Healthy eating and activity on Menopause Monday

Michelle Eliot

1235 now, you're with BC Today. Well, today is week three of our Menopause Monday segment. We have been conducting a deep dive into issues facing women in the perimenopause phase of life. We learned that many common hormone replacement therapies are now fully covered under the National PharmaCare Plan in BC. And last week, we delved into questions with OB-GYN Dr. Tracy Rogers. Now you can watch or hear replays of those programs on our YouTube page, CBCBC, or you can go to the CBC Listen site as well for our podcast. Today, we are talking about nutrition and fitness. So you can call us, what are your questions about nutrition and fitness during the perimenopause phase? And what has your fitness or nutrition journey been like in perimenopause and menopause? You can call us 604-669-3733, 604-669-3733 or 1-800-825-5950. You can also send an e-mail, BC Today at cbc.ca. And again, we're watching your comments on our TikTok live. I have two guests with me today, fitness coach Karina Inksterr and registered dietitian Vesanto Melina. Good afternoon to you both. Thank you so much for being with us.

Karina Inkster

Thanks so much for having us here, Michelle.

Vesanto Melina

It's great.

Michelle Eliot

It's really, isn't it so great to be talking about this?

Vesanto Melina

It is, yeah.

Michelle Eliot

How much have you heard people actually talking about perimenopause?

Vesanto Melina

Well, I've had clients that were really interested, they wanted to go through this period because it can be such a challenge. or you can coast through it much more easily. And then after, it really makes a big difference to know where you're going.

Michelle Eliot

Absolutely. This is why we're talking about it. You know, Karina, it's interesting. I was at the gym yesterday and someone I know came up to me and we were just chatting and she said, I've actually not been here for a couple of months. I've just been so tired. I'm going through perimenopause. What do you hear from clients?

Karina Inkster

Well, most of our clients are either going through perimenopause right now or they're post-menopause. So the vast majority of our clients are somewhere on this spectrum. And what we hear a lot is this idea that, oh, I don't have time, I don't have energy, I don't have an hour out of my day to spend at the gym. But what is actually true is you can get results from 20 minutes, from 15 minutes, from 10 minutes. It doesn't have to be a long time. And so you could actually make strength training work for the energy that you have on any given day.

Michelle Eliot

10 minutes.

Karina Inkster

Absolutely. A lot of our clients train 10 minutes a day.

Michelle Eliot

What does that look like? What does those 10 minutes entail?

Karina Inkster

Usually it's at home because generally you're not going to go to the gym for a 10 minute workout. I mean, some people might. But normally that is either dumbbells or resistance bands, which are very, very, very versatile to do home workouts. And it's a full body workout, usually three or four moves, no breaks or very minimal breaks for 10 minutes.

Michelle Eliot

What are the biggest concerns, so, that people who are going through perimenopause face, first of all? What are the things they need to address through fitness?

Karina Inkster

Well, that's a good question because I feel like there are two sides to the coin. So one side is absolutely natural changes that happen as hormones change. We're not anti-aging here, right? We're aging well. We're not against normal physiological processes, right? But on the other hand, there are things we can do to help us through this time. And a lot of folks aren't strength training, and that's one of the main things that we can do.

Michelle Eliot

Okay, and you can do it in 10 minutes. And what about you, Vesanto, from the perspective of nutrition, what are the biggest challenges that people face as they enter perimenopause?

Vesanto Melina

Well, several things are going to happen that look pretty bad, like you're going to start losing bone mass, you're going to lose muscles. and that has effect on your metabolic whole picture. So you really have to start changing things. You need to have less calories and better nutrition. And that can make a really big difference. Like, for example, with your bone mass, if you start getting the right foods in, it means you're going to really want to not spend much on junk food, hardly anything.

Michelle Eliot

What are the right foods then to address?

Vesanto Melina

Well, one of the really helpful foods is... is soy milk and soy foods, and actually cooked soybeans can really make a big difference, surprisingly. So you can have something like a bean salad that's got some cooked soybeans in it, and that kind of tricks your body that there's still some estrogen there, because the isoflavones are, your body thinks they're estrogens.

Michelle Eliot

Can you delve more into what is happening to a woman's bone density as they enter this stage of life?

Vesanto Melina

Well, it's interesting. Our bones go up till we're 30, our bone mass, then over level, then gradually drop or quickly drop. So what you can do is make them not drop very quickly, the bone mass. And you want to get a lot of nutrients in there because we think of obviously calcium always.

