How to Lose Weight During Perimenopause
The following is a transcript of this episode. It has been edited for clarity.
Intro: So does anything you eat or drink these days make you gain weight? Are you struggling with fatigue or brain fog? And why does it seem harder just to maintain your figure? If you’ve got questions about diet and weight loss during perimenopause, I’ve got answers. During an informative chat with nutrition and weight management consultant Julie Court, who, by the way, works out of Brightlingsea, England, where women are lucky enough to have menopause coaches. So put down the smoothie, forget about the planks for now, and join us. Welcome to More Beautiful, the podcast for women rewriting the midlife playbook. I’m Maryann LoRusso, and I invite you to join me and a guest each week as we strive for a life that’s more adventurous, more fulfilling, and more beautiful than ever before.
Maryann: Hi, Julie, thank you so much for joining us today.
Julie: Hi, Maryann. Thanks so much for inviting me on. I’m delighted to be here.
Maryann: Well, today we’re going to talk about one of my favorite topics, health and nutrition. Julie, a common complaint that you must hear from women in midlife is, I’m doing everything that used to work to maintain my weight, or to lose weight, and it’s no longer working. What’s going on here? Is it really harder to lose weight after age 40?
Julie: Absolutely, 100 percent. And it doesn’t have to be 40, I think it’s that point, as soon as you kind of start experiencing those hormonal changes taking you into perimenopause, that you start finding that little bit of weight gain starting to creep on, or even just difficulty trying to maintain where you’re at, trying to put on, you know, the same pair of jeans that you’ve always worn, but they’re that little bit more snug. You know the feeling?
Maryann: I know the feeling, yeah.
Julie: So unfortunately for us, that’s a combination of our shifting hormones. People tend to think of it being more of a decline in estrogen, but it tends to be a bit more of a fluctuation really, going up and down. But also at the same time, in midlife, we’re hitting a point where, you know, we’re losing muscle mass. So, you know, we’re not burning off as many calories as we were before. But equally, we might just be that little bit more sedentary that we were, you know. We’re sat in front of computers working all day, we’re driving to and from the office, you know, we’re just not doing those everyday activities that we might have done before. So unfortunately, it’s a bit of a time where everything seems to come at once and create the perfect storm.
Maryann: Right. You mentioned fluctuating hormones. And that’s interesting, because we all do think, you know, we blame estrogen, right? It’s our dipping estrogen. But you’re right. I mean, if it’s fluctuations, it can also happen during other times of life, right? Because I remember in my early 30s, I hit this period where I felt my hormones were kind of changing a little bit and it was harder to lose weight, and then it kind of evened out. Are there other periods in a woman’s life when you might get some of that?
Julie: Well, I tend to focus primarily on perimenopause and menopause. So that’s really where my expertise is. But yeah, definitely, when you come out the other side, when you’re postmenopausal, it can get a little bit harder again.
Maryann: Yeah. And what about stress? Cortisol. Does that also wreak havoc on your ability to lose weight?
Julie: Absolutely. And like I say, it’s kind of one of those factors along with sleep that makes everything that much harder for us. And like I say, it always tends to hit at this point in our lives. You know, we’ve got so much more going on. We’ve got, you know, we might be at our peak professionally. But we also might have teenagers at home that you’re butting heads with. You know, perimenopause and menopause going up against puberty, you know, it’s a perfect storm, isn’t it?
Maryann: It totally is, yeah.
Julie: But equally at the same time, you know, we might have parents that are getting older, so we’re having to take care of them. You know. So more often than not, we’re pushing ourselves to the bottom of the pile, putting everyone else’s needs ahead of ours, so we’re not really taking care of ourselves. So there’s a lot more we could do to help ourselves with that. So, I mean, cortisol, like you mentioned particularly, it’s a known kind of fat blocker. So it’s hitting us, like I said, at that time where you’re getting those factual fluctuations anyway, but it’s gonna be preventative in, like, if you’re trying to lose weight, and help starting you get up to where you want to be.
Maryann: Right. So what are some of the things we can do? What are some of the lifestyle choices that we can make to help us?
Julie: So really, it’s a massive case of keeping things simple. I tend to find everyone overcomplicates things a little bit more than they need to and I think at a time where, you know, you might already be having brain fog amongst everything else, you want to keep things streamlined, as simple as possible. So in terms of lifestyle, I would say sleep is the number one thing that you want to keep on top of. Now, I know that that is way easier said than done. You know, it tends to be the place that when I’m working with my ladies that we actually tend to start. So although they come to me primarily to help with their weight loss, we’re actually starting on working with their sleep. So with that, we’ve started looking at maybe sleep hygiene, you know, making sure that you’re keeping to regular sleep times or going to bed, regular times of getting up. You know, taking care of technology, you know, making sure at least for an hour or two before bed, you know, you’re not constantly checking your emails on your phone, or, you know, doing some late night working.
Maryann: That’s so hard, right? That’s my challenge, putting the phone down.
