A very common question I get asked by patients is along the lines of ‘what sort of exercise should I be doing?’ I could talk for hours on this, as there are so many nuances, but I would like to try and outline some key concepts. However the single most important point in my opinion is that whatever you do, at best you should enjoy it, and at worst be neutral about it but do it because you want the benefits. There is absolutely no point trying to commit to and make healthy habits of something you actively dislike! It simply won’t work in the long term, and incorporating something into your routine that you can stick to is no.1 priority.
Increasingly, the evidence for weight / resistance training is getting stronger and stronger (pun intended). If you’re not currently doing anything like this, you really don’t need to be an avid gym goer to take advantage, there are so many ways to get the benefits without setting foot in a gym. Over the last few decades, take a look round any gym, and typically it will be predominantly men doing the weights, whilst women do the cardio.
I would like to tell you the science behind why this needs to change. In the peri-menopause years (let’s say 40-50) women start to lose oestrogen. Oestrogen is a potent hormone when it comes to muscle strength in women, and of course we are all losing muscle from our mid-30s. The decline in oestrogen levels only exacerbates this. Strength training helps to minimise this, but importantly, it’s heavy lifting that helps.
What do I mean by heavy lifting? Imagine any exercise you might do with a weight (and this could vary from a tin of beans for a lady in her 80s to a 30kg dumbbell in a 30 year old athlete). Imagine now that weight was sufficiently heavy that at the most you could do 10 repetitions with good form (which is super-important). Doing 8 repetitions is what a personal trainer would call leaving ‘2 reps in reserve’ and that is what women should aim for. This is far more effective in terms of stimulus to the muscles that for example knocking out 20 repetitions with a light weight.
Please please please do not think this is just for gym-goers and athletes. The vast majority of people can do this, and it has huge benefits!
I wrote last week about the importance of nutrition and its timing around exercise, but let’s get a bit more specific here. For most women, I would recommend about 15g of good quality protein pre-workout for a strength session. After exercise, oxygen consumption will remain elevated for some time and this will aid recovery. If a woman is doing cardio work, I would recommend adding 30g of carbohydrate. This is not a lot, but is hugely beneficial. However, (and this is an important point) the carbs are not there to provide calories for the exercise, they are to stimulate the hypothalamus (brain area). Without this fuel, the brain turns on what is known as catabolism, which causes muscle breakdown, and the very first thing to go is lean muscle mass. This is precisely the thing that women should not lose!!
How about after exercise? I would suggest the following: age 20-40, approx 35g of high quality protein (ideally luceine orientated) to be consumed within 45 minutes. For older women, increase this to 40-60g, because they are more metabolically resistant to food and exercise).
Typically women’s metabolism will get back to baseline within 60 minutes, whereas for men it can take up to 3 hours, meaning women should consume protein in a shorter window after their workout.
For carbs however, men deplete their liver and muscle stores of glycogen (fuel) more quickly than women, and need to replace carbs more quickly. I certainly feel this, and need to eat carbs really quickly after exercise or can start to feel unwell. For women, I would suggest 0.3g/kg of carbohydrate within 2 hours, and remember real food beats supplements for this, as will contain other electrolytes that help you repair and recover better.
I really hope you enjoyed this blog, but more importantly, that you give it some real thought as to how you could take some of this advice and use it in your own live or that of your loved ones. Strength training helps in so many facets of health – mental health, ageing, dementia, heart attacks, strokes, diabetes, cancer….. the list goes on. Doing strength training in the right way, with the right fuel, is such a powerful thing and I really want to encourage you to try.