Welcome to Everyday Wellness Podcast. I'm your host, nurse practitioner, Cynthia Thurlow. This podcast is designed to educate, empower, and inspire you to achieve your health and wellness goals. My goal and intent is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives. this is the start of a new thursday series called the midlife minute that is really designed to address listeners questions in a little bit longer length of time and or deeper dive into topics ideally we're going to keep these podcasts under 20 minutes occasionally we make over to 30 but I'm trying to reinforce some key concepts and ensure that I'm addressing listeners questions in a way that's really helpful. So the questions that I will be addressing topics are going to be items that I'm being asked over and over and over again. I hope you enjoy this series. Please share with your friends. And as you know, you can always send your questions to support at Cynthia Thurlow.com. I appreciate each and every listener. We're back for another episode of Midlife Minutes. I had a whole constellation of questions that came in around how do I properly fuel my workouts or what are the signs if I'm under fueling for my exercise? And I think this is particularly relevant because many of whom have been fasting, intermittent fasting, doing some type of time-restricted feeding for many, many years. and you can slip slide into a situation where you are chronically under fueling your body. So let's talk about this. You're gonna see me looking down at notes because I have some research that I'm going to quote. This is a common pattern. I think that as we are seeing shifts in the microbiome, we may not be as hungry as we once were. We see shifts in muscle mass. We may also experience alterations in our ability to properly fuel our bodies. We're being told we need to eat more protein. We need to be conscientious about carbohydrates. We need to switch up our fats. It can be very confusing. And so I'm hoping I'm going to provide greater clarity around these kinds of circumstances. So the typical scenario that I see is that you're exercising more, eating less. Your body composition will not shift. Your energy, sleep, and recovery are just getting worse. And what's the thing to do? because we're being told we have to lift the weights and we have to eat the protein. And so I think it can be very confusing. It can be overwhelming and it can also be incredibly frustrating. And so under fueling our workouts becomes a larger issue. I'm not suggesting that it's not important to properly fuel your exercise when you're younger, but in middle age, it becomes kind of a catastrophic problem if you're chronically under fueling your bodies. And so we know that after 40, we have alterations in progesterone and in most instances, testosterone as well as estradiol. It can make muscle protein synthesis less efficient. It can really increase our need for protein. Our ability to recover also diminishes and we become much more cortisol sensitive. And so when I talk about this lack of stress resilience in middle age, it's really speaking to the fact that with diminishing levels of circulating progesterone, we are just going to be less stress resilient and we are going to be much more sensitive to cortisol. Cortisol is catabolic. I remind people this all the time. It's such an important hormone. In an acute situation, not a big deal. Like right now, I'm recording this video for you all and my cortisol is probably up because I'm alert and I'm engaged and I'm needing to draw upon my vast knowledge of information and make sure I sound articulate and cohesive and concise. But cortisol elevated over time can be very catabolic, which means that it breaks down muscle tissue. It impacts our immune function, leads to leaky gut, dysregulates blood sugar and insulin and can make it even harder to lose weight. And then the piece about insulin resistance, as we're losing muscle mass, we are also becoming more insulin resistant as we were losing estrogen estradiol predominantly we were becoming more insulin resistance And this just adds to this issue around stress or the lack of stress resilience So this may contribute to more fatigue, more energy issues, more sleep disruption, alterations in body composition, the things we do not like seeing can be more problematic. I talk about how cortisol, there are more cortisol receptors on our abdomen. I think it's 40 times more cortisol receptors. so that cortisol belly that we don't like seeing when we're stressed becomes a problem. So alterations of body composition, less muscle mass, more fat mass. You know, it's when your pants get tight, you're craving foods you don't want to be eating. You're not sleeping well. It becomes a vicious cycle. And so we talk about how critically important muscle is for metabolism. It's a glucose sink. It imposes insulin sensitivity, protects bone density, and helps maintain resting metabolic rate, which if you look at the expert research that's done, suggests that our metabolism really doesn't start to change until 60. I kind of cry a little bit of BS there because I think that it does not take into account what is happening specifically in women's