Next Level: How Perimenopausal and Menopausal Women Should Exercise and EatTo
build muscle and maintain body composition for longevity, perimenopausal and
menopausal women need the following four pillars: high-intensity interval
training, heavy resistance training, jump training, and protein.
Sims,
S. T., & Yeager, S. (2022). Next level: Your guide to kicking ass, feeling
great, and crushing goals through menopause and beyond. Rodale.
Dr.
Stacy Sims: Female-Specific Exercise & Nutrition for Health, Performance
& Longevity, Huberman Lab, July 22, 2024.Sources:https://www.drstacysims.com/nextlevelhttps://www.hubermanlab.com/episode/dr-stacy-sims-female-specific-exercise-nutrition-for-health-performance-longevityAlmost
all research on exercise and nutrition has been conducted on men, and
recommendations for women are often inferred from studies on men. However, as
exercise physiologist and nutrition scientist Stacey Sims pointed out in her
TED talk, "Women are Not Small Men." Diets and training methods designed for
men may not be suitable for women, and simply applying male nutrition and
fitness plans does not yield optimal results for women.![]()
Sims focuses on studying female nutrition and exercise performance, examining how
the unique biomechanics and fluctuating hormonal levels in women affect their
bodily functions and athletic performance. Her first book, ROAR, explains the
gender differences in training and nutrition across different life stages and
challenges existing notions about women in exercise, nutrition, and health,
which is more applicable to younger women.![]()
Her second book, Next level: your guide to kicking ass, feeling great, and crushing
goals through menopause and beyond, is aimed at perimenopausal and menopausal
women. It discusses how women should scientifically approach diet and exercise
in response to dramatic hormonal changes to maintain peak condition and enhance
performance.Women's
health, particularly reproductive health, has received considerable attention,
while the health of women over or approaching childbearing age—such as those in
perimenopause, menopause, and postmenopause—has been neglected (CityReads | The
Understudies of Women Health: Menopause). As an important aspect of
perimenopausal and menopausal women's health, exercise and nutrition are also
lacking. I have read Sims' Next Level and listened to Andrew Huberman's
interview with Sims titled "Female-Specific Exercise & Nutrition for
Health, Performance & Longevity," summarizing Sims' recommendations for
improving the health of perimenopausal and menopausal women through exercise
and nutrition and the underlying scientific mechanisms.Why
is the health of perimenopausal and menopausal women important? From a social perspective,
this group is substantial and has significant implications for achieving
healthy aging. According to the Menopause Group of the Obstetrics and
Gynecology Branch of the Chinese Medical Association, the average age of
menopause in Chinese women is 50. Perimenopause is a longer transitional phase
before menopause, which can start as early as 36 and usually begins around 45.
If we consider women aged 45 and above as the perimenopausal，menopausal
and post-menopausal group, data from the 2020 Seventh National Census shows
that there are 303 million women aged 45 and above in China, accounting for
44.1% of the total female population. The total number of women aged 50 and
above in China is 247 million, slightly more than the 239 million men in the
same age group. With the acceleration of aging, the number and proportion of
perimenopausal and menopausal women are expected to continue rising.The Resilient Female AthletesBeing
elderly does not mean being weak. Let's see how female athletes are creating
new achievements in their later years.In
1967, Kathrine Switzer became the first woman to officially register and
receive a bib number for the Boston Marathon. Despite being attacked by race
officials who tried to forcibly remove her from the course and tear off her bib
number when they discovered she was the only female runner, she persevered and
completed the race. As she continued running marathons, Switzer established the
"261 Fearless" organization to actively promote women's marathon
running and played a key role in getting the women's marathon added to the
Olympic Games. In 2017, to mark the 50th anniversary of the first official
female finish at the Boston Marathon, 70-year-old Switzer ran the Boston
Marathon again, finishing only about 24 minutes slower than when she first
competed at age 20.
At
the 2024 Paris Olympics, Kathrine Switzer sounded the starting bell for the
women's marathon.
Gymnast
Oksana Chusovitina began competing in the Olympics at the age of 17 and
continued to compete on the Olympic stage at 49.![]()
Chusovitina
competed in the Tokyo Olympics
Source：https://olympics.com/zh/news/exclusive-oksana-chusovitina-la-2028-goal-interview![]()
At
the Paris Olympics, 61-year-old Ni Xia Lian defeated a Turkish player in the
first round of the women's singles table tennis event, making her the oldest
winner in Olympic table tennis history.
Source:
https://m.thepaper.cn/newsDetail_forward_28258161![]()
58-year-old
Chilean player, Zhiying Zeng, competed in the women's singles table tennis
preliminary rounds at the Paris Olympics.
