Curb Menopausal Weight Gain with Dr. Mary Claire Haver

Hey, J.J. here. Can you believe how fast the holidays are knocking at the door this year? One minute it's pumpkin spice season, the next you're getting your guest room ready and wondering where their wrapping paper went. And that's when I turned to Wayfair. From bedding and towels to holiday decor and last minute stocking stuffers, Wayfair has everything you need to get your home and holidays together fast. And for way less. With Wayfair, I know I can refresh my guest room in no time. Maybe I'll add a soft new comforter or a few holiday throw pillows. With Wayfair, it's so easy and everything arrives super fast. Plus, there's free shipping for any order over $35 easy and total peace of mind. So whether you're hosting, gifting, or just adding those final festive touches, Wayfair has your back. And when the holidays wind down, Wayfair has everything you need to tuck it all neatly away. Smart storage solutions for every room from the kitchen to the closet. Get organized, refreshed and ready for the holidays. For way less head to Wayfair.com right now to shop all things home. Wayfair Every style, every home. That's W A Y-F-A-I R.com hey, it's JJ here. You know, I've been talking about environmental toxins forever, and laundry detergent is a sneaky one. A lot of them contain harsh chemicals like dyes, preservatives, and even UV brighteners. Those brighteners don't actually clean anything. They just coat fabric so your eyes think things look whiter or brighter. That's more chemicals I don't want on my family's sheets or skin. And if you've got sensitive skin or allergies around the house, this can be a big problem. That's what got my attention about Earth Breeze. It looks like a dryer sheet, but it's actually laundry detergent. You toss one in the washer and that's it. No pouring, no mess, and no heavy plastic jug. Their packaging is lightweight cardboard, which helps reduce plastic waste. And if you choose the fragrance free option, it's gentle, hypoallergenic, non irritating, and non sensitizing. I really like how simple it is and how fresh and clean everything comes out without those unnecessary chemicals. Right now you can try Earth Breeze for up to 40% off with free gifts@earthbreeze.com virgin that's earthbreeze.com virgin for up to 40% off plus free gifts on your first order Ray Ban Meta glasses come with open ear audio so you can listen to your favorite music without blocking out the world around you.

Hey Meta, play Gorgeous. Here's Gorgeous by Doja Cat.

You can also ask Meta AI questions here.

Hey Meta, when's Doja Cat's next concert? Doja Cat is playing at the Los Angeles Theater next Tuesday.

Sweet Ray Ban Meta Glasses available at Ray Ban stores and other authorized retailers. I'm JJ Virgin, PhD dropout. Sorry, mom turned four time New York Times bestselling author. Yes, I'm a Certified Nutrition Specialist, Fitness hall of Famer and I speak at health conferences and trainings around the globe. But I'm driven by my insatiable curiosity and love of science to keep asking questions, digging for answers and sharing the information that I uncover with as many people as I can. And that's why I created the well Beyond 40 podcast to synthesize and simplify the science of health into actionable strategies to help you thrive. In each episode we'll talk about what's working in the world of wellness from personalized nutrition and healing your metabolism to to healthy aging and prescriptive fitness. Join me on the journey to better health so you can love how you look and feel right now and have the energy to play full out at 100. You are going to want to listen to this interview probably five times. Holy smokes. It's so good. I am so excited about this guest today. I can't believe I didn't know her before 4. I think that maybe she's my soul sister. This is going to give you so much great information. If you're perimenopausal postmenopausal on what you can do if you're gaining weight, lose that weight, optimize your health, feel better and we're going to go into hormones. Like should you do hormone replacement therapy, what should you consider? What are the latest on research with it, can you start if you didn't start right with you went through menopause. So much great information. Plus we are going to dig into the Galveston diet. Over 100,000 people have gone through it, so there's a reason. Let me tell you a little bit about Dr. Mary Claire Haver. She's a board certified OBGYN who's devoted her adult life to women's health. She began to go through menopause and she got midlife weight gain and nothing was working. And so she dug in to the science, figured it out and created the Galveston Diet, which is now an online program and a book that you can grab. It's the first and only nutrition program in the world created by an OB GYN designed for women in menopause and besides that is also a culinary medicine expert. So she's just got everything that she needs to really nail this and that's why she's getting such Great results. In 2021 she opened Mary Claire Wellness and it is based on her work with the Galveston Diet so that people can come in and get the help that they need. She lives with her hubby, her two daughters. One of her daughters is studying nutrition too. How cool. And she's the author of the Galveston Diet and she's created an inflammation quiz that you are all going to get for free. Plus I'll put all of her social channels and her book there too and you can go to jjvirgin.com galveston diet to get it. Now you might be wondering, how do I spell Galveston? Here you go. G A L V E S T O N diet galveston diet jjvirgin.com galvestondiet and I will be right back with my new pal Mary Claire. Hey, it's JJ here. Now let's be honest. The holidays are basically a financial ambush. Travel, hosting gifts, surprise holiday school, things. Suddenly you're wondering how December turned into a spending spree. If you want to keep your finances under control this holiday season, you need to be using Monarch. It's rated the Wall Street Journal's best budgeting app of 2025. Monarch is the all in one personal finance tool that brings your entire financial life together in one clean interface on your laptop or your phone. What really grabbed my attention is how fast those little holiday expenses pumpkin pile up with Monarch. Seeing everything in one place makes it a lot harder to accidentally overspend. And honestly, I appreciate anything that keeps me from starting January with a money hangover. You'll love exploring the holiday spending category. Imagine how good it will feel to actually see what's happening before your credit card statement does that whole dramatic reveal thing. Monarch basically shows you exactly where the money is going in real time. And that level of clarity could change everything, right? Don't let financial opportunity slip through the cracks. Use the code virgin@monarch.com in your browser for half off your first year. That's 50% off your first year@monarch.com with code Virgin.

