Muscles and the menopause - protect your muscle mass and live longer!

Longevity is very much a buzzword of the moment. When it comes to finding ways to increase longevity, there’s always a big focus on obesity and losing fat, but the importance of building and preserving muscle is often overlooked. A lack of skeletal muscle has been referred to as ‘the root cause of disease’, and the simple fact to remember is, the greater your muscle mass, the greater your survivability. This is because having healthy muscle mass reduces your risk of diseases including cardiovascular disease, cancer, dementia, type 2 diabetes and osteoporosis.

But also, what use is longevity unless we have a good quality of life? There's a proven link between the amount of strong, metabolically efficient muscle tissue we have and how well we live, particularly as we age. This is why it’s so important for women in perimenopause and menopause to work on preventing muscle loss and building muscle mass, for healthy ageing.

There’s a common misconception that muscle is simply there to support our skeleton and help us move, or to help us look buff, but it does so much more than that! Muscle has a role in making hormones, reducing inflammation, balancing blood sugar and regulating the immune system – so it’s easy to see how a lack of muscle can be bad news for our health.

Building healthy muscle can have the following benefits:

- Increase basal metabolic rate (to support fat burning and weight loss)

- Increase energy levels

- Decrease inflammation in the body

- Decrease stress hormones

- Decrease risk of heart disease, cancer and dementia

- Prevent sarcopenia (age-related muscle loss) and reduce the risk of falls

- Protect the skeleton and prevent osteoporosis

- Support blood sugar balance to prevent insulin resistance and type 2 diabetes.

What’s the link to menopause?

As we age, our body composition changes, and typically we gain fat and lose muscle as we head through midlife (sound familiar?!) Women start losing skeletal muscle as early as their thirties and menopause accelerates this loss, with women seeing their biggest decrease in muscle mass and strength at this time. This is caused by the loss of testosterone and oestrogen and imbalances between the two hormones, which play a key role in building and maintaining muscle mass. Women often report muscle aches and pains, cramps and stiffness as they head through perimenopause and menopause, as oestrogen levels fluctuate and fall.

There is also the concept of ‘anabolic resistance’, which is a reduced ability to build muscle as we age. This can result in the condition sarcopenia, which is age-related loss of muscle mass and strength, and is associated with increased risk of falls and fractures. Anabolic resistance can start in our 30s or 40s if we don’t do anything to prevent it, but we can overcome it with diet and exercise.

As women enter perimenopause and menopause, they are also at increased risk of insulin resistance and type 2 diabetes. This is because the body becomes less responsive to the hormone insulin and women can’t handle carbohydrates and sugars in the same way as they did when they were younger. Muscle acts like a reservoir to absorb sugar from the bloodstream and store it to use for energy later, preventing blood sugar spikes. As muscle mass decreases, the reservoir gets smaller, resulting in more sugar staying in the blood, leading to higher blood sugar levels, high insulin and insulin resistance. Muscle also needs to be metabolically healthy to be more insulin sensitive and able to take the blood sugar out of the bloodstream.

So, what can we do about it and how do we build metabolically healthy muscle?

1. Eat more protein, the right type of protein and at the right time

2. Do high intensity interval training (HIIT) and resistance training

What is protein?

Protein is one of the three macronutrients, the other two are carbohydrates and fats. Most foods are a combination of these three, to varying amounts. The building blocks of protein are amino acids and that is what protein is broken down to in the process of digestion. The amino acids are then used by the body to build new proteins, depending on what is required: muscle, tendons, bones, cartilage, skin, blood, hair, nails, enzymes, antibodies, hormones, carriers, and much more.

There are 20 amino acids and countless ways of stringing them together to make an almost limitless array of different proteins. Nine of those amino acids are essential, meaning the body cannot make them, we have to take them in via the diet. For this reason, we have to eat protein foods.

A diet low in protein can result in these symptoms:

• A slow metabolism and weight gain

• Trouble losing weight

• Difficulty building muscle mass

• Low energy and fatigue

• Poor concentration and difficulty learning

• Moodiness and mood swings

• Muscle, bone and joint pain

• Blood sugar changes that can lead to diabetes

• Slow wound healing

• Low immunity and susceptibility to colds and infections

How much protein do you need?

Protein requirements are calculated on the basis of body weight and activity level and vary from person to person. However, as a general guide, I advise women in perimenopause and menopause to aim for 1-1.2g protein per kg of body weight (e.g., a woman weighing 10st or 62kgs should aim for between 62-74g protein per day).

Ideally you need 30g protein at the first meal of the day, with 2.5g of the amino acid leucine, to optimise muscle building. After an overnight fast whilst sleeping, your body starts the day in what’s known as a catabolic state, where it has used up all of its energy stores for body processes. High protein at the first meal is therefore really important to flip the switch to building muscle and turning on genes involved in this process.

Here are some approximate protein amounts in foods to use as a guide:

- 1 large egg - 6g

- 1 chicken breast - 31g

- 2 sausages - 13g

- 1 salmon fillet - 25g

- a handful of nuts and seeds - 5g

- 1 thumb of hard cheese - 4g

Is it possible to get enough protein on a vegan diet?

A ‘complete protein’ usually refers to a food that contains all 9 essential amino acids, and most of these are animal foods (meat, fish, seafood, eggs, dairy). There are very few complete proteins in plant foods, but this can be overcome by combining grains with pulses, for example rice and beans, as together these foods supply all essential amino acids.

Whilst it’s possible to meet your protein requirements on a vegan diet, you’ll need to eat more food and a diverse range of plant foods. To help with this, many vegans opt for a protein supplement or vegan protein powder. I know a lot of nutritional therapists don’t like protein powders because they describe them as artificial, but personally I’m a fan. I find adding protein powder to food or a smoothie, whether vegan or not, can really help meet the high protein demand for the first meal of the day.

Resistance and High-Intensity Interval Training (HIIT)

Muscles are made of protein and whilst you need to consume protein to be able to build muscle, you also need to combine it with resistance training. Exercise reconditions muscle tissue, which means it stresses muscle and causes it to break down and then builds up new muscle tissue.

Women in midlife should ideally be doing a combination of cardio training (brisk walking, running, cycling, swimming etc) and resistance training (making your muscles work against a weight or force i.e., weightlifting, resistance bands, yoga, pilates etc.) Also, ideally one day each week of HIIT training (short bursts of high intensity exercise followed by short rest periods), to support fat burning and promote muscle synthesis.

One final note is to take care when exercising in perimenopause and menopause, as oestrogen has an impact on tendons and ligaments, and low levels of oestrogen can increase the risk of injury. It’s a good idea to start slowly and build up. Consider working with a personal trainer, who can produce an effective workout programme for you.