Source:
https://sports.xinhuanet.com/20240728/6cf7f193774d4e6fab1168449af6755b/c.html![]()
Fifty-three-year-old
cyclist Rebecca Rusch, 7 world champions
Source:
https://www.rebeccarusch.com/![]()
In
2021, 52-year-old ultra-endurance cyclist Leah Goldstein became the 1st female
ever to WIN the overall SOLO division of the gruelling Race Across America.
Source:https://leahgoldstein.com/unlocking-your-endurance-potential-the-gift-of-hard-work/![]()
In
2013, 64-year-old Diana Nyad, after several failed attempts, succeeded in her
fifth try by swimming 110 miles from Cuba to Florida without a shark cage. Nyad
became the first person to achieve this feat.
Source：https://diananyad.com/the-cuba-swimThese
outstanding female athletes have set strong and inspiring examples for a new
generation of older women. For ordinary people, maintaining health through
scientific exercise and nutrition can lead to an independent and active life in
old age.Contrary
to the common belief that older women should slow down and engage in gentle
exercise, Dr. Sims advocates for perimenopausal and menopausal women to avoid
moderate-intensity exercise and instead polarize their workouts by combining
high-intensity training with low-intensity recovery. Dr. Sims highlights three
key exercise pillars suitable for perimenopausal and menopausal women:
high-intensity interval training, strength (resistance) training, and jump
training, which help improve body composition, metabolism, insulin resistance,
brain health, and reduce cortisol levels.Why doing high-intensity interval training?Perimenopausal
and menopausal women should not slow down their exercise; on the contrary, they
need sprint training.In
high-intensity interval training (HIIT), short bursts of intense exercise are
alternated with relatively short recovery periods. Any activity that raises
your heart rate to over 85% of your maximum heart rate is considered
high-intensity. As you enter menopause, incorporating the shortest and most
intense form of HIIT—sprint interval training (SIT)—is crucial. As the name
suggests, SIT involves ultra-short bouts of exercise, lasting 10 to 30 seconds.
These are highly beneficial for perimenopausal and postmenopausal women.Although
sprint interval training (SIT) is challenging, it greatly benefits both
physical and mental health. One of the biggest advantages of SIT is its ability
to improve body composition by increasing lean muscle mass and reducing fat in
a relatively short amount of time. It is particularly effective at lowering
abdominal and visceral fat levels without requiring changes to your diet.SIT
strengthens and increases the number of mitochondria in your body, improving
insulin sensitivity and lowering fasting blood glucose levels, which is
beneficial for cardiovascular and metabolic health. It also promotes the secretion
of more human growth hormone (HGH), increases testosterone levels, reduces
estrone (a less desirable form of estrogen produced by fat tissue), and
counteracts the effects of cortisol. As a result, cortisol decreases, leading
to lower overall stress levels. With reduced cortisol, the stimulus for body
fat accumulation is also minimized. Pushing your body to its limits during SIT
also stimulates vascular endothelial growth factor, making your blood vessels
more responsive. This not only improves athletic performance and blood pressure
but also enhances overall cardiovascular health and reduces hot flashes.How to do high-intensity interval training: You can
perform up to three sessions of HIIT per week, but be sure to give your body
sufficient recovery time. Generally, two sessions per week are sufficient. If
you're particularly busy, you can reduce it to one session per week to maintain
good conditioning.Muscle
is your engine. It determines whether you can live an independent and active
life. However, muscle is highly susceptible to loss during the menopausal
transition. While everyone naturally loses some strength and muscle with age,
with proper resistance/strength training, you can rebuild and maintain more
muscle.Dr.
Sims emphasizes that menopausal women shouldn’t just do strength training—they
should do heavy strength training. Women often tend to use lighter weights for
high repetitions, such as lifting a 5-pound dumbbell 20 times. Trainers often
refer to this as "sculpturing," promising that women can "tone"
without "bulking up." This mindset needs to change because it is
misleading and particularly unhelpful for menopausal women. This type of
training only builds muscle endurance, but at this stage, you need muscle
strength more.Another
common method is using moderate weights for 10 to 12 repetitions. When you
train in this range, tiny tears occur in the muscle fibers, and your body
repairs these tears by adding more material, making the muscles bigger. This type
of training can increase the amount of lean muscle, which isn’t inherently bad,
but it won’t truly stimulate satellite cells or replace the muscle and strength
gains lost with the reduction of estrogen.True
strength growth lies in increasing the maximum force your muscles can produce
in a single contraction—that is, the weight you can lift or move in one effort.