Julie: Yeah, I’ll tell you what, what’s something that really helps with that is you can set the Do Not Disturb on your phone after a certain time. So you’re just not going to get those notifications or anything else. I think sometimes if you’re just not aware that they’re there, then it just removes that temptation to pick up the phone. But also, in terms of your bedroom, you know, keeping the bedroom cool, making sure you’re wearing layers, you know, so you can strip back and keep cool, and making sure you know that your bedroom is actually kept for sleeping, or sleeping or sex, that’s what I’d say, just keep it for those things. And it just primes your mind that that’s when you go to bed, that’s what you’re going to your room for, rather than all those distractions. And again, it’s a prime opportunity for you to make some time for yourself. Like I was saying earlier, that we don’t prioritize ourselves. But you know, just using, I don’t know, maybe 15 minutes before bed, you know, just to read a book, do a little bit of unwinding yoga, a little bit of meditation, whatever it is for you, you know, you’re just creating that little bit of space, just telling your body that it’s time to rest, that you can unwind, that it’s safe to get ready for bed. You know, just taking your thinking brain kind of out of the equation can be really helpful. And then of course, you’ve got all the nutrition side of it, which doesn’t start just at bed, you know, that’s going throughout the whole day. You know, making sure that you know, you’re not drinking alcohol every night after work, that you’re keeping caffeine to the mornings. You know, people often wonder whether they’re allowed to drink caffeine or not, you know, I don’t have a problem with people drinking teas or coffees. But really, most people can take, I’d say run about two cups a day, but you need to give it to the morning because the effects of caffeine can last 12 hours into the day.
Maryann: The two things you just mentioned are the two things that I can no longer do. Drink alcohol. I mean, if I have one glass of wine, maybe, but two, I’m up all night. And the same thing goes for caffeine.
Julie: Yeah, you get the hot sweats.
Maryann: I don’t get those. I just get very interrupted sleep.
Julie: Yeah, it’s unfortunate, isn’t it? Taking away all our pleasures at the same time.
Maryann: It really stinks, yeah.
Julie: Yes, we have to choose our moments. But I do have a little bit of a tip with their alcohol. If you are going to drink, you’re better off having daytime drinking now than evening drink. When you’re meeting up with your friends, go for a lunchtime drink because that gives you enough time to enjoy it. But then enough time for your liver to deal with it. So by the time you go to bed, you’ve kind of dealt with all the alcohol. You’ve got to get the best of both worlds. So you can have your drink, and then get to sleep.
Maryann: We’re moving from late nights to boozy brunch.
Julie: Yeah, that’s the way forward. Absolutely.
Maryann: But why can’t we metabolize the alcohol? Is it the sugar?
Julie: Well, we lack the enzyme. We start to lose that with age, that breaks down alcohol. And also our liver, it’s busy trying to detox other hormones. And if you’re throwing alcohol into the mix as well, then that makes your symptoms worse. But anyway, while we’re talking about alcohol, if you can keep alcohol, just two or three days, completely clear, then that can be really helpful as well.
Maryann: So there’s a lot of confusion too about diet. And I mean personally, I’ve always pretty much stuck to a Mediterranean diet. Small meals throughout the day, I stop eating early in the day. But there’s a lot of trendy stuff going on now. There’s keto and there’s intermittent fasting. What would you recommend? I mean, you’re all about simplicity. So do you look at any of those trends and say go for it, or do you…
Julie: No, not really. Yeah, just keep it simple. There’s no need to overcomplicate things, or essentially go through all these different fad diets. I mean, keto…People do successfully lose weight in the short term. But research shows us over and over and over again that in the longer term, you end up gaining the weight back and then some. But particularly during perimenopause, and menopause, keto could be particularly disruptive in terms of managing your symptoms. So my work isn’t just about helping people to manage their weight and lose weight, but also to manage their symptoms as well and help them feel more like themselves again. So it’s coming at it from both angles, really.
Maryann: Yeah. While we’re on the topic of keto, I did read something the other day about protein and women in perimenopause. That we need more protein when we’re going through this. I’d never heard that before.
Julie: Yeah, generally, as we age, we think that there’s an increasing need for protein. But I think it’s about how we balance our meals. Because nobody in society, generally now, is lacking. If you look at that in terms of, if you want to look at as macronutrients, for how much protein you have, nobody tends to be deficient now in protein. For me, it’s more looking at how we balance and balancing our meals out. I tend to find that we’re way more carb heavy than we need to be. And although I’m certainly not on the Keto side of things, I think there’s a moderate grounds to be found there.
Maryann: In terms of intermittent fasting, though, I mean, I do find that if I don’t eat for a 12 hour stretch between bedtime and morning, it does help.
Julie: Yeah, definitely. Time restricted eating, I definitely feel that there’s a place for that. I mean, I think there’s different terms. So like intermittent fasting, you’ve got different kinds of protocols where you have longer periods of time, and I think they can cause a lot of stress on your body. But the time restricted eating that you’re referring to, I think could be really helpful at this time of a life.
Maryann: That’s a little more moderate version of intermittent fasting, is what you’re saying?
Julie: Yeah, so really, you’ll get in your fast overnight while you’re sleeping. And it’s really flexible in that you can choose the 10 hours that you’re going to eat in. You know, some people have to have breakfast as soon as they get up. So they’ll be having their dinner earlier on in the evening. So they might be finishing eating at six. Whereas other people that can push their breakfast back to, say, 10 o’clock, they might finish at eight. But I think whatever time you started, I don’t think you should be going kind of beyond nine o’clock, really, in terms of having a meal. But certainly, if you’re going to be having your last meal later on in the day, then you’d kind of want to be looking at having your main meal as lunch really, because I think a heavy meal before bed is a bit counterproductive in your sleep. You’re never gonna be able to sleep when you’re digesting a heavy meal.
