The Hidden Cost of Diet Culture in Menopause

Hey, stay tuned for this one. This episode I am diving in with a nutrition and movement expert who is one of us, so in the ranks among those of us who are postmenopausal. And, you know, she's got years of experience of doing this. And we really, we, I would say we did not just dive into science and go study after study after study. And I think sometimes that's valuable, but I think what we did today is far more valuable. And I hope that what it will do is prompt you to think a little bit more about your own feelings about yourself in certain areas that we unpacked. So cannot wait to dive into this one with you. You're in perimenopause, menopause, or postmenopause, and you're not slowing down, you're just getting started. But the old rules don't apply anymore. The workouts that worked before, they're working against you now. The advice you've been given, incomplete at best. I'm Debra Atkinson, and I'm the founder of Flipping 50, the pioneer in fitness for women in midlife. For more than 40 years, I've been in the trenches with women just like you, and for the last 12, right here on this podcast, and, and the founder of Flipping 50: The Stronger Way app and membership. Welcome to Flipping 50 the Stronger Way, where science meets strength, where you'll find the tools, research, and real talk to build the body and the life you want in your second half. Each week, you'll get evidence-based exercise and nutrition strategies, conversations with leading experts, and honest answers to the questions your doctor didn't get answers to in medical school and doesn't have time to answer in an appointment. This is your show. Let's get stronger. I must have been 8 or 9 years old, and I was at Sharon Phillips' house because that's where I went when I closed the door, said to my folks, when they said, where are you going? I said, outside. And they knew I was going to Sharon Phillips' house. So there I was next door, sitting on the porch swing, probably having just consumed popsicles. But in the summer, we were sitting and I distinctly remember that day, we were having a conversation about our thighs. And I think she brought it up, but I think I agreed that if we could just slice off our thighs right there, the fat part. And we were 9. And that came back to me in the middle of this episode. And so there's a place in this episode, in our conversation with my guest, where we talk about body image and where it started and our relationship with food and how that started. And like a meme on social media that says, "How it started and how it's going," I think today is really a check-in with, "How's it going?" for you. And I hope that what we prompt you to do most of all is not just listen, but then listen, check in with yourself. And if you're walking or you're lifting, or if you are commuting or cooking as you're listening, I hope that this resonates. My guest today is a recent new friend and colleague. Met her in February of this year at a conference in New York City. Heidi Skolnick, she's author of the upcoming, that is due September 26th, "Your GLP-1 Game Plan: What Your Doctor Didn't Tell You About How to Eat, Move, and Thrive on Weight-Loss Medication." And she is co-author of the New York Times bestselling "The Whole Body Reset." And she is part of the Women's Sports Medicine Center at Hospital for Special Surgery. Heidi oversees performance nutrition at the Juilliard School and the School of American Ballet. Prior, Skolnick worked with the New York Knicks basketball team, New York Giants football, New York Mets baseball, and she has earned two master's degrees in physiology and human nutrition. Now she's got a whole list of more credentials, but I wanted you to hear those upfront. First and personal because such a diverse dichotomy of clients. And as a realist, Heidi believes M&M's can fit into healthy eating style along with the red peppers, the red meat, the broccoli, and the fresh fruit. I think you're going to love this episode, and we really want to hear from you behind the scenes afterward. So don't forget, you can always find me in Instagram DM. And P.S. If the episodes that we share are helpful, thank you so much for sharing them with a friend. It's how we spread the word and it's how you and I end up having great playmates at 90 when we have all the energy and the strength in the world and we need somebody to share it with. Heidi, thank you so much for joining me.

It's great to be here. It was wonderful being on the panel with you and I'm so excited that you invited me on.

Excellent. And so many things to dive into here. I didn't want to waste a minute. So first of all, though, I think this is so relevant. I'm just going to call out the elephant in the room. I think it really helps to take nutrition advice when you're a woman in midlife from a woman in midlife. How important do you think that is?

You know, that's an interesting one because, because I was a woman younger, still having women older come into my office. Right, right. And so I think it has more to do with credibility and people knowing what they know. Mm-hmm. Because as we know, there's so many influencers out there. So there are people who are in midlife or beyond who are giving out nutrition information that is not accurate or is based on their own experience. And their own experience is valid for sure, but it doesn't mean that it's relevant, accurate, or appropriate for everybody else. And so, but what is true is that when I was a younger woman, trying to give advice, and I knew to believe with the woman sitting in my office and what they were saying, which didn't always align with what I was told, to believe the woman sitting in my office, because you can't ever go against somebody's own personal experience. Right.

Feelings never lie.

They're never wrong. Right? Right. Yes. Okay, so I do have way more empathy, understanding. It hit me later than many women, I think because of my lifestyle and knowledge, but it still hits, right? Like, we get there, we're aging, it's okay, there's changes that occur. And, and even though I know so much, it's still a struggle at times. Like, there is that attitude adjustment and understanding and letting go while also doing what I can to stay healthy and vibrant and vital. So all of it's true.

So given that, given what you've just said, have you, or has that made you think, gosh, you know, so many of us have gone through this or going through it, and yet we're, we're each an individual thumbprint. But this hints to me, and you probably hear more women come back to you and talk about it, that we still need more research. Like the evidence-based stuff says this, and yet all these women show up and they're not like those subjects at all.

