Jono (00:16)
Welcome back to the bite me nutrition podcast. Uh, today I'm chatting to Kat uh, I've already talked to Kat a lot, you know, just in life, which is cool, but she's already also been on the podcast to talk about, uh, shift work. I think that's what we spoke about last time. Hey, um, but we're gonna change gears this time, uh, to talk about perimenopause cause we get tons of questions about it. And, um, Kat is kind of, she's the person that I ask lots of questions. Of when it comes to a lot of my clients managing menopause. So I thought, why not record the questions and the conversation and go through all of that today. So before we do that though, Kat, can you say hi and give us a little bit of a background on who you are and what you do?

Kat (00:43)
Okay.

Hi, yep, as Jono said, we talk a lot. I'm one of the dietitians in our team at BiteMe Nutrition. My background is in nursing and have more recently also become a dietitian and in the space and really loving understanding more and working with women with their health and going through the different hormone cycles and understanding how to optimize. Really what's going on with those changes and how nutrition can really help to support what's happening with women through our lives. Yeah.

Jono (01:33)
Yeah. Yeah. It's, uh, I mean, obviously there's a lot happening and there's a lot of changes. And I feel like, unfortunately, there's not, um, there seems to be two ends of the spectrum. There's either people who don't give any advice or just kind of wave people away and say like, Oh, it's just, it's what happens. It's a natural stage. Like good luck. Um, which is pretty, pretty sucky. Um, but kind of equally sucky is I think there's a lot of people making pretty full on claims about you need to completely.

Kat (01:50)
Yeah.

Yeah, yes. Yeah.

Jono (02:03)
fundamentally change the way that you eat and exercise and live as a human being, which I don't know, I think is probably not what we're going to be talking about today either. So can you, let's set the scene though, before we dive into that, like what, what's happening? What's going on?

Kat (02:14)
Yeah.

Yeah, yeah, so exactly to help understand it, it just helps to know the basic fundamentals of what is going on for a female and a woman through their lives. And you can really sort of break it down to three main hormonal cycles that women go through. And that's really reproductive years and that's, you know, our menstrual cycle and, you know, childbearing age and things like that. Then we sort of more go into our hormonal cycle of perimenopause. And then on from there is menopause, which is really marked by the decline in our estrogen levels. And then menopause is diagnosed really at that 12 months of amenorrhea, which means 12 months of your period cessation. Yeah.

Jono (03:07)
Yeah. And so what's like, why, why is knowing that important?

Kat (03:15)
What's really important about it, I guess, is more specifically as well as we're going through perimenopause, a woman can really start to experience a whole range of different symptoms and things like that. They can be quite debilitating almost on your life, you know, it can really impact your sleep, your activity, your body composition, and then it can have more of a physiological impact as well on our bone density and our heart health and things like this. So it's really important to have that understanding of what's going on. And it sort of gives you that little bit of closure of things. You know, some of them think they're going a little bit crazy and not really understanding why suddenly they can't sleep or they're feeling really anxious or they're feeling really low and being like, hang on, it's actually, you know, there's something going on with my hormones and I'm having these changes where I'm seeing that fluctuation in my estrogen levels and with more of those sort of marked symptoms and being able to really support. Support a woman through that time.

Jono (04:16)
Yeah, yeah. Can you take us through what's going on with those hormonal changes a little bit more?

Kat (04:21)
Yeah, I think more specifically today, we just hone a little bit more on the hormone estrogen, just because that's really what we're seeing that variation through perimenopause and as I touched on that decline into menopause. So estrogen is a steroid hormone that is produced for females in the ovaries and it has a really important role in obviously our reproductive health. It helps to prime our uterus and things for pregnancy.

Jono (04:44)
you

Kat (04:50)
But it's also really important in protecting our bone health. So it helps with the development and maintenance of our bones. It helps to inactivate osteoclasts, which are essentially cells that degrade bone. So estrogen helps protect our bones. And it also has a really important role in terms of our heart health. So it can help to sort of stop bad cholesterol, which has LDL cholesterol, and it can sort of help to promote good cholesterol, which people may have heard of HDL cholesterol.

Jono (05:20)
Yep, yeah, okay, so, estrogen is pretty important.

Kat (05:23)
you

Jono (05:27)
climbs.

Kat (05:27)
right.

Yep. Yep. Good summary.

Jono (05:31)
That doesn't sound fantastic. Um, and obviously there's lots of things that contribute to bone health and heart health, but are there some, I guess, what are some nutritional things? Cause that's, that's what we do. Um, that someone can implement during sort of perimenopause to help with those changes.

