PostMenopause Bones: How Much Bone are You Losing?

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It's made by a trusted family-owned company that we all can feel good about. Third-party tested for purity and potency. And if you're interested, you too can try a sample for just $6. But even better, you can get 30% off forever with discount code FLIPPING50. That's FLIPPING50. Just go to flipping50.com/blueskycbd. We'll put that link in the show notes and you'll find it everywhere on Flipping 50 at My Favorites. What are you waiting for? Good night. In case you haven't got the memo, this month we're talking a lot about bones. Okay, I know, and you're probably like a child, like, "Mom, stop it." So I do apologize, and then not so much. So if you get a little irritated by me but then begin to feel like, "Oh my goodness, I need to pay attention to this because I actually don't know what my status is," or, "I know I didn't test test well and I don't know that I'm doing the right things to improve my bone density next time, then I have done my job. Postmenopause bones are at greater risk of fracture, continued bone loss, and in need of specific exercise to target and protect. Whether you're fragile, high risk, or you're one of millions of women diagnosed with either osteoporosis or osteopenia wanting to reverse it, if you're postmenopausal, this is particularly for you. It's a quick episode targeting specifically women postmenopause to complement this month-long heavy emphasis on bone health. From the research, quote unquote, average bone loss is 1.5% per year for the spine and 1.1% to 1.4% for the femoral neck, and that's your hip. In the first 4 to 5 years post-menopause. Slow losses or losses slow, I'm sorry, slightly after this. And then they increase again in later decades. So where are you? I'm 59. I hit that menopause-specific target at 56. Now I would have to admit the pandemic did a weird job on several people. And I'm one. So I had a breakthrough. I had a couple. And then they got my hormones wrong. We got supply chain issues even with hormones. For those of you who are subscribers for Flipping 50 Proteins, by the way, we know about supply chain demand problems, don't we? And let's hope that's past. But I had to try a new— or I didn't have to, but it was kind of already imposed. They had it locked and loaded and about 2 inches from my arm before they said, oh, by the way, we didn't get the one we usually use, we're using this, and we think it won't be a problem. Well, it was. I'm that 1%, and I had 5 breakthrough bleeds in about 8 weeks. That was last year. Now, it wasn't exhaustive, kind of like huge bleed, but it was— I'm in post-menopause, come on, stop it right now, this is not okay, right? So, um, that, that happened. However, I would still dictate 56, went through menopause. I'm 59. I'm in this swing, right, where I darn sure know I'm lifting heavy twice weekly. I'm doing as high impact as I can tolerate and doing that a couple times a week. Now I'm still doing impact other days per week, but a little less, less high intensity. Because why? Because you also have to be concerned about safety. So instead I'm varying it. So maybe moving more side to side lateral work as opposed to high jumps and drop jumps and box jumps that are, that are much more high. You also have to find your fine point. So here's the deal. If I just scared you, that's not the intention, but woken up, it's time to be fully awake about this. We don't want to be on the other side of regret. Look, it would've been much easier had you jump roped and done gymnastics as a kid. Better still if you started serious strength training and stopped starving yourself in your 20s. Even better if during your pregnancies you ate more knowing the baby was priority and that your bones were last in line. They were getting drained if you were not eating enough, if you were trying to avoid gaining too much weight. And if you're perimenopause stages, if you didn't lift then and consume high quality protein, then now, right now, whatever stage you're in, this is the time to get serious. I'm Debra Atkinson. You're listening to Flipping 50, where I address yours and my top struggles and concerns, and I share what to eat, how to move, and how to change your mindset so you can have the energy and vitality that you Need and Deserve. And this is all science-based on science featuring women who are in midlife and menopause. We talk and break this down into the application. What does it look like in a program? What does it look like? And, you know, interestingly enough, I just— there are so many great podcasts out there. There are so many great becoming a little more science-based podcasts, and this is really important that when you're listening to something, you are actually like looking at, okay, the science says, and not taking that flat line for anything. You're taking what science, what was the science, who were the subjects, how many subjects, how long, were they like me? You've got to start asking and drilling down. I will share, that's what we do 100% of time here. There's no point in talking about something if it's not relative, because you are my people. You are the reason we're here. So make it clear to you that— I'm hoping I make it clear that anywhere that you go to gyms, working with a personal trainer, you actually have to ask them. So they, they may be fantastic at doing functional exercise and protocols for your tendinitis in your elbow, and they may