Welcome to Walgreens. What can I help you with today?

Hi, I need a last minute gift for a secret Santa. Something thoughtful, impressive, not a fruitcake.

We've got Ferrero chocolates, artisan coffees, even a spa kit. Any Vibe.

You're going for whatever.

Says, wow, this guy's great at giving gifts.

How about this premium skincare gift set? Just needs a bow.

Will look like you planned it weeks ago.

Well, happy holidays gifts, holiday decor, and more.

The holiday road is long.

We're with you all the way, Walgreens. I'm excited to dive into everything. Menopause and weight gain. Dr. Mary Claire Haver. I'm super excited you're here with us.

Thanks for having me.

And I know we're going to dig into the Galveston diet, too. So we got a lot to talk about here. I forget what I was reading. And they said, you know, going into menopause doesn't affect your weight at all. And I go, clearly this was written by a guy or someone in their 20s or 30s, because having weathered that storm, I know that to not be the case. So how did you decide to really tackle a very difficult subject? Menopausal waking.

You know, I wish I had some altruistic reason. It was literally the most selfish reason in the world because it happened to me, and I beat my head against the wall. I was obsessively working out. I was calorie restricting to probably dangerous levels, and it wasn't sticking. It wasn't working. And so finally, being a scientist, having come to Jesus with my husband about my attitude and getting up in the middle of the night to weigh myself after I'd have to pee because menopause, and he's like, what you're doing is not working. What do you tell the kids? What do you tell me? You know, you're a scientist. Figure this out. So that kind of led to my, all right, if the old calories in, calories out really isn't working that well, why, you know, I know I'm menopausal. That's what's changed. And then it just led me down the rabbit hole of learning about menopause and inflammation and nutrition and visceral fat and insulin and leptin and ghrelin and cortisol and all the hormones, all the fun stuff. And so why all the things that work for us in our 20s and 30s stop working in our 40s and 50s? You know, that we just have to change the game.

So I was in graduate school and doctoral school, and I was working my way through by seeing clients and personal training and nutrition, and they were all in their 40s and 50s. So this was back in the 1980s. I'm so lucky, because what I was being taught in graduate school and. And you know what I was being taught, which is, you've got to create a calorie deficit one way or the other. Eat less, exercise more, and man, it didn't work. It didn't work right. And so that led me on this crazy path of going, all right, well, if your body isn't a bank account, what the heck is going on? And that was like, your body's not a bank account, it's a chemistry lab. And it's so great because we are digging so much more into it. As I first started looking at it, it was very simplistic. We were like, it's insulin or cortisol. Now we know it's a couple more things. So let's dig in. Because there's so many things that come up as women are going into menopause. It's like, should they fast, should they calorie restrict, should they keto, should they, like, what the heck should they do? Let's talk first about what is going on as someone is heading into perimenopause here or they're in perimenopause. Like, what things are happening that are causing this weight gain?

In our 20s and 30s, for most of that time, we are. Most of us, of course, not all are enjoying normal, regular menstrual cycles. And we've learned to adapt to these monthly changes. Right at the beginning of perimenopause, the amount of estrogen and sometimes progesterone that we create each month begins to shift in a downward fashion. It's not a steady state decline. It's often like a roller coaster bouncing up and down on this downward trend. So you end up like this. And this process can last seven to 10 years. And the declining estrogen levels are doing several things to our body. There's hardly an organ system in our bodies that doesn't have estrogen receptors that's being affected. Now from a weight standpoint, what we know is that from a physiologic basis, we start seeing a shift of where fat is deposited where it used to be for most women, about the hips and thighs. All of a sudden, we're seeing abdominal fat gain or intra abdominal fat gain where we've never had it before, despite not changing one thing in our nutrition or exercise habits.