Yes. I mean, we know that women are under-researched, right? Like, that there's just not enough across the board at every age and for different populations, meaning, you know, the most elite athletes, female athletes also don't have the research, and we're not small men. So yeah, we don't have the research. And then having said that, it's very hard to tease out. Hormones and menstrual— again, within the athletic world, this whole idea of menstrual cycling and do we adjust training based on it or don't, there's so much individuality in terms of that experience. So understanding yourself and your own cycle is different than trying to adjust an entire team's, you know, workout based on that. And the evidence just doesn't support it. But there are certain people who are touting that, right?

Yeah, absolutely. So what about the nutrition side of things? Is there a way to eat to support your cycle, or what would you say to that?

Oh, that's interesting. I didn't see that question coming because, you know, Here we are on the other side and talking about a woman of a certain age. Um, there are some things, but not to the degree that I think has been popularized, you know, or is again trending, or, you know, because the reality is actually we get more hungry, um, right before our cycle. So, right. And, and, but that's when you're feeling bloated because of hormonal, you know, and that's when you're feeling a little— and so then you don't want to eat more, but you actually need to eat more. If you ate more, you probably wouldn't— like some, for the women who talk about binging and craving. So a lot of it is based on our headset and mind games of how we, you know, again, in the whole thin ideal and the pursuit of the thin ideal, as opposed to like, you can need up to 300 to 500 calories more. Eat the sandwich instead of the salad. Not that you can't make a good hearty salad, but depending on, you know what I mean, like that idea of less when you actually need a little bit more. And yes, you can have, you know, more complex carbs and more protein and getting your B vitamins and, you know, magnesium. Like, yes, there's all of that in there, but do you really need to cycle it out. I think there's some basics to, uh, to how we eat always, and then there's slight understandings of when you're hungrier or how hard you're training, or, you know, the whole diet behavior that messes us up more than whether we're eating a few more foods that have more magnesium in it. Yeah, I—

gosh, I wish I could be a fly on the wall in your room and take all the recordings back from that. But I'm dying to know, what would you say are the biggest myths, the beliefs and perceptions that we carry with us, most likely because we learned them at a time we were very impressionable, and then we just carry them through? And we humans like to be right. So it's very hard to change our mind if we've attached to that thought for so long, even though logically, as intelligent women, we can sit in a room and nod our heads up and down all day. But it's hard to change the action that you take based on that. What is it that we carry with us that you would say, I see this frequently, we still believe X and it's not serving us?

Well, there's a list, but it does start with diet culture, right? It actually starts at a very young age. We know that girls who are even— by the time they're in third grade, they're worried about being fat.

Yeah.

Right? There's this old cartoon I have, and it's two girls getting on a scale. Like, they're standing around a scale, and one says to the other, "I don't know what that is. I just know that when you get on it, you cry." Oh, yeah.

Yeah, I've seen them.

Right? And it's like, but how heartbreaking, right, is that girls are talking, even if they're not taking action to diet, they're talking about diet. It's so pervasive. It's already— they've already integrated that as their approach toward food. Not food as nourishment, not food as energy, not food as pleasure, not food as culture, not food as comfort, not food as, you know, all of the different things that— nourishment, for sure, you know, but all of the different ways in which food serves us. And it serves us differently at different times. Sometimes it's very dysfunctional. Like, again, with a lot of my athletes, you got to eat to keep up with your training. But that's not how we approach it. We approach it as something to restrict, something to feel guilty about, something to— we don't just say that food is bad. We say we are bad because we ate it. I'm so bad I ate a cookie. True. Right? So that's now moralizing food, which is also very cultural, which food we're talking about. But it becomes then very wrapped up in emotion and our sense of self. And I think, like, that's that whole intuitive eating piece of, like, we become so separated from how it just feels to eat, the pleasure of eating. And have I had enough? Well, how do you know that if you're restricting all the time and then countering it with either restricting more or then binging and then not feeling good about that binge or overeating. You know, I'm not sure, you know, what is overeating, but yeah, it's very— I think, and I think we carry that even when we try to— because it's so pervasive that it's hard to get away from because it is part of our vernacular, how we talk about food. Yeah.

Yeah. And we nurture with it. Like we turned right back around and here we are, you know, cooking for everybody. And it is sometimes the way we love people.

Yeah, well, I think that's a beautiful way, as long as you're not forcing people to eat that food or guilting them into finishing the plate, you know. Or yeah, but I mean, it's a beautiful— breaking bread with people, gets to sitting around the table, it's a beautiful practice. I mean, I don't know why the— I mean, it's not true in every family. Just had this discussion because I am as somebody in the nutrition world who is not— I'm not a chef. I'm not big on cooking, right? And so, but the role is expected that I would be. When you go to other people's homes, you know, that role, that female-male role of like the women are in the kitchen and the men are out having a drink or something. And I'm like, you know, I'm not down for that. I, you know, whatever. I don't do my own. But that's a different story for another time. If you love to cook or you love to feed your family, you love to nourish your family, and food is one way to do it, That's beautiful. It's just the— again, it's just the guilt that you might put on top of it, or the manipulation that might come with it. Not feeding them. Feeding food is one of our— I mean, you're born, you cry, you eat, right? You breathe, eat. It's one of the most— right?

So true. I have a 7-month-old grandson right now, and so we're like the milk lady.

Like, yeah, I'm like Okay. Okay.

I'm being schooled. Totally. I want to ask about— and I, your bio just makes me want to spend like 2 weeks with you and ask so many questions because there's such a dichotomy and diversity among who you're working with that I'm dying to ask what's the difference between, you know, ballerinas and basketball players and the way that they eat, but I guess I wanna dive in and ask, what kind of mistakes are very active women who I would call them, and I like to have them think of themselves this way 'cause I think it helps their healthy attitude toward fueling, calling them athletic because they are intentionally exercising for a specific outcome. May not be winning a race or being on a platform, but it desires an outcome. What mistakes do they tend to make in fueling for what it is, the result they want, that say, somebody who's a prima donna or who's a basketball player, an elite athlete, would never make?

