Latest / The Dr Louise Newson Podcast / 290 - Exercise: how to stay active and strong in menopause and beyond, with Matt Roberts

Transcript

290 - Exercise: how to stay active and strong in menopause and beyond, with Matt Roberts · The Dr Louise Newson Podcast

1:03
So on my podcast today, I'm delighted to introduce to you
1:06
Matt Roberts, who some of you will know and some of you might
1:09
not. I've actually stalked him from
1:11
afar for many years, actually watching him long time ago
1:15
actually when personal trainers weren't quite such a thing.
1:18
Looking at him in various media sort of newspapers, showing how
1:22
to do very simple exercises, making it look very simple but
1:27
very effective as well. And I was very honoured to be
1:31
introduced to him recently at a longevity event.
1:33
And so now I've hooked him onto my podcast.
1:35
So it's a very exciting day for me.
1:37
So welcome, Matt. Thanks for coming today.
1:40
Well, thank you. I mean, it's a pleasure to be on
1:42
and likewise I've kind of, you know, watched all the work
1:45
you've been doing from distance and it's nary that is and has a
1:49
natural follow on with what I do.
1:51
And increasingly, you know, hormone health overall, this
1:55
kind of crossover between what the fitness and the health and
1:59
training community do or should be doing is sort of quasi
2:03
medicals more crossover, more understanding.
2:05
You know, certainly I've been doing this a long time.
2:08
I've been doing this for, you know, 930 years.
2:10
I'm 51 years old now, since my first club when I was 22 years
2:13
old. And from day one it was always
2:15
about data and there wasn't much data you could gather at that
2:19
point in time. But it was very much in my core
2:21
thinking that it needs to be that we could analyse
2:23
individuals in a really precise way.
2:26
And I always had teams of doctors, medics that we
2:29
consulted with and dietitians and less so hormone specialist.
2:33
Ray Star have to say it was much more of a thing in the last
2:36
maybe 1520 years we became able to actually really use the data
2:40
and understanding in a much better way.
2:42
Whether that was because of us or whether that was because of
2:44
the general kind of community understanding, I don't know.
2:46
But where we are now is where I think it always envisages it
2:49
should be, is that we have this really interesting, great
2:52
merging of a whole range of skill sets with our liver
2:56
specialists and we have on site and our dietitians on site.
2:59
Now physio is on site and osteopaths and we can start with
3:01
hormone specialists, you know, like yourself and it's something
3:04
which it's a really nice place to be, I think between what
3:07
medicine and the fitness world are doing.
3:09
And this isn't in all cases, by the way, this is very much I
3:12
think in the upper ends of it. I did a good job of
3:15
understanding bodies better. And I think it's important as
3:18
well as I stress that, you know, looking at fitness and health,
3:21
while inevitably fitness is always linked into the body
3:24
beautiful and building up muscle mass and having a certain shape
3:27
of being a certain size. It's not how I view it.
3:29
I mean, I view that as being the good and byproduct of what we do
3:33
and what we do is always make sure a body is super healthy.
3:37
We focus on the Wellness end of things.
3:40
I'd say certainly over the last several years in particular, we
3:42
really have skewed the business towards being a health span
3:46
business. And I say health span perhaps as
3:49
opposed to just longevity. I don't think we can necessarily
3:52
extend our longevity from what we do per SE.
3:54
Lots of other medical interventions can do, but what
3:57
we do is make sure that, you know, individuals function in a
4:00
way that means they can be be unbelievably active whether they
4:03
are 35 years old or 95 years old.
4:07
And if for me being now 51 years old, my goal, well, look, when I
4:11
turned 30 years old because you're stupidly when you're in
4:13
your 20s, you think you're getting older when you're 29
4:15
years old and 1st it's going to hit the old person.
4:18
And I said, well, I'm going to hit 30.
4:20
You'll be the same shape and health and well-being as when I
4:23
was 20 years old. And because I was an athlete in
4:25
my teen years, I was a sprinter. There was lots of DACE
4:28
collection that I had. So I could actually quite easily
4:30
look at some metrics around where I was being 30 compared to
4:34
being 20. And I was bang on the same, same
4:36
numbers of body fat and blood pressure and the blood data and
4:39
speed and power and so on. So, you know, raw force 10 years
4:43
got to being 39 and well, I need to be the same shape when I was
4:46
40, when I was 30 in there for when I was 20 and the same
4:49
happened at 50 as well. And with all the metrics that
4:52
I've got, my data hasn't shifted.
