Coming back to New Zealand has been an eye-opener. A month in Switzerland in a small ski village and hardly ever, did I see an overweight mid-life woman. Even when I visited the larger cities. Although the 2017 OECD report suggests that both Switzerland and Korea are countries where obesity rates are projected to increase over the next two decades, arriving back in little old Aotearoa-New Zealand it hit me – everywhere I turned at the airport, there were women carrying extra belly-fat. A lot of it.
It was a visual reality check confirming the OECD report, that adult obesity rates are highest globally in America, Mexico, New Zealand, Australia and the United Kingdom. They are lowest in Japan.
For Australia, New Zealand, the UK and America, these are not statistics to be proud of. But of most concern is that over 40% of these stats belong to women. And if these women are in menopause or post-menopause, which many of them are (obesity rates in the America, New Zealand and Australia are highest in menopausal and post-menopausal women), then this doesn’t bode well for heart disease rates as we age. Nor does it bode well for our joints and physical function as we get older either.
Which begs the question:
How did a generation of women in their 50’s and early 60’s become so overweight and unhealthy and most importantly, how can we turn this around?
It’s a question I had to answer myself when menopause increased my weight too – over 15 kg of fat that seemed to appear within a year. I had become one of the those stats too. Undertaking my doctoral studies at the time, I was also conscious of the conversations I was having with my study participants with over half of them saying that the exercise and ‘healthy eating’ they were doing, wasn’t shifting their mid-life weight gain in menopause. As a researcher I kept my mouth shut obviously, but as my head was nodding, my brain was saying, ‘#metoo’.
The worldwide prevalence of obesity has tripled between 1975 and 2016. In 2016, more than 1.9 billion adults aged 18 years and older were overweight. Of these over 650 million adults were obese. What has gone so wrong? Afterall, none of us were born to be obese throughout our lives – it’s not a trait that is part of our genetic chemistry as women. And whilst there is increasing evidence that our gut genes that control satiety (fullness) matter for weight gain during our life-time, we weren’t destined to live in a body that is carrying lots of weight. Our body is physiologically designed to maintain a weight that helps our health, not hinders it.
Menopause is the time of our lives when, almost at a flick of a switch, our health changes and suddenly we feel older than we really are. For thousands of women, this age and stage throws us into other health problems too. Just like our mother’s generation.
Which brings me back to thinking about how did we become so overweight? Is it our diet? Is it lack of exercise? Is it hormonal? Is it our self-discipline (or lack of it)? Is it that we have become so disillusioned that we just ‘give-up’? Is it that, as women, we are so stressed and busy that we don’t have time to focus on us? What is it? What’s gone so wrong?
Some of the best physiological, health and behavioural research in the world all come to the same conclusion …. weight gain is not just one thing [Kadouh & Acosta, 2017]. It is multi-factorial. Social, economic, behavioural, hormonal, nutritional choices, exercise choices – it’s a jigsaw of factors that we need to slowly put together. So I did.
As I had become one of those health statistics too, the first thing I said to myself was – ‘What is menopause and why am I putting on weight at this time of life when I exercise daily and eat well?’
The answer partly lay in understanding how excess oestrogen prevails in our food chain and for women who have had a lifetime of diets high in fats and proteins (and an environment that is, in a word coined by obesity researchers, ‘obesogenic‘, then our liver health may not be what it should either. When our liver isn’t working properly to break down cholesterol and excess oestrogens (which we also obtain from HRT), in menopause, because our liver also undergoes structural changes with lowering oestrogen levels), then many of us put on weight – especially around our belly. [Brady, 2015].
Researchers now know that modern western living with processed food, sugars, stress, chemicals and for us, some of our exercise choices or not, over decades, are all factors that accumulate in mid-life, contributing to greater damage in our muscle and cardiac cells which contain our mitochondria. It’s why I often tell women who attend my seminars [please see the Event page for Christchurch, Perth & Canberra tickets], that as women in our 50’s and early 60’s, we have been the ‘guinea-pig’ generation for so many food, exercise and medicines that have impacted negatively on our health over the years, especially our mitochondrial health. As we all know, what we have been doing over the decades around our food & beverage choices, the amount of food we eat and our various ways of living in an environment full of chemicals and stress, is not working for disease prevention. And as women on my study found, as I did too, the type of exercise we are doing may not be working for weight loss in menopause. This is all to do with what I believe is the ‘forgotten factor’ in weight loss management for women in menopause – the ability to turn around our mitochondrial health. If we don’t do this AND we aren’t sleeping well AND we aren’t eating the right foods for our changing internal environment in menopause, AND we are already overweight AND we feel stressed, AND we work in a mainly sedentary job, then no matter what crazy diet you are on, or what exhausting exercise you do, your weight will not shift. I know this from experience and it’s why too many women give-up on trying to lose their weight in mid-life, but if this is you, then you mustn’t! Your health as you age depends it!
