All your menopause questions, answered!
Kat’s back!
After her first episode covering nutrition for menopause at a higher level, we’ve dived in deeper to some more specific topics like fat loss, lean body mass, metabolic changes, supplements and HRT!
If you enjoyed the first episode but left with some questions, this answer has you covered.
Time Stamps
00:00 Introduction and Recap of Previous Episode
02:49 Body Fat Accumulation and Patterns in Menopause
07:37 Practical Changes for Managing Body Composition
14:11 Diets and Supplements for Menopause
20:29 Understanding Hormone Replacement Therapy (HRT)
22:32 Key Takeaways for Managing Menopause
Transcript
Jono (00:01.215)
Welcome back to the bite me nutrition podcast today. have another guest podcast, which is good. You don't have to listen to me. get to listen to someone who knows so much more about this stuff than I do. we've got cat back, say hello to cat everybody actually. No, say hello. Yeah. Yeah. This is not interactive at all. I don't know why I said that. yeah. So I really wanted to get cat back onto chat a little bit more or a lot more probably about menopause and things because
Kat (00:17.038)
I'll say hi. Hi everyone.
Jono (00:30.889)
We've already done one podcast together about that topic and it was really informative. got lots of information out of it. Lots of good feedback. And then of course, as is always the case as well, lots more questions about menopause because understandably it's a pretty, pretty full on topic with a lot of unfortunate noise out there about it as well. And it can be an interesting time. So we, first and foremost, if you haven't listened to that first episode, look, Kat
ask for a little bit of a recap, but you could also just pause it and go listen to it and that would be better. So let's assume that you've done that, but just if you haven't, what were some of the things we covered in our first episode?
Kat (01:11.84)
Yeah, so in the first one, we just really went over like the basic overview of what's happening for women through perimenopause and menopause and in that stage of their life, we sort of touched on really those four hormonal cycles that a woman experiences from our reproductive age where we're sort of having a menstrual cycle and then we can transition through into perimenopause where we start to see those changes in our hormones, know, particularly estrogen, testosterone.
and then sort of entering them into menopause and then also post menopause in that podcast as well. We sort of looked at what is occurring at more of that physiological level for women in terms of cardiovascular health and bone health, which become a little bit more prominent going through menopause and then sort of how our nutrition can come into play to support our health during that time.
Jono (02:04.989)
Yeah. Yeah. So again, lots of stuff. A lot of what we'll talk about today will probably make more sense if you've gone back and listened to that podcast episode. So please make sure you've done that. but I think we'll start with probably a few questions about body fat and weight gain and those style of things, because it is a really big topic that comes up a lot understandably in this space. So, I guess the
Kat (02:14.466)
Yeah.
Jono (02:35.317)
how, why are things different in terms of body fat accumulation and body fat patterns and all of these sorts of things around menopause than maybe someone has experienced earlier on
Kat (02:49.934)
Yeah, yeah. So yeah, really what's sort of happening in that stage, if we think about menopause and that typically occurs between the ages of 45 and 55 and really, yeah, that average age of 51, but obviously there's, you know, broad spectrum within that. And then so we can think about perimenopause as being, you know, that several years prior to menopause. And what is occurring there can be a huge array of symptoms, know, up to 8 % of women can start to experience.
various types of symptoms, know, really common one, like hot flushes, know, libido changes, fatigue, anxiety, palpitations. But yeah, a really big one that we see with our clients, and is probably one of the dominant things they come to work on with us is noticed body composition changes and changes to their weight. And that one seems to be really one that can be, I wouldn't say burdensome, that's not the right word, but it can be quite frustrating for women because they're not really understanding.
know why they're having these changes and they feel like they're doing lots of things and it's not working for them and it's you know on top of you know all the other things that could be occurring in terms of other symptoms and things so it's just a lot on the plate. Favorite part is the dietitian.
Jono (04:06.52)
Byte -size facts, all of these things.
