Exercise: how to stay active and strong in menopause and beyond, with Matt Roberts

Joining Dr Louise on this week’s podcast is Matt Roberts, one of Britain’s foremost fitness experts and personal training pioneer. Matt opened Europe’s first exclusively personal training gym in 1996, is a bestselling author and is responsible for honing some of the most famous physiques in fashion, sport, film, music and politics.

In this episode, Matt and Dr Louise discuss the importance of strength training, cardio and mobility exercise for health span, as well as some of the key barriers to exercise during perimenopause and menopause –  and how to overcome them.

Finally, Matt offers advice on getting into good habits during menopause, whether you are already active or haven’t exercised for a while.

Find out more about Matt at www.mattroberts.co.uk and follow him on Instagram @mattroberts_lifestyle

Click here for more about Newson Health.

Transcript

Dr Louise Newson: [00:00:11] Hello. I’m Dr louise Newson. I’m a GP and menopause specialist, and I’m also the founder of the Newson Health Menopause and Wellbeing Centre here in Stratford upon Avon. I’m also the founder of the free balance app. Each week on my podcast, join me and my special guests where we discuss all things perimenopause and menopause. We talk about the latest research, bust myths on menopause, symptoms and treatments and often share moving and always inspirational personal stories. This podcast is brought to you by the Newson Health Group, which has clinics across the UK dedicated to providing individualised perimenopause and menopause care for all women. So my podcast today, I’m delighted to introduce to you Matt Roberts, who some of you will know and some of you might not. I’ve actually stalked him from afar for many years, actually, watching him long time ago, actually, when personal trainers weren’t quite such a thing, looking at him in various media, sort of newspapers showing how to do very simple exercises, making it look very simple, but very effective as well. And I was very honoured to be introduced him recently, a longevity event. And so now I’ve hoiked him on for my podcast. So it’s a very exciting day for me. So welcome, Matt. Thanks for coming today. [00:01:39][88.3]

Matt Roberts: [00:01:40] Well, thank you. It’s a pleasure to be on. And likewise. I’ve kind of watched all the work you’ve been doing from distance, and it’s an area that is, it has a natural follow on with what I do. And increasingly hormone health overall, this kind of crossover between what’s the fitness and the health and training community do or should be doing is sort of quasi medical, there’s more crossover, more understanding. Yeah, certainly I’ve been doing for a long time, I’ve been doing this for my own 30 years. I’m 51 years old and I set up my first club when I was 22 years old. And from day one it was always about data and there wasn’t much data you could gather at that point in time. But it was very much in my core thinking that it needs to be that we could analyse individuals in a really precise way. And I always had teams of doctors, medics that we consulted with and dieticians and less so hormone specialists at the very start, I have to say it was much more of a thing in the last maybe 15, 20 years we became able to actually really use the data and understanding in a much better way whether that was because of us, whether that was because of the general kind of community understanding. I don’t know where we are now is where I think I always envisaged it should be, is that we have this really interesting, great merging of a whole range of skill sets with our liver specialists that we have on site and our dieticians on site, physios on site and osteopaths. So we consult with homeless specialists like yourself. And it’s something which it’s a really nice place to be, I think, between what medicine and the fitness world are doing, which isn’t in all cases, by the way. It’s very much, I think, in the upper end of it by doing a good job of understanding bodies better. And I think it’s important as well as I stress that, you know, looking at fitness and health, while inevitably fitness is always linked into the body beautiful and building up muscle mass and having a certain shape and being a certain size, it’s not how I view it. I mean, I view that as being the good end by-product of what we do. And what we do is always make sure our body is super healthy and we focus on the wellness end of things. I’d say certainly over the last several years in particular, we really have skewed the business towards being a health span business. And I say health span perhaps as opposed to just longevity. I don’t think we can necessarily extend our longevity from what we do per se, and lots of other interventions can do. What we do is make sure that, you know, individuals function in a way that means they can be unbelievably active, whether they are 35 years old or 95 years old. And yeah, for me, being now 51 years old, my goal when I turned 30 years old, because you stupidly when you’re in your 20s, you think you’re getting old when you’re 29 years old, 30s going to hit and you’re an old person. And I said, Well, I’m going to hit 30 in the same shape and health and wellbeing as when I was 20 years old and because I was an athlete in my teen years, I was a sprinter. There was lots of data collection that I had. So I could actually quite easily look at some metrics around where I was at being 30 compared to being 20 and I was bang on the same, same levels of body fat and blood pressure and blood data and speed and power and so on. So roll forward to ten years ago got to being 39, well, I need to be in the same shape when I’m 40, as when I was 30, and therefore when I was 20 and the same happened at 50 as well. And with all the metrics I got, my data hasn’t shifted. I’m within a fraction the same body percentage, within a fraction the same weight. But it’s not because things just stay the same. You got to work on changing as you change and changing as you age because no doubt at all that if you sit and you’re complacent and you do nothing, you age. It takes consistent work and it takes the understanding of how to use rest and how to understand blood data, how to understand how you view to changes and all of these things. It takes real diligence in doing it. So we’re like a guinea pig to myself over how to ensure we can get the best results. And so for my client base people that you like yourself who see things that I write about in the press do. I try to take things that have complicated science backgrounds and simplify them and make sure it’s case of, okay, what can we actually do? What’s the real things as proper take homes on this? [00:05:43][242.8]