Yep. I remember my mom going through this and she called it shifting sands. And all I could think of is, I am not having my sand shift. Like, that is not happening. Where literally I was like, it looked like her butt had gone where her gut was like. I was like, what happened here, Mom? You know I've been reading a lot in preparation for my next book on protein and menopause and things that start to shift and anabolic resistance. And the fact that as we start to head into this, we increase our anabolic resistance, especially if we haven't been exercising. So our protein needs go up and that actually drives our hunger.

That's a huge part of what's happening on a menopausal basis is there's chronologic aging, which is what's happening to all of us, regardless of our reproductive status, regardless of, you know, if you're a man or a woman. And then there's also endocrine aging, what's happening to our ovaries and endocrine function. And what we go through is very different than what men go through. They may have a slight decline in testosterone, but we drop to less than 1% or functional estrogen levels. What you're referring to this anabolic resistance in medicine? You know, on my end, we call it sarcopenia, the loss of muscle mass with age. And so, yes, women who have at least 1.5 grams per kilogram of lean body weight have less visceral fat, less muscle loss, and stronger bones versus women.

Who don't say that number again, because I want people to really get this.

So it's 1.5 grams for every kilogram of lean body mass. And there's several online calculators you can find to help you figure out from metrics to pounds. But for most women, it's around 75 to 100 grams of protein per day.

And I've heard that the average woman is getting somewhere in the neighborhood of 45 to 60 grams.

And she's stacking it at her evening meal.

Yes.

So you're having toast for breakfast or carb, oatmeal y kind of thing, and then lunch, you might have a little bit of protein with your salad or whatever, and then you're kind of saving your protein load at night. The other thing to remember is that we really can't process more than about 30 grams as women of protein in a sitting. So one of the things I learned from studying the elderly was we've got to stretch that protein out throughout the day. Every meal and snack should have a nice source of protein in it as well.

So I've been really looking into that 30 gram thing to go, okay, how much of that is urban legend? Because you would look at it and go, well, wouldn't that depend, like, I'm 6ft tall and literally 14% body fat at 59, like I've got a lot of muscle on me, clearly how much I can utilize, you know. And so some of it would be. Cause I look at protein and go, well, do we want it for function or fuel? We want it for function, so how much could we really utilize? It's gotta differ. But what's interesting here, and this is where maybe you can clear this up. Cause and. Or maybe we'll both just go, gosh, head scratcher, is some of the research I've been reading is you need more protein if you are sedentary to overcome. You know, it would seem the opposite. Seem like if you're really working hard, et cetera, you need protein, more protein. Now, some of the research I'm trying to think of where I just found this data was saying you need more protein. As a sedentary person. It was a researcher out of Canada, and I'm like, why would that be? Is it the anabolic resistance? We're trying to push the threshold. I think the answer to all of this is what we do know is 30 grams seems to be a really good threshold base. Wouldn't you agree?

For most. And like you said, you know, in my clinic, I have an in body scanner, so I'm able to give people realistic, you know, estimations of their muscle mass. And we have discussions around that and protein needs when I'm calculating their macros, but I can't do that for the rest of the world. We have to just rule of thumb, approximate. You know, when we're doing visceral fat.

Let'S talk what visceral fat is. Let's define it. It is so clear that we have to use scales as biometric tools to learn what your weight's made up of and to really understand not just your body fat, but where that fat is. I mean, we've got to know how much muscle you have and where your fat is. Those are the key metrics. So I'd love you to dig into both of those.

So subcutaneous fat is the fat we've all known our whole lives. It's in our breasts, it's in our hips, it gives us cellulite, it gives us curves. If you have large amounts, could put wear and tear in your joints, but in and of itself, it's really not metabolically active or that dangerous. Visceral fat is the fat that gets deposited in and amongst our abdominal organs. It can wrap around the heart as per cardial fat. You'll see it in fatty liver disease. You'll see big, thick omentums which are usually thin. And, you know, we all have some fat there, and you'll see it wrap around the bowel as well. And that type of fat is very, very different. It's metabolically active. It creates cytokines, it creates its. Its own inflammatory organ. It becomes an endocrine organ, pumping out, you know, inflammatory markers, raising levels of inflammation, which then makes you more insulin resistant and drives more fat. I mean, you get in this terrible negative feedback cycle. And part of what's driving this for us as women is declining estrogen levels in menopause. Hormone replacement therapy can actually attenuate this. Now, elevated levels of visceral fat are a stronger marker for chronic disease risk than your weight or your bmi. So I think we need a big push from a medical standpoint and getting these types of scales in people's hands, in offices, so that as we're counseling our patients, you know, I'm sure as tall as you are and as much muscle as you have, you probably tip the scales towards a BMI that doesn't reflect your health status at all.