Well, first of all, let's not make the assumption that elite athletes don't make similar mistakes, right? I still see it and it still is pervasive. But there's— do you know RED-S, the RED-S model?

Yes, but explain it to my listener.

So the RED-S model is Relative Energy Deficiency in Sport. And within the RED-S model, It's called the Female Athlete Triad or the Athlete Triad because it does apply to men too. But basically, it's saying that whether it's inadvertent because we're very busy all day or it's more purposeful because we're engaging in diet behaviors, we end up having what's called low energy availability. And that means, like, we have to feed our physiology. We feed our lungs, our heart, our kidneys, right? We feed actually our digestive system, our brain, our bone health. That bone turnover that's going on throughout our life. So our bone health— like, every system in our body requires energy, and that's our resting metabolic rate that's serving, all right? That's so even when we're sleeping, we are actually still fueling our entire body. It comes out of the carbohydrate in our liver. Liver glycogen feeds that, and then when we wake up, we break the fast, we replenish. Different story, getting off track. So, when you engage in physical activity, that's additional calories that are needed to your resting metabolic rate.

Mm-hmm.

And your energy goes to what you need is most immediate. So if I'm running or I'm lifting or I'm playing basketball or field hockey or taking a dance class or, you know, whatever it is you're engaging— playing tennis, pickleball, you know, whatever you're doing— that energy goes there. And then what's left feeds the rest of our fuels, the rest of our body, our physiology. And when you don't have enough, you have low energy available. For all of those different systems. And if it is chronic over time, when it's chronic, when it's severe, all of those— the duration of it can lead to a conservation of energy. We reapportion where the energy is going to go. So for, for women, younger women, teenagers who are, who are really in this deficit, they can end up shifting the energy away from, let's say, their hormonal system. They don't get their period. It's not a badge of honor. Look how busy, how hard I'm working. It really means your body is not functioning at its optimal. You're not fueling it enough, and then you're not laying down the bone. So the teenagers I work with, it's really imperative because we have until about age 19 to lay down 90% of our bone for the rest of our life. Yeah. Right now, thank you. We're that bone bank, right? And so if you didn't lay it down, now, now you have a woman in her 40s or 50s with osteopenia and saying, but I eat well, but I have to go back and go, but did you in high school? Did you in college? Were you aging? And usually we can trace it back unless they're even continuing. We still need calcium, we still need calories, we still need all of that afterwards, still turning over bone, but we've reached our peak bone and now we're trying to replenish what we have and keep what we need. What we have.

I so, yeah, I so love that you said that. I, you know, I talk frequently about how I recently found out a couple years ago, DEXA scan, that I had osteopenia in 3 sites. And I was just, how rude, you know, like I'm a professional. And, and as I began to tell my story, I was like, you know, you can't, you can't outrun your history. And, you know, high school and early college, I did not have great eating habits. Even continued in grad school, I had more Diet Coke than anybody needs ever to have. Yeah. You know, and, you know, you, you can do what you can do once you know better, but you can't necessarily go back and make up for those things. So I love that you said that.

And yet, and yet, probably a lot of what you're doing now, not knowing, but like you're saying, you know, like you, you may have had osteoporosis had you not done all that you're doing now, like all the strength training and the bounding or jumping or whatever you're doing, the force movement. If you weren't eating up to meet your needs now, you know, that it could have been in a— you could have been further along. And perhaps now that you know it, you might outgrow it too, because that's the thing about osteopenia. There's still some chance in there. Right. And delaying the progression is a big deal.

Yeah, absolutely. Well, actually, I've reversed it, so that's a good thing. Yeah, story for another day. But I want to ask, so coming back to energy deficiency, so when you're a teen, it's very easy to show, like you see it. If you're a teenage girl, you know. But what happens when there's a woman post-menopause? Who's got that. We don't have that showing up anymore as here's your telltale or your you can't get pregnant sign. How do they know? How do they feel? Because they're amidst a storm where they already maybe don't feel good. It's hard to parse out.

It is. And it's really sort of this diagnosis differentiation. And I would say with all that we don't know, as you said, going back to medical, like, I think there are so many women who suffer from body dissatisfaction in a way that it drives— and, and because that's always a question, why am I doing something that's a little on the psychological side? Why, why do I do so much work on body image? And it's because poor body image often drives our, our diet behavior, right? And until we work on that, it's hard to totally be able to allow ourselves to recognize the food we're entitled to and eat appropriately. So I think there are women— there are these points in our lives that we are particularly vulnerable. And I think that menopause is one of that, where we'll see women become dissatisfied. They might already have a subclinical sort of dysfunctional eating pattern anyway, engaging in that. And now it takes on a whole nother sort of round of it.

They might have had it when they were in teenager or college years.

Then it might have been somewhat— better, maybe, maybe not. And now again. And so, right, like from brain fog, because I talked about the hormonal dysfunction, but it's brain fog, it's gastric upset, right? It's bloating, it's slowing to constipation. It's like a lot of these similar symptoms that can be hormonally driven, but also can be made worse by this, again, to underfueling, chronic underfueling, and then exercising more to try to outchase their body changes. So they're exercising more. Like you said, they're very athletic. You don't have to be— you don't have to be a professional athlete to really be engaging. And in fact, that's another thing. Like, you're right, we're gonna— we're gonna want to talk for hours, is that, you know, some women— they're— look, we have a whole population that we want to encourage to move more that are not moving enough, right? So let's talk about them in a minute. But let's talk about right now the woman who is pursuing you know, their health, their well-being, but also their body ideal. And they're exercising a lot. And what happens is they think every day should be a PR, right? Like every day they should go to the gym and they're giving it— every day is a HIIT class.