bodies. There's a randomized trial in older women that shows that resistance training preserves fat-free mass during weight loss, especially when protein intake is adequate. When calories and protein are too low, the opposite can happen. So if you're lifting weights, great. If you're doing that two to three days a week, fantastic. Got to hit your protein macros, no less than a hundred grams a day. And sometimes the easiest way to go about doing this is to track your macros, not obsessively, but chronometer has a great app. It also tracks micronutrients. So not just protein, fat, and carbs, but also specific minerals that you may be deficient in. And so we know that as we are aging and muscle mass becomes something that is more challenging to put on. I just did an amazing podcast with Dr. Andy Galpin. He's an exercise physiologist and expert in this area. And he said, I really cried BS that women can't put muscle mass on as they're getting older, but it requires diligence. It's not as easy as it was when we were 20 or 25, probably when we weren't even thinking about muscle mass, let alone the fact that we needed to be strength training diligently. We know that older adults need more protein per meal to stimulate muscle protein synthesis. We talk about this a lot, no less than 30 grams per meal. I would actually argue you want more than that, closer to 40, 50 grams per meal. And that protein leverage of hypothesis plays a role here as well. If you're not eating enough protein, guess what's going to happen? Your body's going to be looking to make it for those calories. And it may explain why you're standing in your pantry at eight or nine o'clock at night, looking at chips or thinking about the ice cream in your refrigerator or freezer. We're thinking about a delectable dessert that you can kind of throw together. Your body is looking for calories. It's looking for nourishment. That's why I keep reinforcing you have to eat enough protein. You have to have a wide enough food window to actually get that protein in. And this is why about 18 months ago, I stopped doing intermittent fasting with as much vigor and as regularly as I once did. It doesn't mean that I don't think it's a good strategy. I just think a lot of women are chronically undernourishing their bodies, and that can be at the expense of muscle mass. If you're a woman in midlife or beyond, you'll probably notice those changes in energy, strength and recovery just don't feel like they used to. And what's frustrating is that for many women, this happens even when you're eating well, lifting weights, prioritizing protein and doing all the right things. You're not lazy, you're not unmotivated, and you're not doing anything wrong. A big part of what's changing actually starts inside your cells. As we age, our mitochondria, the energy-producing structures inside our cells become less efficient, and when mitochondrial function declines, it can show up as lower energy, slower recovery, reduced muscle strength, and feeling less resilient overall. This is a normal part of aging physiology, and it's one of the reasons midlife can feel so different. And that's why I've added Mitopure gummies from Timeline Nutrition into my daily routine. 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There were other randomized trials that show that higher protein diets during weight loss preserved lean mass and supported resting energy expenditure. And this is why we have to eat enough. And sometimes when I'm looking at food diaries, or I'm looking at chronometer with patients, and I realized like they're eating 600 to 700 calories a day, and they're wondering why the scale won't budge. I'm like, your body thinks you're starving. Like, this is not me saying, don't ever fast again. But I think we have gotten to a situation where we have become accustomed to just need a lot of food. And we don't realize we've gotten to a point where we're eating just a minuscule amount of food, which is not enough to build muscle, which is not enough to support hormones in the body. It's not enough to fuel our brains. And I know the OMAD community takes great offense and gets very upset because I'm poking a bear. These are uncomfortable truths. I think for each person listening, you really have to think about, are you consuming enough protein? And if The answer is no, you need to change what you're doing. So we know that women feel better when they prioritize protein at each meal and they support recovery. So that means you're not working out hard seven days a week. It means, you know, you're taking a break. Like today is a recovery day for me. I walked on the treadmill because it is bitter cold in my part of Virginia. And with the winds and with the snow that we got yesterday, it just makes it a whole lot easier to walk on the treadmill on an incline plus or minus my weighted vest, depending on what I feel like I need. And this is designed to be a recovery day. I'm going to work out harder tomorrow. I'll work out harder on Monday, but we need to ensure that we are getting adequate recovery. So what are some of the signs you may be under fueling? Are you always tired after workouts? Like, do you feel like that day or the