4:54
I'm within a fraction, the same body fat percentage from the
4:57
fraction, the same weight. But it's not because things just
5:00
stay the same. You've got to work on changing
5:03
as you change and changing as you age because no doubt at all,
5:07
but if you sit in your complacent and you do nothing,
5:09
you age. It takes consistent work and it
5:12
takes the understanding of how to use rest and how to
5:15
understand blood data, how to understand how your VO2 changes
5:19
and all these things. And it takes full diligence in
5:22
doing it. So I'm like a Guinea pig to
5:24
myself over how to ensure we can get the best results.
5:28
And for my my client base, people that you like yourself or
5:32
see things that I write about in the press and do I try to take
5:35
things that have complicated science backgrounds and simplify
5:38
them and make sure it's case of OK, what can we actually do?
5:41
What's the real things as proper take homes on this?
5:44
But it's so important actually. So when I was at medical school
5:47
many years ago in the late 80s, we didn't really learn much
5:50
about exercise at all. And I'm active, but I'm not
5:54
like, I'm not a runner, I'm not a sprinter.
5:56
I've always cycled, like as a student I cycled everywhere
5:59
because it was so much cheaper than getting the bustle or
6:02
public transport or whatever. And so I was sort of fit just
6:05
because I was psych. Ivan was cycling out to
6:07
nightclubs sometimes because I didn't really drink much and it
6:09
was just easy. And then I would do pop aerobics
6:12
or step aerobics. You know, that was a really big
6:15
thing in the 80s and 90s. But that was just my choice.
6:19
But actually as a medical student undergraduate, I didn't
6:22
really learn much about muscles. I didn't know muscles produced
6:26
chemicals that were really beneficial.
6:28
I just thought they were there to like move our arms and legs
6:31
really literally. I knew a lot about the anatomy,
6:33
but not about the Physiology of muscles.
6:36
Knew a little bit about bones that they're metabolically
6:38
active. But, you know, Fast forward 30
6:41
years, obviously my knowledge is very different because I've
6:44
self-taught. But you're absolutely right,
6:47
Matt, it's about how we look after ourselves and keep well.
6:50
And I think I'm fitter now than I was as a medical student in a
6:53
different way. You know, just I do a lot of
6:57
yoga and I'm physically stronger, but actually that
7:00
helps me to be mentally stronger.
7:02
And, you know, I still can't fit into my wedding dress.
7:05
And I've been married 25 years. You know, there's quite a few
7:07
people in there. I'm 54, probably can't fit into
7:10
and I'm, you know, my wedding dress was fitted.
7:13
But it's very important that we think about exercise, I think in
7:18
very different ways because I have patients who are extreme
7:22
athletes. That's fine.
7:23
I have other people that literally find it very difficult
7:26
to get up from the sofa. And these are often women in
7:28
their 70s and 80s that haven't really done much exercise and
7:33
it's catching up with them. They have this sarcopenia, loss
7:35
of muscle mass. They might have some
7:37
osteoporosis, they have muscle and joint pain, they're more
7:42
exhausted, they might have some urinary incontinence or urgency.
7:46
Even just getting out of a chair to go to the toilet is massive.
7:50
And so I think often when you're young and fit, you could never
7:54
imagine being that old woman in a chair unable to get out to the
7:56
toilet. Whereas one of the things that
7:58
keeps me exercising is like, I don't want to be that woman.
8:02
I don't want to run marathons because I'll never be able to
8:06
unless I gave up my job and had loads of time or whatever.
8:08
But I really, really wanna be able to get up without a Zimmer
8:12
frame, not be in a nursing home. And that's where you're talking
8:15
about this health span, I think is important because so often
8:20
you can zone out with personal trainers or extreme athletes
8:24
thinking I'm never going to be that person.
8:26
And one of the things I've always liked about your work is
8:28
you simplify it so you is something for everybody.
8:33
And I think that's really important, isn't it?
8:36
Yeah, it is. I think that's, you know, 99.99%
8:40
of people are never going to be an athlete.
8:42
So you want to focus the work you're doing not on the naughty
8:44
point, naughty 1%. Any sphere is focusing on the
8:47
broad masses of what can we all do to make sure that we have
8:50
this ability to stay younger for longer.
8:52
Frankly, that's the goal, isn't it?
8:54
It's retaining as much of the youth and the vitality and
8:56
vibrance as you possibly can. And within that then you feel
9:00
well. And we have to remember that
9:02
when someone starts to exercise, whether they have done something
9:05
before or have not, the percentage growth they can get
9:10
in muscle size, strength, strength in particular is the
9:14
same. So if someone has the same input
9:17
in relative terms to their fitness ability, the return they
9:20
get on their time investment is the same percentage change.