have— this is great, I think they're pretty good, you know. And when somebody says that to me, I'm like, okay, for you, for you and a woman in your 60s or your 50s or your 40s or wherever you are, are they talking to you about your endocrinology? Are they talking to you about that? Are they asking you about your bone density? Are they talking to you about your lean muscle mass and how much you have of it, how much you've gained or lost in the last 3 months? Because if they didn't ask that question, they're not all that great. For you. You need to help them be better. Now, you may, by asking, start to alert them that you are an educated population, and they cannot take that for granted because you don't. All right, let's dive in. So here's the postmenopausal bone 411, right? With none of these situations or concerns— when you're an adolescent, you're in your 20s, your 30s, you're pregnant, you're perimenopause, your postmenopause, should you start at the ideal of what I'm about to say? I'm going to give you— this is what you want to do for postmenopausal bone density. But you may be able to say or have to say, I can't do that. I have no cartilage in my knees right now. They want to do replacement, but they won't do it yet. So I'm limited with what I can do. You may say, I've had the post replacement. My surgeon doesn't want me to screw up his beautiful work because this is really the case most of the time. So you may have, I can't do that, but I can do these things. I can do that. Perfect. It's what all of us are going to do at any given time. It's kind of like you need to eat the rainbow. Well, you may say, what, but I don't like broccoli or green beans. Fine. There's plenty of other foods out there for you, right? So you can still get a great program. Almost none of us are going to be able to do 100% of each of these, but here's what you would If you could do the perfect bone density program, strength train major muscle groups in 8 to 12 repetitions or fewer, or fewer, not more. 3 to 4 sets of them. Multiple sets is far better than a couple of sets of many exercises. 2 to 3 times a week. Now I say 2 to 3. At Flipping 50, we choose 2. So this is like, you know, I have employees apply for a job. We talk about a range of pay. If we talk about 2,000 to 5,000, I'm thinking 2,000, they're thinking 5. This is not a good thing. So we specifically say, here's your goal, I want you to do twice weekly strength training because the significant difference is non-existent. 2 and 3 times gets almost identical results. One is not better than the other, and I would say 90% of the women who show up to Flipping 50 maybe have been around the block once or twice. And I don't mean your expertise or experience sexually at all. What I mean is that you've tried other programs and you're already tired. You've already overtrained and overdone it, and we have to restore before more. If your adrenals and your cortisol are being taxed out, you will never, ever, ever also gain bone density. Stress and a lack of sleep also pull bone from you. Yes, right? And so that's a really important thing to consider. So strength train. I would suggest 8 to 12 reps or fewer. So you might want to start with 8 to 12 if you've got some experience. You have no experience, you're going to have to start with greater than that, 15 to 20, over the course of weeks and about 2 months. In terms of safe, reasonable, sane progression, you're going to get to the point where you're doing 8 to 12 or fewer. Okay, 2 to 3 times a week, twice is enough if you're doing the rest of these things. You're going to add power to your lifting after you've established this base. You're going to lift quickly and pause, control it, and then you're going to lower slowly under control. Now, we're not talking about move quick, quick, quick, quick, quick. We're talking about quick Pause there and slowly lower that down and pause there, and then quick and do it again. That's power, that's on purpose, that's not momentum. The third thing is weight-bearing activity, but we're not talking walking, and for a very, very long time, and it's very misunderstood. Now look, if you've been lying on the couch, walking is good. Walking is your first step, pun intended, steps, but The more impact you can get, the better. The research points to 3 to 5 sets of 10 to 20 jumps, 4 to 7 days per week. I demonstrate in a YouTube video what these look like and share about 14 of them. Now, these are— this is not an all-inclusive list of impact. There's tons of ways that you can get impact: hopping on one foot, jumping on two feet, jumping forward and back, jumping side to side, jumping onto a box off of a box. And so, so many things that you can choose. Stomping your feet can actually be beneficial. Dancing, walking, uh, squat jumps, power jumps— lots of things that apply here. But think about it again, 3 to 5 sets of 10 to 20 jumps. Could you just stand up right now wherever you are, and if you're out for a walk, go you, and do 20 little jumps? 