Well, you know what the problem is? And one of them, I think, is because every day you turn on your social media and for whoever you're following, it is a PR. And so, you know, you're, you're not seeing maybe that whole truth. You're just seeing they keep posting their PRs because they're not going to post a bad day.

Yeah, yeah, yeah. And also, I'll tell you another thing about it, but let me finish this point. So you're right. So, so what happens is they don't train like athletes do in the sense of having a really, um, determined sort of path of periodization. Like, I'm going to work on strength, I'm going to work on endurance, I'm going to work on power, I'm going to have a rest day or a rest week. Uh, but never mind a rest day every, every— right? Like, how many are going— like, when I see women in my office and they're like, I I can't take a day off. Like, oh my gosh, you know what you need? You need a day off every week or 2 days off. Yeah, you know, and that—

like, you just like scared a whole lot of women out there, and they're like, oh my God.

Yeah, so I think it's that, um, and I get caught up in it too, you know. I, I, you know, again, like, I feel like I can relate to my clients because I'm one of them, right? Like, I am— I'm a post-menopausal woman. Like, so and my peer group, all of it. So it's this idea of like, how do we really know how to train on our own? Why having an expert in exercise is so helpful so that you can have more of a plan and you're not just going hard every day, 365. Even if you take one or two, like knowing how to do different things and incorporate different levels of intensity.

Amen to that. Just something that you just said, I think it ties into the relevance of right now in time. So ACSM just changed the recommendations and we updated the resistance training and we were, we were just going to talk about those who aren't exercising. And I think those changes are very relevant for simplifying. Like we're going to stop making it so complicated so that you can much more easily start without feeling you're already doing it wrong. But you mentioned periodization and, you know, when that said, you know, periodization doesn't really matter, it doesn't really help. And, and yet I want to be sure that everybody who is exercising hears, don't go backward. Like if you've already had sex, don't go back to holding hands because it's not going to be quite the same, right? I mean, we don't want you to backtrack if you are doing it and having semi-good results. Periodization does matter. This episode is sponsored by the Flipping 50 Menopause Fitness Specialist. It is the framework that we designed our entire membership and program based on. Since 2013, I've been developing that after 30 years of working with women in midlife. That was born, and in 2018, we rolled out the Menopause Fitness Specialist to train other fitness and health Pros on how to actually prescribe exercise. Here's where we're going next, in case you want to get started now, that we're actually training physicians on exercise prescription, knowing they get very little of it in medical school, and hoping that it also bridges the gap for you who may be a fitness or health professional, or want to be, who works with women in menopause, because there is so much demand and so much room for you right now. If you are working with women in menopause but not getting all the results, don't have a reliable, predictable framework that gets you results over and over that people know, like, and trust, come and talk to us. We'll put the link in the show notes for today. That's the Flipping 50 Menopause Fitness Specialist. And if you want to head on over to fitnessmarketingacademy.com, it's where we have all of the content dedicated to you health and fitness pros. And I think more for women with declining estrogen than ever before because we're more prone to injury. And so we need to take care of— yes, you can go hard, you're not broken, but yes, recover hard too.

Yeah.

And so you get the benefit. I just, I think that bears saying because, you know, we're on one hand saying "It doesn't matter." And then on the other, I'm saying, "Hmm, I think it's going to." Like when you get started, we want a rhythm of go a little harder, go a little lighter, go a little harder, go a little lighter. Yes.

Yeah, hard, easy days. Maybe I shouldn't say periodization as much as, you know, sort of a plan of hard, easy days. And look, again, the recommendations for someone who's already working hard, right, is like I said, let's come back to that for people who aren't yet moving.

Yes.

Different recommendations because there's a different nuance. Like, the person working hard can nuance, right? And exactly, started doesn't need all of that.

Exactly.

Start moving and everything and anything is helpful.

Yes.

You know, right? So, you know, and in fact, for those that work hard, you know, the idea of, you know, being sedentary and how much we move throughout the day and including movement snacks or exercise snacks versus one workout You know, like, you don't need to go to the gym if that's not your jam yet. You know, you can just start with, are you getting up every hour at your desk? Here I am. Can I do some— can I do some heel raises? Can I march in place? You know, that those bursts of activity help with moving our insulin sensitivity, right? Knowing that going for that 10-minute walk after a meal helps with some glucose uptake, gluco— for, you know, like that whole pathway and insulin regulation. And yes, building some muscle is really helpful for so many reasons. And you don't have to be this bodybuilder. It doesn't have to get to what we were just saying, that those who are being really intense about it. But 2 or 3 times a week, major muscle groups, whether you're using bands, whether you're using free weights, whether you're using machines, you know, there's all these different ways in. And they're all helpful and, and will move you toward improved health and well-being. Mm-hmm. And body confidence— talk about, again, you know, the issues of postmenopausal women. You know, there's a body confidence that comes when you feel strong.

Yeah, absolutely. It is. I, I'm finishing a book myself, and the last chapter I finally told my editor her like, I, I'm a quick start. I really wanted to start this book. I hate the middle, but I'm at the end. And that last chapter is like, oh, I love this chapter because it's about power. And I'm not talking just about jumping and explosive movement, but I'm talking about the whole reason we're doing this is the inner power. Yeah, that you have. Yeah, yeah.