9:24
So this idea, maybe it's too late for me or I can't do it
9:27
now, I'm too old, I've never done it before is wrong.
9:30
Whatever you do, you gain. And in fact, actually there's
9:32
more chance to be gaining a slight higher percentage when
9:35
you haven't listened before. You started with a lower base.
9:37
Now clearly the strength changes as percentages are different.
9:41
If you've got high strength to start with or low strength to
9:44
start with, the percentage are the difference.
9:45
You're going to feel the difference irrespective and with
9:48
that difference, with that change in the strength, you get
9:51
a, an absolutely linear response in terms of your mobility.
9:55
So you're right to say people struggle to get out of their
9:56
chair and that's a horrifying thought that you're actually
9:59
unaided can't stand up because that's when things are starting
10:03
to slow down dramatically and you start to get them secondary
10:06
illnesses and various issues alongside that.
10:08
So we've got to have that raw basic of what are the functional
10:13
patterns and movements that you need in your life to not be at
10:16
risk. And as someone gets older, the
10:19
problem with sarcopenia is something which is not to do
10:22
with the size or anything else. It's to do with the risk of
10:24
falling. So if you haven't got muscle
10:27
strength in your glutes, in your hips, and your mobility is poor,
10:30
you stiffen up because you sat slow for too long, your chance
10:33
of tripping, falling, damaging the bones is much higher.
10:36
Combined of course with the effects for a female of the
10:40
menopause on bone health, the effects of not exercising on
10:44
reduced bone density and health. All the things that we do that
10:48
are strength based are all positive for making sure you've
10:51
got greater mobility, greater stability, greater bone density
10:55
and the risk someone having an issue when they're 65 and that
10:58
break of a hip where the mortality rate just goes style
11:01
rocketing goes away and it's really about what can you do?
11:05
And it's very much that person who sat in their chair can't get
11:09
up. Well, just put four or five
11:11
cushions or two cushions on the edge of the chair and just stand
11:15
up and just literally bend your knees so you can just touch your
11:18
cushion so your knees aren't going to go fully down.
11:20
And do it multiple times. Small range of motion squats as
11:24
an example. And do that for 12:15, whatever
11:28
the number might be, 2025 reps It gives you that chance of re
11:32
engaging those muscles. And these are basic base things
11:35
that can be done. And you get the butt to be
11:37
stronger, the quads, the thighs to be stronger.
11:40
And the amount of stability and strength it gives you in the
11:43
core key areas is massive. And it's that kind of thing.
11:46
It's just you haven't got to go to the gym necessarily.
11:48
Great. If you can and you do so, what
11:50
can you do around your environment to make sure you've
11:52
got the tests that you need? And we, we have to keep testing.
11:55
And like I say with myself, I mean, as time goes by, what's
11:58
noticeable with anybody, everybody is it takes the same
12:02
amount of work to get the same game because I haven't slipped
12:05
backwards anywhere, but the rate of which can fall backwards
12:07
increases. So your retention of muscle
12:10
strength goes more quickly. It takes an ongoing diligent
12:13
approach to ensure you stay on top of it.
12:15
So it can be done and it can be simple and it does take just
12:19
this idea. I am the person that can do
12:21
this. Do actually people lose track of
12:23
the idea of it's not me, that's not what I am?
12:26
Well, imagine that you are. Imagine that it is you.
12:28
Imagine you are that person who can do the activities.
12:30
Imagine that you are the person who's active.
12:32
And then you have that mindset of I can actually feel as though
12:35
I've got control of me, of my life.
12:38
It's so easy. I think you're right to be on
12:40
that slippery slope. So I've had a viral infection
12:42
over the weekend and so I haven't done any yoga for three
12:46
days. And for me, that's quite a long
12:48
time at the weekend. I tend to do a longer practice
12:50
as well, but I just haven't felt.
12:52
And it was probably the right thing to rest my body, but it
12:54
would be very easy to forget that I've ever done yoga and not
12:58
do it. But I know that if I left it a
13:00
longer period of time, it would just be so much harder to get
13:04
back into. And I end my yoga practice with
13:07
a headstand and I'm very proud of being able to do headstands.
13:10
But I do sometimes think, God, if I didn't keep doing it most
13:14
days, I wonder how long it would take for me to not be able to do
13:17
a headstand. And it's a bit of an internal
13:20
sort of thing. But that's just a mark of
13:22
anything like just doing bending down and touching my toes.
13:25
I can do that very easily because I do it a lot.
13:28
But it wouldn't take long at 54 to stiffen up.