Actually, I just had a DEXA done. I did a DEXA in my late 30s, and I just did another one and I did an inbody like two years ago. And I'm always 13 to 14%. I always tell people I'm a weirdo. I'm one of those real mesomorphic people. I always have been. So I have much lower body fat than normal. If my body fat's higher, I actually don't feel good. It's just when we were in grad school, normal body fat ranges were 18 to 22% for women, up to 25%. Now it's changed. I love how the norms have gotten bigger. That doesn't mean healthy's gotten higher body fat. But I think what we need to discern now is if you were storing a lot of fat on your hips and thighs, you might not like it, but it's not going to kill you. It really isn't the body fat. It's where that body fat is. Way back when I was using skin fold calipers, a tape measure, and a scale, because we didn't have anything else and we had underwater weighing. I remember having this woman who by skinfold calibers was very lean, but, you know, her waist measurement, her waist to hip ratio, she was like greater than one. She was literally what I would call potato on stilts. She had so much. If we could have done a DEXA or an inbody on her, then we'd have Found so much visceral fat, but we had no way to look. You just knew. That's where I think at the very least, because I've been looking at how do you take this to the masses and make it actionable? I mean, at the very least now a waist to height and a waist to hip can be super helpful. At least you can see we teach.

Our students a waist hip ratio as a better measurement tool for your progress in the program is really tracking that instead of just this obsession with the scale that we all have, that this is a better indicator of what's going on internally and what's going on inside of you. Because not everyone has access to a DEXA or inbody or any of the scanners. But I would love to see that happen. And then we teach the principles. Okay, so what are some nutritional principles that we know in women in midlife and menopause, post menopause help to drive the visceral fat levels down. And they're very simple. One is making sure you're getting a minimum of 25 grams of fiber per day in your diet. And most women are only getting half of that amount.

I know. Let's talk fiber so we can hear it again. Let's talk fiber. Let's unpack fiber. Then we'll talk protein. I love all these. We're going through all of them. But fiber. Let's hear it again because, gosh, it feels like if fiber was a drug, it would be like the most prescribed drug for weight loss and health right there with sleep.

If no one ever takes anything away from me other than this one fact, ladies, minimum 25 grams of fiber per day. And most of that should come from food. If you need to supplement to make up the gap, do it. But ultimately the fiber source should come from food because foods rich in fiber have a lot of other wonderful things about them. Avocados have fat, keep you full, longer, packed with nutrients. Fruit, vegetables, legumes, all those things that keep you healthy from nutritional standpoint. Men, it's 38, they need more than us, because, you know, men. But for a woman, minimum 25 grams per day. And to order to get that, you're probably going to need to track what you're eating, you know, until you get used to it. And then you know how much of whatever you need to eat per day to hit those goals.

Well, and I think it's tracking for a short period of time, like tracking forever. Forget it. No one's going to do that. But boy, just tracking and then spot checking once Every once in a while. Here's what I give an example of. We did a really funny YouTube on this once on wine. You're at home drinking wine and your glass gets bigger and bigger and bigger and bigger and bigger and bigger. I actually got a glass for one of my girlfriends that could hold the whole bottle as a joke, you know, and you go out to a restaurant and they give you your like 4 ounce wine glass and you're like, what's this? You know, and so it's the same with. We tend to under eat on the protein side, but on the vegetables, we really need to measure all of this. We need to measure our protein to get really clear that we're getting enough. We need to measure our vegetables to make sure we're getting in those servings. So I love that tracking. Amen. Let's go on to the next one you were mentioning.

Protein, Protein. So making sure you're getting not only adequate amounts, that 1.5 gram per kilogram of lean body mass, minimum per day. So 75 to 100 ish, depending on height, weight, muscles.

And that was ideal body mass, right?

Ideal body mass, yeah.

How are you helping someone determine what that ideal body weight should be?

You know, most women know the weight at which they were happy. I'm like, would you weigh at 25 when you felt good, when you get out and run a mile or climb some stairs or whatever number that is? Because you have to assume their muscle mass was pretty good at that age. And so let's just use that number. So you know, what's your goal weight? Within reasonable. Then we do the calculations, take the pounds to kilograms and then I walk them through that, Then we look at the numbers that way.