Kat (04:10.582)
So yeah, what's really occurring there and yeah, we talked more into the hormones in that first podcast is that decline in estrogen. And that's really where we do see that redistribution of where the weight is held in the body. And it really shifts to that more central abdomen gluten ties, this around that midsection. And we can also see that increase in the weight circumference there as well. So I think what's important
to note is might not necessarily be a weight change, but really that body composition change and what we mean by body composition is can be referred to obviously like fat mass, muscle mass and bones, or you might hear it as well to be fat free mass or our fat mass as well. So it can come together muscles and bone in one, and then we're also looking there at our fat mass. So women going through perimenopause and menopause can have a really significant increase in their fat mass.
and particularly that visceral type of fat. So that's that internal type of fat and particularly around our organs and things in our abdominal region. And we know that that can have that increased risk of cardiometabolic diseases such as heart disease and diabetes and all that really not so fun kind of path that some individuals go through there. So yeah, there's a lot going on in terms of those body composition changes.
Jono (05:34.197)
So is it always a increase in body fat or is it more of a redistribution of body fat or is it both? Is it different in different scenarios?
Kat (05:49.644)
Yeah. Yeah, and it's not, I guess, as black or white as that because I guess there's lots of other variables that are also occurring for a woman at that stage. But in terms of, guess, just menopause itself, it's not specifically the cause of weight gain, so gain in weight, but it really is that change in body composition. And then I guess with that, you can see that little bit more of a domino effect in terms
Okay, so if we have a higher fat mass and a low fat free mass, then we can start to see changes in our metabolic rate. So then our energy requirements might be a little bit lower. So then, you know, we're eating the same and we're training the same, but we might not necessarily be quite as efficient. And I'm not saying it's, a significant change, but you know, some women might feel like their lifestyle hasn't really changed in terms of what they're eating and how they're moving. I can start.
to see that change and on an average women do experience about around two kilos of weight gain over that five years through menopause. But yeah, I wouldn't say it's that direct cause going on there.
Jono (06:59.761)
Yeah. Yeah. I'm recorded a little while ago, but from memory, first podcast, we definitely go through the environmental factors as well. Hey, you know, like you said, it's not just the shift in metabolic rate or a shift in body composition that's often going on at that period of time in a woman's life is a lot going on. so, okay. There's
Kat (07:26.286)
Thank
Jono (07:27.337)
potential shift in body composition, the potential changes in fat free mass and fat mass. What do we do? Is that it? Yeah, that's life. There's nothing you can do about it or are there some practical changes we can make?
Kat (07:37.964)
Yes.
Kat (07:45.801)
Yeah, and I guess just to expand a little bit more, first of all, is also could be going on for a woman. think just to note that menopause is a natural process and part of our aging and it is meant to occur. And I think, yeah, we delved in really deeply in the first one, you those lifestyle things that are happening in terms of family and, you know, we can significantly have less movement and things like that. But I think also,
we're entering that midlife phase. And sort of, you've got to think about with aging as well, you know, at that physiological level, again, we're not necessarily sufficient at using energy, creating ATP and we can also see changes in terms of, you know, increased inflammation and all these other things that occurring, compounding to what's going on in that greater picture of just seeing that weight change or that body composition change. So I think having that in mind,
All those sort of different elements can then help I think a bit in terms of what can we do? And that is the big question, right? Because a lot of people do know, right? It's not rocket science that we're saying, you know, the body composition changes, there's more weight around the midsection. Like women who are living through it are well aware that that is what is occurring for them. Yeah, it's the one, how can we help support and manage that? That's, I think, probably that bigger ticker.
Jono (09:03.471)
Yeah, yeah.
Kat (09:10.954)
And that simple answer for fat loss or weight loss is creating that calorie deficit, energy in versus energy out. But as we've sort of touched on all those extra sort of factors we want to think about in terms of how can we be smarter about creating that calorie deficit so that, know, we can have it not sustainable as we talk about in biometrician, a diet isn't sustainable, but I think obviously creating that
change that we're working towards and our goal and obviously making it maintainable and supporting our health outcomes as well. So we can think about things in terms of what's your macronutrient distribution looking like? Have we got enough fiber? we including enough protein, which is really going to promote muscle maintenance, which you know is that going to help with that fat free mass, which is then going to help with that metabolic effect as well. Protein is also more satiating. It also has very slightly higher thermic effects than our other
Jono (10:02.69)
Mm -mm.
