, you ask more of your body. That is stress and you've gotta feed that or not feeding it is more stress. What happens when you're under stress creating lots of cortisol? Your body actually will store fat. You can't burn fat. It's potentially going to shut down. You'll feel more fatigue, you'll feel more tired, more moody, more depressed, more anxiety. Not good. So we've really got to factor all these things in, but this is a great solution. So considering Monday and Friday you hit that 10-repetition range, Wednesday you do a resistance training workout. This is if you're post-menopause, but you're aiming for about 16 repetitions. That's still about 65%, and that's within the range that works for 3 times a week. And you're doing unilateral work, so you are reaching muscular fatigue as well as hitting the bone density. So that way you've got an ideal combination to provide the stimulus for the bone without endocrine disruption. So you're keeping everything in check. And then the thing to do is come back and let's use our common sense. How do you feel? How is it working? What are the results? So not only the results on your bone density, your DEXA scan, which is going to tell you your bone density, but you won't do that test generally more than once a year. Now, you might test in 6 months, but bone takes a while to respond, takes about 9 months at least. So often they'll schedule you annually. And by the way, I think we're all waking up to the fact we need bone density scans. We need that DEXA scan. A lot of people are beginning to use it for body composition as well. You got to get that thing scheduled in advance. Okay. So you may be thinking, I'm not due for that, you know, until August. And right now it's early May, mid-May. Do it now. Trust me, I know on this one. Okay. So it's It's a great thing that everybody's becoming aware, but you don't want to wait on this. So when you're, you know, letting another 3 months go by, and if it would have shown you, you're actually losing. We need to change something. We need to change your nutrition, your sleep, your supplements, your exercise regimen, your stress level. We need to look at your gut health to be sure we're absorbing everything. And we can do that when we test regularly at home, looking at your body composition. And I know some of your, in your, your scales, your smart scales in home are telling you bone density. You know, I would take that with a grain of salt. It's not a true DEXA scan, but I would watch your lean muscle mass, not in percent, but in absolute pounds or kilograms. Make sure that's going up, it's not going down. Because if you're losing muscle mass, potentially you're losing those friends pulling on the bone that will give you that bone stimulus that you need and that you want. So don't also forget that we need protein for our bones as well as for our muscles. Bones are 70% protein, you know. And back in the day, if you ever heard, you know, having a high protein diet you know, is diuretic, and that's going to make you lose your calcium. That has been eradicated, and that's no longer true. So it's no longer a risk factor. Low protein diets are a risk factor for low bone density. So there's a lot of things that we have to be willing to— I have to unlearn this. We've got to let it out to let the right thing come in. And because we learned something at a very impressionable age, it can be hard to let go of it because we're kind of just defaulting. And sometimes we believe something so hard that it seems like it's true, but it could be it's only true for you and not for others. Okay, there you have it. Resistance training is essential for menopause. Why are we losing the muscle mass and the bone density? Both. It comes back to the estrogen. Testosterone also comes into play, but it's an important— when we go down that road, we lose it dramatically and we've got to replace it. We can with the right movement. So to open up the door, though, for some of you who are feeling, I can't lift heavy or I feel vulnerable, because of maybe your endocrine system, you're dealing with adrenal insufficiency or a vulnerability, or arthritis. You know, maybe you feel weakness in an old injury and you just have this gut feeling I shouldn't be doing that. There you have it. Now you have a little more open window between 10 and 16 repetitions is still within that range. And pay attention to how you feel. You don't have to ramp up to 3 times a week right out of the gate. Start with 2, make sure you're feeling good, recovering completely, learning great form, and then open that up and be sure you're giving yourself adequate rest between high-intensity interval training. Those, those keys are really important. So there you have it. You will find show notes at flipping50.com/resistance-training-is-essential-in-menopause.

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