Maryann: Never. Oh, boy. So getting a little bit deeper into diet, what are some of the tips that you give your clients on eating?
Julie: OK, so when my clients tend to come to me, right, so I might get someone come in that’s got a bag full of supplements, and they’re like, yeah, I’m taking all this, why isn’t it working. And then when we actually drill down to what they’re eating on a day to day basis, they haven’t got the basics right. So they might not…OK, they might be skipping breakfast, having a handful of nuts to see them through till a very late lunch. And then it might just be something that they’re picking up at the last minute from the shop. And then if they are having dinner, it might be something that’s not homemade, that they’re just grabbing on the way home again. So for me, the majority of the time, I find, it’s just getting a real back to basics approach in place. So that would be for us, you know, trying to start at three balanced meals a day. And that’s not like, light lunches. We’re talking three filling, satiating meals. Some people might, if we’re working in that 10 hour window, might find they’re better off with two larger meals and a light snack. You have to play around a bit really to find what works for you. But basically, I think what we’re aiming for is that when you have your main meals, you’re not feeling the need to snack in between. You know, you’ll know when you’ve got that kind of balance, because there’s no blood sugar drop. You’re not experiencing that need to reach out for that, you know, a packet of biscuits at three o’clock in the afternoon because you got your breakfast right.
Maryann: Right. And isn’t it amazing that, you know, we were raised to think fat was bad. And now it just seems so natural to just, you know, reach for the avocado or the nut butters, right, to satiate ourselves and get us through the next four or five hours, you know?
Julie: Yeah, absolutely. And it’s not just fats. I mean, the push for us to have sugary cereals for breakfast, you know that we were starting our day with just carbs, you know. But yes, like, a simple breakfast would be, you know, some eggs. You can make an omelet really quickly and easily. But time seems to be an element, people say they haven’t got time, but actually they have, when you can strip it back to the basics. But before we move on from that, what a balanced meal should actually look like if you were looking for a visual on that, would be, say, half a plate of vegetables. A quarter of that would be your carbohydrate component, and then a quarter protein. If you were to look at your clenched fist, that’s the amount of carb you should be having, and equally the same amount of protein. And now if you think about the kind of meals that we’ve been having, pasta tends to be, like, the backbone of all of our family meals when we were growing up. And you think, gosh, in that amount of pasta, compared to that…It was like a bowl of pasta with maybe a little bit of sauce on it.
Maryann: Right. Or if you had protein, it was taking up, you know, three quarters of the plate. And then a little bit of vegetables. There’s a restaurant here in San Francisco that kind of reverses that. They are primarily a vegetarian restaurant. They do have protein on the menu, you know, meat. But when they serve you, it’s like you said, it’s like, you know, three quarters of the plate are vegetables. And then the meat is just like a quarter.
Julie: Yeah, that’s what you want to be aiming for. And you’ll know when you’ve kind of got that kind of balance right, because you just end the cravings, you’re not having to fight yourself to go, oh, I don’t really want to go and get that bar or chocolate or buy the crisps or whatever it is because you’re full and it’s seeing you through to that next meal.
Maryann: Right, it curbs the cravings. So, you don’t believe in meal plans or counting calories, right?
Julie: So, definitely not in counting calories. There’s too much joy to be had in food there for us to be sitting there counting calories. And I just don’t see that there’s a place for it anymore. I think you know when you’re eating well, and eating right. Our focus shouldn’t be on counting everything that we’re eating, it should be on the nutrition and the nourishment we’re getting from that. You know, you could look at, you know, the low fat yogurts maybe, you know, like you used to get, that might only have like…I don’t know, I don’t buy them. So I don’t even know how many calories they have in them. They might have a ridiculously low amount of calories in them, but they’re full of sugar and sweeteners. So we need to be looking at whole foods, really, as a way forward. And then you don’t need to count calories. You can just look at food, enjoy food, take it for what it is. You don’t need to count.
Maryann: Right. I remember my mom counting calories when I was a kid. She had a little notebook she’d write everything in. So I just kind of know the caloric content of many things because I watched her do this, but…I don’t count calories. But I have to say that sometimes after, you know, like a whole holiday season, for instance, of eating a lot of sugar and a lot of treats, I will kind of reevaluate where I’m at. And I kind of loosely, in my head, say, um, I probably had like 400 calories for breakfast. I kind of do this loose calculation to kind of determine where I am, and if maybe I need to cut back a little. Is that bad to do?
Julie: No, I think that’s probably quite a nice way of doing it, isn’t it? Because you’ve just got a loose kind of idea of where you’re at. And actually, for some people, filling out a food diary once every now and again can be really helpful, because we tend to be in a little bit of denial, I think, sometimes, of exactly what we have had, and maybe forget about the odd, I don’t know, treat you’ve had from the fridge when you walk past and you open the door and just have a little something, you know, it’s those bits get forgotten about. And I think that’s where a food diary, just once every now and again—so you can see where you’re at—can be useful, and just for highlighting areas that you can work on. But as a rule going forward, I don’t count calories and I don’t get into habits. I don’t encourage my ladies I work with to weigh things out, or…You get to know by eye about the portion sizes and what feels good.