13:32
And that's where it's so easy or it's easy to continue.
13:37
But then, and there's people my age who go, well, that's
13:40
ridiculous, Louise. I will never be able to do a
13:42
headset. I will never be able to touch my
13:43
toes. No, but you will be able to walk
13:46
up the stairs a bit quicker. You will be able to run for the
13:49
bus, you will be able to walk up the escalator rather than just
13:52
waiting for it to take you up. And it's harder, isn't it, to
13:56
start, I think, when you've let bad habits sort of slip and not
14:00
do as much exercise. It's human nature to find a
14:03
shortcut. It's human nature to find a work
14:06
around. It's human nature to go for the
14:08
comfy option. And we are very guilty of that
14:11
now because we have the ability to make our lives become very
14:14
comfortable, very warm, very cozy, and not have to exert very
14:18
much at all and to remember what boys designed to do.
14:22
The slip off rate if someone stops doing something per your
14:25
point is that if you do nothing, nothing, nothing for two weeks,
14:29
nothing really changes. You don't lose anything at all.
14:31
It's a minimal percentage drop and your strength through in
14:33
your VO2 capacity, your half lung capacity and strength, 4
14:37
weeks, it starts to slide. You might lose maybe 5 to 10%
14:41
after 8 weeks. You drop off a Cliff and you
14:44
pretty much lose all that you've done in the previous six months.
14:47
All of your fitness work, all the effort that you put into it.
14:50
You lose all of it within eight weeks.
14:52
So you've got to stay on it and you have this window.
14:54
You can get away with getting the virus and being a well, it
14:56
doesn't make any difference. You feel like it has been a
14:59
reality. You're OK.
15:00
You can get away with being on a business trip somewhere because
15:03
you have no time to exercise for a few days.
15:04
Not a problem. If you decide suddenly just
15:06
because you forget you need to or you lose the urge to exercise
15:10
and move and be healthy. 8 weeks and you're back to where you
15:12
were at the very start of your program.
15:14
The longer you've been active for over many years, you might
15:17
get a bit of an increase in duration of that, but you still
15:19
have a huge drop in your capacity and your fitness.
15:21
So we've got to, yes, got to stay very, very consistently on.
15:26
Consistency is the key. It's not necessarily about
15:29
hitting the high, it's being consistent all the time.
15:32
If there there was one thing, I mean, effectively, there's one
15:35
facet of fitness, which is probably the most important
15:39
thing that anybody must be focusing on.
15:41
And it's the one that for most, for a lot of females, they tend
15:44
to avoid the most, which is strength work.
15:47
Strength work is the mainstay of our hormone health.
15:51
It's the mainstay of our bone health.
15:53
It's the mainstay of our ability to actually physically function
15:56
and move. Without muscle strength, our
15:58
skeleton can't hold up. It's the mainstay of all that we
16:01
are as a being. Without that we wouldn't be
16:03
anything at all. Increasing your strength, I do
16:06
mean strength rather than size. There's two very different
16:10
elements of how we train muscle. We don't want mass.
16:13
What we want is highly activated, very strong tissue
16:17
which is functioning and able to keep you doing all that you need
16:19
to do and more. And that's the high metabolising
16:23
tissue as well that will burn energy.
16:25
That should be the the one thing you must must do.
16:29
The second thing is probably quite equal seconds.
16:31
First, in a way, is doing zone 2 cardio training for zone 2
16:37
cardio is that thing you must do every other day, four days a
16:41
week of constant pace. It's for most people a fast walk
16:46
or it's a sat on a bike at your gym ticking a lot for 40
16:50
minutes. And it needs to be 1 speed, 1
16:54
intensity, 1 pace. And it should feel like as
16:56
though we're having conversation now and it's fine.
16:58
You should go into, we could have this conversation, but
17:00
we've just pressing ourselves a bit harder, a bit breathless.
17:03
Heart rate's about roughly 70% of your maximum capability.
17:07
So it's definitely overloading you, but you're getting slightly
17:09
sweaty, but you're not exhausted.
17:12
And it's sustainable for that 40 minutes.
17:14
The reason why that's important is what we're looking for always
17:17
is really good mitochondrial health.
17:20
So our mitochondria are the they decide on how our cells kind of
17:24
use energy in a way. So they decide on how we utilise
17:26
fatty acids, That's how we utilise glycogen sugar.
