We all know that a little exercise or activity makes a big difference to our health, but none more so, than to our brain and cardiovascular health as we move through menopause.
In the 1980s I used to teach ‘aerobics’. I had just returned from my OE (Overseas Experience) and was fascinated by the aerobic classes offered in the recently emerging fitness industry.
The pioneer of Jazzercise, Dr Jackie Mills from Les Mills, (that’s her in the image below) was teaching a class in the South Island, and I was there – my first-ever aerobics class. It was packed full of sweaty, heavy-breathing women in bare feet, tights and leotards!Â
Jane Fonda might have bought women’s aerobics into our living room, but Jazzercise bought aerobic exercise-to-music into larger settings – the gym.
My doctoral studies taught me that aerobics to music changed not only the approach to exercise for women, but also allowed them to enhance connections with others and change their moods – “those early days of aerobics helped me to cope and improved my mood” was a common theme shared with me.Â
It’s a theme that I want to now bring into the menopause conversation, because, as I found myself, even though we may have been exercising for decades, our menopause transition can be a game-changer for our tolerance to exercise.Â
The Womenâs Healthy Ageing Project (WHAP) commenced in 1990 as a study examining the health of Australian women from midlife (then aged 45-55 years) before the menopausal transition and into ageing.
This fabulous study has almost 30 years of data on mood, dietary intake, risky behaviours, physical activity and social connectedness among other factors.
Principle Researcher and Neuroscientist, Professor Cassandra Szoeke is very clear that the one thing that we can all do for our health, including our brain health, as we age is to MOVE!
There are so many different forms of exercise or activities to choose from these days, but when it comes to brain and cardiovascular health, one type stands well above the rest.Â
Despite the emphasis on harder workouts in many structured exercise programmes these days, the Women’s Healthy Ageing studies undertaken by Professor Szoeke and her team suggest that the type of exercise we do as we move through menopause shouldn’t just be focused on ‘hard-out’ athletic-type exercise.
Not only because if women aren’t sleeping, they aren’t recovering from more vigorous, exhausting exercise, but also because, when it comes to our brain health, dementia prevention and cardiovascular health, Professor Szoeke suggests that aerobic exercise, such as walking is best.Â
This is a similar message to that of Exercise Physiologist, Professor Hirofuma Tanaka. ‘Vascular function in general and arterial stiffness in particular is a barometer for cardiovascular disease risks that increase markedly with advancing age’ he mentions in his article exploring the anti-ageing effects of aerobic exercise (Tanaka, 2019).
Thatâs why, as part of my newsletter this week, Iâm having a shout-out for good old-fashioned aerobic or endurance exercise for all of us during menopause ⊠especially those of you who want to halt your belly-fat and look after your heart and brain health as you get older.
There is a reason for this – it’s to do with how our changing oestrogen levels cause changes to our blood vessels as we age. They become ‘stiffer’ as they lose some of their elasticity.
The way to help reduce the effect of this is to change our diet and increase certain vegetables which help our vascular network (celery and beetroot are just two favourites that I promote in the MyMT programmes) and increase our aerobic exercise.Â
SLOW JOGGING is an exercise method elaborated by Professor Hirofumi Tanaka (Fukuoka University, Japan). He chose the term âslow joggingâ to emphasise that jogging doesnât always have to be done at pace.
“Slow is a perfectly good way to do it”, says Professor Tanaka and I agree. The key he says, is to maintain ‘niko niko’ pace. It is a an efficient, healthier, and pain-free approach to running for all ages and lifestyles. Professor Tanaka’s work on vascular stiffness and exercise is also important. As he mentions,
‘In sedentary humans, arterial stiffness in the central (cardiothoracic) circulation increases with advancing age even in healthy men and women. Elevations in arterial stiffness are believed to contribute significantly to the pathophysiology
of the age-related increase in CVD and, accordingly, have been identified as an independent risk factor.’ (Tanaka, p. 1, 2019).Â
Womenâs heart disease is the forgotten factor in discussions from exercise, nutrition and lifestyle practitioners when it comes to womenâs ageing.