Maryann: Right, right. You also say ditch the scales. I have to admit I have a scale in my bathroom, and I step on it maybe like three times a week. For me, it’s just interesting because I’m going through perimenopause, and it’s really fascinating to see the ups and downs. Because it kind of, for me, it validates that I’m not crazy. That I could be eating very well and I can still gain weight on certain days, you know, because of, for instance, you know, water weight gain or something like that. And it kind of helps me realize that I’m going through this tumultuous time. But I know you’re saying it’s not good to do it every day. Right?
Julie: Definitely not, I think at the most, I would say to people to do it once every four weeks to get a realistic…If you’re looking at actually managing your weight or losing weight over a longer term, then once every four weeks would roughly kind of fit in with a cycle, give or take. So you’re comparing like with like. You know, the hormonal fluctuations that we experience over a course of a month, as you’ve just pointed out, just now highlighted quite easily on the scale, along with, you know, bowel waste that we haven’t got rid of yet, along with, you know, we’ve had a highly processed meal, that salt causes us to hold on to a little bit extra water. So to compare like for like, going forward, I’d say once every four weeks.
Maryann: Well, then I have a question about that. So if, you know, at week four you weigh yourself and you had, say, a salty meal the night before, but you’re four pounds more than you were, a couple of pounds more than you were the last time you weighed yourself, wouldn’t that be kind of disheartening to see that?
Julie: That’s why I say at the most. So my clients generally don’t weigh themselves at all. But some will still like that indicator. So I would say to them once every four weeks at the most. But the reason I discourage the scale is because even though the aim might be weight loss for a particular client, we want to shift that focus away from the scale. You know, you’re more than a number. But also, we all know how bad that feels to get on the scale. You know, when you feel that you’re doing really well. And having a great time, you’ve been eating really well. And you’re like, oh, I feel really great, I’ve got more energy, I’m sleeping better. And you say, I’m going to get on the scale. And you go, what? I’ve either not lost anything, or maybe it says that you’ve put on a pound. And then straight away, you’re like, oh, OK…right down into that guilt binge cycle where you go, well, I’ve put in all this effort, I’m not getting anywhere, forget it. I’m going to start again on Monday and go off on a binge all over the weekend. And all that good work and effort that you’ve put in in changing your lifestyle for the longer term…You know, you’ve just been that straight off straight away.
Maryann: So you’re putting the focus on the process, on the feeling good, on the changing lifestyle.
Julie: Absolutely. Every lady that I work with, that’s what we’re thinking about ultimately, is looking at how they’re managing their symptoms. The weight loss almost becomes a byproduct, because when you’re feeling great about yourself, when you’re able to have that confidence to put yourself forward at work again, because you can think clearly. You know, these are the things that matter to us actually in life. You know, it’s not that number.
Maryann: Right. And then what are some other smaller things we could do? Like water. How much water should we be drinking?
Julie: So on an average, two liters is roughly kind of what you’re going to be looking for. But we also need to remember that some of that’s going to be coming from the food that we eat. And you know, herbal teas, they count as well. So what I would suggest is finding out what your starting point actually is. So to measure how many glasses you might be having a day already. And then not to go…If you find that you’re really under on the amount that you should be drinking, not swinging from one end of the scale to the other and downing pints and pints of water to get…because you’re going to be on the loo constantly. You know, you’re gonna get in the car to go to the shop and then you’re gonna be like, Christ, I need to go to the toilet. So equally likewise for waking up at night. If you’re waking up at night thinking you need the toilet, you know…So you don’t want to be leaving all your water to the end of the day, and then drinking loads of it thinking, well I’ve got to catch up now. So my advice would be to sip it over the course of a day. Get a water bottle that you can, you know, put in your bag, that you can carry around with you, you know, put in the car. And I think just having it there or putting it on your desk, it just naturally encourages you to drink.
Maryann: Yeah, I have a 64-ounce water bottle on my desk and I love it.
Julie: Yeah, and I think a lot of us seem to have lost touch as well with, you know, our first cues. Like we tend to think that it’s hunger straightaway. But I think when you start drinking more water again, you start to recognize that cue, and then I find that people tend to get really thirsty, you know, like, OK, I’m thirsty all the time now. And they start to build that up. But it’s really helpful for headaches, for the hot flushes, for joint pains, you know, for skin changes. So just drinking enough water can have a really, really great impact and quite quickly.
Maryann: Right. And water is especially important if you’re working out, right? Let’s move into exercise a little bit. What are you recommending your clients do in terms of workouts to supplement their evolving diets?
Julie: So whatever they enjoy, you know, wherever you find fun. There’s no point in saying, oh, my friend Susan down the road, she goes running every day, I’m gonna go and start running. And then you say, well, do you enjoy running? And they’re like, no, I hate running. There’s no point.
Maryann: You don’t want to run if you hate it. I love it, so I do it, but yeah.
Julie: So it’s whatever you enjoy. You might like dancing, so go dancing. You might like walking with your friends, go walking. Whatever it is you choose to do, it has to be something you enjoy. Otherwise, you’re never going to maintain that going forwards. But equally, I do advise against HIIT workouts, particularly if…
Maryann: We should say it’s high intensity interval training you’re talking about.