Kat (10:09.614)
macronutrients like carbohydrates and fats. We're going to think about, yeah, our activity levels and that can then contribute to make it a little bit more challenging to work out what your calorie deficit or energy deficit is going to look like than what it was when you were 20, 25, running half marathons on the weekend and partying until 6 a .m. Not that everyone did that, but particularly if you lived through COVID. Yes, I didn't.
Jono (10:33.077)
We had very different 25 year olds. Yeah, definitely different.
Kat (10:40.523)
But you know, you can definitely go to town on large intakes and so considering those stages and as I mentioned, know, that just the natural aging process and what's going on there, our environment, you what kind of support system do we have around us, your partners might not be as invested into changing their diet and things as well at home and you know, you don't want to be cooking two types of meals.
So it's really about thinking about all that extra sort of nitty gritty and how we can create a plan that's gonna support those elements and sort of help you work towards achieving those goals there.
Jono (11:20.787)
Yeah. Do you find you're such a pro cat, always talking about protein. Do you, do you find, know for me with my experience with clients moving through menopause, protein is often a bit of a gap for them. Is that, is that something you've experienced as well?
Kat (11:26.668)
Yeah.
Kat (11:41.341)
Yeah, it is or yeah, there'll exactly a couple of meals where they're doing really well, but you know, there's always ways to get closer to that more optimal. And I think even just from our guidelines, they're set, they're already set pretty low. And if we're thinking about just the bare minimum to sort of support muscle maintenance, we're looking really like that one to 1 .2 kilos, the body weight. And yeah, getting to that kind
amount of protein does need a little bit of planning and thinking about it's not really a macronutrient that we eat a lot of quite easily unless it's the carnivore diet dare I say it right now
Jono (12:20.445)
Yeah. That's what you have. Everyone heard Kat say the carnivore diet is the best diet for menopause. No. Yeah. That's right. It's the best carnivore diet.
Kat (12:28.993)
As long as it's got fried veggies and whole grains with it.
Yeah, but yeah, it does take a little bit of thinking and tweaking about to sort of get there consistently in the day to day.
Jono (12:45.587)
Yeah, yeah, yeah, I agree. think it's that one that can be not overlooked, overlooked, like you said, I think, I think getting to the RDI, the daily recommended intake is pretty doable, but getting to that more optimal level that we want to see for supporting, you know, muscle mass and bone density and things for a lot of people can feel a bit unnatural and can definitely take more of an effort.
So yeah, and then especially, like you said, even more critical at this stage in life. maybe earlier on in life where we didn't see the drop off in muscle mass, you're kind of getting away with lower protein intakes. yeah, you got to be just a bit of a bro, just a bit of a bro to get that up there. Yeah, perfect. yes, calories in calories out, but with an extra layer of complexity.
Kat (13:31.67)
Yeah.
Kat (13:42.424)
Yeah.
Jono (13:42.961)
I guess at this stage of life as well. So I mean, almost a good segue into diets and things in general. I know we just joked about the carnivore diet, but obviously with menopause as an industry, which is a horrible thing, a sentence to even say, but it feels like it is becoming one. What are some of the diets that you've seen?
around or dietary changes that have been recommended for menopause that you've seen? Are there any that are valid? Are there any we should ignore? Like how could, how should we approach that messaging around food and menopause?
Kat (14:26.016)
Yeah, so there's a huge amount out there, definitely lots of noise and then guess lots of valid information as well and it can be challenging to shift through. it's having a little radar of some red flags and keywords to look out for can sort of help you sift through it a little bit better. You know, if you're seeing this reoccurring on someone's webpage, maybe think, I don't know if this is going to be.
you know, the best option to be making these changes in my life and in my diet. I think firstly, anything that tells you to remove whole food groups, particularly without doing any talk with you or any sort of proper assessment going into what your diet looks like and your medical history or anything like that. Particularly, I think big ones that you sort of see removed are dairy and wheat for gluten, both those food groups.
as long as you don't have any allergies or intolerances are very good for us, very important for our health and have a really important role in terms of, you know, preventing heart disease and bowel cancer in terms of fibres and things that we get from whole grains and whole grains contain gluten. So if someone's telling you remove those, think watch out or just have that in the back of your mind. Any sort of drastic changes to your routine, your way of eating.
promising is going to be some sort of magic solution. For an example, could be something like intermittent fasting is gonna fix X, Y and Z and you'll live to 150 because of intermittent fasting. Yes, I mean, it can be beneficial in terms of creating that calorie deficit for fat loss, but there isn't gonna be any sort of special magic trick that you'll get
you know drastic changes like that in your day by having said that's something you enjoy and how you like to eat and live your life, go for it. But I think just be mindful of changes like that. And sort of promoting various different supplements that you need to have that are gonna fix all your symptoms. Again, that are gonna help you live longer and the anti -inflammatory and all these kinds of things.