Your mitochondria matter for your weight loss. It’s not about exhausting exercise, or hard-to-follow diets. it’s about understanding how the body gets rid of the fat that is already there and targeting a lifestyle plan that is specific to our age and stage of life – menopause! That’s what many programmes don’t take into consideration. It’s why, as I lay in bed this morning I planned my slow jog. After being in Switzerland for over a month, I could tell that the women there did lots of walking and hiking. Living in a small alpine village, the walking is often up hill. With everything in close proximity, it’s also easy not to use a car. Walking and hiking at altitude boosts your mitochondria and this is where your fat-burning takes place. That’s why, for a generation of women used to doing lots of high- intensity exercise or living their life in ways that don’t help our mitochondrial health, it’s a slippery slope to putting on weight. Especially during menopause which is the gateway to your biological ageing.
Which brings me to my dog! At 15 years old, Jack has arthritic hips and has become slow with age. But there’s another issue too. For 5 weeks he was in the kennels whilst we were away in Europe. This means that he had missed his long, slow walks that we give him every morning. He was lying around more, or alternatively, only doing shorter bursts of intermittent activity playing with the other dogs.
When I picked him up he was noticeably slower, stiffer and according to the Vet, because he was being fed different food than the scientific, high Omega 3 food that we give him, in only 5 weeks this has made his hips stiffen up and I can see he has put on weight. The vet encouraged me to get his fitness and weight back under control.
Does this sound familiar?
I had to select a route this morning that suited both of us. And for both of us, the exercise needed to be aerobic (with oxygen), not anaerobic (without oxygen – when you can’t talk because you are so out of breath). Slow jogging with the odd hill to stimulate strength in the hips, butt and quads and at least 10 minutes longer duration than I normally do, to add duration and stimulate the mighty mitochondrial cells. When we love our mitochondria, we burn more fat for energy and we improve our health as we age. It’s the same for the dog.
I talk a lot about mitochondrial health in the MyMT programmes, especially the weight loss programme called Transform Me. It’s such an important part of how we can reduce the inflammation that builds up in our cells and tissues and reduce our weight. Mitochondrial health is important in lifestyle medicine and for women in menopause, turning around our mitochondrial health is crucial for weight loss and improved health as we age. Weight loss is not about crazy diets, such as the Keto diet, it’s about adjusting our lifestyle to suit our changing hormones in menopause which is the ‘gateway’ to our ageing. This is what I teach women to do in the 12 week online MyMT Transform Me programme.
Mitochondrial cells are present in your muscles, including the heart muscle. They store oxygen. They are crucial for boosting our metabolism and fat-burning. Without healthy, well-functioning mitochondrial cells, we have no energy for daily life, nor do we have the energy for exercise, because our mitochondrial cells are where fats and glucose are turned into energy. But here’s the thing for menopausal women – as we go through menopause and lose oestrogen and we are therefore biologically ageing, we lose muscle density and tone. This means we also lose a good number of our mitochondrial cells which does not bode well for your health as you age – especially for women who are doing too much exercise and they aren’t sleeping all night. It’s why we have to boost them and produce more of them. If I’ve struck a chord for some of you, then your increasing fatigue levels are due to your mitochondrial cells not doing their job properly. With the wrong exercise and nutrition in menopause, you’ll feel even more tired and experience aching muscles, sore joints, more hot flushes and disturbed sleep. the same as over-trained female athletes.
Your beautiful mitochondria cells provide you with almost all the energy that your body needs to eat, breathe, exercise, fight disease and age well. They store oxygen which is why they are known as the power-house of our health. Without properly functioning mitochondria then we lose life-giving energy and our body struggles to maintain optimal levels of health. Furthermore, for women transitioning through menopause, without well functioning mitochondria, we can also lose the ability to manage our weight at this time as well. That’s because your fat burning occurs inside your mitochondrial cells.
Hormonal changes during our menopause transition are often the catalyst to decreasing mitochondrial function and for millions of women, these changes increase our weight. That’s why we need to do everything we can to boost mitochondrial cell function as we age. If we want to improve our immune health, weight management, joint health and energy levels, then we need to do things that improve the number and size of our mitochondrial cells. We need to stimulate them to grow larger. That way they hold more oxygen which enables us to not only burn fats better, but enables us to live our life with energy and vitality (as long as we can sleep though!).
For over 20 years, I have taught exercise physiology to PE Teachers, Personal Trainers, Sports Science students and Exercise Professionals. One of the fundamental lectures I taught was called, ‘Metabolic Adaptations to Training’. In this lecture, I spoke about the role of the mitochondria in our energy production and how, when we stimulate our muscles (including heart muscle) to grow more mitochondria and to enlarge, then we boost our capacity to store and utilise more oxygen. In every lecture, I shared this,
‘ Skeletal muscle mitochondria increase in both size and number with aerobic training, providing the muscle with much more efficient oxidative metabolism and supplying more energy to the human body.’