1, 2, 3, 4, 5, 6. And everybody's gonna look at you and then say, should I be doing that? So that's how fast it is. Probably takes less than 2 minutes to accomplish this for a given day, but you don't have to do it all at one time. You could do, you know, do a set, do a set while you're on a break, do us— do another set later, and that's it. 3 to 5 sets, okay? But you're getting impact and stimulus for your bone. And I give you those ratings in the show notes today. The numbers associated with them are the ground forces. So from the start dance steps is 2.7. That is, 2.7 is the— how much ground force is it— to all the way down to a vertical jump, which is 7.1. Now, that's, that's not quite 3 times, but it's a significant jump, pun intended. But if you can't do that because of prolapse or incontinence or joint replacement or the need for joint replacement, that's okay. You're just going to find your line. What can I do? What can you do? And again, And maybe you have to back up and you can strength train slowly, but you can't do high impact. Okay, eliminate that one because you probably do this one: yoga, 12 minutes a day, according to Dr. Lauren Fishman, who was a guest on the What, When, and Why to Exercise— or What, When, and How— wow, it was mine, but it was May— to Exercise for Women 40 and Over, the summit. Dr. Fishman was on the summit. He was So fun to talk to. And they're in the, in the process of studying which of these 12 yoga moves— but each one was done for a minute. So if it was something like a warrior pose, you have to do it on the right and the left. It was each 30 seconds and switching. If it was something like, uh, corpse pose where you're lying on your back— that's an easy one, I like that one— but that's how easy it is, 12 minutes. And they found that in a longitudinal study over a long time and a big group of women who were postmenopausal and had osteoporosis they gained 1% of bone density every year, not just the first year, which is often common when you add a new stimulus and then it slows down after that. But no, the continuous gains were over the course of a year. Now you may think 1% is not a lot, but a cumulative gain of a percent every year is a lot when in fact the usual average losses can be 1 to 3% or 1-4% each year, depending on where you are relationship to menopause and to your exercise and health habits otherwise. Next up is HIIT, high-intensity interval training, that activates fast-twitch muscle fibers. So what we want you to do is, yes, you could combine the high-impact ground force stuff that I talked about earlier may be your HIIT, but they may not be. It depends on what you're able to do, and you may have to eliminate the high impact. But if you can do high-intensity exercise and not do impact, you're still doing fast-twitch muscle fiber, which helps build bone because that pulls on your bone. And that is one of the factors. So you're not getting the direct force by hitting the ground to the bone, but you are getting the force to the bone because the muscle is responsive. So we're talking about, you know, agility ladders. Stairs, moving quickly, responding to somebody throwing you a ball, moving side to side laterally. And literally, you could be doing this also just on a bike— sprint and recover, and sprint and recover. You could do it on an elliptical trainer. So you don't have to have— as my illustration here, you don't have to have high impact. You could do it in a swimming pool, either running or horizontally actually swimming. You can do it on a rowing machine. So there are many, many ways to do high-intensity interval training that would stimulate fast-twitch muscle fibers. And yes, even better if you can do this in a reactive way and you have skills and you can combine it with your high impact. Now you're kind of crossing out two things that you need with one activity, and there's a little less time involved, right? Yes. Okay. And you're going to decrease your risk of falls. All right, let me talk to you about this. So exercise effects on bone vary. So in this list I'm about to give you, resistance exercise on the femoral neck— that's your hip, that ball and socket joint in your hip— again, there is exercise without resistance on the femoral neck. What are the results of that? Resistance-only exercise, not adding any high impact or anything else. There's functional exercise, on the femoral neck or the lumbar spine. Balance exercises have been tested. Bone loading exercise alone, meaning that kind of jumping, squatting kind of thing, but no other resistance to it. All of these kinds of things have been studied, but here's the problem. A review of literature that included many studies, like just looked at a smattering of all of them, showed mixed results for exercise effects on bone because it's the Wild West. There's no consistency among all of the studies that only looked at resistance training. The protocols were different, meaning how many, how many sets, how much, how long was it in weeks or months. It was all just all over the board, the exercises that they did. So just just checking your weight training box— yes, I weight train, you know— that may not support significant changes in your bone. You really need to make sure, is this study, you know, first of all, is it big enough? Did it go long enough? Do we have conclusive evidence that this protocol works? When we pull program protocols into Flipping 50, nothing makes it if a small study only. It's got to have had a significant impact positively on a group of women in postmenopause or perimenopause over time. And this is really, again, an important question. If you walk into a classroom where it's a group fitness class and there's men and women and, you know, people of all ages, you need to ask a little bit about who designed this program. And where's the science? Who is it on and who was it shown? There have been some studies, and this was probably between 5 and 10 years ago when I first looked