Middle age and the menopause have been on my mind lately, not least because I turned 44 last year, but also because I’ve been working with colleague Leah Dunthorne on a project aimed at women in midlife and beyond, a group we believe are underrepresented in the fitness space.
There’s no doubt that for us women the menopause can represent a huge change in health and fitness priorities. The associated hormonal changes impact a woman’s life physically, mentally and emotionally, and I’m pleased to see there’s been an increase in women speaking about their experiences in the media of late. In spite of this, there is little out there that meets our needs in an exciting and dynamic way, which is where Leah and I have been banging our heads together to create something more exciting and relevant (more on that later*).
One key exercise related element for peri-menopausal and menopausal women to be aware of is the need for exercise that stimulates maintenance of/improvements in bone density. Just at the time of life when women are often encouraged to take it easy and do a bit of light yoga or Pilates, we actually need to get vigorously active in new and interesting ways. I’m an advocate for both Yoga and Pilates, but we also need to remember that stress is the stimulus for adaption, and if we want to stay strong, maintain our bone health and feel capable and confident as we move past mid-life, then we need to assess what we’re doing and the impact it will have in the light of things changing.
CHANGE
On a personal level too, it feels like a great time for me to check in with myself about my fitness priorities now and going forwards. I’m constantly testing training regimes and movement methods as a way of learning, so this reassessment has given me new focus and helped me to stay motivated.
In fitness as well as in life we can get stuck in old ways of thinking and doing because we are entrenched in habits. For me, although the habit of exercise is one I’ve always kept, the purpose and point of that exercise has evolved with me, as I have evolved as a more complete person. Knowing the why of any goal is important if you are going to stay motivated, and for me there’s no better way to develop than through the constant process of challenging my assumptions and trying new ways of working on myself through exercise.
With this in mind the last six months have been something of an experiment as I move into what I hope will be the healthy and productive middle part of my life. Several of my clients have been interested in my experiences and explorations so I thought I would share and discuss them here for your interest and/or motivation.
BODY COMPOSITION
I’ve been curious about my own bone density for some time, but have never gone as far as getting it assessed or measured. Increasingly, proactive people are assessing their health markers before there is a problem, and private clinics are popping up that allow you to look at where you stand on a number of possible health issues before you move into the dis-ease ranges that would raise the alarm under medical supervision.
Several of my clients have used a service in London called “BodyScan’ – a company that offer dexa scans that assess your body composition by looking at bone density, muscle mass and body fat. Strange though this might sound I decided this would be a great birthday present to myself this summer and booked a slot at BodyScan’s Marylebone clinic. In practice the test simply involves you stripping and stepping into a medical gown to lie on a slab for a few minutes as low level x-rays are passed through your body.
I really didn’t have any expectations going into this test, but what was interesting for me was how the information I gleaned both confirmed some of the things I might have hoped for, and revealed several things that have motivated me to change my own exercise program going forwards.
BONE DENSITY
In relation to bone density I’m aware that you can’t always predict where you might sit on the spectrum. Genetics play quite a significant role, and most bone is laid down in your teens and twenties. Gains in bone density after your 30’s and into later life can be hard earned. I had hoped that my bone density would be pretty good owing to the fact that I include strength work in my training and have been running for the last few years fairly regularly. Both types of exercise are good for bone density, with loaded muscles pulling regularly on bones and the ‘impact’ of the eccentric landing forces associated with running being a known stimulus for density at the hips and spine.
However, my early years were relatively low impact. I swam competitively as a youngster and then switched to cycling as my main sport in my mid-teens. I’m also relatively light, so day in day out I don’t carry a lot of load about, and I’ve noticed that lighter women tend to have lower bone densities for this reason. Cyclists also can be at risk of lower bone density, and anecdotally female cyclists who go on to take up running can be more vulnerable to stress fractures.
My Bone Mineral Density scores put me within the normal range for my age
So the first piece of good news coming from my BodyScan was that my bone density falls within the ‘normal range’ according to their database. Admittedly the data base is compiled of those going in for a scan, but it still offers a snapshot of where you stand in relation to their average, and perhaps more importantly, where you stand relative to your own body as you begin to retest. Certainly my results here were not exceptional and I’d like to be in the ‘light blue’ of the upper ‘normal’ levels, but I think I can be relatively pleased that my pre-menopausal bone density is looking good so far. For those whose numbers look on the lower side here, a more medical grade bone density test is recommended, but this measure is a good initial indicator of where you are.
BODYFAT
There are many different ways to measure body fat including the manual calliper methods and the various electronic scales that claim to give you a body fat percentage too. The dexa scan is a more accurate method of assessment giving you a precise measure of the number of grams of fat in your body rather than a percentage number that can be less accurate.