Dr Louise Newson: [00:05:43] And it’s so important. So when I was at medical school many years ago in the late 80s, we didn’t really learn much about exercise at all. And I’m active, but I’m not like, I’m not a runner, I’m not sprinter. I’ve always cycled like as a student, I cycled everywhere because it was so much cheaper than getting the bus or public transport or whatever. And so I was sort of fit just because I was, I even was cycling out to nightclubs sometimes. I didn’t really drink much and it was just easy. And then I would do pop aerobics or step aerobics. You know, that was a really big thing in the 80s and 90s. But that was just my choice. But actually, as a medical student undergraduate, I didn’t really know much about muscles. I didn’t know muscles produced chemicals that were really beneficial. I just thought they were there to move our arms and legs really, literally. I knew a lot about the anatomy, but not about the physiology of muscles. Knew a little bit about bones that they’re metabolically active. But, you know, fast forward 30 years. Obviously, my knowledge is very different because I have self taught. But you’re absolutely right. It’s about how we look after ourselves and keep well. And I think I’m fitter now than I was as a medical student in a different way. You know, just I do a lot of yoga and I’m physically stronger, but actually that helps me to be mentally stronger. And, you know, I still could fit into my wedding dress. And I’ve been married 25 years. You know, quite a few people in their 50s, I’m 54, probably don’t fit. And I, you know, my wedding dress was fitted, but it’s very important that we think about exercise and I think in very different ways because I have patients who are extreme athletes, that’s fine. I have other people that literally find it very difficult to get up from the sofa. And these are often women in their 70s and 80s that haven’t really done much exercise and it’s catching up with them. They have this sarcopenia loss of muscle mass. They might have some osteoporosis, they have muscle and joint pain. They are more exhausted. They might have some urinary incontinence or urgency. Even just getting out of a chair to go to the toilet is massive. And so I think often when you’re young and fit, you could never imagine being that old woman in a chair unable to get up to the toilet. Whereas one of the things that keeps me exercising is like, I don’t want to be that woman. I don’t want to run marathons because I’ll never be able to, well unless I gave up my job and had loads of time or whatever. But I really, really want to be able to get up without a Zimmer frame, not be in a nursing home. And that’s where you’re talking about is health span I think is important because so often you can zone out with personal trainers or extreme athletes thinking, I’m never going to be that person. And one of the things I’ve always liked about your work is you simplify it. So you… it’s something for everybody. And I think that’s really important, isn’t it? [00:08:35][172.1]