That makes a ton of sense. Okay, so protein and you, how are you having people then eat it? And what are some of your favorite sources?

We are not restrictive, so I am an omnivore, I eat anything. But we of course have people on our program who are vegan, vegetarian, whatever, and it's a little more of a challenge because they have to really fight to get their protein levels in. So for me, one of my favorite ways to break a fast is they call it the Merclair smoothie. My students do. I did not name it after myself. Plain Greek yogurt, 5%, nothing added. And then we add lots of stuff to it. So I add hemp, chia flax, fresh fruit, usually berries and some kind of a nut. I mix my nuts up every day so that I get the different nutrients and that combination just Packs a punch. You know, you got your fiber, you got your protein, you have your omegas, you have anthocyanins through the berries, you know, and. And it's delicious. I mean, for me, I love it.

I call it the protein fat fiber trifecta.

You know, when you're at a restaurant, I'm like, look, ask them for double veggies and get some lean grilled, you know, meat that's going to rock your world. And I tend to order things at restaurants that we don't cook a lot at home. So I'll eat more shrimp or fish, where at home we'll do more chicken or beef, turkey. So those are some of my favorite ways to make sure I'm getting protein in.

So there's one, there's two. What are some of the other ones?

Snacks, Nuts. I just made a big pot of lentils last night. When I meal prepped. That's another great source of fiber and protein. And so we talk a lot about, you know, meal prepping, having things on hand, pre getting your lunches done, throw it in the bag and go so that you're prepared, especially if you don't have time.

Right. That is the huge one. All right, any other tips? I have definite inflammation question to ask.

The holidays are all about family. But at the Chrysler Wrap up the year sales event, it's all about you. Enjoy every mile in the most awarded minivan in America, the Chrysler Pacifica. With the most standard safety features in its class. Available stow n go seating, and the available stow and back built in vacuum. Make the most of the holidays with a great deal at the Chrysler Pacifica Wrap up the Year sales event based on Ward's small van segment. Based upon the latest available competitor information, Chrysler is a registered trademark of FCA.

US LLC for visceral fat. Limiting the added sugars, and this is something that, you know, they're, oh, well, I'm not gonna have fruit. I'm like, no, no, no. Added sugars are the sugars added in cooking and processing. And this is something that the American Heart association and the World Health Organization are really honing in for. So much so that the FDA is now requiring added sugars to be on the packaging. So it's the last thing under carbohydrates. They both agree. For women somewhere limiting your added sugars to 20 to 25 grams per day. So women who are able to do that through their nutritional choices have much less visceral fat than women who don't.

I had to interview him twice because you're like my work obsession is, do you know Dr. Rick Johnson?

I don't.

Nature wants us to. Oh my gosh. You wrote the book Nature wants us to be fat. But when I was writing the sugar impact diet where I really looked at, you know, the role of fructose, both insulin and glucose, what was raising insulin, glucose? I think you've got to look at both of them. And then fructose against nutrients and fiber, the good of carbohydrates and the bad of carbohydrates. And you know, he was talking about how just the change from cane sugar to high fructose corn syrup, what it has done to NAFLD and visceral adipose tissue. So I just don't see a place for added sugars. And one of the things that's really frustrating is when they sneak it in and lie to you by putting in apple juice concentrate.

Right. So we are big in the program about read those labels. Here are some of the hidden words to look for. But now that the FDA requiring added sugars to be on the label, it's a lot.

Yes. Amen.

When you look at a tablespoon of sugar or, you know, the equivalent of berries, the berries have fiber built in. It's going to slow that absorption of the fructose down. The minerals and nutrients are going to just make you so much healthier and keep you full longer. And there's no comparison of the two.

Yeah. You cannot compare an apple and apple juice.

Right.

And apple juice concentrate. You're looking at a piece of fruit and a soda.

Exactly.

And if it's dried fruit is candy. Like let's call it what it really is. Now let's talk inflammation. I know you're going to give everyone your inflammation quiz and we're going to put that@jjvirgin.com Galveston diet. You've been talking through the Galveston Diet. This is what we are actually talking about. This is the program that you put together when you started struggling, did all the research and then now you've taken how many people through this?

We have about 100,000 through our different levels of programming.

That's just crazy. Amazing. And your book out now, so that's very exciting. If you're listening to this podcast, it's not quite out yet. You can pre order it, but most likely it is out. And you'll want to go get this@jjvirgin.com galvestondiet that's where you'll get the inflammation quiz. Let's talk inflammation, why it's problematic and your favorite Anti inflammatory foods.