Julie: Right. Particularly if you’re not sleeping well, you know, it’s just compounds that amount of stress that your body’s experiencing. So definitely, I’d avoid HIIT if you’re not sleeping very well. And those kind of high, you know, high impact…You don’t have to go sweat it out at the gym, you don’t have to feel like you’re punishing yourself. You know, it should be pleasurable and enjoyable.
Maryann: Yeah, it’s interesting you say that, because I was doing a lot of that stuff in my early and mid 40s. And then when I got to my late 40s, it suddenly wasn’t working, and I was gaining weight. And then I did an exercise class with this one trainer, who explained that when you’re going through this hormonal upheaval, it’s better to do sustained aerobic activity where you can actually breathe through your nose. And just to keep it at like level five, six, and not go into the 7, 8, 9. And when I started doing that, when I was running slower and just doing it for longer, the weight started pouring off, and I felt I had more energy. I wasn’t so tired all the time. It was an amazing breakthrough for me, to ditch the high intensity.
Julie: And actually, you just hit the nail on the head as well about feeling the difference and feeling good. Because that’s where a lot of my kind of behavior change work comes in, is that, you know, we don’t change through depriving ourselves from feeling good, beating ourselves up and feeling bad. We change through feeling good. You know, it’s easy, isn’t it? You know, when you feel good, then you go, OK, I want to do that again. So that’s where we focus a lot of my work.
Maryann: I’m not saying it feels great to be running, but afterward, it feels great, yeah.
Julie: See, I’m missing running at the moment. So I had to give up running earlier on in the year. I got a back injury back in, god, May. So a few years back, I was doing marathons, I ran two marathons. And so I’ve always run, and actually, until this happened, I remember my husband and I having a conversation and he said, I don’t think you’ll ever give up running, you’ll always be out. But then I have to stop with this back problem. So I’ve not run since May.
Maryann: Do you miss it?
Julie: I don’t know, I was. But I found an absolutely new love of walking now. And I really feel like just this slower pace for a little while has been really good for me. You know, just that taking it down a little bit. I can see there’s a shift coming now that I’m thinking, oh, maybe New Year, I might start to build up again. You know, I’m feeling that energy coming back. But I think it’s really important to kind of listen and do what feels good.
Maryann: I agree. I think a lot of people discovered walking during the pandemic too, don’t you think?
Julie: Absolutely. Yeah, everyone’s out walking and you know, still keeping it off as well, which is fantastic. It’s a great form of exercise.
Maryann: But I agree that you need to do what you enjoy. My husband’s a cyclist and he keeps trying to get me on the bike and I do not like it.
Julie: Oh, me neither, I’m terrible. I don’t think I’ve got the thighs for cycling.
Maryann: But then I tried to get him to go running with me and he’s too slow. So I’m like, go on your bike.
Julie: Yeah. You can combine the two, that might work.
Maryann: Bike next to me running, maybe. Yeah, I don’t know, we’ll figure it out.
Julie: So where are we, what were we just talking about?
Maryann: We were talking about exercise, but can we tie that into…
Julie: Strength.
Maryann: Oh, yes, strength. Let’s talk about strength.
Julie: Yes, strength and resistance training, that’s really important. So to help with, you know, your decline in muscle mass, you need to keep working on your muscles to build that back up. So you’re burning off that little bit of extra just naturally over the course of the day. That’s really important to include.
Maryann: Yeah. What about hormone replacement therapy? Where does that come in? If you feel like you’re working with a client, she’s doing everything she can, she’s still getting symptoms, would you send her to her physician for that?
Julie: Yeah, absolutely, if that’s something that my client’s open to. And I’m absolutely all for HRT. I take it myself. It’s made quite a big difference on my lifestyle. And actually, I think my main consideration for it was the meno rage, you know, hearing myself, the way that I spoke to my daughter, the way that I spoke to my husband sometimes. And actually, that’s probably where most of the women decide to come to see me. Like I said, it’s not because they’re prioritizing their own needs, but because they’ve heard the way they’re speaking to someone else that they love and decide, OK, I’ve got to do something about this now. You know, that whole thing. We don’t want to do something for ourselves. But when we see that maybe it’s affecting someone else, we do something about it. So yeah, for me, I took it, I started to take it when I think I drew a line in the sand. I just heard myself and was like, oh no, no, I need to go and get some home HRT for that. But equally it is to protect my long term health. You know, I’m coming up on 42 now, so I’ve got a long time ahead of me. The sooner you can take HRT, the better it is for your long term health. And you know, it’s very protective against cardiovascular disease, osteoporosis, dementia. So it’s something I want to look after, you know.
Maryann: Yeah, I have that in my family. I mean, there’s been so much controversy over HRT, and I want to do a whole episode on that with a doctor that’s coming up. But what you’re saying is don’t suffer. If you’re feeling like the symptoms are just too hard to control, see your doctor, talk about your options, right? Just take care of yourself.
Julie: Absolutely. And actually, you know, when you’re in the darkest depths, you know, when you’re really struggling with brain fog, maybe that rage, you know, feeling really low, you can’t see the wood from the trees. So you’re not going to start exercising, you’re not going to manage your stress, you’re not going to sleep, you’re not going to manage your diet, because you’ve got no motivation whatsoever. So HRT might just be that little shove in the right direction to get you to a point where you think, OK, I can see a bit of light now and I can start to incorporate these changes. Because HRT is not a magic bullet in itself. You know, we need to look at our lives as a whole, you know, look at what we’re eating, the HRT, but you know, how we’re moving and everything else as well.