And, you know, again, functional capacity, like the idea Like, you, again, referring back to before, and you're going, these are athletic women who, you know, they're not pro athletes, they're athletic, yes. But let's go shift back then to the other person who really has trouble walking down the block or walking upstairs. And, you know, it does impede quality of life, or they may not realize it until they get a little bit more fitness on their side and they can walk that block or, you know, catch a bus or go on a trip or play with their grandchildren without being winded. And that's such a win.

Yeah.

And that's not about going on, you know, 30-mile bike rides or competing, you know, doing, you know, having to, to split time and, you know, do all of those things like their PR. Like, it's not about that. It's like, how are you feeling?

Yeah.

In life.

And I think way too soon, and we don't even realize it ourselves, that your world starts shrinking. I mean, it's not just like you're thinking twice about taking a trip or flying anymore. It's like you're thinking, do I want to go to the store?

Yeah.

Whether it's to be seen or because it's too much energy expenditure, it's too much.

And you don't— and you don't get energy from resting.

Yeah, yeah. Interesting concept.

Not being, you know, again, not to be the opposite, which is don't ever rest, you gotta move, move, move, because again, it depends your mindset and where you're starting from, there's certainly people that have to say, it's okay to breathe, it's okay to relax. You will recover better if you have the— but the flip of it does, it's so easy. You know, again, I am going to share, you know, it's not about me, but let me share something else.

Since you asked.

Since you asked. You know, this year was a rough winter here. I live in the New York City area and we had a lot of snow and I feel pretty good about my balance and my movement. And I also noticed I'm getting more cautious as I'm walking. You know, like, I don't want to fall. I don't want to slip. And I would never have thought about that when I was younger. And I absolutely am thinking about it. And I know that I don't do as many balance exercises as I can because I assume I'm pretty good. I used to be a dancer. I kind of got this, you know. But so I started and they were more challenging. Than I thought because we do naturally lose some of our proprioception. There's more than proprioception to it, but as we age and you have to practice it, like use it or lose it. And so yeah, I don't want to be— I don't want to be afraid to go out in the— I love going out in the winter. I love walking my dog. I love doing a little snowshoeing. I just love, you know, being out there and I don't want to feel like I can't go out in the winter.

Yeah, no, totally get it. Something keeps coming back to me. I saw a clip and I think of this now because we lost Robert Redford this year, right? But he was on some kind of a clip and he was just saying— and he was just being Robert Redford, he wasn't being an actor— and he said, you know, I think at some point we all start to hesitate about doing things, and I think that's sad. He was just asked about aging and he just, in the voice that only he can, But it was— it's exactly true. Like, you just had that moment, and I have too. I'm like, God, when did that start? When did that happen?

Yeah, yeah. And, and, and again, so I want to be honest because it's not this toxic positivity, like getting older is all great and wonderful, or just if you just accept your body, it's fine. First of all, it's a practice, right? It's not like— and And again, movement isn't like— I am a mover. Like, I get antsy, but I recognize everybody is not. Some people are way more comfortable not moving. Moving is very uncomfortable. There's a genetic component to motivation and all of that too. Not that we can't— like everything that's genetic, we can overcome it by the action and intention and goal setting and being realistic to what is comfortable but push our comfort zone. And that's a mindset. So I don't want to be glib. And, you know, it's not like just, oh, stay positive and everything about aging is great. It's more like, yeah, let's just sort of recognize what am I going to do about that? Do I want to practice balance so I feel more comfortable? Right. Or— yeah. Yeah.

I want to— I want to segue here because I don't want to let you go without asking some contemporary moment that we're in. What do you think of the way we are twisting protein? I mean, I feel like, you know, protein wine is coming out any day. Like, what are we doing to protein? What are we doing to our thoughts about it?

Where—

what are we doing?

And, you know, I— my last book, The Whole Body Reset, is a very protein-forward book trying to, you know, help people who, as they age, understand anabolic resistance, how we have to overcome that. Protein timing throughout the day. And people— and it's very helpful and I believe in it, but people just take these messages and instead of saying, "I need adequate protein, what does that look like?" It becomes protein maxing, you know? And it's like, right, protein popcorn and protein— protein wine. I didn't know protein wine, but protein wine, like protein cookies. Like, no, there's not— like, it's just your portion of the protein foods and making sure that you're not eating only oatmeal, that you have some yogurt with that. Or, you know, like, it's not— it is not that we are I think it was, yeah, we are definitely overdoing it on our zest for protein. And, you know, the unfortunate thing about that, aside from all that energy, wasted energy and money, and it again takes away from just understanding what a balanced plate is, the anxiety, like adding more anxiety. Am I getting enough protein? Am I getting enough? How do I— like also if you don't get protein in the meal, it's not like you then lose all your muscle. And eating more protein, by the way, doesn't, give you muscle. It helps to prevent muscle breakdown, but you have to do that strength training, resistance training, right? The messages get so construed and add to the anxiety of just being able to eat. Like, yeah, it's, it's just being a little more mindful and purposeful, but it's not, it's not magical. It's—

well, I'm so glad you said that. I, you know, but just an illustration of this conversation, I almost a year ago, literally Italy right now, spent almost a week at a resort with a friend. So next door to her room was me in a solo. Came over and we were talking about, well, you know, do you want something to eat? She said, I just had, you know, and I wanted a little bit more protein, I said to her. And she's like, well, what is— what do you mean by that? I'm like, you know, some protein. She didn't know. She— we went to the refrigerator and opened it up and She goes, "Is that a protein? Is that a protein?" I'm like, "That's an avocado." I mean, like, are you messing with me? I'm like— and she was not.