Jono (16:23.379)
Mm
Kat (16:41.4)
Just watch out for those kinds of things. Lists of food you need to avoid, places you can't eat out. I think all those feel a little bit on restriction and I think that's something to us to be mindful
Jono (16:54.429)
Yeah, it's always things you shouldn't do, isn't it? It's always listed, you shouldn't have this, you can't have this. Yeah, well, that's the opposite. You need, must have all of these. Yeah, yeah. In terms of supplements, are there any good ones specifically for potentially managing menopause, I guess menopause symptoms? Are there, yeah, are there any we...
Kat (16:56.758)
Yes, HF of supplements. Yeah. Yeah.
Jono (17:21.673)
maybe should be looking at or are they all best avoided?
Kat (17:27.502)
No, there are. I guess the evidence in terms of, and like within Australia, and there's Australia practice guidelines for menopause, which are really extensive and give a lot of information about, you know, current practices in supporting women through perimenopause and menopause. There is for symptom support, some non -hormonal
have a medication. So we're looking more at SSRIs, so antidepressants there and gabapentin, which can have a role in helping cough flashes. And then I guess, more so in types of complementary therapies, you're at like cognitive behavioral therapy, acupuncture and hypnotherapy, which can be beneficial with supplements and medications. I think with over -the -counter medications, you just want to be mindful that the strong evidence isn't really there yet to support.
many of the over the counter medications and that can be things that women might be here regularly like black cornish, red clover, vitamin E, phytoestrogens, so soy as a supplement, evening primrose oil, yeah, we're not at a place yet where the evidence is strong and we can really recommend that across the board for women.
Jono (18:38.973)
always hard to say.
Kat (18:50.134)
Yeah, it's very inconsistent. mean, if you're taking those things and whether it's placebo or it's working for you, mean, great. There's not really a huge country indication with a lot of them. And I guess if we're thinking more those types of nutrients in our foods, so, know, vitamin E from foods like extra virgin olive oil is a really powerful antioxidant and it has a role in reducing inflammation. And then, you know, if we're thinking
phytoestrogens, which are polyphenols found in our soy based foods. Again, they can have positive influence on our health, can help with cholesterol management and things like that. So I think at a food level, you're including them great. I've just been mindful with the supplementations there. I will make a note in terms of bioidentical hormones. So these are hormones that are made by
They're not approved by the TGA, so the Therapeutic Goods Administration. It's just that the clinical trials isn't there yet and there's no real controls over the production prescribing with dosage. So you do want to be mindful of someone who's telling you to take those because there's no real support for taking them safely yet.
Jono (20:03.197)
Yep. Yeah. I didn't know that about TGA approved in Australia, for the bioidentical hormones and also, I guess for normal stuff, the supplement story sounds fairly familiar across the board. Hey, we found something that seems to be pretty effective in food. So let's jam it into a supplement. And suddenly we haven't seen the same, or, know, yeah, I'm just confident about. Yeah.
Kat (20:25.548)
Yeah, exactly.
Jono (20:29.737)
A bit of a, I guess similar to the medication and supplemental, supplements, supplements, sorry, supplements, a topic that comes up quite a bit as well is like HRT. What can you tell us about HRT given that you are not, we are not doctors.
Kat (20:51.788)
Yeah, again, So yeah, HMT is definitely something to talk about with your doctor in terms of if that's right for you to have screening. And then, know, there's again, really good tool kits for health professionals. There's one that is a toolkit for managing menopause, it's evidence -based and it can really help dictate or direct the type of therapies that's going to be beneficial for you in terms of managing your symptoms.
