Flex Appeal- More on Muscle Loss & Menopause
 

Weight training for muscle health

Women often report an increase in fat and a drop in muscle despite maintaining their exercise, eating, and lifestyle routines. In fact, women can lose as much as 3 to 5% of their muscle mass each decade after the age of 30. This degenerative and involuntary loss of skeletal muscle is called Sarcopenia and is a significant reason for the decline in strength and functional capacity observed in older adults.

A major contributor to muscle loss is the decline in estrogen during menopause. Estrogen plays a crucial role in regulating the ratio of protein synthesis. But what does this mean? Let's break it down. Protein synthesis refers to how effectively our bodies utilize the protein we consume to build lean body mass, also known as muscle, rather than breaking down our existing muscles to use their protein for energy. The protein synthesis ratio is a balance between the rate of protein synthesis from consumed protein and the rate of muscle breakdown. When estrogen levels decline, our bodies synthesize the protein we consume at a higher rate (a positive effect). However, the breakdown rate of our muscles also increases, and it does so at a greater level (a negative effect), offsetting the potential benefits of the increased synthesis rate for maintaining and building muscle. It's important to note that as estrogen levels decline, we become less responsive to stimuli that promote muscle growth, such as weight training.

 

 

 

So, what does all this mean? 

In simple terms, it means that the amount of high-quality lean protein you consume needs to be higher than when you were younger, and the intensity of the stress you put on your muscles during strength training should be significant. In other words: consume more protein and lift heavier weights (1).

Dr. Raubenheimer and Simpson from the Charles Perkins Centre coined the term 'Protein Leverage Effect,' which suggests that if you do not increase your protein intake, your body's drive to achieve this amount will cause you to feel hungry and continue eating until you reach the necessary protein level. Given that energy expenditure tends to decline as women age, it's likely that we require fewer carbohydrates and more protein to compensate for the changes during menopause. According to Raubenheimer, "...the good news is that it appears very small changes to the diet, such as prioritizing protein, reducing fats and carbohydrates, and being physically active, could make a big difference in the long term” (2).

If Raubenheimer's theory holds true, you will feel full once your body has consumed sufficient protein. Time and further evidence will evaluate this theory more thoroughly; however, if you have monitored your feeling of fullness when eating protein first and slowly, you may have noticed feeling satisfied.

Other research supports increasing protein intake to sustain muscle as well as increasing lean body mass (muscle) while reducing body fat (3). In fact in a double blinded randomized control trial of a 12-week high protein (25% of diet form protein) versus standard protein (15%) and control group found that those on the high protein diet, without changing exercise habits. Lean body mass was significantly higher and fat mass. What is clear is 25% of your diet versus 15% may be easily missed if you are not conscious about your protein intake. 

There are also additional benefits of protein:

  • Protein is more thermogenic than carbohydrates or fats, meaning it may help burn more calories required to digest a meal (5).

  • Protein can help prevent blood sugar spikes or dips because it converts to glucose more slowly than carbohydrates (6).

  • Eating protein may make you feel more full earlier and longer than lower protein diets, however research on this is mixed.

Meet Carolyn, a 46-year-old mother of four children under 18 years of age. Carolyn, a former university soccer player, still enjoys playing in a women’s league a couple of nights a week. However, she faces the challenges of the daily grind, from getting the children out the door to commuting her 45-minute drive to the office. Her evenings are consumed with making dinner and shuttling everyone to their various extracurricular activities. With such a hectic schedule, Carolyn finds herself exhausted.

Despite her commitments, Carolyn is determined to maintain her soccer routine. However, she's noticed a concerning trend over time: her muscle tone and strength are diminishing, and she's experiencing more soreness with longer recovery times than usual. 

Can you relate to Carolyn's struggle?

What do you mean by lean protein?

Lean protein is a source of protein that is high in protein but low in saturated fats and calories. It helps you to boost your protein intake without overshooting your caloric intake requirements. It also helps you to amp up your metabolism while supporting your immune system.  Here are some great protein examples and some vitamins and minerals found in them:

  • Boneless and skinless chicken breast: also rich in vitamin B3 and B6 (metabolism boosters), thiamine, riboflavin

  • Turkey breast: niacin, vitamin B-complex, choline, phosphorus, potassium, zinc

  • White fish such as tilapia: choline, niacin, vitamin B12, vitamin D, selenium, and phosphorus

  • Beans and lentils: also rich in fibre, folate, and iron

  • Soy such as tofu, edamame beans: thiamine, riboflavin, vitamin E, magnesium, copper, zinc, potassium and manganese. Edamame is also high in fibre

  • Nuts and seed: also rich in fibre and healthy fats

  •  Eggs: choline, leucine, vitamin D, B12, Iron. You can also get Omega-3 eggs for a boost of Omega-3

  • Greek yogurt or cottage cheese: vitamin B12, riboflavin (B2), and selenium. It's also a good source of calcium, phosphorus, zinc, pantothenic acid, vitamin A, and potassium

  •  Protein powders

 

How much protein should I eat?