at this, because BTS and Len Mills, I think it is, kind of merged since. But these are group— Les Mills, thank you. Jeez, brain fart, it's been so long. They had— they have merged since, but these programs are kind of the kind that you could walk into a group fitness studio and you would know somewhat what to expect because it was predictive that every instructor— you didn't have to call anymore and say, who's teaching, to find out if it was going to be a good class or not. They have to all teach the same protocol. So it was less, you know, this one's good, this one's bad, for owners and for gym members, it was just a better experience. But in programs that were less meals or BTS, the study showed there was not a positive impact on bone density from those programs. So then you have to wonder, well, who was this designed for? And it may have simply been based on guidelines and position statements, but that's not necessarily a direct correlation with any one population. So this is where we just law of averages. You're not average, right? And neither am I. No one is. So we've really— we're going to be better off going to, you know, a studio that caters to women in menopause, but that it's not a label on the door or a title on somebody's business card or on their Instagram handle. They've actually got the training, or they do the training of other people.. So, okay, let's keep going. All right, for programs targeting menopause or post-menopause bone, you want to know what your goals specifically are. And I would suggest, number one, stop or slowing your bone losses. You want to look at that. I would want to stop mine. That's my number one goal, right? And then gaining bone density. So this is really important that you mentally know you can do this, we can do this, that you're probably not going to have any bone gains if you're still losing. And your losses may be related to gut health and your sleep and stress habits as much as any exercise void. So overall, higher levels of physical activity, and in all the literature, were associated with better bone health. But when It's, you know, combining targeted recommendations below. So you need to know weight-bearing balance and functional exercises must also include a resistance training component to be effective for bone. That means either they included a weighted vest, you are wearing a weighted vest, or most optimal resistance training as a component of your weekly routine in addition to yoga, not necessarily at the same time. So a weighted vest while you're walking is probably not nearly as good— wearing that weighted vest for 30 or 40 minutes, not nearly as good as doing strength training for 20 or 30 minutes a couple times a week. Just thinking about that should give you pause, huh? Right. Walking speeds lower than 3.5 miles per hour prove ineffective for bone benefit. Now, if you're listening and you're, you're small, you're really petite, and/or you're larger size and petite, and you find 3.5 is feeling really fast, give yourself a little grace here. So I do think there's a little bit of relativity here. And, you know, if you're finding it hard to go faster because you're limited in mobility, you are probably doing all the good you can right now. So stay the course. Stay the course. You're doing fine. The bullseye for bone— I've shared this recently on a podcast. I'm going to include it in the show notes for this one, but I'm gonna jump down. So the text and copy will be in the show notes today, but I'm going to jump down to what was not effective in postmenopausal bone improvement. This is really important, okay? So pay attention. So you may be doing any of these. Now's the time to make a change. Number 1, resistance training at less than 80%. That means 80% of a 1-rep max. Now, never ever do we want anybody to go in and do a 1 or a 3-rep max because that's dangerous if you have bone density issues. It's really silly and stupid to get hurt doing that if you don't have bone density issues. But what does that equate to? That's 8 to 10 repetitions to muscle fatigue. That means if you, you get to 10 and you feel like I could do 2 more or 5 more, you're not actually at the point where you're supporting your bone density. Will your muscles get stronger if you have a lighter weight doing more reps? Yes, but you are not doing the same bone good. This distinction I've been talking about for almost 25 years. No, longer. Well, yes, this is correct. Since '95. Can't do math. That's not strong suit. But this I find is still something that most consumers, and I mean you, and part of the reason is that trainers and health coaches don't understand, that if someone wants specifically bone density support, that they need to get on a track for exercising now safely and very progressively moving up with their weight, that simply doing lightweight more reps is not going to work. Functional training alone did not work. And what do we mean by that? Well, you all know those classes that are new toys, new props. I found this, I just went to a workshop, this is such a great exercise. This is not a good way to exercise. The good way to exercise is for you to define your priorities and to match the exercises that fit that priority. Don't go shopping for the movement, for the tool, or for the prop. I'm gonna let that sink in. What also doesn't work is balance weight-bearing alone. So standing in one place still doing a tree pose, probably not helping your bone density very much. Okay, now I know