[Wilmore & Costill, The Physiology of Sport & Exercise]
A supplement such as MitoQ, or CoQ10 (which is important to take as we age as well because levels of this powerful compound decline) helps us to have more energy. But the real-deal comes from simple, aerobic, endurance exercise. This is the type of exercise that puts us into steady-state breathing. So I don’t mean anaerobic exercise (hard-out exercise) as this puts a lot of stress on our mitochondria when we aren’t sleeping all night and contributes to poor immune health. Doing lots of high intensity exercise all the time doesn’t help you lose weight either. This is because you aren’t fat-burning – you are burning sugars instead.
Aerobic exercise must be done for a minimum of 30 minutes and preferably up to 60 minutes. I know that some of you don’t have time to do this much exercise in your day, or you have existing health problems or joint problems which make running or walking challenging. But you can find other non-impact ways to improve your mitochondrial cells too – including swimming, cycling, rowing, dancing, hiking or cross-country skiing! I did a lot of hiking whilst away – I feel fitter than I have for years.
You don’t always need high intensity activity in your life, when you can get the same benefits from longer, duration aerobic exercise (with some added strength training). Yesterday, I had an email from a lady concerned that despite changing her diet, she was making no headway with her weight loss during menopause. She was considering doing my programme. When I enquired as to how much exercise she was doing, she said she met with a group of women 4 times a week and their Personal Trainer put them through high-intensity exercise at every session. Even though she wasn’t sleeping all night, she was doing Burpees, sprints and all sorts of ‘Boot Camp’ exercises. Whilst these are fun and it’s great to train in a group for the motivation and social support, I explained that she wasn’t ‘fat-burning’ – all she was doing was training her body to search for glucose to replace this into her muscles because she was always exercising at higher intensity. The other thing she wasn’t doing was that she wasn’t sleeping. When we don’t sleep, we don’t recover from all of the high intensity exercise and this also blocks fat-burning mechanisms too. Sleep first. Exercise later. That’s part of the principle of the MyMT Transform Me programme. I’m not interested in women doing lots of exercise until they sleep all night and restore their energy. Otherwise it’s a slippery-slope to more weight gain and worsening hot flushes.
It’s a popular misconception that high intensity exercise is required for significant physiological gain and as an educator, I’ve come full circle on my beliefs about the value of this for women as they age. As many of us have now discovered, the popular saying, ‘no pain, no gain’ is simply not true. Most of us first learnt to exercise at a time when high-intensity exercise did not have the emphasis that it has today. The problem is that a lot of people (including fitness-industry professionals) now think that this is the only way to train. It’s not. And in a body that is ageing and losing muscle density, we need to identify the strategies that help our mitochondria to function better as we get older. That’s why I encourage women who do the MyMT programmes, that exercise is only one part of the health puzzle and finding the right way to turn around health and boost mitochondrial function is crucial to our healthy ageing. That’s why the principles of the MyMT programmes follow my research on healthy ageing for women.
Whilst exercise is just one aspect of turning around our weight in menopause and improving our health, the top activities that help your body to develop more mitochondria are slow jogging/ walking; swimming; cycling and moderate resistance training that is higher in repetitions. The best time to do these activities to stimulate fat-burning, is in the morning, before you have had food.
This morning I was out just as the sun was coming up. It was cooler and as a way to kick-start my metabolism for a busy day ahead, it was a great way to start the day. The dog was slow, but so was I. But do you know what?
The most important thing wasn’t what we were doing, but that we were ‘out there doing it.’
Use it or lose it. How about you?
I love it when women on the 12 week MyMT programmes begin to turn around their mitochondrial health and get back in control of their weight and changing health as they transition through this really important life-stage. Finally, they see a way through their menopause transition that gives them hope that their energy levels can pick up again and they can therefore, burn fat effectively without crazy dieting or too much exhausting exercise.
When I discovered through my women’s healthy ageing research, the power of turning around mitochondrial health for improved health as we age, I made so many changes to my day-to-day lifestyle, that made such a difference to my overall health – this included the type and timing of food, the type and amount of exercise and all the other strategies that I have in the MyMT programmes. It’s also why I also encourage women who are exercising to mix up their workouts inside the gym and outside! It’s something that we tend to forget about – getting outside to workout helps our mitochondrial health. I love this photo of Sally biking through the forest. Energy levels restored!
Of course, the highest priority for improving our health and energy is turning around sleep quality. If this hasn’t improved during your menopause transition, then what this may result in during your post-menopause years, (your periods have stopped for a year or more), is worsening immune health or auto-immune problems, such as arthritis or other joint/ muscular problems.
If you aren’t sleeping well and you are going through your menopause transition, I invite you to join me on either of the MyMT programmes – it will literally change your life… and your (mitochondrial) health.
Wendy Sweet, PhD/ Women’s Healthy Ageing Researcher/ Member: Australasian Society of Lifestyle Medicine
Brady, C. . Liver disease in Menopause, World Journal of Gastroenterology, 21(25), 7613-7620
Kadouh, H. & Acosta, A. (2017). Current paradigms in the aetiology of obesity. J. of Gastroendocrinology Techniques, 19: 2-11.
OECD Report (2017). Obesity update 2017.