The range of protein in menopause is 1.2 to 2.0 gm per kilogram (or 2.2 pounds) of body weight. If you are active and lifting weights, you should lean closer to the 2 gm per kg. In other words, a 130 pound active woman should consume at least 120 grams of protein in a day. To keep it easy, aim for about 30 gm of protein per meal (3-4 times/day) as an easy way to start increasing your protein intake. While it is best to eat real foods, supplemental sources such as protein shakes or bars can help especially when you are on the go. Be careful of sugar and calorie content as these can be high. We do not want to encourage obsessing about protein counts so use this as a guide to prioritize protein in each meal. Work to achieve this as a new healthy habit and build from there!

 Tips:

  1. Calculate the amount of protein you need in a day. Do not get in the ‘tracking obsession’ loop! The goal is to get healthy.

  2. Build your meals around protein-start with what your protein source will be then add in whole grains and vegetables and healthy fats

  3. Protein can be hard on the go. You can pre-cook protein sources in advance so they are ready to go. 

  4. If you are eating out, look for protein based meals before the pastas, unless you are in the mood for pasta then treat yourself! Maybe you can add a meat source if there is not one included.

  5. Keep the deck of cards or palm of your hand trick top of mind to eyeball protein portion sizes

Check out our section on Protein for more information and tips!

Lifting Heavy Weights

Afraid of ‘Looking Bulky’

It's a common misconception among women that lifting heavy weights will lead to quick and significant muscle mass gain, resulting in a bulky appearance akin to Hulk Hogan. However, the reality is quite different. Lifting heavy weights for muscle gain is distinct from lifting for sheer power. Achieving a bulky physique through weightlifting takes considerable time and dedication, often spanning decades.

In our discussion, we'll debunk this myth and outline some best practices supported by current research. Contrary to popular belief, to build muscle mass, higher repetitions (around 12-15) are more effective than lifting heavier weights with low repetitions (1-2). Opting for higher repetitions not only strengthens you but also promotes muscle growth. Conversely, heavy single or double repetitions primarily focus on strength training, which contributes to bulkier muscles. The key here is that you have to use heavy weights to stress the muscles enough that they need to move into a state of repair. This will allow for the benefits you want to achieve. If you do not task the muscles, you will not see the same benefits.

By understanding these principles and incorporating them into your workout routine, you can achieve your fitness goals without the fear of bulking up excessively.

Prehabilitation

Even if you're not currently experiencing menopausal symptoms, regular exercise, especially strength training, is crucial for preventing various health conditions such as osteoporosis, heart disease, inflammatory diseases, insulin resistance, and it's also beneficial for mental health.

However, humans tend to be resistant to changing behaviors until a problem arises. So, how do we convey the urgency and importance of incorporating regular exercise, particularly among women? When it comes to discussing exercise, changing behavior can be one of the toughest challenges.

But fear not, we're here to help! Stick with us and explore PAUZ Health's video tips on building a personalized strength training program. Together, we can empower women to prioritize their health and well-being through regular exercise.

By following protein and strength training guidelines and gradually building on them over time, we can achieve our health goal of maintaining and/or building lean muscle mass.  Remember to listen to your body, stay consistent, and celebrate your progress along the way!

 Book a session with a PAUZ expert if you want personalized help and support (www.pauz.health).

References

  1.  Gregorio L, Brindisi J, Kleppinger A, Sullivan R, Mangano KM, Bihuniak JD, Kenny AM, Kerstetter JE, Insogna KL. Adequate dietary protein is associated with better physical performance among post-menopausal women 60-90 years. J Nutr Health Aging. 2014;18(2):155-60. doi: 10.1007/s12603-013-0391-2. PMID: 24522467; PMCID: PMC4433492.