Yeah.

So fast forward months later, she's finally getting it. It took a couple more voices. I was just one of those 7, you know, she needed to hear. And then all of a sudden she goes, "I think I'm going to start a new product." like, I'm going to create pancake protein pancakes. And I'm like, oh no, like, we've gone so wrong here. How did, how did we get here? It's just a little nuts. But this really bothers me. I think the thing that bothers me so much is for older adults, I've read, I'm sure you can back this up, that we need both. We need the protein and we need micronutrient Yes. Sufficiency. We need a lot of different micronutrients. Yes. And we need that for muscle strength and protein. And we're squeezing that out. We're squeezing out fiber.

Yeah. No, you're right on. 100% right on that. In the pursuit of protein, and that's why I said we have to go back to the balanced plate, we're pushing out other— we still need whole grains. We still need carbohydrate. We still need fruits and vegetables, and we still need healthy fats. Fats, you know, we need all of it. So it's just how much, right? It's the proportion of it, but it's not— if we eat, we either overeat protein and everything else, and then there is weight gain, you know, or we eat so much protein we push out these other nutrients and we're not balanced in what we're giving our bodies and what we need. And yes, you know, there is, there is a connection actually to all of the other fruits and vegetables and micronutrients that also support support our, um, our muscle health, our mitochondria. Like, we didn't get into the weeds here of some of that, you know, and, and help and fats for mitochondria, and which is really our engine, is aging, you know. There's, there's everything, everything goes from like systems to cells, right? And we, we do, we need it, we need it all. We need a balanced plate.

So there's a woman listening who is I'm doing all the things, she'll say. I'm doing all the things. I eat well, I'm eating my protein, and I'm lifting weights, trying to get good sleep because I've asked her about that, and I'm still not gaining muscle. What would you say to that?

I don't know because it is so personal and there are some other things. But I would say that, you know, sleep's part of that equation, that I don't know. There is a genetic component. There is, like, how, again, how we grew up. You know, we know one of the reasons food insecurity— there's, you know, so many reasons food insecurity is horrible, but it also has to do with, like, metabolic disease later in life, right? Because you don't even have the muscle when you're younger. And so there's just so much to a lifelong of it. And that if she wasn't doing what she was doing, would she be losing more muscle? Like, is she maintaining muscle? Right? And some of our, at times, our expectation of what our bodies should look like versus what they look like. Like, I could eat and exercise exactly as you do and we would not look the same. It's true.

Very true. And I love that you said that because I remind women of that every day. I think we hear repeatedly in our Community, someone will say, "You know, I did this program, I did this program next, and I still haven't gained any muscle." And I said, did you lose any? And I'm like, pat yourself on the back because most women are losing 3 to 8% a decade and you're holding on to yours. Don't forget, that's a win. And, you know, it's like, is your body composition pretty good? And if it is, then maybe we're coasting and we're good.

Yeah.

Focus on the energy and the strength.

I think— I think that's a really important point. What you just said is that focus on, again, function, right? So amount of muscle mass is related, and I hope I'm saying this right, but I don't think it's the whole picture in terms of strength, right, and power.

Right, right.

So that, you know, functionally, how are they doing? And when we can focus more on what we can do and not on a number, as it relates to anything, I think we're better off. But, you know, I also get that that's one way to track progress is to look at muscle, but, um, and not just weight. But so it's a tricky, it's a tricky thing, but we could obsess over— we can pick so many things to obsess over.

Oh, should we? Let's do.

Okay, kidding.

But okay, so, and I think they're asking the right question. At least they're focused on the muscle as, as opposed to the fat. But I'm going to swing back the other way, and that is probably the challenge that most women in midlife would like to overcome. That's where body image comes in again to be problematic. It's like, and it's like I'm, I'm not in control because whatever I do is— feels like I'm like beating my head against the wall. And they would if they could, if they knew what it was. But I'm willing to guess that you are going to say it's custom, it's different for every woman, and there's no one-size-fits-all in terms of how do you help yourself reduce that fat or avoid gaining it?

Yeah. Yeah, I don't have the answer. You know, I think that there's two different, you know—

You're fired.

I know. So, on one hand, research would say, again, our metabolism does not change between 20 and 60. There's this great study a few years out, Pons' work. Yep. And so, men gain weight too, by the way. Right? It's not just women. Men gain weight midlife and beyond. Sure. So we're making it this female problem as opposed to an aging issue. And there is some study also that a little bit of weight as we age is actually good for us, but muscle is important. So there's that. It's not our metabolism, it is our activity, our food. And it is true that our hormones do shift in a way that lays down the fat differently. It doesn't cause us to lose muscle. It doesn't— estrogen loss does not cause us to lose muscle. And we don't have to exercise differently, per se. Like, the same program that when you're younger works when you're older. You may need a little bit more for recovery. I mean, that's your area of expertise, so you tell me. You know, my understanding is, like, again, we just need to be doing it and be doing it consistently. And most people take a few years off. I mean, I think that's changing now with this— with all of this attention. But I think many women— well, we know most— not as many women participate, not as many girls participate in sports, and then not as many women continue, you know, lift weights. And so they enter the age already— they enter mid-age with less muscle mass than men do. It's same thing with bone. So, so there's— so if they start around menopause or postmenopause, they're already a little— not that you, you can't at any age, your body responds.