Kat (05:50)
Yeah, so perimetopause is sort of touching us, that really good opportunity to start some of these nutritional changes and understanding what's going on with your body to set you up for, you know, the next decades. It can be quite a challenging time for a female because it's that ending or that loss of that reproductive age and there's a lot of social stigma and things around that about, you know, women aging and it's not overly socially accepted and

Jono (06:00)
you

Kat (06:16)
from a physical and a social and environmental level. So it's actually a really good opportunity to have a check -in with your health and set up some foundations for going on. I know from working in the public health care system and within emergency and really seeing how, you know, our biohealth and things like osteopenia, osteoporosis can really impact.

quality of life later on, you know, things like having a fall and you break your hip and a lot of people then lose their independence after an injury like that. So setting up now for your later self is a really good opportunity. And what that can look like with our diet more specifically is how our diet can support our bone health and then how our diet can support our heart health as well. With bones we know calcium is going to be.

Jono (06:48)
you

you

Kat (07:11)
uh, nutrient there that we hone in a little bit on and then as well we're looking at vitamin D because vitamin D is really going to help with the absorption of calcium. So for example, um, you know, our calcium requirements, a thousand milligrams a day, and that does increase as we get into our fifties up to 1300 milligrams. So a glass of milk, for example, could look like 300 milligrams of calcium. So, you know, having two glasses of milk and a serve of yogurt.

You're getting closer to your requirements across the day. Yeah.

Jono (07:48)
1300 is, that's not to be sniffed at. I don't think I've ever had a client come to me who's already managing 1300 milligrams most days. Like, yeah, like you said, you can absolutely do it through diet, but yeah, yeah, you've got to plan. You've got to think about it for sure. What about, so for bone health.

Kat (07:48)
Yeah, yes, yeah.

Yeah, yeah, it definitely takes some thinking about. Yeah.

Jono (08:09)
Yes. Resistance training before anyone. Like I said, yes, we know that we're just here to talk about the nutrition. Um, what about for the heart health piece of the puzzle? What can we do?

Kat (08:12)
I'm going to go to bed.

Yep, heart health as well as looking at, you know, reducing our overall intake of saturated fats. So those are things, you know, our processed meats, our packaged types of food, fried types of food. You know, if you're having large regular servings and butters and things like that, you're reducing your intake from there. But also then thinking about what you're replacing that with if you're having less saturated fats. So, you know, you want to be replacing it with either unsaturated types of fats or those healthier types of fats like.

Omega -3, so your olive oils and your nuts and seeds and avocados, and then as well as your complex carbohydrates. So, you know, your whole grains, your wholemeal breads, your nuts and seeds, fruit and veggies, always come back to them. You can't go wrong if you're including those in your diets. But yeah, big fundamentals and as well as you want to have a little check -in with your sodium intake, because that's going to have that.

Impact that on your blood pressure and things like that.

Jono (09:20)
Yeah. Yeah. So is there a diet?

Kat (09:27)
Okay.

Jono (09:31)
Would that you would prescribe that is the best menopause diet that there is or what should we be looking for there?

Kat (09:33)
Yeah.

Look, if we really wanted to be marketable and make things sound sexy, yes, we would be really honing in on one specific diet and promoting that. But really there's no one size fits all and it does sort of come down to the individuals and what their dietary intake is like and their environment and what their home environment is like and all other kinds of things that we take into consideration in someone's diet.

Jono (09:50)
Deal.

Kat (10:09)
Cost of living and things like that as well. There are however, you know, dietary components that we really want to incorporate and this is probably most reflected with the Mediterranean style type of diet because it's really rich in our plant foods which are going to be giving us lots of antioxidants, polyphenols, it's really high in those uncitrated healthy fats that I spoke about, those complex carbohydrates, it's got lots of legumes and lean proteins as well.

Jono (10:13)
you

Kat (10:38)
I think just being mindful though, the Mediterranean diet is probably a bit lower in our serves of our dairy types of food. So you want to be making sure you still getting adequate amounts of calcium if you're sticking more to a Mediterranean type style of diet.

Jono (10:51)
Yeah, yeah, gotcha. If someone doesn't consume dairy.

What do they need to be worried about? What should they be focusing on from a...

Kat (11:09)
Yeah, you definitely don't need to have dairy to get enough calcium, but you do need to have a little thought into it about making sure that you're still getting calcium in your diet because dairy is a very easy, convenient source. So that's either like our fortified types of foods. So if you're having plant -based milks, making sure it's fortified with 120 milligrams of calcium per 100 mils, you could be looking, there's a really great, like some fortified tuners.