17:30
And if they're functioning badly, we tend to have a
17:33
propensity towards using up, bringing up more glycogen, more
17:35
sugars than we do fatty acids. These are marginal differences,
17:39
but our insulin resistance then gets tweaked and adjusted and
17:42
that causes all swell problems. Now we've got to train our
17:45
bodies to become very efficient and zone 2 cardio, this
17:48
sustained 40 minute spell without changing the intensity,
17:53
whether it's walking or biking. Biking is great because it's
17:55
very sustainable, gives you very rapidly, very strong, healthy
18:01
mitochondrial capabilities, and your body gets very efficient
18:04
and starts being able to just really get used to that and burn
18:07
away much more fatty acid as an energy source than it does
18:11
sugar. So you go do those.
18:12
Those two things are your mainstays to focus on.
18:15
There's a whole bunch of other things as well, actually, but
18:17
those are the two things that you want to get right.
18:19
And how we use cardiovascular training, how we there, we're
18:22
using cardio work to create cardio.
18:25
Strength is different. Again, that's interpal training,
18:28
how we give you muscle. The side if you want it is
18:29
different. Again, that's a very specific
18:31
training program, an eating program to gain mass.
18:34
In the main, it's by giving you exercises that give you direct
18:39
strength. And you know, off the bat, to
18:41
give you an idea on the numbers with this one, someone's going
18:43
to the gym or doing workouts at home.
18:45
The amount of reps that you do defines your intensity.
18:49
So if you can do a an exercise that you can do for around
18:53
really 8 to 12 reps that's in the strength gain zone, you're
18:57
unlikely to build up a whole lot of size during that kind of
19:01
range. 8 reps somewhere there where you get really therefore
19:04
high loading to be heavy enough that you couldn't lift it more
19:08
than eight times. That's a heavyweight.
19:10
We don't want to weight, that's light that you do 12/15/20
19:14
times. If you're looking to try and
19:15
create strength, gives you probably some strength
19:17
endurance, that's different. We're looking for direct pure
19:21
strength. Now, that means doing a pretty
19:23
heavy loading when you're doing a squat with some weights in
19:26
your hands deciding maybe or a bar on your shoulders or a leg
19:28
press machine in the gym. It means working up to level.
19:31
I wouldn't say jump straight into this, by the way.
19:33
You've got to work up to that level over some time.
19:36
And at that level where you're doing 810 reps, you build such a
19:39
huge degree of strength and you test the muscles and therefore
19:43
the tendons on the muscles and the tendons attached to the
19:45
bones, you create really good bone density build.
19:49
And this gives everyone phenomenal abilities to burn
19:52
away calories. It gives you a really amazing
19:55
change in your gluten usage and your insulin resistance.
19:58
It gives you a far better use of sugar and your chances of
20:02
becoming. Free diabetical lessened if your
20:05
muscles get stronger and utilize that programme more quickly.
20:08
So it's a must go to. It's a thing which you have to
20:11
do to ensure we have functional strength.
20:13
We've got therefore hormonal strength for guys who are
20:16
listening as well. If you want to get some
20:18
testosterone gained, and this is a big problem, you know, the
20:22
data on testosterone in males is horrifying.
20:25
The levels of this generation are less than their fathers
20:28
before and less their fathers before them, which I think is
20:31
horrifying, staggering. We're seeing that with male
20:34
sperm counts as well. You know, 50% drop in some
20:37
studies over a 40 year period. I mean, bad data.
20:40
And this is all based on us as human beings not challenging
20:44
ourselves in the same way as we need to.
20:46
And females absolutely need to be physically challenged, need
20:50
to be pushed. I think that we've got to focus
20:53
on having a box ticking exercise.
20:55
So in the course of a week in your programming, what do you
20:58
need to do? We've got to work on
21:00
fundamentally strength first, cardio fitness second, equal
21:04
first, mobility within that mix as well and some way of calming
21:09
the system too. So within that, what are you
21:11
going to choose to do? So the strength side, you kind
21:14
of got to go to the gym or you've got to have some weights
21:16
at home and do some really big overload.
21:18
The cardio you can work into a program and think about if
21:20
you're going to do cardio, how does that work?
21:22
You've got a dog, what are you doing already?
21:23
You're walking the dog. Are you walking fast enough with
21:25
the dog to get your heart's level?
21:27
It needs to be. Or you can check it out.
21:28
You can find out. You can do a manual check or get
21:30
a wearable. I wear a whoop device on my
21:32
wrist and look at your data with the mobility work you do.
21:37
Yoga yoga's great example of a thing which is very, very good
21:40
for us in lots of ways. Mobility for flexibility, good
21:43
mentality as well. But we won't tick the box on the
21:46
strength or on the cardio side. And all the data shows that as
21:50
well. We need to do lots of stretching
21:51
mobility work, but again, it's not going to give you what you
21:53
need in the strength. So if you're choosing your week
21:55
of workouts and I'd sort of would point towards people,
21:58
perhaps you focus on doing polite sessions and yoga
22:01
sessions and and so on and they're working out.