I’m visibly pretty slim with long light limbs, but I’m aware that I’m not as lean as some people might imagine, and that I tend to carry any bodyfat around my abdomen – something that puts you at greater risk of secondary onset diabetes and certain other health conditions. I was interested to learn more accurately my current body fat, its distribution, and see how it compares to more manual methods of measurement I have intermittently used in the past.
My bodyfat on this first test in July came out as 23.8%, or more accurately 14145 total grams (14.145Kg of fat). This puts me in the healthy but towards leaner category, but as expected that fat distribution is weighted towards my abdomen with an android/gynoid ratio of 0.93.
MUSCLE MASS (LEAN TISSUE)
By general standards I could be called lean, although by ‘endurance athlete’ standards these numbers are very average. For those looking for endurance performance such as runners, cyclists and triathletes, body fat percentages under 20 for a woman are desirable and quite common in trained amateurs. Where power to weight ratios become a determinant of performance there can be an emphasis on weight loss (ideally fat loss) to improve competitiveness. These days I’m in a position that I have nothing particularly to aim at, and increasingly have an eye on broader health markers more than any one dimensional performance measure, so I’m pretty happy with these numbers.
However, I think it’s a good reminder that weight alone doesn’t tell you everything you need to know as you get older. I weigh (to within a Kg) more or less the same as I did when I was 18/19 years old. A lot of people might be proud of that fact, but as we age we may weigh the same on the scales but have a very different body composition. Some endurance athletes who are light may have poor muscle mass and in actual fact not be as ‘lean’ as expected. One thing I want to guard against for myself is becoming what I would call a ‘fat-thin’ person. Someone light and slim with poor muscle mass and a higher than expected amount of bodyfat.
SARCOPENIA
“Sarcopenia” is the term given to muscle wastage that occurs as part of the ageing process and can be one of the reasons people are unaware that their body composition is beginning to change. Potentially you could stay the same weight and have measurably similar limb or trunk circumferences, but actually have lost muscle mass and gained fat.
This process can be offset by the right kinds of exercise, but it’s a concern because loss of muscle mass is directly related to loss of functional strength as well as balance. In fact the three main risk factors for falls in the elderly are low muscle mass, balance, and the number of prescription drugs that person is taking.
So with my body fat within good parameters, what struck me most from my first BodyScan was that my lean mass measures that were fairly average. Since I am average in size I suppose this is to be expected, but the numbers also revealed that my lower body muscle mass was below the BodyScan average. That’s to say that I have less lower body muscle mass than most women doing the test.
On the left the cross section of a healthy young thigh, on the right a sarcopenic thigh from an older person.
THE AEROBIC ANIMAL
On reflection, I suppose I shouldn’t be too surprised at this for a number of reasons. Historically, I’m an endurance athlete and for the defining (early) years of my athletic life that was very much the emphasis of my activities. Even into my 30’s when I took up cycling again semi-seriously, the endurance animal in me dominated, and this type of training will always lead to aerobic efficiency and carrying minimal muscle. In fact muscle gain is undesirable due to the power to weight related reasons I outlined earlier.
More than that the hormonal responses to aerobic vs. strength based activities are diametrically opposed. Aerobic exercise is mostly catabolic in stimulus (breaking down), whilst strength exercise is anabolic (building up). This is one of the reasons I reassure my cyclists and other endurance athletes that 2-3 hours of strength training a week will not lead to increases in muscle mass in the face of 2-3 times the amount of time spent on aerobic exercise.
ISOLATE THEN INTEGRATE
One other element in my training history to consider is that the strength work I have done throughout my career has been very functional in orientation. The focus has been on developing useful strength in compound movements where you use your whole body. This remains the most important type of strength in my opinion, but by its very nature it emphasises movement efficiency across chains of muscles working together, sharing the load so that muscle development per se is not the goal of the program. In a nut shell, bodybuilding is not the name of the game, strength through movement is.
This functional emphasis remains central to my philosophy and way of working, but the results of this BodyScan did get me thinking about whether I could gain muscle mass if I wanted to, and longer term whether I could translate those gains into greater functional strength. ‘Isolate then integrate’ is a principle I understand and work with in view of rehabilitation (or prehabilitation) from injury, so why not work a little bit more like a body builder (whilst maintaining all the big movements) and see what happens.
The timing of this BodyScan in July came at a moment when I had an annoying calf injury too, and I was reminded that I had been running a fair amount without putting in the muscular work needed to support that. So, taken together with the results of the scan I was motivated to prioritise my gym workouts over other activities and make some headway with my muscular fitness. In practice this has meant making sure I get in the gym 2-3 times a week with a more focussed mindset and structured program.
THE RESULTS ARE IN
Five months later and just before Christmas I went back to the clinic for my reassessment. One of the things I was taught in my training was ‘if you’re not assessing, you’re guessing’, and with this in mind part of my reason for the retest was that I really wasn’t 100% confident how things were going. What’s more, as is often the case without review, my motivation was waning. I’d been putting in the work solidly for 5 months and was beginning to struggle to get to the gym, and also I was struggling to recover.