  2. Simpson SJ, Raubenheimer D, Black KI, Conigrave AD. Weight gain during the menopause transition: Evidence for a mechanism dependent on protein leverage. BJOG. 2023; 130(1): 4–10. https://doi.org/10.1111/1471-0528.17290 

  3. Haghighat N, Ashtary-Larky D, Bagheri R, Mahmoodi M, Rajaei M, Alipour M, Kooti W, Aghamohammdi V, Wong A. The effect of 12 weeks of euenergetic high-protein diet in regulating appetite and body composition of women with normal-weight obesity: a randomised controlled trial. Br J Nutr. 2020 Nov 28;124(10):1044-1051. doi: 10.1017/S0007114520002019. Epub 2020 Jun 9. Erratum in: Br J Nutr. 2021 Sep 28;126(6):959. doi: 10.1017/S0007114521001896. PMID: 32513334.

  4. Protein"requirements" beyond the RDA: implications for optimizing health. Phillips SM, Chevalier S, Leidy HJ. Appl Physiol Nutr Metab. 2016 May;41(5):565-72.

  5. Protein Controversies In Diabetes. Franz MJ. Diabetes Spectrum. 2000. Vol. 13:3, 132

  6. Deer, R. R., & Volpi, E. (2015). Protein intake and muscle function in older adults. Current Opinion in Clinical Nutrition and Metabolic Care, 18(3), 248–253. https://doi.org/10.1097/mco.0000000000000162 

  7. Gregorio, L., Brindisi, J., Kleppinger, A., Sullivan, R., Mangano, K. M., Bihuniak, J. D., Kenny, A. M., Kerstetter, J. E., & Insogn, K. L. (2013). Adequate dietary protein is associated with better physical performance among post-menopausal women 60–90 years. The Journal of Nutrition, Health & Aging, 18(2), 155–160. https://doi.org/10.1007/s12603-013-0391-2

  8. Ihalainen, J. K., Inglis, A., Mäkinen, T., Newton, R. U., Kainulainen, H., Kyröläinen, H., & Walker, S. (2019). Strength Training Improves Metabolic Health Markers in Older Individual Regardless of Training Frequency. Frontiers in Physiology, 10. https://doi.org/10.3389/fphys.2019.00032 

  9. Institute of Medicine (US) Food Forum. (2010). Nutrition Concerns for Aging Populations. Nih.Gov; National Academies Press (US). NCBI - WWW Error Blocked Diagnostic 

  10. Maltais, M. L., Desroches, J., & Dionne, I. J. (2009). Changes in muscle mass and strength after menopause. Journal of Musculoskeletal & Neuronal Interactions, 9(4), 186–197. NCBI - WWW Error Blocked Diagnostic 

  11. Phillips, S. M., Chevalier, S., & Leidy, H. J. (2016). Protein “requirements” beyond the RDA: implications for optimizing health. Applied Physiology, Nutrition, and Metabolism, 41(5),
    565–572.

     

    Protein “requirements” beyond the RDA: implications for optimizing health

  12. Sims, S. T. (2016). Roar: how to match your food and fitness to your female physiology for
    optimum performance, great health, and a strong, lean body for life. Rodale.

  13. Verdijk, L. B., Gleeson, B. G., Jonkers, R. A. M., Meijer, K., Savelberg, H. H. C. M., Dendale,
    P., & van Loon, L. J. C. (2009). Skeletal Muscle Hypertrophy Following Resistance Training Is Accompanied by a Fiber Type-Specific Increase in Satellite Cell Content in Elderly Men. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 64A(3), 332–339. https://doi.org/10.1093/gerona/gln05

  14. Schoenfeld BJ, Grgic J, Ogborn D, Krieger JW. Strength and Hypertrophy Adaptations Between Low- vs. High-Load Resistance Training: A Systematic Review and Meta-analysis. J Strength Cond Res. 2017 Dec;31(12):3508-3523. doi: 10.1519/JSC.0000000000002200. PMID: 28834797.

  15. International Society of Sports Nutrition position stand: Protein and Exercise. Campbell B, Kreider RB, Ziegenfuss T, La Bounty P , Roberts M, Burke D, Landis J, Lopez H, and Antonio J. J Int Soc Sports Nutr . 4: 8, 2007.

  16. Muscle full effect after oral protein: time-dependent concordance and discordance between human muscle protein synthesis and mTORC1 signaling. Atherton PJ, Etheridge T, Watt PW, Wilkinson D, Selby A, Rankin D, et al. . Am. J. Clin. Nutr. 2010. 92, 1080–1088.