22:04
It's great, but it's not enough. We need to test you and
22:08
challenge you and do those things because they're also
22:11
great, but they're not the mainstay.
22:13
So how you construct your week is about let's get the box
22:16
ticking done over. We have to do these things over
22:18
here and the rest you can enjoy because you might not enjoy the
22:21
weight training, but if you don't enjoy it, say, well enjoy,
22:23
not going to do it, that's fine. But you are going to probably
22:25
have some issues with the bones and with the hormones and with
22:28
the muscle structure and shape as time goes by.
22:31
So there's a degree of let's find the things that you like to
22:34
do. Let's make sure we take the
22:35
boxes on. Did you do the things you had to
22:37
do as well? Yeah, it's so important and
22:40
actually a lot of it doesn't take that much time.
22:42
You know, I've got 3 weights at home, which makes it a lot
22:45
easier. So I don't have to factor in if
22:47
I factored in going to a gym, coming home from a gym, that's
22:50
probably as long as it is to actually do the exercise.
22:54
And so it's very easy to take make the excuses, you know,
22:56
depending on, you know, I'm quite happy exercising on my
22:59
own. I don't need to be surrounded by
23:00
other people, whereas other people do need that motivation.
23:04
But it's having something that definitely is varied that's
23:06
right for you. And you know, one of the things,
23:09
things I see a lot more in the clinic, there's women who are
23:12
fit and active, but then their fitness falls off a Cliff
23:15
because their hormones drop. And it's very easy to say to a
23:20
hormonal woman, oh, you just need to exercise and then you'll
23:23
be better. Well, actually these women, and
23:24
I found eight years ago when I was perimenopausal, I stopped
23:28
exercising because I had such bad muscle and joint pain.
23:31
I had reduced stamina, I had lots of muscle strength as well,
23:34
and I knew I was putting on weight, especially in my
23:36
midline. And so to tell me, oh, of
23:38
course, just exercise, actually I couldn't physically I found it
23:41
really hard. But we know that all three
23:44
hormones, estrogen, progesterone, testosterone,
23:47
build our muscle as well as our bones.
23:50
But I'm very interested in mitochondrial function.
23:53
So as you've already mentioned, the mitochondria, the powerhouse
23:56
of all our cells, we have receptors for estradiol, which
24:01
is a nice form of estrogen, testosterone on every single
24:05
mitochondria. There's some good studies
24:07
showing that our mitochondria work better, especially with
24:11
respect to sarcopenia and bone strength in the presence of
24:15
hormones. And so it's a combination.
24:18
Obviously our muscles will produce hormones as well as our
24:20
brain and our ovaries, but it's that whole thing.
24:24
So often people are told, well, if you exercise, you'll feel
24:28
better, but they're not addressing the hormones.
24:31
And, you know, hormone prescribing is half of what it
24:34
was 20 years ago. And no wonder that people are
24:37
less fit, more obese, because, you know, it's trying to run a
24:42
car without diesel or oil or whatever.
24:45
It doesn't matter. Or electricity, depending on
24:46
your car. But it's very hard.
24:49
You've got to be looking. And you know, you mentioned
24:51
about what we eat is crucially important.
24:54
So many women I speak to aren't having enough protein.
24:58
They think they're eating well, but they're not.
25:01
And then they haven't got hormones, but they're still
25:03
trying to exercise and then they end up feeling like failures.
25:05
And it's no surprise. And that's where your work is so
25:08
important as well because it's looking throughout, it's looking
25:12
at every single factor. Whereas I think so often you can
25:15
just be siloed thinking hormones are going to control everything
25:19
or exercise is going to improve everything.
25:21
And of course it's not. It's a combination, isn't it?
25:24
Yeah, so a few points to that. Absolutely.
25:25
I think that firstly with the point of when someone is going
25:29
through perimenopause, menopause, and they don't feel
25:32
like being physically active, damn right you do.
25:35
I mean, it's something which is as a male, it's only an
25:38
understanding looking at how someone gives me symptomatic
25:40
feedback that you can see why someone would not feel like
25:43
doing a great deal. And the answer to that is you're
25:45
going to pick and choose your moments because some days are
25:47
better than others. On those days when you feel
25:49
good, fine, use that day, that's great.