Jono (11:29)
you

Kat (11:38)
You're looking at then just whole food types of things like our leafy greens and almonds things like that as well. Yeah.

Jono (11:50)
In a good way, yeah, yeah, if you're looking for dairy.

Kat (11:50)
That's pretty good. Yeah. Yeah.

Yeah, I definitely get clients on that one. Yeah. Pretty much your whole daily in one, one team. Yeah.

Jono (12:05)
Yogurt with sir yeah yeah

Kat (12:05)
Yeah, that's also great. Yeah.

Jono (12:10)
Yeah. Cool. Um, heart health, bone health. Yep. All right. Good. Good day. We're good there. Um, another, another huge area that always comes up, like obviously there's a lot of the, um, mental, psychological, social changes that, that, um, you know, people are managing through that time as well, but also get lots of questions about kind of the physical changes, like body composition changes.

that they might be experiencing through perimenopause, their body feeling quite different or looking quite different. Can you talk us through what's going on on there and why we might see those changes?

Kat (12:49)
Yeah, yeah, that is probably one of the first things, yeah, a lot of clients bring to attention first is that they've noticed their body's changing and that it's not what they once were. And I think there's one element of recognizing that our body will change and that we're not gonna look like what we did when we're 20. Sometimes that's unfortunately, sometimes that's not, but I definitely know as we've touched on already, yeah, social environment can put a lot of pressure on us to be.

looking like that throughout through our whole lives. But then there is also that physiological side with that decline in the eschidrine, we can see that redistribution of where we hold our fat mass in our body. So it'd be more centrally around our abdomen, around our hips and around our butt essentially. So that's why a lot of women really has that noticeable marks change of their body composition.

Jono (13:42)
you

Kat (13:43)
With that, we also see so reduced muscle protein synthesis, which is essentially reduced ability to gain muscle. And we also get an increase of fat mass. Again, then with that, we have lower energy requirements because muscle is a metabotically active tissue. So we're burning more energy. So when we have a bit less muscle mass and a bit more fat mass, our body isn't as efficient as energy burning essentially. So we don't need as much food.

Jono (13:50)
you

you

Kat (14:11)
We do then also have our social side of that where our lives change quite a bit as we age. We might not prioritise ourselves first. We could be working, we could be looking after children, we could have sick older parents. There's lots of other things that are going on and you don't just have endless time to train like you once did or prioritise your food or anything like you did. And that sort of slips as well a little bit to the wayside there, yeah.

Jono (14:41)
Yeah, for sure. Yeah. As always, lots of factors at play, right? Never just the one thing to blame.

Kat (14:49)
Yeah.

Jono (14:50)
What are some things we can do to negate or reduce these kind of body composition changes?

Kat (14:58)
Yep. One is really getting that understanding of our energy balance and it's not just that simple energy in energy out, but that is a really large concept of it essentially, because that's really been, yeah, exactly. Because we know we're meeting that balance that's going to either help us lose or gain weight depending on what our goal is. But also I think more specifically is we're really wanting to make sure we're maintaining.

Jono (15:10)
good place to start, right?

Kat (15:25)
that muscle mass as I touched on how muscle mass is metabolically active tissue. So then the more we have, the more energy we're going to be burning. It's not significantly, don't think you're just going to suddenly be able to eat an extra 500 calories because you've got an extra 200 grams of muscle mass, I wish. But it's still, it's obviously more optimal to maintain if not put on muscle mass. Not only that, as you touched on, paired with

resistant training, it helps to protect our bones, it helps to keep us mobile, it helps to keep us, you know, active and healthy and yeah, I think making sure we've got adequate muscle mass and doing that is making sure we're eating adequate amounts of protein and pairing that with resistance training.

Jono (16:13)
Yeah. Um, protein, protein, protein, proteins. Everyone listening. It's not just for bodybuilders. Um, yeah, even get a little bit of anabolic resistance as we age. Like you mentioned, there's, yeah, that sarcopenia, that decline in muscle mass. So it's even probably even more important than it is in your pre menopausal years to get that protein in. So, um, yeah, I, I guess protein and supplements as a

Kat (16:18)
Yep.

you

Thank you.

Jono (16:43)
Bit of a segue into supplements because like any area in our field, there's a lot of noise.

Kat (16:44)
Mm -hmm.

Jono (16:55)
the shiny and fancy and they say

Are there any menopause specific supplements that someone should be taking during menopause or are there some, if there's none that we should be taking, are there some ones that maybe commonly come up?