  17. Effects of leucine and its metabolite β-hydroxy-β-methylbutyrate on humanskeletal muscle protein metabolism. Wilkinson DJ, Hossain T, Hill DS, Phillips BE, Crossland H, Williams J, Loughna P, Churchward-Venne TA, Breen L, Phillips SM, Etheridge T, Rathmacher JA, Smith K, Szewczyk NJ, Atherton PJ. J Physiol. 2013 Jun 1;591(11):2911-23.

  18. Amino acids: Metabolism, functions, and nutrition. Wu G. Amino Acids 37: 1-17, 2009.

  19. Dietary protein for athletes: From requirements to optimum adaptation. Phillips SM, and Van Loon LJ. J Sports Sci. 29 Suppl 1: S29-S38, 2011.

  20. Nutritional modulation of training-induced skeletal muscle adaptations . Hawley JA, Burke LM, Phillips SM, and Spriet LL J Appl Physiol. 1985(110): 834-845, 2011.

  21. Ingested protein dose response of muscle and albumin protein synthesis after resistance exercise in young men. Moore DR, Robinson MJ, Fry JL, Tang JE, Glover EI, Wilkinson SB, Prior T, Tarnopolsky MA, and Phillips SM. J Clin Nutr. 89: 16 1-168, 2009.

  22. The effect of protein timing on muscle strength and hypertrophy: a meta-analysis. Schoenfeld BJ., Aragon AA, Krieger JW.  J. Int. Soc. Sports Nutr. 2013 10:53.

  23. MTOR signaling and ubiquitin-proteosome gene expression in the preservation of fat free mass following high protein, calorie restricted weight loss. McIver CM, Wycherley TP, and Clifton PM. Nutr Metab. (Lond.) 9: 83-7075-9-83, 2012.

  24. Role of protein and amino acids in promoting lean mass accretion with resistance exercise and attenuating lean mass loss during energy deficit in humans. Churchward-Venne TA, Murphy CH, Longland TM, and Phillips SM. Amino Acids 45: 231-240, 2013.

  25. Effect of nutritional intervention on body composition and performance in elite athletes. Garthe, I, Raastad, T, Refsnes, PE, and Sundgot-Borgen, J. Eur J Sport Sci. 13: 295-303, 2013.

  26. Fatigue during high-intensity intermittent exercise: Application to bodybuilding. Lambert, CP , and Flynn, MG. Sports Med. 32: 511-522, 2002.

  27. Low Carb Diets Promote a More Favorable Body Composition than Low Fat Diets. Volek JS, Quann EE, Forsythe CE. Strength and Conditioning Journal. Feb 2010. 32 (1), 42-27.

  28.  Glynn, EL, Fry , CS, Timmerman, KL, Drummond, MJ, Volpi, E, and Rasmussen, BB. Addition of carbohydrate or alanine to an essential amino acid mixture does not enhance human skeletal muscle protein anabolism. J Nutr. 143: 307-314, 2013.

  29. Science and Development of Muscle Hypertrophy. Schoenfeld BJ. Human Kinetics, 2016.

  30. Disassociation between the effects of amino acids and insulin on signaling, ubiquitin ligases, and protein turnover in human muscle. Greenhaff, PL, Karagounis LG, Peirce N, Simpson EJ, Hazell M, La yfield R, Wackerhage H, Smith K, Atherton P, Selby A, and Rennie MJ. Am J Physiol Endocrinol Metab. 295: E595-E604, 2008.

  31. Splanchnic and leg substrate exchange after ingestion of a natural mixed meal in humans. Capaldo B, Gastaldelli A, Antoniello S, Auletta M, Pardo F , Ciociaro D, Guida R, Ferrannini E, and Sacca L. Diabetes 48: 958-966, 1999.

  32. Nutritional aspects of women strength athletes. Volek JS, Forsythe CE, Kraemer WJ. Br J Sports Med. 2006 Sep;40(9):742-8.

  33. Effects of the Menstrual Cycle on Exercise Performance. X.A.K.J., De Jonge. 2003. Sports Medicine. Vol. 33, No. 11.

  34. Long-term creatine intake is beneficial to muscle performance during resistance training. Vandenberghe K, Goris M, et al. Journal of Applied Physiology. 1997 Vol. 83:6, 2055-2063

 
 
 

 

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