[Angela Foster] (0:15 - 1:26)
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I'm testing myself and my family. Get 10% off at getstride.com forward slash Angela, or check the link in the description below. There is also, right, a very, um, very real kind of, I suppose, extra pressure on women in general, particularly perimenopausal women.

And it's funny because when you speak to people, you'll hear a lot of kind of, I guess, that hustle mentality on Instagram and the like, we all have 168 hours in your week, or we all have the same number of hours in our day. And I always think to myself, well, maybe you haven't been a midlife woman yet, because when you chuck in the demands of, you know, children, your career or business like I have, right, and then you've got ageing parents, we are under so much stress. How much do you think cortisol and stress is playing a part in the weight gain that women experience during midlife?

[Dr. Rocio Salas-Whalen] (1:26 - 2:25)
I think midlife is a very difficult stage for women's health and women's weight, right? And it's not that we cannot do anything about it, right? Because we are going to have those life stressors, our children are continue to grow, our parents are going to continue to age, our business hopefully is going to continue to thrive.

So it's more what we can do around those things that can help me overcome the hurdles that are going to come along with that, right? And I think perimenopause is a huge, it's a huge, it could be a hard hurdle to overcome, giving all the extra things that are happening in our life. But if we have control of one, it's actually our hormones, right?

That we can kind of remove that hurdle, because we may not control the ageing of our parents, of our kids and all the other stressors that we have in our life.

[Angela Foster] (2:26 - 2:49)
Whereas with hormones, we can gain support and we can make the right, to the extent we can, to make the right lifestyle decisions, right? Yeah. I mean, we were talking there on the true and false, you know, around the decline in oestrogen and perimenopause and this redistribution of body fat that we see from the kind of hip and thigh area into the abdominal area.

Can you describe a bit about what's going on there and the challenges that women are facing? Yeah.

[Dr. Rocio Salas-Whalen] (2:49 - 4:49)
So oestrogen is meant to keep our body fat in like in a fertile stage, right? And a fertile stage for women is body fat in your hips, in your thighs, in your breast. When the drop of oestrogen starts to happen in perimenopause, and we have to remember, it doesn't go from 500 to zero, it's not a steep decline.

Doing perimenopause can last for 10 years, it's going to be like a rollercoaster of estradiol and progesterone, your hormones, when they're going to be up, when they're going to be low, when they're going to be in the middle. It's that fluctuation that is actually changing our body composition, because our body's recognising we're not in a fertile stage anymore, right? So your body composition starts to shift.

And I hear this all the time, women coming to me and saying, this is not how I used to gain weight. When I gained weight, it was in my hips, it was in my breast, now everything's going in my abdomen. I think every woman in midlife is one of the things that they notice is they gain weight differently.

And this is because of that fluctuation of oestrogen and progesterone and dropping testosterone. And added to this, we can lose lean muscle mass, or harder for us to build muscle mass, right? And when you lose muscle mass, your body fat goes up, right?

When you don't have that metabolic organ that incinerates fat for energy, well, your metabolism is going to slow down. So what slows our metabolism with age? The lack of muscle.

So what slows metabolism when somebody loses a lot of weight is the loss of muscle, right? Because muscle consumes fat for energy. Muscle consumes about 80% of the glucose in your blood for energy.

So we need that factory of burning calories and burning fat to keep going. But if we lose it, then we can tend to accumulate more fat. And because we're not in such a fertile state now, that fat is going to go intra-abdominally.

[Angela Foster] (4:50 - 5:50)
Yeah, and it shifts. I mean, what you've described there is a really real problem, right? Even athletic women.

So for example, yesterday, I went and had the core kind of analysis done of my VO2 max and addexa and had a look at that, had a look at my bone. And it's really interesting what you're saying there, because I train regularly most mornings, and I strength train at least four times a week. And what I've noticed over the last kind of couple of years is it's just getting harder and harder for me to gain muscle mass.

I can get stronger, but I have to really prioritise my, and that was the thing that came up for me is really prioritising protein and sufficient calories. Because my metabolism actually was, I think it came up as like 11% faster. So almost like I can't eat enough to hold on to that muscle, right?

So whether you're gaining weight or either way, you're actually finding it harder as a menopausal woman to gain muscle. And this becomes even more of a problem, right, for people who then take the GLP ones, and they're losing both fat and muscle.

[Dr. Rocio Salas-Whalen] (5:50 - 7:05)
Because think about it. I mean, I don't know if you're on a GLP one or not, right? But let's say you're not, again, I don't know.

What I want you to answer is, it's you struggle to get protein. I'll say about myself, I lifted weight since my 20s. And I like getting protein in your diet is my main goal in a day, right?

Like you think about food, okay, how is this going to nourish my muscle? How is this going to nourish my training? And it's hard.

Imagine if I suppress your appetite by 50%, right? So it becomes almost mission impossible for patients on a GLP one to meet that requirement of protein to maintain or even more to build muscle, right? I'm not saying it cannot be done.

It can be done. And that's going to tell you the expertise of whoever's prescribing you this medication is if they can guide you, along with prescribing you GLP one to guide you how to not only preserve muscle, but to gain muscle and to maintain muscle, right? That's what you should expect from your provider who's giving you a GLP one medication.

And if I know there's not enough experienced doctors in this medications, right, but educate yourself. And you can add that to whatever your doctor is also telling you.

[Angela Foster] (7:06 - 8:30)
I hope today's episode inspired you on your journey to vibrant health and high performance. Make sure you check out the show notes for a summary of all the important links to everything we talked about. And if you enjoyed this episode, hit the follow button and share it with a friend on social media.

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Angela presents a bitesize episode inn which she explores the physiological changes behind midlife weight gain, focusing on the role of cortisol and the hormonal shifts occurring during perimenopause. 

They highlight how the decline and fluctuation of oestrogen and progesterone lead to a redistribution of body fat from the hips and thighs to the abdominal area, as the body transitions out of its fertile state

WHAT YOU’LL LEARN
- Hormonal Fat Redistribution: During perimenopause, declining oestrogen levels signal the body to shift fat storage from fertile areas like the hips and thighs to the abdomen.

- Muscle Mass and Metabolism: Loss of lean muscle mass in midlife significantly slows metabolism, as muscle is a primary "metabolic organ" that consumes glucose and fat for energy. 

- The Importance of Protein: Prioritising high protein intake and sufficient calories is essential for building and maintaining muscle, especially as it becomes harder to do so during perimenopause.

- GLP-1 Considerations: While GLP-1 medications can aid weight loss, they often suppress appetite so significantly that meeting necessary protein requirements for muscle preservation becomes a major challenge.