True.

But then the other thing is there is, there is another very good study that does say no matter what you're— no matter where you start, no matter how lean muscle, thin, trim, middle, whatever, whatever your weight, you gain about 10 pounds on average.

Yeah.

And that doesn't matter, doesn't— it's across. Um, so that's conflicting science, go, go figure, you know. Yeah.

And so there's a lot of women listening saying, I don't want to participate.

Like, I don't want to get in that line, for sure. But, you know, again, part of it is, do you feel better knowing that it is somewhat inevitable? And I'm going to do everything I can to be strong and have that body confidence and be able to participate in my life. Because does it matter? Like, it is different for athletes in terms of performance, right? Or what they're doing, or if they're an aesthetic athlete, because there is some. But if I'm a, you know, if I'm an accountant, Does it matter if I have 5 more pounds versus what it would take for me to lose those 5 pounds and the struggle, you know, the undereating, the not participating in life, or not being able to eat after 6 or whatever? You know, so some values clarification.

Speak into this. How much of our, you know, the history that we have with food and the automatic, I think, decision to— as soon as we want to control it, we want to control the weight, we immediately eat less. We go for the salad or whatever it is that has the fewest calories on the menu.

We don't eat carbs.

Exactly.

We're starving.

And yet, you know, then we're— that's what I call foot on the brake. And then we try to put the foot on the accelerator with the exercise. So we're burning out the motor already as we speak. How much of weight gain in midlife is immediately our reaction is to do that, to eat less, exercise more, because that's what they've always been told. Yeah, but we are a part of slowing our metabolism when it doesn't, just physiologically, not yet anyway. And then, and then we contributed to the problem.

Yeah.

If you wanted to say to a woman you know, you're not stuck with the metabolism you have right now. Here's what you would do if you want to turn that engine back on. What would you tell her?

Yes, so I think that you're, you're right on in terms of— that's what we were getting at before, like, how do we tease this out? We sort of got sidetracked in our own conversations, but how do we tease out how many women are dieting their way through menopause? And so a lot of that symptoms that they're feeling, how much is coming from what? Right? Yeah. Everything from— yeah. So I think it's hard to, as you were saying, change what's deeply ingrained in terms of permission to eat enough, to exercise enough, not over, right? Not nothing. I mean, your realistic weight is the weight you can maintain by moving appropriately, what kind of, and eating appropriately, whatever that means, right? Like, but eating enough, not having to restrict, and not binging all the time. Not, not moving, but not having to be at the gym 4 hours a day, double, you know, whatever, like, right? So it's, and then that's your realistic weight, which is different than many women's ideal weight, which is the weight they were in college, in their mind, the week after they had mono. Right, like, how long— and how long did you maintain that?

That's so true. And I think we conveniently forget the hard parts, you know. We remember, oh, if I could only be back there, or if I could get back to that. Yeah, you know, it's like, do you really? Do you remember whatever else was going on too, right?

Yeah, yeah, yeah. And again, it's hard.

Yeah.

And there could be other things going on for people. I mean, I don't, you know, yeah.

In general, if you were making recommendations and, and looking at things like Dan Buettner's study and his beliefs in what we know about blue zones, what do you think is true for eating for our best, most optimal longevity, meaning the healthspan, like we're stronger longer, not just living longer?

Yeah, yeah. I mean, I, I do believe, first of all, I— it is individual. Everyone has their own culture, heritage, and body history. But in general, I do believe in, in nutrient timing throughout the day, like those balanced meals throughout the day, because you're like, again, vitamin C. If we want to get into like, so, you know, like, so vitamin C, it's a water— it's a water-soluble antioxidant. You know, you— it's not available if you eat it only in the morning, it's not available at night, like when your body is using it for tissue repair or any of these other things, as, you know, free radical or whatever. So you want a little bit at every meal. It's not about, it's not about mega dosing, but it's like, you know, having an orange at breakfast and then you have some tomato on your sandwich and you have some broccoli with dinner. That's vitamin C throughout the day. You know, it's, it's again, so I think that, you know, you have protein at each meal, you have an adequate amount, a little bit more when you're older, a little bit less if you're smaller, a little bit more if you're bigger. You know, it's the same thing with grains. And yet, we don't have to eat perfectly to eat healthfully. Like, it's just not true. Your body can handle a cookie. You know, it's the guilt that you carry with you and that makes you like, again, that's like, you don't ever have to eat a cookie, but you're not, all your nutrition is gonna go away 'cause you had a cookie. But back to the longevity. Yes, we need those fruits and vegetables. We need those phytonutrients from plant-based. I am not a plant-only. I think you can be plant-based and not plant-only. I'd like flexitarian, eat what's available, eat what you like, eat an array, you know. And, and that's, you know, this— the whole longevity wellness field, and I'm part of it, but I hope I'm more evidence-based, which to your point is just that you look like the same thing we keep talking about strength training. You need cardiovascular fitness, cardiovascular fitness for your heart and lungs. Well, that has not gone away. It's just that people used to only do that and not do the strength. In the same way, we need that balance plate for fitness, right? We need our resistance training, we need cardio, we need some mobility. The other thing that's really hard as we get older, and balance, right? Some balance exercises. And so, you know, that plus eating well, not eating perfectly. And the other things that are, you know, it is, it's gratitude and it's sunlight, it's nature, it's relationship-driven. You know, these verticals that we've devoted, that I've devoted my life to, are still only two. You know, exercise and nutrition are still only two verticals in healthcare, like the social determinants of health, which really don't get talked about.