25:51
On the days when you just don't feel like that, there's no way
25:53
you can, you can push yourself. You go choose the things on
25:55
those days that will make you feel a sense of personal
25:58
well-being, personal satisfaction, feeling whether
26:02
you want to get some increase in vitality, get some calm, find
26:06
some time, whatever the thing might be.
26:07
You find your exercise and your routine to suit that thing.
26:10
But on those days when you can is something, then you make the
26:12
most of that moment. But it might be there one in 10
26:14
or it could be one in two and that will vary enormously.
26:17
The prescription of hormones. It's a minefield, I think
26:22
something which, you know, you're a huge expert in this
26:24
area. And one thing from a point of
26:27
view of me working with clients who go to see specialists is
26:31
there's still a great deal of uncertainty over people wait and
26:36
they can I do it without? Can I sort of find another way?
26:39
Is there a way to do it naturally?
26:41
And so and the answer in I think most cases is there's not, I
26:45
think that there needs to be intervention and that's where
26:48
the regular testing, the regular consultation, the regular
26:51
update, symptomatic checks are vital and there needs to be
26:55
constant adjustments. I think that the, from my point
26:58
of view, a way to keep on just micro adjusting over extended
27:03
periods seems to make absolute sense in response to symptoms,
27:07
in response to things that we see with performance in people,
27:10
their ability to be energized in their workouts, in their life,
27:13
their sleeping, all these things.
27:15
If your sleeping's out clear and you can't do anything, you're
27:17
knackered. So the intervention with
27:20
hormones is vital for males as well As for females.
27:24
Females obviously have much more timeless males.
27:28
You know, TRT is without question is a huge and positive
27:31
intervention for lots of males. We're seeing some, you know,
27:34
data on males as we know personally in our testing in the
27:37
clubs a broadly is poor. So we have to have that.
27:40
And then combined with that, right now the issue we have
27:43
increasingly with females who are going through the menopause
27:46
is the concern over the weight gain has important point where
27:50
the using Azampic and Wergevy and Manjaro to try to lose
27:53
weight and it's just fighting with the wrong tool.
27:57
I think they're an interesting medication.
27:59
I think they have a place clearly.
28:01
I think they have some great upsides When used phenomenally
28:05
tightly within a brief at a low dose.
28:08
There's a good chance it gives people weight loss only if
28:13
they're doing a very specific strength training program and
28:15
only if, as you said, their protein intake is high enough to
28:18
sustain themselves and then muscle.
28:20
Otherwise it's a one way St. downwards and I suspect and I'd
28:25
love to get your feedback on how much that increased use of the
28:29
GLP one agitators which these products are, is affecting
28:32
hormone health. It must be, surely?
28:34
Yeah, I actually don't prescribe them and I'm too concerned about
28:39
their long term risks actually that I wouldn't be rushing and
28:41
prescribing them. They probably do have a role,
28:44
but I'm more concerned about or more interested in prevention
28:49
actually. But also a lot of women when
28:51
they have their hormones optimised, all three hormones
28:54
actually can really make a difference because obviously
28:57
menopause is a cardio metabolic problem.
28:59
People's metabolism changes. But a lot of people if they
29:02
don't have adequate estradiol, they're active, nice form of
29:06
estrogen, they'll produce more estrone in their body.
29:09
And the fat cells produce estrone as well as all sorts of
29:12
other inflammatory cytokines, chemicals.
29:16
And you know, estrone is not good, but it's made in fat
29:19
cells. So people then put on weight
29:21
because they're producing more fat.
29:23
And so I'll often work very hard with patients to optimize their
29:28
hormones properly in a physiological way, think about
29:32
how they exercise, really look at their nutrition, even, you
29:36
know, looking at their sleep, their mental health, because
29:38
that can make a difference to their metabolism as well.
29:41
And then wait because it can take three to six months to
29:44
really have an effect rather than rushing into these drugs,
29:48
which someone told me a few days ago, actually, I'm not going to
29:52
mention names, of course, but a menopause specialist she had
29:55
seen, she's absolutely, you wouldn't look at her and think
29:57
she was overweight, which said, I've got a bit of belly fat.
29:59
And I went to see this doctor and they said, oh, we could just
30:01
give you a low dose of, you know, one of these drugs.
30:03
And I'm like, hang on, no, they shouldn't be used first line.
30:08
Absolutely. I think it's so easy to just do
30:11
this. Whereas actually you want to put
30:14
in habits that are sustainable, that are going to really make a
30:18
difference. And also, you want to build
30:21
muscle and you still need fat, as in good fat as well.
30:24
Whereas I worry about some of these drugs, what they're doing
30:28
to bone density, what they're doing with fat in the brain and
30:32
the cells as well, and what they're doing to hormones.