Maryann: Right. What is something that you feel makes the biggest difference in a woman’s life and how she feels? Is it diet, is it one thing?
Julie: Gosh, so again, it’s a combination, I would say. So movement, getting out, moving your body, feels great. Release those endorphins, but again, protecting your long term health, great for cardiovascular disease. Because that’s something else we got to look at. We’re not just looking at now, we’re looking at long term health. So yeah. And laughter. If you can get out with your friends, start seeing your friends and laughing, there is no bigger tonic, is there, than laughing with your friends.
Maryann: Yes, yes. I would wholeheartedly suggest a girls night out anytime.
Julie: Whenever you can get one, definitely.
Maryann: Right. I want to talk about vitamins briefly, because there is such a discrepancy between what nutritionists—because I saw a nutritionist here in San Francisco a couple of years ago—recommend and what Western doctors recommend. My primary care physician doesn’t believe in any sort of vitamins if your bloodwork is normal, except for maybe vitamin D. But yet, the nutritionist might recommend just a slew of other supplements. And they read bloodwork very, very differently. A nutritionist may pick up on a predisposition, whereas a Western doctor may not see that, you know, if the numbers are within range. I mean it’s very confusing, I think, for women. Right?
Julie: My take on that is, I would always focus on diet primarily. And like I said earlier on, some women come in and they’re taking, you know, maybe five or 10 different vitamins. They’ve seen one person, they said they need to take this, they’ve seen someone else, they’ve recommended this, and they’ve read this in a magazine. I find, for many of those women, that is seen as an easy way out. That, you know, if I just take this, it’s going to cover for me not having a very healthy diet, it’s going to cover for me not working out. So a majority of the time, the women that are coming to see me, we’re saying to stop taking a lot of those vitamins, or taking supplements, and just getting their diet back to basics. And by starting slowly like that, it enables them to be able to feel the changes that the food that they’re eating is having on their body. And then it will encourage that change in the longer term. You know, something as simple as changing the amount of caffeine that you’re having. You know, one of my ladies came in and she said, you know, I drink tea all day, every day, I always have done. You know, I’ve always been a bad sleeper. But you know, I can’t give up. I can’t give up caffeine. It’s just how it is.
Maryann: She can’t sleep, but she’s drinking tea all day?
Julie: Yeah, so all we did was—just for two days of the week, and I let her choose the two days—I said so just go away and try it for two days, and tell me how you feel. And then she came back and was like, I can sleep through the night. So you know, for her, it’s not that she’s having to try to stop doing something. Right? She can sleep, so it’s like a no-brainer. So you introduce that across the rest of your life. And that’s very much the kind of core of our work.
Maryann: Yeah. In the US—I don’t know about in England—there’s a divide between, I mentioned, Western medicine and alternative, holistic medicine. But some doctors are now starting to incorporate holistic medicine into their repertoires. My doctor says, you know, go to an acupuncturist or whatever. You’re starting to see this melding of a lot of different medicines. And I think that’s great. What do you think about that?
Julie: Absolutely. I absolutely agree with that. It’s very much, you have to find what works for you. You know, and particularly in perimenopause, and menopause, you know, what works for one woman’s going to be completely different for everyone else. So I’m very much for keeping my eyes open and seeing what research is out there. And then just sharing that so other people can make their own decisions on things that they might want to try for themselves.
Maryann: Is there a way that a client can make the whole, you know, changing of the diet thing easier on herself? Like, little lifestyle tweaks like preparing vegetables, you know, once a week, or shopping in a certain way? Are there certain little things you recommend?
Julie: Yeah, so, you mentioned preparing vegetables ahead of time. So you know, if you’re cooking a meal anyway and the oven’s going, you can always put a tray of vegetables in to roast. You can put them in the fridge. You can pull them out at breakfast and make a quick omelet, or you can add them to a warm salad for lunch. It’s really easy to bulk things up. Equally, I’m a huge fan of leftovers. So generally for lunch, I never have to prepare anything. And it’s something that I try to kind of encourage my clients to go down that route as well. It’s just preparing that little bit extra with your evening meal. You’ve already got something prepared for lunch. So you’re not having to think, what am I going to eat? You know, it’s just there. And we tend to put a lot more care and effort into what we have for our evening meals. So just having it done there, you know, you’re gonna get something nutritious and healthy. And so it’s always easy to follow that up with something else as well.
Maryann: Yeah, I love salads. So I spend Sunday chopping vegetables and putting them in little bags in my refrigerators so that every night I can just toss things together and make a salad.
Julie: Then you’ve made an interesting point there as well about, you know, that’s your Sunday night routine. So if you’re trying to start something new, kind of pinning it down to something you already do, so it becomes an automatic reminder. So, say you want to start planning, you’re doing your shopping there. So you will plan your meals you’re going to have out for the rest of the week. You might say, every Wednesday, after I get back from my workout class, that’s when I’m going to do my list. So it’s just pinning it down to things that you already do, so they become an automatic reminder for you to do them if you’re trying to start something new. But equally, it’s focusing on feeling good, and starting really, really small, so that you can feel what’s working, and then it becomes a no-brainer. The momentum builds. All these little…Although they might seem very small things to be doing—you might be thinking, they’re not going to get me very far—but when you combine all these things over the weeks and months, they become this huge thing where you’re living this happy, healthy lifestyle and feeling great about yourself without having to have, you know, really beat yourself up to get there.