So when I went down the rabbit hole of research to help me figure out why calories in, calories out wasn't serving me or my patients, my friend, my girlfriends, who were all roughly the same age, one of the recurring things that was coming up was inflammation through nutrition. How to lower inflammation through nutrition? Can it make chronic inflammation worse? And so when I looked at what are we doing to treat chronic inflammation, every single thing was nutrition. There wasn't a drug or a medication to take. It was just, eat more of this and less of that. This will start fixing itself. We kind of knew that it was like porn, you know, when you see it, what is healthy. But no one actually sat us down to teach us what healthy eating was about. Now I went back to school to learn that. In 2018 and 2019, I became culinary medicine certified.

I saw that. So cool. I only know two other doctors. Uma Naidu, who's heading up the Harvard School like she does psychiatry and food is medicine. And then Steven Masley, two doctors. There's three of you. We need a lot more.

Everything about the way I practice medicine.

Wow. How so?

Nurse practitioners, physicians, NPs, PAs, and pharmacists and registered dietitians can all get certified in this. It taught me one, the basics of nutrition and then medical nutrition as well. But also like cultural differences all about obesity and all the causes. Like you said, it's a chemistry lab, not a bank account. And the chemistry lab is so much more complex than we ever imagined. And when you layer in, we are not little men, we react very, very differently to different environmental responses. And how to use all of that to treat each patient as an individual, including socioeconomic reasons that they don't have, the choices that some other patient might have, and cultural things about things that they like to eat. How can you take that and make it healthier for them? I mean, it really was one of the best things I've ever done in medicine.

That is so cool. It kind of led you down the path of realizing, I mean, when you really think about it, what's creating inflammation in the body? Chronic inflammation. Not like, broke my leg or I pulled a muscle.

Aging is one thing we are breaking down every day, okay? We're never going to be as healthy as we were yesterday. And that's just part of getting older and what we put in our bodies. And for women, declining estrogen levels associated with menopause, those are the top three.

So the aging thing, you know, we can support as much as possible with exercise and stress reduction. Sleep, the estrogen. We can do bioidenticals, which we should do a whole nother show on. The food is the one here that you can make such a shift in. So you said eat this, not that. What are the Eat this is your favorite. Eat this is eat this.

If it came from God, it's pretty much okay unless it's a known poison. So fruits, vegetables, legumes, nuts, seeds, you know, those are your top five. And then lean meats kind of are neutral. They're not super anti inflammatory. Now heavily saturated fats can shift you more towards an inflammatory pathway. Meats can be made, any food can be made inflammatory. So if you take a meat and you pump it full of nitrites and artificial colors, right.

If you make it bologna, you just created a problem.

You overly process something, you're losing any of the nutritional benefit. Added sugars, you know, things just pumped into food to make it more sellable, last longer on the shelf are things that we should eat on a limited basis.

Makes a ton of sense. So we're just going to go there because we need to. Because I would love to have your input because it's still, you know, I feel like this is still a controversial subject when it shouldn't be is hormone replacement therapy. So I'd love to hear how you work with it.

Back in the day when I trained, right. So I was in the middle of my training, residency is what we call it in obgyn when the Women's Health Initiative study was released and the uproar.

Yeah, I was going to say, what a firestorm.

And you know, we were like after all of that fallout at the time, only if there's no option and she is going to jump off a building without hormones, should we even offer it otherwise try antidepressants. Some actually can help with hot flashes. The other thing was we were only treating symptoms, so we're only trying to make the hot flashes go away. You know, we might try to help her bones stronger, but we have all these other medications with tons of side effects, by the way, that can keep her bones strong. If she's not sleeping, give her a sleeping pill. If she's having vaginal estrogen, is very, very safe. Does not fall into the same category that was not studied in the whi. Really, a lot of women have just suffered. A whole generation of women have suffered needlessly. So now this bombshell study came out and I'm embarrassed for ob GYN because it was done by the American Heart association that went back and looked at The WHI and every other study that's been done as far as heart disease and women's health, and this was published in Circulation magazine at the end of 2020, right. As Covid was still kind of crazy. So it kind of took a little bit for it to gain. But what they found was women who were starting young, so starting in late perimenopause or early menopause, who were offered hormone replacement therapy and accepted it, and then they followed them for 20 years, have lower incidence of heart disease, lower incidence of cardiovascular death than women who did not take hrt. Also, they have a lower all cause mortality death from any reason, and a lower all cause mortality from cancer.

And that is so huge because heart disease, that's established, but that one.

So right now, American College of OBGYN and North American Menopause Study are not saying, hey, we should offer HRT for primary prevention of heart disease, but this is a conversation I'm having with my patients. These are things to consider. You will probably live longer. We know you will suffer less. We've known that forever. And we're learning about mental health, Alzheimer's and dementia.