Michelle Eliot

Right. Yeah.

Vesanto Melina

But we also need to think about protein. It's like the mortar that the calcium gets stuck into. And then there's vitamin D, there's potassium that helps you keep the calcium there. There's, let's see, there's minerals like zinc and copper. And the phosphorus, they're just all kinds of things. So you You've got to eat well. You've got to have all these.

Michelle Eliot

Sure. Yeah, but people know that, I think. But what does that look like? What is a day like with a good diet addressing all of those needs?

Vesanto Melina

A good day would have, for example, at breakfast, you'd have some kind of protein source and calcium. I'm using, for example, kale smoothies A lot. And we have, there you've got the isoflavones in the soy, and you could have the calcium in the kale. You've got blueberries, which give you potassium. There's just a whole mixer. And I use protein powders.

Michelle Eliot

Okay.

Vesanto Melina

Yeah, and I use a really clean one that doesn't have a lot of junk in it, you know, no extra little frills. So that can be one start and other people might use, my co-author on our books, Brenda Davis, uses cereals and she puts on it ground flaxseed, which also is another isoflavone replacement.

Michelle Eliot

And it doesn't taste like anything really.

Vesanto Melina

No. It'll make things thick and gummy. But yeah, so she'll put on fortified soy milk and it's important to use the fortified milks. I've had clients that were trying to just use the cash, blend up some cash. But the fortification can help. There's vitamin D, there's calcium, there's B12. So anyway, that makes a really big difference. Yeah.

Michelle Eliot

Sounds delicious so far. Karina, did you want to add anything to that? What does a good workout look like, even if it is as short as 10 minutes?

Karina Inkster

Health Canada suggests two times a week strength training will actually give us bone density, strength, muscle, body composition results. And they don't put a time frame on it. So we have lots of different variations, like the 10 minutes a day that I mentioned. Three days a week, 20 to 30 minutes. There's lots of different options. But the main piece for a good workout is that you're training all of your major muscle groups in compound movement patterns. So that means instead of focusing your workout around single joint moves like bicep curls, calf raises, tricep extensions, you want to work multiple muscles at once, like bench press, lat pull down, variations of rows, squats, lunges, deadlifts. Those kind of lifts.

Michelle Eliot

Okay, yeah. These are all things, I do like to go to the gym for so many reasons. So these all sound familiar to me, but what's the difference between those, something like a bicep curl versus something like a lat pull, which is, I guess, you're holding on to this contraption and you're pulling it down. Why are those two different things, different exercises?

Karina Inkster

There's a time and a place for the single joint moves and for the compound lifts. But for people who are just starting out or those who have minimal time to train, who aren't in the gym for, an hour a day, five days a week, which is most of us, by the way. Yes. The compound lifts allow you to lift more weight, which is more helpful for bone density, especially for folks going through perimenopause. And you'll get your workout done faster. So you're going to just train in a more effective method. So you could use what are called super sets two moves, usually for different muscle groups. So you do move A, move B, move A, move B, and you don't have to take breaks in between because you're working different muscle groups. So you could do a push-up with a squat, for example, and then do three sets of those and then move to the next.

Michelle Eliot

Okay, a push-up and a squat, do three sets of those and move on to the next. That sounds pretty simple. Let's put out the numbers again as we ask you about fitness and nutrition in the perimenopause phase. What has your own fitness or nutrition journey been like during perimenopause and menopause? What are your questions about diet and exercise during perimenopause? I'd love to hear from you. 604-669-3733, 604-669-3733, or 1-800-825-5950. Our Our e-mail address is bctoday@cbc.ca. We have an e-mail from Patricia who writes, in 2018, we transitioned to a whole foods, plant-based diet due to my husband's heart disease. His health improved phenomenally, and mine simply got better. But looking back, I realized menopause for me was a non-event, virtually, no hot flashes or anything. So I'm wondering if there is a connection between eating healthfully and hopefully in terms of control of pause systems or if that was just an anomaly. Patricia, thank you very much.