Maryann: Right. You know, you hear a lot of talk of superfoods, right? Every time you turn around, there’s a new superfood. Are there truly superfoods? And if so, like, what are some of the ones you recommend?
Julie: Do you know…Some foods are better, might contain more nutrition than others. But really, what I think you need to be focusing on is variety, rather than individual foods. You know, the old five a day. I don’t know if you have it in the states, so you have to have five a day, like fruit and vegetables. We have that. But that’s kind of old hat now. What we need to be focusing on is variety. The more variety, plant based variety, you can fit in over the course of your day and week, the better. So rather than, like I say, focusing on whatever the fad superfood is at the moment, just focus on incorporating as much different plant based food as you can. So for some people, that might just be picking one new recipe a week, you know, to get excited about, to incorporate something new. And that’s all really great for your gut. And we know that gut health is so important now.
Maryann: Oh yeah, probiotics. We didn’t talk about that. There’s probiotics, there’s prebiotics. What’s the girl to do?
Julie: But again, it’s really easy to get all that just from your normal diet. So prebiotics are the types of foods that feed the bacteria in your gut. So you’re talking about asparagus, onions, leeks, garlic, you know, all those kind of run of the mill things you’re already including in your diet. So they feed the bacteria. But then to get extra, the sort of probiotics you’re talking about, kimchi, sauerkraut, those kinds of things…
Maryann: Fermented foods, right? Any kind of fermented foods.
Julie: Absolutely, yeah. And they’re great. And there’s some evidence around weight loss for fermented foods as well. But again, I think it’s more about promoting diversity.
Maryann: Right, right. Do you like smoothies? Do you think that they’re a good idea?
Julie: No, not really.
Maryann: Too faddish?
Julie: It’s not that. I think, generally, we put way too much fruit in there, and it just acts as a sugar dump. And the kind of number one thing we’re trying to do with, I think, having three balanced meals a day, is to keep your blood sugar level balanced. You know, having that homemade smoothie or shop-bought smoothie that’s got, you know, might be so big and it’s got so many different fruits in it, once they’re all whizzed up and liquefied…
Maryann: You should come to my house, because I make a smoothie that no one in my family will drink, because it has like maybe a quarter of an apple and a handful of blueberries, and the rest of its greens and my family will not drink it.
Julie: Oh, no. It’s different for kids, though. Like my daughter, I can happily make her a smoothie. We’re just way more sensitive to sugar at this point. So we just have to make sure we manage that.
Maryann: Add that to the list of stuff we can no longer eat. So depressing.
Julie: Well, everything in moderation.
Maryann: Right. Are there any foods that you’re loving right now? That you feel like, I don’t know, you just feel like they make you feel great? Or foods you’ve discovered or tell your clients about?
Julie: Do you know, it’s so individual, and it kind of goes back to what I was saying about finding a new recipe every week. You just need to be excited about it. You know, we’re all different starting points, you know, so I don’t recommend particular recipes to my clients. I try to encourage them to go out and find what excites them, what really lights them up. Because it’s that that makes a difference. I was talking on another podcast last week about when I first started to learn to cook, because when I left home I think the only thing I could cook was like a roast dinner.
Maryann: That’s pretty good.
Julie: Yeah, but that was it. And then I got Jamie Oliver cookbooks and then I started to learn about, you know, like herbs, and then that really lit me up. I was like, oh my god, home cooked food can taste really nice, you know, it tastes better than this other processed food. And that’s where, you know, things start to, again, build that momentum. So it’s finding out kind of where you are, taking that forward at, you know, a pace that suits you. So you’re learning, you know, at the right pace for you, not overwhelming yourself. So it’s very much a little kind of journey of discovery, isn’t it?
Maryann: I love that. I love Jamie Oliver, too. My kids used to love watching him until one day he cut up a rabbit on television. We were actually in London, visiting London. And we’re watching his show, and he cut up a rabbit. And my kids said, that’s it. We’re done with Jamie Oliver.
Julie: We’re done. Oh, nevermind.
Maryann: Oh, my gosh. Yeah. I mean, I agree with you. I think it has to be something that lights you up. That’s the bottom line with all of this, right?
Julie: Absolutely. And that’s why I don’t do the meal plans. I don’t, you know…It’s about helping you to discover what it is you need to do, and doing it at the pace that works for you.
Maryann: Right. I remember there was a time when I was just so sluggish. I could not get out the door to go running. I hadn’t run in a few weeks. And then I started saying to myself, like a little mantra before I went out, like, this is gonna feel so good, Maryann, you’re gonna feel so good. Just do it. And I kind of talked myself into it. And then I kind of examined how I felt when I got back, you know, talking to myself saying, don’t you feel good? This feels great. And I found that really helped me.
Julie: Yeah, I think there’s a lot of research around that, kind of around the affirmations. The way you talk to yourself is really important. Your brain does hear that and take that on board.
Maryann: Yeah. Interesting. Are most of your clients in the over 40 range, or do they run the gamut?