30:34
Actually, are they having a negative effect on hormones in
30:37
men and women? There's so much we don't know.
30:39
And if we don't know, then it's actually better to think about
30:43
the basics. And actually, it's interesting
30:45
when people say they want to manage their menopause naturally
30:48
because it is actually more natural to have hormones than
30:51
not. It's not actually natural to
30:53
live without hormones. So we just need to think.
30:56
And even for men, testosterones being labeled or mislabeled,
31:00
because sadly, a lot of men are using testosterones that are
31:04
synthetic, which are chemically altered, which are not the same.
31:07
They're anabolic steroids. Whereas the pure testosterone,
31:10
of course, isn't an anabolic steroid.
31:12
It is a natural hormone that we produce.
31:15
And a lot of men don't have it as they age for all sorts of
31:18
reasons. So there's a lot we need to
31:21
think about. But I think the big message of
31:23
this podcast, Matt, is about individualisation.
31:26
And that's certainly for me as a doctor.
31:28
Every patient's different, everybody's journey's different.
31:32
And when you're thinking about exercise, everybody's coming
31:35
from different beginnings, but also they've got different
31:37
endpoints. And so making sure everything's
31:40
tailored is crucial. So it's the new year, people are
31:43
thinking hopefully more about exercise, movement, being
31:48
healthier. So just before we end, 3 tips
31:51
for those people that might be sitting here thinking it's all
31:54
very well for them to talk like that, but what am I going to do?
31:57
So what are the three things that they could do that's going
31:59
to start for them to continue? Well, very simply, I mean, the
32:03
one thing you should definitely be doing fundamentally because
32:05
it's very easy to do is going doing that zone 2 cardio we
32:08
touched upon. So if you can make a goal for
32:10
yourself for each week, don't make it too onerous.
32:13
Make it 3 days in the next week and thereafter you're going to
32:17
do a 14 minute long fast-paced walk with your level being about
32:20
that 7 out of 10. So you've got that slightly
32:22
puffy feeling and do that. That's one for sure because
32:25
anyone can do that. That's straightforward or to
32:27
think about as well, making sure we build on that strength.
32:31
So let's choose to do four or five key exercises, simple ones.
32:37
So probably a squat, probably a lunge, maybe a step up, possibly
32:42
a form of a press up. Make it make the easy versions
32:44
because we have an edge of a table.
32:46
It can be on the edge of a bench in the park, anything you like
32:50
and some form of a pull test. Now that could be ideally some
32:53
form of a pull up exercise because in the gym it's a pull
32:56
down exercise. Choose four or five things for
32:58
the big muscle groups. And when you're doing those,
33:00
think as we discussed before, the intensity, are you doing a
33:04
level? We're going to about 10 reps
33:07
roughly is a struggle. Is that where you're at?
33:10
If you're starting from fresh different fine.
33:12
If you're into this already a little bit, are you doing that
33:15
degree of overload for four or five sets of that, The high
33:20
volume, the four or five sets, 10 reps and the last two reps
33:24
you're thinking, I can just about do this.
33:26
That should be your second go to those things easy.
33:29
Twice a week is all I want. If you can do more, great, do
33:32
more. But twice a week and I wanted to
33:34
focus as well on mobility. And the mobility section is
33:40
straightforward. You want to choose just probably
33:42
3 or 4 key exercises if you only stretch out your thighs and your
33:47
hamstrings and use some spinal flexion, lying on your back,
33:51
pulling your knees towards your chest and some rotation where
33:54
you put your knees to one side, lying on your back.
33:57
Those four stretches alone give some spinal mobility, some
34:01
stretching in towards the limbs in the quads and hamstrings and
34:04
those alone give you a good start.
34:06
So you've got a little bit of strength to work in there, the
34:08
cardio work in there and your mobility in there.
34:11
And those are the simplest ways you can do something.
34:13
Now beyond that, you can do much, much more.
34:14
If you do in the next week the the cardio three times, the
34:19
strength work twice and mobility three times, perhaps post The
34:23
Walking, then you're doing a pretty good start to your year
34:25
if you're doing nothing else. Perfect, great advice and
34:29
actually hopefully achievable. So thank you ever so much for
34:33
your time, Matt. It's been a great pleasure
34:35
having you on my podcast. My pleasure.
34:37
Thanks for inviting me. Great to see you.
34:42
You can find out more about Newson Health Group by visiting
34:46
www.newsonhealth.co.uk and you can download the free Balance
34:52
app on the App Store or Google Play.