BC-Today-March-16-Gas-prices-spike-healt_Media - Trim - Trim- 2.mp4

Transcript

Vesanto Melina

Oh, yeah. Mine was like that too. I have a healthy, whole food, plant-based diet. You can look at a food guide on nutrispeak.com. That's my website. There's a food guide on there. They actually used a similar model with our Canada food guide. But you'll see that half the plate is vegetables and fruits. Those really help with bone mass. And then you've got the legumes, the beans, peas, lentils, there's basically 20 kinds of beans that we can eat, all different things, all around the world, they're different ones. And then grains are either lots or less, depending on how many calories. So, and then the calcium foods are in every food group. So they're surprisingly, yeah, we used to, you know, I've been a dietitian for a long time and through these different food guides, and we used to have a milk group. Now we're realizing that we get calcium from all kinds of different foods. And for example, with the vegetables, the leafy greens like kale, broccoli, napa cabbage. Then the fruits, the oranges, the fortified orange juice, if you use that, or figs. Then Mexican people always had fortified tortillas with calcium. Then the nuts and seeds, the tahini dressing. You don't use oils, you use tahini, calcium. And almonds. And then the tofu, black beans, white beans, those are superstars. And then the fortified milks. So we can get calcium from all these different foods.

Michelle Eliot

This is really encouraging that you're talking about actual food, because let me go to our next caller here now who wants to know about supplements, because that is, we're hearing so much about that these days. Again, our number 604-669-3733, 604-669-3733, 1-800-825-5950. My guests are fitness coach Karina Inkster and registered dietitian Vesanto Melina. And Anita in Vancouver, welcome to the show.

Anita

Hi, thanks for taking my call. So I eat very well. I enjoy the vegetables and the fruits. Should I be taking calcium supplements, vitamin D supplements as well? That's always been my question.

Vesanto Melina

Great question. And for now, and for Canadians. So I find most of my clients get about 600 milligrams of calcium a day, whereas the recommended up to age 50 is 1000. And after 50, it's 1,200. So it's way better to have a calcium supplement, but not too much. And it's better to have it in two places in the day. So you might have 300 in the morning and 300 in the evening. And then for vitamin D, this is a lively area, I'll tell you. Like, we're finding, of course, in Canada, we don't have much sunlight. But I was even speaking in Honolulu a couple of weeks ago, and they're short of vitamin D because of things like covering up and smog. So anyway, and also, we are learning so much about vitamin D. The recommendations are not clear what we need. So you can get your vitamin D, serum vitamin D checked and see what the levels are and then take some and adjust to the right level. You have to pay a bit for that. And then the other one nutrient that's interesting is omega-3 fatty acids. Keep your brain going well into old age. And we used to think of that as a fish source, but fish are getting short of it these days. Plus they get it from microalgae in the first place. So we can just take a microalgae supplement and that really helps a lot.

Michelle Eliot

Anita, does that help? That's very helpful. Thank you so much for the call. It's interesting, those supplements, but I feel like we're constantly bombarded with so many different kinds of supplements. What are your thoughts on that?

Vesanto Melina

Yeah. some people are taking a lot of some ground up little plant from the other side of the world, which you could, you're better to eat the plants that grow here in BC, and you don't need something from South America. But we do need these supplements. And if you're going wholly plant-based, you also need vitamin B12. Yeah.

Michelle Eliot

Okay. Thank you very much for that. Your thoughts on that, Karina, on supplements. Is that something you hear about as a fitness coach?

Karina Inkster

Absolutely. I think in the fitness world, there's a disconnect because folks are trying to make money and folks are also trying to help increase population health, right? So my coaching team and I are super fans of creatine, B12, of course, like Vesanto just mentioned, but we're always skeptical overall of the supplement industry. So we want to make sure we're looking at long-term research results. Creatine is one of the few that's actually very well supported in the research. We can talk more about that in particular if you like. But mostly we want our clients to get their food and their nutrients from whole foods, like 80% of the time if they can. And 20% fun foods, whatever they like. And then like 2% supplements if they need them.

Michelle Eliot

Yeah, so why don't we talk about creatine and what the science is actually telling us about that?

Karina Inkster

There's some interesting research coming out, and I think we do need more long-term research on this particular thing. There's interesting research coming out on cognitive benefits of creatine. So it potentially helps with healthy aging, maintaining function, maintaining cognitive function as we get older. But what has been really well established in the research is it's like an extra battery of energy. which, by the way, could help when we're experiencing hormonal changes and we don't have a lot of energy and we're tired or we didn't sleep very well. So you can take it at any time. It doesn't have to be around a workout. And it's very useful for short duration, high intensity exercise. So it's not going to help with a half marathon or endurance swimming, but it will help if you're doing sprints or if you're doing strength training.