Julie: No, most of them are around that over 40 range. I mean, when I first started working in this field, I wasn’t niched into perimenopause and menopause at that point. And there was a set of ladies of a certain age that I couldn’t understand why they weren’t seeing the same sort of results as every one of my other clients were. And it was only when a friend of mine asked me if I knew anything about menopause that I went off and found out some. Because I didn’t know anything about it. So I took myself off and did a bit more training. And then all of a sudden, it was like, oh, wow. I went down the rabbit hole.
Maryann: Such an important niche. And you’re right. Until recently, I don’t think we really addressed perimenopausal needs as being a specific set of needs.
Julie: Right, and there are specific recommendations and kind of nutritional requirements that we need to be looking at. I’ve kind of honed it all down and looked at what the women need when they’re coming into me. They need all that kind of fluff removed. It really is coming back to basics. And, you know, quite often you’ll hear on social media, you know, if you’re experiencing this symptom, you need to eat this, if you’ve got this symptom, you need to eat this. But there’s no point even going that route unless you’ve got the basics right.
Maryann: Right. I like that. Julie, one thing I did want to ask you is, when you began working with more women in this age group, did you start to notice that upon entering perimenopause, these ladies were experiencing a redistribution of weight? That is, where we used to have excess weight collect on our hips and our thighs, now, suddenly, any extra pounds end up on our waistlines. Not that we don’t love our changing bodies or accept ourselves for who we are, but we just like to know why this has happened. We blame our hormones again. And is there anything we can do about it? Can we change our diets or make lifestyle changes that will combat this midlife belly, if we don’t like it?
Julie: That’s such a good question, Maryann. So as we move through perimenopause towards menopause, we start to see a general downward shift in our estrogen and progesterone levels, and we start to change the way we lay down our body fat. So moving away from the more traditional female areas of hips and bum, and moving more towards the abdomen. At the same time, we start to see women becoming more insulin resistant, and there’s a direct correlation really between lowering estrogen and seeing this increase in insulin resistance around this time. So put simply, insulin is a hormone responsible for lowering our blood sugar levels. And what insulin resistance means is just that our body’s changed the way it responds to that incident, so there’s more sugar circulating around that results in you storing more fat. This process is really exacerbated by a high sugar, high carbohydrate diet, so it’s something we need to be focusing on and aware of at this time. That said, I don’t recommend keto diet. This can lead to a worsening of your symptoms, and often leads to a significant reduction in the amount of fiber from the diet, which is also important for symptom management. So put simply, we really just need to focus on some dietary and lifestyle changes that we can maintain for the longer term. And they’re really basic, simple things to focus on. But I would like to point out that there’s no specific diet or exercise program that can focus on any one particular part of the body. So to start with, I mentioned about carb intake. So if you can focus on a moderate carb intake, so reducing down the amount of bread, pasta, sugary foods, pastries, smoothies that you’re consuming day to day, and shifting your focus so that you’re eating more whole foods, so beans, lentils, maybe brown rice, quinoa, green leafy vegetables, and making sure you include in plenty of healthy fat, so avocado, oily fish like salmon, seeds, nuts. The easy way to look at getting balance in your diet is to have three satisfying meals a day. So what that should look like roughly is a half a plate of vegetables, a quarter protein and a quarter carbohydrate. And a really easy visual reference for people is your clenched fist. So both your protein and your carbohydrate portion should be no bigger than your clenched fist. Other specific ways you can look at managing your weight during this time is making sure you keep to regular exercise, so a good 30 minutes raising your heartbeat so you get a little bit puffed, three to five days a week. I’d say the main thing is to do something you enjoy, so you can make this a regular part of your lifestyle. Stopping smoking. Alcohol, alcohol is a key one here. So even if you’ve got the best diet in the world and you’re coming home and consuming half a bottle of wine every night, you’re going to be blowing the amount of carbohydrate you’re consuming out of the water. So a really important area to focus on, not just for your weight, but symptom management as well. What else? Sleep. So yeah, it’s a bit of a catch 22. But if you can get to a place where you get more sleep, that can help decrease insulin resistance, and help you curb your cravings in the day. But also, getting better blood sugar control helps you get better sleep. So like I say, if you can focus on that three balanced meals with the correct kind of portions, you’ll be setting yourself up and hopefully getting a better night’s sleep as well. The real point here, I suppose, is consistency. You need to really work at it to be consistent, to see results. And that should really help you in terms of managing your weight.
Maryann: Is there anything else that you feel you want women over 40 to know? Especially if they’re struggling right now.
Julie: You’re not alone. So many of us are experiencing the same kind of symptoms and changes as what you are. But equally, not to feel like your body’s working against you. You know, your body’s actually working with you. You know, the extra little kind of bits of fat, they produce their own type of estrogen to offset some of that that you’re losing. So your body’s actually trying to help you. It’s not trying to work against you. So that might make you feel a little bit better there. And then maybe when you’re trying to introduce changes, just do one thing at a time. Make it really small. Just do it one day a week, just to give you somewhere that’s easy to start, and then build from there. And don’t pressure yourself too much. Yeah, baby steps. Learn what feels good, and what’s working for you.
Maryann: I like that. Thank you so much, Julie, for taking time today.
Julie: Oh, you’re welcome. Thanks so much for inviting me on.
Maryann: Your clients are very lucky.