âNatural menopause confers a 3-fold increase in Cardiovascular Disease risk and post-menopausal women account for over 30% of the female population at risk for CAD in India alone.â  (Shrivastav et al., 2019, p. 142).
It goes without saying that most Doctors in Australia, the UK, America and New Zealand might be nodding their heads in agreement too. All of these countries have the highest rates of post-menopause heart disease and this is another argument for aerobic exercise, because it is evidenced to improve cardiac health and cholesterol levels.Â
Aerobic exercise helps to increase HDL-cholesterol levels (the ‘good’ cholesterol) and decreases blood triglyceride (fats) levels. It also helps insulin to work better too.
Insulin is a hormone that also gets out of balance as we move through menopause, especially if belly-fat is increasing in our post-menopause years. When we increase our âgoodâ HDL-cholesterol, this binds to the âbadâ LDL -cholesterol which, during menopause, can build up in the liver and our blood vessels, and the HDL-cholesterol effectively helps to remove the harmful LDL-cholesterol.
If women have a fatty-liver and/or are putting on more and more weight as they move into post-menopause, then helping to boost HDL-cholesterol levels is crucial for your improved health as you age.Â
If your blood lipids are high, then your âgoodâ cholesterol called High Density Lipoprotein Cholesterol (HDL-Cholesterol) may well be low. If it’s under 2.0 mmol/L then you need to boost it until it is over 2.0.Â
Increasing your HDL cholesterol will also improve your heart health.
âPost-menopausal women have more degradation of HDL when compared to reproductive women, so the HDL levels are decreased in post-menopausal women. HDL cholesterol is significantly decreased in post-menopausal women.â (Shrivastav et al., 2019, p. 144)
Menopause is the time of our life when we need to change how we look after ourselves, including with our exercise. Thatâs why I have designed the Re-Build My Fitness programme, which women are doing after they have either completed Circuit-Breaker (for thinner/ leaner women) or Transform Me (for women wanting to lose weight).
Don’t forget too, if you are a Health Professional, then the 6 week online, self-paced learning MyMTâą Weight Loss Coach Course is available for Practitioners too.Â
References:Â
Eapen, D., Kalra G. et al. (2009). Raising HDL cholesterol in women. Int. Journal of Womenâs Health. 1, 181-191.
Kodama S., Tanaka S., Saito K., Shu M., Sone Y., Onitake F., Suzuki E., Shimano H., Yamamoto S., Kondo K., Ohashi Y., Yamada N., Sone H. (2007). Effect of aerobic exercise training on serum levels of high-density lipoprotein cholesterol: a meta-analysis. Arch Intern Med. 167(10):999-1008.Â
Laakso, M. et al. (1993). Lipids and lipoproteins predicting coronary heart disease mortality and morbidity in patients with non-insulin dependent diabetes. Circulation. 88:1421-1430.
Samargandy S, Matthews KA, Brooks MM, Barinas-Mitchell E, Magnani JW, Janssen I, Hollenberg SM, El Khoudary SR. Arterial Stiffness Accelerates Within 1 Year of the Final Menstrual Period: The SWAN Heart Study. Arterioscler Thromb Vasc Biol. 2020 Apr;40(4):1001-1008.Â
Shrivastav, D., Akshay, B. & Parekh, P. (2019). Study of serum lipid profile in reproductive and post-menopausal women. Int. Journal of Medical & Biomedical Studies, 3(9), 142-145
Szoeke, C. (2021). Secrets to Women’s Healthy Ageing. Melbourne University Press: Australia
Tanaka, H. (2019). Antiaging effects of aerobic exercise on systemic arteries. Hypertension, 74, (2). 237-243. https://doi.org/10.1161/HYPERTENSIONAHA.119.13179