following day you need to take a nap because you're just so worn out? Alterations in your menstrual cycle. For those of you that are still getting a cycle, if you notice that you're really regular, and then all of a sudden you're not particularly regular, or you've just noticed that as your exercise has gotten more intense, you seen changes in your regularity of your cycle Are you waking up between 2 and 4 a you getting a drop in your blood glucose You know for some patients when they wearing a continuous glucose monitor can be incredibly insightful to see, are they getting a drop in their blood glucose or their blood sugar at night? That's provoking this cortisol awakening response that they're getting. That's, you know, encouraging their liver to free up some stored glycogen to keep their blood sugar stable, but it also wakes them up. Is your hair thinning? I noticed when women lose 15 pounds seems to be the sweet spot. If you lose more than 15 pounds, that's when a lot of women will see alterations in their hair. They may have nail issues. They may notice skin issues. They may not recover if they have an injury quite as well. Has fat loss stalled despite more effort? That's a big one. And you have to get honest with yourself and you have to consider and think that you may need to change up what you are doing. If so, your body may be in a stress adapted, under-fueled state. They call it relative energy deficiency or REDS. Talked about this on the podcast several times, but I would lump in the over-fasters and the chronic dieters in there as well. So I think the big priorities need to be, irrespective of whether or not you intermittent fast, eat enough protein, you need to have at least 100 grams a day, period, full stop. Number two, you need to support strength training. And that means, you know, if you're just starting out, then you need to work with a trainer who's experienced training middle-aged women. You want to work with someone that's going to be able to start you from, if you're brand new, start with body weight exercise, lighter weights, then progress to heavier weights. Heavier weights are as unique as we are. What works for me may not be enough for someone else, might be too much for someone else. Prioritize sleep and recovery. I always say sleep is foundational to our health. And if you're not getting enough sleep, that's an issue. I would say the other thing is making sure you're adding in foundational supplements like creatine monohydrate. I talk a lot about this. You don't have to buy my products, but make sure you're using a high quality creatine monohydrate. You want to look for Crea Pure or Crea Vitalis. They're both made by the same company, but now they're kind of pushing all of us in the health and wellness space to use Crea Vitalis. Stay tuned for whether or not I'll have to actually make that adjustment because you have to license it through a specific manufacturer in Germany. Things like magnesium or electrolytes, staying well hydrated is really, really important. Managing your stress. When I have intense workouts, I don't have intense workouts the next day. I typically will allow myself at least 48 hours between tough workouts. And you want to avoid chronic calorie restriction. I think we as women, I mean, I certainly grew up in the 80s and 90s. We were all fat phobic, thin was in, And I use that in air quotes. We were just conditioned to believe that women aren't supposed to necessarily be strong. They're supposed to just be thin. And so we now recognize how detrimental that is. And so, you know, the big thing is your body isn't broken, but we don't want to be under fueled. And so I invite every single listener that is listening to this podcast to just consider maybe you need to change things up and it's okay if you need to. Again, 2024 was a big year for me. really what everything that happened with my father really forced me to acknowledge I was probably not necessarily doing it purposefully, but probably in some situations, like when I'm traveling or I'm speaking on stages or I'm doing podcasts outside my area, I might not be able to get in enough food. So there are things that you can take like essential aminos. My favorite is Keon. We'll drop a link below so you can get a discount on your order. But Keon aminos are what I use to kind of buffer my protein intake on days when I just cannot get enough food in, but I want to protect the precious muscle that I'm building and that I already have. I personally really like their capsules. I don't love the taste of the amino powders, although I have plenty of patients that do, but we'll make sure we include that discount for you in the show notes. Thanks again for a great midlife minute. Let me know what you want to learn about, you can go to support at Cynthia Thurlow.com. You can send your questions directly there. You can also join my free Facebook group called the midlife pause backslash my name. That's a very supportive community of over 13,000 women. There's a couple men, but the men that are in there are there to learn more, to help support their loved ones. If you love this podcast episode, please leave a rating and review, subscribe and tell a friend. you