Yeah, so true. All right, I hate to open up a can of worms before letting you go, but I want to ask you this this question because I think you probably see a lot of women that maybe not exclusively, but appetite I find is a problem. Like, having a good appetite— more women that I speak with don't have an appetite than have a ravenous appetite or even cravings. And not true for you?

Uh, no. Okay, interesting. Okay.

Yeah, it is. We're attracting different people.

Yeah, clearly. Yeah.

But my segue was, so in your new book, you know, I'm guessing you've had some reason to dive into this. Part of it is quieting down the noise and the hunger and the appetite. For me, when I have women say, I'm thinking about doing that because of belly fat, and then I'm, I'm concerned because they already don't eat eat a lot. They already seemingly don't eat enough, and now we're looking at reducing it further. Can you speak into that?

Sure. Well, first of all, back to you. I was gonna bring this up, and again, we got sidetracked before when you were talking about, um, under, you know, when, when somebody goes, starts to eat a little less, you know, that works for a little bit. But for most people, once they start to try to diet, which is why it's so hard to really lose weight, is then our appetite-regulating hormones kick in and make us even more hungry.

Yeah.

It could work for a few days, but it's very hard to sustain. And so then it drives us to even be hungrier and we regain weight and we can regain more fat weight than we lost. And muscle's hard to gain, as we've said. It's easy to lose and it's hard to gain. So it, that's not a helpful model. So the new book you were referring to is your GLP-1 Gain Plan: Everything Your Doctor Didn't Tell You About Eat, Move, and Thrive on a weight loss medication. And I have to say that I was, at first, a little conflicted myself about writing this book because I've been an anti-diet nutrition person for a very long time. And I think both things are true, which means that I— the reason I wrote it is actually I was driven because my husband was on one and I watched as he went through and became malnourished. And I, like, there is a place for people in our space to really support those who are on a GLP-1 to eat well and move well to support this incredible tool that has changed people's lives. Those people who need it, you cannot eat and exercise your way to a healthier weight, to weight loss. It doesn't happen for people who are obese. Obese who have obesity, I should say, right? Recognizing obesity as a disease that it is because you can't— it is persistent and lifelong and there's no real cure. And there are ways to manage it. And so these medications are really miraculous in that way, but they really aren't to be used alone. They're a tool and you still need to learn how to eat and and how to move, because your cardiovascular fitness isn't improved on these, and your muscle strength is not improved unless you're doing strength training. And in fact, because you're on this restrictive diet, you lose more muscle right now. For those who really need it, that trade-off of risk—

worth it.

Yeah. But if you're talking about a healthy female who wants to lose 10 or 20 pounds, but otherwise is totally healthy, then you're looking at risk-benefit ratio now, right? So it's, it's, um, and, and the fact that I think it is leading to, again, you know, um, uh, pressure on thinness. Like another, a new, a new era of thin is in that is detrimental to our health and well-being for those who don't really need that medication. Mm-hmm.

Yeah, I think we're looking at a lot of that and we're seeing, you know, any body image issues that midlife women are having. They're looking at women in Hollywood right now. It's just driving it, twisting the sword right now.

But again, that person in Hollywood— and look, that's part of why I'm a no judgment person either, though. It's like, I'm not judging the pressure of why you're on it, you know, you feel that you, you need to be on it for that. But those Hollywood people are making their living on an aesthetic.

Uh-huh.

It's not getting to the thin— I don't— it's like never an individual, it's the pressure, right? But it's not an aesthetic that I totally appreciate, but I recognize that it's an aesthetic that exists. Um, but again, do you need to look that way if you're a banker, a secretary, you know, like whatever you're doing in your life, whatever it is, like, it's your, your job does not rely on that. And why does your self-esteem rely on that? I mean, we could go into, you know, we—

yeah, that's a whole nother— yeah, that's a whole nother hour. Yeah, for sure.

I have those empath problems at times. I do, you know. Yeah, because it's real that the, you know, it's, it's real. You know, the— all of the images. But yes, I think both are true. I think these medications can be extremely, extremely, um, life-changing, and I think they could be incredibly detrimental to our collective— the female collective well-being.

Yeah, totally agree. And on that, I hate to do it, but I'm going to wrap this up with you. So the whole body Reset. It's behind you. It's out right now. They can get their hands on that. And the new book, Your GLP-1 Game Plan: What Your Doctor Didn't Tell You About How to Eat, Move, and Thrive on Weight Loss Medication, that one comes out when?

September 22nd.

Okay. Are you doing some preorders, some juicy stuff?

Not there yet. I'm just getting the copy-edited version back, actually, today. So we're a little early for preorders, but thank you for the, you know, for the ability to plug it. I'll be back. Absolutely. And yes, please, you know, look for it.

Absolutely. Thank you so much. Okay, everybody, you know, we love to hear from you. And so behind the scenes, you can DM me personally. Nobody else has got their little grubby fingers back there. So let me know that you listen to this. And when you see that I'm tagging Heidi as we're sharing this, let us both know. If you have questions or you saw the episode, we all love to hear from you. Thank you so much. Thanks again, Heidi.

Thank you.

The information shared on Flipping 50: The Stronger Way is for educational and informational purposes only and not intended as a substitute for medical advice, diagnosis, or treatment. Always consult your physician or qualified healthcare provider before beginning any exercise program, making changes to your diet, or adjusting any medications or supplements. Individual results may vary. Debra Atkinson and Flipping 50 are not responsible for any injury or adverse outcomes resulting from information presented on this podcast.