Where I had made rapid progress on the first three months of my plan, moving more weight and feeling stronger, this progress had not been without difficulties. Some of the time I was pushing the boundaries a bit, and I had to modify/change some of the exercises in my plan. I went through a patch where my lower back ached too, and had to figure out and avoid what was aggravating that, whilst still achieving my goal of muscle and strength development.
Furthermore, I have continued to include the other activities that are part of my lifestyle, like swimming a couple of times a week and running a couple of times too since my calf injury recovered. Also, my work with clients is most important to me and sometimes can feel quite physical at the end of the day, so unwilling and unable to become a complete gym rat I wanted to know if what I was doing was enough to see progress.
So it was with no real idea how things were going and what the result would be that I stepped back on the scales and into the scanner on 17th December, just before taking a break for Christmas. The results showed that I had gained 420 grams of muscle mass, but had also gained 678 grams of bodyfat. Knowing that on the scales I weighed about a kilo more than back in the summer it would have been too good to be true to have all that weight be pure muscle, but I was a little disappointed not to have gained more.
A STEAK ON EACH BUTT CHEEK
So, I had made a couple of small steaks. Not bad. But I had also laid down a bit more lard. Not really a disaster either. Interestingly much of my muscular gain was in my ‘trunk’, but on the scan this included my buttocks as part of that core, and my hope was that some of that gain was in my gluts where I had been putting plenty of effort in with squats and deadlifts as well as various isolated curls.
Diet and nutrition are of course an important aspect of any fitness program, but fairly obviously if you are aiming to build muscle you have to eat enough of the right things at the right time to add quality weight to your frame. Many women in mid life are nervous about gaining weight and sometimes don’t eat enough, but I certainly don’t fall into that category.
Rob (the BodyScan advisor) and I discussed the results, and though of course I would have liked to have gained more muscle, I was pleased to see things going in the right direction. Though I would rather not gain body fat in the process, going forwards I’m keen to make some adjustments to my diet to avoid gaining too much more.
CONSISTENCY AND RECOVERY
Importantly we agreed that consistency and a longer term mindset was important as I regroup and progress my program. So often in the New Year people hit a new health and fitness plan so hard that by mid February they are burnt out, and may then slip back to where they were or further. Rob encouraged me to consider how I would feel in another 6 months time if I had gained another 500grams or so of muscle, making a round kilogram for the year.
One of the things we brainstormed together was the issue I was having recovering from one session to the next. I have found in working with my clients that recovery from strength training is hugely variable. Some people can repeatedly load their bodies and recover within the usual 48 hours (unless the loading is unusual), while others (like myself) really feel the soreness impacting on other activities and further training.
For muscle development (or hypertrophy) in particular, volume is one of the key things you need in the program. Put simply, the more you can tolerate the better, but you have to be able to tolerate it, and if you do too much it takes so long to recover that you end up with less volume overall. Put simply, where I had been aiming for three sessions in the gym every week, more often than not I found that I was still so sore from the second session that I dropped the third.
MATHS AND VOLUME
So going forwards my plan will be to limit myself to a maximum of 12 working sets in any session, or closer to 50 minutes in the gym rather than a bit over an hour. My hope is that this will allow me to maintain that third session and try to build a couple more sneaky steaks onto my skinny frame. I intend to moderate the intensity of the sessions a little too, not feeling like I should always be pushing to increase load, but instead focussing on consistency and muscle tension as well as movement control. Taken together I’m hoping that will help me to hit my target of three sessions more often than not through the next 6 months.
As we move towards spring and summer I may want to introduce more running into my program, and it will be interesting to see if this conflicts with wanting to hang onto that extra bit of muscle, or whether I’m able to achieve the holy grail of losing unnecessary fat and maintaining that important muscle mass. I certainly know that only a couple of years ago I was 2-3Kg lighter when I was running more, and now I’m curious how that would have measured up under the scanner, and whether I was any leaner or just had less muscle mass.
Although I may have been lighter for running, I know my body well enough to understand that neglecting the gym work means niggles and injuries can appear when I take my eye off the balance of my program. So now that I’m back running injury free, there’s another reason to stay focussed on my strength and conditioning, even when the weather starts to warm up and the sun starts to shine.
PLOTTING YOUR COURSE
Most people have multiple goals and real life challenges can make training programs a constant work in progress. One thing that none of us can change is that we are all getting older, but we can make sure that we stay in touch with what we need physically as well as mentally and emotionally by reviewing and reassessing our priorities. Not everything in health and fitness is changeable, but knowing where you are has to be the first step in plotting a course for your future.
LadyBones is a project I’m involved in with colleagues Leah Dunthorne and Nancy Staniland specifically aimed at 40+ women. We offer exercise targeting our 4 essential pillars of Bones, Agility, Balance & Strength. To find out more go to our wesbite www.LadyBones.co.uk