Joint pain, bleeding gums, it goes on.

And on, on and on and on. We know your gut health gets worse in menopause. There's something protective about estrogen in almost every organ system of our body. If a patient, after that discussion chooses not to do hr. And it's not for everyone. There are people have individual risk factors, but I think every single woman deserves conversation around it and then it's up to her to make that informed choice. But to be categorically denied, the offer.

Is unacceptable and they need to have the real information because there was a whole lot of crazy derivatives from these studies that just were fear mongering. Especially when you see, you know, look at it and go, well, what's the number one killer of women?

Heart disease.

Right. It's heart disease. But there's so much out there of like, you'll take this and get breast cancer.

Let me stratify this risk for your patients. So when you're on estrogen alone, the WHI data, then you're starting from age 50 to 59. Okay, so early young, that's young. I'm, I'm 54, I'm 59. So if you start in that age bracket and we follow you for five years, the chance of all women with no hormones getting breast cancer is 23 out of a thousand. Okay, if I add in estrogen only. So you've had a hysterectomy or you were born without a uterus or whatever. If I add estrogen to this, the risk is now 23 out of a thousand. Zero increased risk. Now, the WH. I only looked at synthetic progestins. That's all that data that we have, though there's some really good data out of France I can talk about later. So those women, that risk went up to 27 out of a thousand. So four more women. Okay. And if you're one of those four, God bless you. But the risk of being obese or overweight is 44 out of a thousand. Okay. And the risk of having two glasses of wine a night every night is 28 out of a thousand. When you think about stratifying the risk. We make decisions every day to get in a car, to drive somewhere knowing we could get in a car accident. We do things to protect ourselves. We follow the rules. We wear a seat belt. You know, we do what we can, but we know that could happen to us and we could die. Okay, so this is how I counsel my patients. Like, if you still choose not to do this, I 100% support you in that decision. But you understand what you might be leaving on the table as far as.

Your long term health in terms of bones, heart and brain.

Right. When I paint the picture of menopause for my patients, I'm like, if you rock a bikini, God love you for it. But I am here to teach you how to have strong bones, strong muscles, a strong mind, and a strong heart and not be plagued by chronic disease that potentially would have been avoidable. And HRT is one part of this. We can't leave exercise out, nutrition out, mindfulness out, stress reduction, sleep, all of the things. Sorry. I get so passionate.

It's so good. There's one other thing that keeps coming up as an urban legend, and I think it's just based on how the studies have been done. And not knowing is this whole idea of if you don't start hrt, you know, as you're going through perimenopause or Right, right as you hit menopause, that you can't do it. You've heard the rumors like you've heard this urban legend though, right? Oh, no, everything shut down at that point. You're done. It's like. But you're replacing it anyway.

There is, once certain disease states have started, like heart disease and like Alzheimer's and dementia, starting estrogen after those diseases have gotten a hook on you might be detrimental. So these are the conversations I have with my patients. Risk factors, disease state. Not everyone is a candidate, but if you're five, ten years past menopause, you have no other risk factors, you are a candidate. We are no longer saying 60, 65. That's a thing of the past. And North American Menopause Society and ACOG support this fully. It's individual discussion of risk factors with your patient.

So I would love to hear one of these. And again, like, we've gone all over the place with so much great information. I am super excited to share the inflammation quiz and remind everybody to get the Galveston Diet. Holy smokes. We are totally aligned. I love what you're doing. You've done so much great research. I'm so happy. You're selfish. Your selfishness has been selflessness, because you've really gotten this out there, and this is what needs to happen for, you know, things to shift. I'd love you to share a success story.

Oh, gosh. Okay, so I. I have a clinic now that I devoted specifically to menopause. I left traditional OBGYN in 2018 to focus on the business, which.

You're a brave woman. I had a girlfriend in OB GYN who went into menopause, and she's like, oh, my gosh. They're so angry and mean.

I've just had the opposite experience. And they feel like they know me because most of my patients now have seen me on social media, and they come in and they just start talking because they feel like we're friends. So I had a woman come in, and she had already been doing the nutrition program for, like, a year, and she had a. She probably had lost 50 pounds or something, you know, of body fat. And she was coming in to talk about hormone replacement therapy, and it was just such a beautiful, uplifting thing for her to come in. She's smiling, and we did her body scan. I got to show her I didn't have a before because I didn't know her before, but show her how low her visceral fat was and how healthy she was, and then get the blood work and show her how great her cholesterol was and her A1C. Now, she did have older labs that she showed me, and I could show her. This is just one patient. When they say, you've changed my life. Living your life on social media is not easy. You have the haters.