If it is right for you, can be very effective for menopausal symptoms. It can also really help, I guess, in terms of negating some of the fat mass shifts and a bit of weight maintenance there. And I think it has previously been associated with weight gain, but really what can be seen there is a bit more contributed to fluid gain. So I think
Yeah, they have appropriate screening and they're mindful of things, know, if your history of breast cancer, endometrial cancer, blood cuts, untreated blood pressure, it can be very effective in managing your menopausal symptoms.
Jono (22:03.205)
so let's assume someone has, well, cause I've, I've, I've asked all my questions. but let's assume that someone's been rude and they've skipped to this part of the podcast. they haven't listened to anything else. If you were to kind of give a little cheat sheet of like takeaways from today, what, what's the important stuff that people should be focusing on, with their health and nutrition at this stage of
Kat (22:28.557)
Yeah.
Kat (22:32.366)
I guess I would, mean, your goals are entirely yours, your own right, and that's what's important to you. But I think maybe to challenge or add another dimension if your goal, you know, is weight loss or fat loss, and maybe think about, you know, that body composition support in terms
muscle maintenance or even better yet, you know, muscle gain because that's really going to have that longer term benefit in terms of what the composition and weight management, but then also in terms of our metabolic health and that side of things as well. You know, another dimension could be focusing on, you know, reducing inflammation that naturally goes into the aging, but then also in terms of our lifestyle with exercise and diet and things like that. just adding that extra.
element and I think you know weight and we just really focus just on the scale and that only tells us one little tiny bit of the picture but then if we're thinking a bit more into body composition you know whether you incorporate body measurements or dexascan or you know strengthen the gym or anything like that and that's going to be you know some other markers of health and a bit more reflective of our longevity because women go through metaphors you know in their 40s and 50s we live longer than men.
So really, you you can have over half your life left through this phase. So that's a really significant amount of time. So think thinking a little bit more that long game as well, what's happening there, know, prioritizing your sleep and stress and those extra elements that really can have, you know, added impact in our health.
Jono (24:08.329)
Yeah. Awesome. Cool. No, no, no. No, you got cover all of it. No, that was awesome. Thank you. Again, we get questions. I'm sure you get more than I do, but definitely during Q &As and things, and then with clients, you get lots of questions about this stage of life. But I feel like we've done it. Well, I haven't done it. You've done a very good job of giving us all that information that we need. Of course, if you're...
Kat (24:09.602)
Big summary. Maybe the biggest summary. Yeah.
Jono (24:36.457)
kind of struggling to apply that information. Are we feeling a overwhelmed with the information that's out there? Flick either myself or Kat, probably Kat, a message, ask her some questions, potentially. If you guys feel like you might be a good fit, she'd be able to help you through that time, especially building that nutrition plan. But if we haven't, I'm sure Kat's happy to, I am as well happy to do a part three if there's things we've missed and questions we've missed.
Absolutely let us know if there's other things you'd like us to cover. Otherwise, make sure you're checking out Kat Georgiou. Did I say that right? Yep, cool. We'll link. I won't forget now. Linked in the show notes, you'll find her Instagram. She posts a lot about this sort of stuff over there. Make sure you've checked out the first podcast as well. Again, that'll be on our website. But otherwise, thanks Kat. Thanks so much for chatting to us today and giving us all that information.
Kat (25:11.734)
Yeah, like the fashion brand. That'll make it easy,
Kat (25:31.032)
You're welcome anytime. Bye.
Jono (25:32.693)
Awesome. Cheers. We'll chat to you guys next time. Thank you. Bye.
Episode Links & References
- Weight gain and the menopause: a 5-year prospective study
- Weight Regulation in Menopause
- Effect of menopausal status on body composition and abdominal fat distribution
- Menopause-Associated Lipid Metabolic Disorders and Foods Beneficial for Postmenopausal Women
- Sleep Deprivation: Effects on Weight Loss and Weight Loss Maintenance
- Cycle and hormone changes during perimenopause the key role of ovarian function
- Menopause - WHO Fact Sheet
- Increased visceral fat and decreased energy expenditure during the menopausal transition
- Treatment of Symptoms of the Menopause: An Endocrine Society Clinical Practice Guideline