Kat (17:14)
Yeah, yeah, sufferance and like this is different from a hormone replacement therapy, which should be spoken about with your doctor and if it's right for you, it's very beneficial in terms of managing your symptoms and going through perimenopause and menopause. In terms of more of the supplement side, there is no one that you should definitely be taking.

Jono (17:16)
you

Kat (17:38)
think it really comes down to the individual and we really want to look at more at supplements of doing exactly that. So supplementing the diet, we do have that high need for calcium and vitamin D and that can be that little bit trickier to meet without adequate dietary planning. So in some instances, women would really benefit from supplementation to bridge that gap. But

that would be really directed through with your health professional and working out, you know, which is appropriate for you and the right dosages around there. There is a lot of information out about all different types of supplements and, you know, things to be taking to support menopause, but the evidence really is quite inconsistent. Some women may find certain supplements really quite beneficial while others aren't. So it's still a bit of a gray area like this.

you know, even for example, the isoflavones of phytoestrogens and things, some women find some benefit with their hot flushes from taking or including more soys and things like that, but some women might not notice anything. It's like I said, it's very inconsistent. So it's down to you and I think really optimizing your food first and then using that to supplement that bridge.

Jono (18:55)
That's a good trademark, not trademark, a hallmark.the evidence is mixed and we're still like, can't make strong conclusions. That's when people sweep in, swoop in with their strong claims and their magic diet and their magic supplements. Because obviously it's not really fun to tell someone, Hey, look, we don't really know much at this stage. We're still figuring it out. I would much rather be like, Hey, take this pill and do this diet and things will be better. But there's a, there's a reason we don't.

Kat (19:12)
Yeah.

Yeah. Yeah.

Yeah.

Jono (19:29)
But anyway, that's right. Awesome. Okay, so we've covered the body composition changes, we've gone through the things we can do dietarily around, you know, your bone health and the...

Yeah, is there anything we've missed? Is there anything else we should talk about in relation to menopause?

Kat (19:54)
I guess probably just a little dietary cherry on top that's obviously going to help in support for paramedicine but just our health in general and that's optimizing antioxidants in our diet and polyphenols. So antioxidants are really through all our fruit and veggies and they help to reduce oxidation and essentially inflammation from that aspect and then polyphenols are types of phytochemicals that can have really positive effects on our health.

and they are also really rich in our plant foods. So I think if you're prioritizing a variety of fruit and veggies, different colors on the plate, making sure at each of your main meals you're including some sort of fruit and veggies and those different colors, it's already a really good start.

Jono (20:42)
Yep. You heard it here first guys. Eat your fruits and veggies.

Kat (20:45)
Yeah, they are good for you.

Jono (20:47)
No, as always, I think the more we, but like the more we unpack fruits and veggies, like the amount of, yeah, exactly. Like you said, like the antioxidants, the polyphenols, and then like the sterols and stannols and like just all the different things. It's not just a stereotypical dietitian recommendation. There's so much good biochemistry going on in plants. Um, amazing. Well, thank you for chatting Kat. This is the third time we've attempted this. We didn't say that at the top. Frickin.

Kat (21:06)
Yeah. Thanks for having me.

Jono (21:18)
software man. But so thank you. Well, actually we haven't actually confirmed that it's recorded properly. So maybe no one will hear this. No, it looks like it's going well. So thank you so much for answering all those questions. Like I said, we get questions about this all the time. We have lots of clients managing this. So I think people are really going to benefit from it. If you, I won't do it because she, I won't do it. Kat won't do it because she's too uncomfortable. But seriously, if you're struggling with this stage of life,

Kat (21:26)
Yes, thank you. Hey.

Jono (21:47)
and the nutrition around it. And you want someone on your team to help you navigate what is important and focus on that. And then also be confident about ignoring all of the other rubbish that's out there. Shoot Kat. I want to say Kat and message and shoot Kessage. Yeah, don't shoot cats. Send Kat a message and she can have a chat and we can figure out what the best sort of path forward is. But.

Kat (22:03)
Don't shoot cats. Yeah.

Jono (22:18)
Thank you so much for chatting, Kat. We'll have to get you back on to chat about some other things or maybe a menopause part two if there were lots more questions coming through. Awesome. I will tag where to find Kat in the show notes. So basically Instagram is the best place at Kat Georgio or you can jump on our website to find her there as well. Otherwise, thanks everybody. We will chat to you next time. Bye.

Kat (22:19)
Thanks, Jono. Yep. Yep, great. Love to. Yeah. Thank you.