the 12 yoga poses proved that there was something going on. However, they are studying right now each of those 12 poses, and my bet is is that the more varied the pose is, like, uh, you know, a moon pose, when the spine is at a different angle, so it is getting more pull from gravity in a very different way than when you're simply standing or seated, that there's more bone density. That's a hypothesis for now. But this is proven not effective is just balanced weight-bearing alone, walking or running alone. And the reason is what we call minimum effective stress, that there has to be more stress than you're used to. So if you are a runner and you've gained, you know, the ability to run a couple of miles easily, you know, anytime you want to, you're not getting more bone density from going out again or doing another day or adding another mile. It's the same stress every step. You're already adapted. So unless you then put on a weight vest or unless you start leaping, you know, you're not getting more. And even male runners, you know, once we start leveling out in about our 70s, males and females become a little more equal for their osteoporosis risk. Women are far more prone to risk from about 50 to 70 because of the dramatic drop in estrogen in that menopause transition, but we catch up with each other. So it's important to, to realize that the men in your life, you know, they may also be bigger boned. There is that they had a little more muscle to begin with. However, when, you know, you've got a lean male, and especially a runner, an endurance athlete, most likely he's prone to osteoporosis a little bit earlier in his life compared to a larger size man. Even resistance training alone is not as significant for bone support as it is in combination with multiple exercises, including resistance. So meaning getting that high-impact lateral forward and back multidirectional work, getting fast-twitch muscle work, doing high-intensity interval training, even if it's low impact, getting the yoga kind of poses, all of that super, super important. So what is what I would describe as functional exercises for bones, particularly postmenopausal, you know, it's related directly to improving your bones. Anything that does that, and that means, you know, if it is safer for you and who you are and right now your balance status, getting on machine weights so that you can safely lift heavier than you might be able to stabilize yourself with dumbbells for now may very functional. Get on a leg press, get on a chest press machine, get on a seated row machine. Those are the 3 biggest powerful impactors of your spinal bone density and your hip bone density, which are 2 of 3 of the osteozones. Now, when you're doing a chest press and you're doing a row, you're also getting some work on your wrist. That's the 3rd of the osteozones, the most likely to fracture. And why is that? It's because it's a very small joint, and we will try to break a fall by putting our hand out to catch ourselves. So be sure that you realize— and by telling you that functional might be using machine weights, if you have the body strength and the stability now to use dumbbells, that is always my first choice. So think about this. I am 59. I know I'm I'm, you know, 3 years and very soon I will be that 4th year beyond menopause. This is peak bone loss time. It's that window of opportunity where it could be happening if I wasn't putting on the brakes. And when I go to a gym, I don't use the machines except for a leg press. I use heavy dumbbells. Why? Because I'm stabilizing through my spinal column when I'm doing a bent-over row and I'm not stabilizing when I would be using a seated row on a machine. Likewise, I am stabilizing using my spine when I'm on a bench doing dumbbells. Picking it up and getting into place is also part of the work. So if you can, you have the ability, or as you get stronger, I would highly recommend that you consider doing that because that is a little bit more like picking up a child. It is a little bit more like picking something up out of your trunk. And I know we don't have to bend over so much anymore. I'm dating myself. We just open up the, the swing from the back. We don't even have to shut the trunk anymore, but we have to get in and out of our back seat. We have to, you know, bend over and pick up rocks or bags of salt and dog food. And you want to be thinking about that. What are things that I want to be doing? Are you picking up a stand-up paddleboard or taking it off of your trunk or getting it up there in the first place? Are you traveling? You have a carry-on that you're putting in the overhead compartment. You want to do it yourself? You want to ask somebody? I mean, these things are, you know, things to consider. So back to one more final point. You do, even though I've given you the— these are— this is the gold standard, the bullseye. You do have to start with less than that before you progress safely to that. So be safe. If you need support, we are here. You can find us at Flipping50.com, either for getting started with a small little challenge, for podcasts, for blogs that are supportive. And you have a search icon right on the site where you can find bone density. Look for all our articles, podcasts, Flipping 50 TV shows that answer questions and help you get specifically the help that you want. And what are you waiting for? Let's start Flipping 50 today. Show notes for today will be at flipping50.com/postmenopausebones. Oh, oh, oh.