You're just doing it for the money. I'm like, I can tell you the amount of time this takes and, you know, to know.

My daughter's a nutrition science major.

Oh, how cool.

Call me out so fast. Other OB GYNs who are out there, you know, kind of policing what I'm doing, they have my back. And so I'm just so grateful that these patients are coming and telling me, you know, you've changed my life. You made me believe in myself. You made me feel like I wasn't crazy. You gave me a safe place where I could go and find a community of women who are going through the same thing I'm going through with real actionable ways to change my health for the better. And stories of looking at their parents and how they're aging and having to take care of them and how they don't want to burden their children with chronic disease. I can't change your genetics, but we can put some changes into place now that can hopefully decrease that risk for you in the future.

And I think the important thing about the whole genetics story is it's been the same for the last thousand plus years, yet our metabolic health risks have skyrocketed like in the last few decades. So it's basically not a genetics problem.

Right?

There you go.

The cost of retirement, of healthcare cost and taking care of yourself when you're older and all the things that you need, I mean, it's absolutely skyrocketed when people were absolutely functional 50 years ago until they died.

Yeah, crazy. Anyway, you're doing your part. We appreciate it. And I want to remind everyone, go to jjvirgin.com galvestondiet here's what you're going to get. You'll get information on the book which you're going to want to grab, and then you'll also get a link to the Inflammation quiz. So, and I'll hook you up with all of Mary Claire's stuff because she is huge on TikTok. She's on Insta, so I'll get you all dialed in there too. And thank you so much for coming on board here. Thank you. Thank you.

Take care.

So how good was that? Wow. That is definitely something you're going to want to listen to again and again. And so many pearls in there. So much great information. A couple things I just want to give you as takeaways. Here is again, you really want to know your body composition. You want to know what your weight's made up of, how much skeletal muscle you have. It's so critical. What I'm seeing a lot out there is that we're not overweight, we're under lean, we don't have enough muscle. And where your fat's located, you might think you know, but really you need to look at it through the eyes of a DEXA scan or an inbody to really see how much fat is around the organs, because that's. The fat's dangerous. You might not like that stuff around your butt and thighs. Learn to love that. That's the safe fat and that's the fat that gives you curves. It's the stuff around your internal organs that's creating the problem. And one of the easy things you can do is do a waist to hip and a waist to height ratio. I actually did a whole podcast just on this and on my DEXA scan. Basically, when you do those and you can Google this, you will be able to really track what's going on. Because if you lose weight but you don't lose your waist, you're making yourself worse, not better. That's why we have to make sure that as we're losing weight, we're holding onto or building muscle while we're dropping fat. And generally, if you're already fit, you're going to have to make a decision, do I want to build muscle or do I want to lose fat? It's very hard to do what's called recomping when you are already a worker outer. If you're not a worker outer, you can do it. Hope that made sense. I've been talking a lot about this topic and about how much protein to eat. That's why I was so excited to hear someone going through all of this, using it in their practice, having huge results with the Galveston Diet. Again, you can get that quiz jjvirgin.com galvestondiet and be sure to check out my social channels. I'm doing a lot on IG and a lot on YouTube where I'm talking about all of this. And we of course also send out blogs and recipes, et cetera. JJvirgin.com if you haven't subscribed yet, hello, subscribe to JJ.com and if you found something of interest here, it would super help me out if you could leave a review because people check those out and make decisions to listen or not based on that. This is how we change the health of the world. Thank you so much. See you next time. Be sure to join me next time for more tools, tips and techniques you can incorporate into everyday life to ensure you look and feel great and more importantly, that you're built to last. And check me out on Instagram, Facebook, YouTube and my website, jjvirgin.com and make sure to follow my podcast so you don't miss a single episode. @subscribetojay.com See you next time.

Hello listeners, this is Anne Bogle, author, blogger and creator of the podcast what Should I Read next? Since 2016, I've been helping readers bring more joy and delight into their reading lives. Every week I tag all things Books and Reading with a guest and guide them in discovering their next read. They share three books they love, one book they don't, and what they've been reading lately, and I recommend three titles they may enjoy reading next. Guests have said our conversations are like therapy, troubleshooting issues that have plagued their reading lives for years and possibly the rest of their lives as well. And of course, recommending books that meet the moment. Whether they are looking for deep introspection to spur or encourage a life change or a frothy page turner to help them escape the stresses of work, school, everything, you'll learn something about yourself as a reader and you'll definitely walk away confident to choose your next read, with a whole list of new books and authors to try. So join us each Tuesday for what Should I Read Next? Subscribe now wherever you're listening to this podcast and visit our website what Should I read next podcast.com to find out more.