To improve this, you need to lift heavy enough weights.How to do heavy lifting: Dr. Sims explains that
while the key to strength training for younger individuals is training to
failure, for menopausal women, the key is lifting heavy.Heavy
lifting is defined as performing six or fewer repetitions with as much weight
as possible.You
should reserve heavy strength training for big compound movements like squats,
deadlifts, and bench presses, which distribute the load across multiple large
muscle groups.Heavy
lifting doesn’t happen overnight. If you’re a beginner, it may take several
months to gradually increase the load. You can start with moderate loads,
performing two to three sets of eight to fifteen repetitions to build a
foundation and muscular endurance. After four to six weeks, you can gradually
increase the weight and decrease the repetitions, aiming for five sets of five
repetitions. When that becomes comfortable, you can adjust your goal to four to
six sets of three to five repetitions.Ideally,
you should be lifting two to three times a week.Plyometric training (also known as jump training)The
key to jump training lies in impact. Jump training involves activities like
jumping, hopping on one foot, and bounding, which involve jumping against
gravity and landing back down, providing additional stimulation to bones and
muscles.Jump
training has a significantly positive effect on strengthening muscles and
increasing bone density.First,
in the absence of estrogen, the body needs intense stimulation to compensate,
thereby maintaining the strength of muscle fibers and their ability to contract
quickly and powerfully. This is where jump training comes into play.Second,
estrogen plays a crucial role in bone development and maintaining bone density.
In the first five to seven years after menopause, women may experience up to a
20% decrease in bone density due to declining estrogen levels. While
resistance/strength training helps improve bone density, to truly enhance your
bones, you need to jump. Jumping in different directions generates stronger
impact forces and sends signals to the bones, prompting them to regenerate and
increase in strength to cope with these stresses.A
2015 study found that just 10 to 20 jumps a day significantly improved hip bone
density after 16 weeks.Therefore,
peri- and postmenopausal women should incorporate jump training to strengthen
their muscles and bone.How to do jump training: It’s important to
gradually and progressively incorporate jump training into your training routine.
Just 10 minutes of jump training three times a week is sufficient. You can add
a short jump training session after your strength training.![]()
Source:
https://foreverfitscience.com/programs/plyometric-training-exercises-agility/Nutrition for perimenopausal and menopausal womenIn
general, you’ll be eating a little less carbohydrate and a little more protein
and fat than you might have in your younger years. As the chart shows, your
needs change with activity. But at the very minimum, on a totally sedentary
day, your macronutrients should look like this:Carbohydrates:
2 grams per kilogram of body weight
Protein:
1.8 to 2 grams per kilogram of body weight, distributed evenly throughout meals
Fat:
1+ grams per kilogram of body weightAs
you increase your activity from a light day with easy exercise (walking, yoga,
or mobility work) to a day with a moderate level of activity (a HIIT session or
one to two hours of cardio) to a heavy day (two-a-day sessions, more than two
and a half hours of hard cardio, or more than four hours of any cardio), your
energy needs go up in tandem with your activity level. Most of the time, women
fall into that moderate activity category, for which they need each day, on
average, 3 grams of carbohydrates per kilogram of body weight; 2 to 2.2 grams
of protein per kilogram of body weight; and 1.2 grams of fat per kilogram of
body weight.Half
of every meal should be a variety of colorful fruits and vegetables. Think of
these as the base of your meals. A quarter of your meal should come from
protein foods, so any kind of lean meat like bison or organic beef, chicken,
and fish; a mix of beans; tofu or tempeh; and/or eggs. The final quarter should
be your whole grains and starches. Again, look to make these as fiber- and
nutrient-dense as possible, so emphasize sprouted brown rice, black rice,
quinoa, sprouted grain bread, and bean- or pulse-based pasta.![]()
In
a nutshell, in order to build muscle and maintain body composition for
longevity, perimenopausal and menopausal women need the following four pillars:high-intensity interval training, heavy resistance training, jump training, and
protein.
1."…a
refocus on muscle as the fountain of youth…it's neither a fantastical elixir
nor a miraculous curative. But muscle can still be a magic pill for
transforming health outcomes. And fortunately, muscle also happens to be the
only organ over which we can voluntarily exert control."— Gabrielle
Lyon, Forever Strong: A New, Science-Based Strategy for Aging Well![]()
2."Which
does more damage, losing muscle or gaining fat? The answer is losing muscle.…People
with less muscle mass have lower rates of survival from nearly all diseases.
During times of infection, physical trauma, and cancer, the human body requires
a significant influx of amino acids. The body sources these from its own amino
acid reservoirs: muscle tissue. The more high-quality muscle tissue you have to
draw from, the longer you can survive." — Gabrielle Lyon, Forever
Strong: A New, Science-Based Strategy for Aging Well
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