Michelle Eliot

Okay. Cheryl is our next caller now in Abbotsford. Hi, Cheryl.

Speaker 5

Hello. Thanks for taking my call. Sure. My question is, I was diagnosed with breast cancer last year, and the oncologist recommended I take a calcium supplement because I'm on a estrogen inhibitor. And so I'm not sure. I'm finding that taking a supplement I was very constipating and they sell them with magnesium, calcium and magnesium together. I was told by 1 doctor, no, not just calcium alone, not magnesium. But then one other one recommended taking the magnesium because that helps relieve the constipation. So I'm not sure what you should do.

Michelle Eliot

Yeah.

Vesanto Melina

Nutrition's a very lively science, I'll tell you. There's so many different ideas. And one of the things about calcium is not to take too much. Like I think about a usual amount is 300 in the morning and 300 sometimes later in the day. That's tiny. Most of the supplements are higher than that. And you don't want these high amounts because they do cause problems. And having it with magnesium isn't a particular problem. Now magnesium is the central molecule in chlorophyll. So guess what kind of foods you're going to get it in? Green ones. Yeah, we're back at plant-based. That should help. And also prunes. I forget what they had, but they had something that helps with our bone strength. I was surprised.

Michelle Eliot

Okay. Well, Cheryl, thank you very much. I hope that helps you in terms of addressing that issue. Thanks so much for the call. Katie is next now from Vancouver. Hi, Katie. Go ahead.

Katie

Hi there.

Michelle Eliot

You had a question. Yeah, you had a question about alternatives to legumes.

Katie

Yeah.

Vesanto Melina

Good one.

Katie

I have reticulosis, so I can't eat a lot of beans and such. So I'm just wondering, how do I get these nutrients?

Michelle Eliot

Yeah, great question.

Vesanto Melina

So what I find, and sometimes I'm working with people with different sensitivities and so on, but foods like hemp seeds are high. The vegetables are high. I've worked with people who were on raw food diets and they ended up being able to meet their protein recommendations without any legumes. So there are other options and you can use seeds, you can use the other fortified milks. So there are a number of different options.

Michelle Eliot

Okay, lots of other options and alternatives for you, Katie. Thank you very much. I want to wrap up by asking you both, I moderated a panel, a webinar on menopause last week, and this really great question came up about, weight gain and weight management and weight loss. And the response was very good, I thought, because it was just sort of saying there's been too much focus on weight. You know, it is not necessarily a sign of health. And so much of the discussion around menopause has been around controlling weight gain. Can I get you to talk about that, Karina?

Karina Inkster

Absolutely. I think this is a really important point and I will use one of our clients as an example. She started strength training for the first time ever. I won't say her name, but this client got into strength training in her 60s and actually gained weight on the scale, almost 4 pounds in those three months. But if you look at her measurements, she decreased her waist by multiple inches. Like I think it was 3 or 4 inches. Quite a big difference. And she did a DEXA scan, which can show us our bone density and our fat distribution and our muscle mass. And she actually gained 4 pounds of muscle in that time. So if all we're looking at is the scale, it is not telling us the full picture. We have to look at other things as well. And if you don't have DEXA scan available or if you don't want to do one, then photos and measurements are kind of like the next proxy measurements you can use. So, if your waist measurement goes down, for example, and your scale weight goes up, that's actually a really good sign that you've gained muscle, and I think a lot of us, especially females, have been taught basically to... dictate how our day goes based on what the number on the scale is, right? And if it's going up, it's bad. And if it goes down, we're doing something right. So there's still these myths about what body weight means. And there's still these ideas of making ourselves small and taking up less space, but that's not going to lead to long-term health.

Michelle Eliot

What a great conversation. I wish we had more time. Thank you very much, both of you.

Karina Inkster

Thank you so much.

Michelle Eliot

So good to meet you.

Vesanto Melina

Can I see one more thing?

Michelle Eliot

I have about 15 seconds.

Vesanto Melina

Okay. It's good to exercise a lot too. Like going to the gym or go for walks around the park every single day. So I do lots of that too.

Michelle Eliot

Wonderful endorsement there. Karina Inkster, fitness coach, and Vesanto Melina, our registered dietitian in Vancouver.