Matt Roberts: [00:08:36] Yeah, it is. I think that’s, you know, 99.9, 9% of people and that’s going to be another thing. So you want to focus the work you’re doing not on the 0.01%. Initially it’s focusing on the broad masses of what can we all do to make sure that we have this ability to stay younger for longer. Frankly, that’s the goal isn’t it? It’s retaining as much of the youth and the vitality and vibrance as you possibly can and within that there you feel well, and we have to remember that when someone starts to exercise, whether they have done something before or have not, the percentage growth they can get in muscle size, strength, strength in particular is the same. So if someone has the same inputs in relative terms to their fitness ability, the return they get on that time investment is the same percentage change. So this idea did maybe it’s too late for me or I can’t do it now. I’m too old. I’ve never done it before, is wrong. Whatever you do, you gain. And in fact, actually it’s more chance of you gaining a say, a higher percentage when you haven’t done before with a lower base. Now, clearly the strength changes as percentages are different. If you’ve got high strength to start with or low strength to start with, a percentage of the difference, you going to feel the difference irrespective. And with that difference, with that change in the strength, you get a an absolutely linear response in terms of your mobility. So you’re right to say people struggle to get out of their chair. And that’s a horrifying thought that you actually unaided can’t stand up because that’s when things are starting to slow down dramatically and you start to get secondary illnesses and various issues alongside that. So we’ve got to have that raw basic of what are the functional patterns and movements that you need in your life to not be at risk. And as someone gets older, the problem with sarcopenia is something which is not to do with size or anything else. It’s to do with the risk of falling. So if you haven’t got muscle strength in your glutes and your hips and mobility is poor, you stiffen. But because you sat still for too long, your chance of tripping, falling, damaging the bones is much higher. Combined, of course, with the effects for a female of the menopause on bone health, the effects of not exercising on reduced bone density and health, all of the things that we do that are strength based are all positive for making sure you’ve got greater mobility, greater stability, greater bone density and the risk someone having an issue when they’re 65 and that break of the hip where the mortality rate just go skyrocketing goes away and it’s really about what can you do. And it’s very much that person whose sat in that chair who can’t get up. Well, just put four or five cushions, two cushions on the edge of the chair and just stand up and just literally bend your knees. You can just touch a cushion so your knees aren’t going to go fully down and do it multiple times. Small range of motion squats as an example, and do that for 12, 15, whatever the number might be, 20, 25 reps. So it gives you that chance of re-engaging those muscles. And these are basic basic things that can be done and you get that butt to be stronger the quads, the thighs to be stronger and the amount of stability and strength it gives you in the core key areas is massive and it’s that kind of thing. You just haven’t got to be going to the gym necessarily. Great if you can and you do. But what can you do around your environment to make sure you’ve got the test that you need? We we have to keep testing. And like I said with myself, I mean, as time goes by, what’s noticeable with anybody, anybody is it takes the same amount of work. You get the same gain because I haven’t slipped anywhere, but the rate of which can fall backwards increases, so your retention of muscle strength goes more quickly. It takes an ongoing, diligent approach to ensure you stay on top of it so it can be done and it can be simple. And it does take just this idea of I am a person can do this. You can actually lose track of the idea of It’s not me, that’s not what I am. Well, imagine that you are. Imagine it is. Imagine you are that person. You could do the activities. Imagine that you are the person who is active, and then you have that mindset of I can actually feel as though I’ve got control of me, of my life. [00:12:37][240.5]

Dr Louise Newson: [00:12:38] It’s so easy. I think you’re right to be on that slippery slope. So I’ve had a viral infection over the weekend and so I haven’t done any yoga for three days. For me, that’s quite a long time, at the weekend I tend to a longer practice as well. But I just haven’t felt and it was probably the right thing to rest my body. But it would be very easy to forget that I’ve ever done yoga and not do it. But I know that if I left it a longer period of time, it would just be so much harder to get back into, and I end my yoga practice with a headstand and I very proud of being able to do headstands. But I do sometimes think, God, if I didn’t keep doing it, most days I wonder how long it would take for me to not be able to do a headstand. And it’s a bit of an internal sort of thing, but that’s just a mark of anything like just doing bending down and touching my toes. I can do that very easily because I do it a lot, but it wouldn’t take long at 54 to stiffen up. And that’s where it’s so easy or it’s easy to continue. But then there’s people my age who go, Well, that’s ridiculous Louise, I will never be able to do a headstand, I will never be able to touch my toes. No, but you will be able to walk up the stairs a bit quicker. You will be able to run for the bus. You will be able to walk up the escalator rather than just waiting for it to take you up. And it’s harder, isn’t it, to start, I think when you’ve let bad habit sort of slip and not do as much exercise. [00:14:01][83.1]

Matt Roberts: [00:14:02] It’s human nature to find a shortcut. It’s human nature to find a work around. It’s human nature to go for the comfy option. And we are very guilty of that now because we have the ability to make our lives very comfortable, very warm, very cosy, and not have to exert very much at all. We have to remember what the body is designed to do, the slip off rate if someone stops doing something per your point is that if you do nothing, nothing, nothing for two weeks, nothing really changes. You don’t lose anything at all. It’s a minimal percentage drop in your strength growing year over year to capacity, your heart, lung capacity and strength. Four weeks, it starts to slide. You might lose maybe 5,10%. After eight weeks, you drop off a cliff, you pretty much lose all that you’ve done in the previous six months. All of your fitness work, all effort you put into it. You lose all of it in eight weeks. So you’ve got to stay on it. You have this window, you can get away with, getting a virus and being unwell, it doesn’t make any difference. You feel like it has, but in reality, you’re okay. You can get away with being on a business trip somewhere because you have no time to exercise for two days. No problem. If you decide suddenly just because you forget you need to or you lose the urge to exercise and move and be healthy, eight weeks and you’re back to where you were at the very start of your programme. The longer you’ve been active for many years, you might get a bit of an increase in duration of that, but you still have a huge drop in your capacity and your fitness. So we’ve got to yes, got to stay very, very consistently. Consistency is the key. It’s not necessarily about hitting the high, it’s being consistent all the time. If there was one thing, I mean, effectively there’s one facet of fitness, which is probably the most important thing that anybody must be focusing on. And it’s one that for most, for a lot of females, they tend to avoid the most, which is strength work, strength work is the mainstay of our hormone health. It’s a mainstay of our bone health. It’s a mainstay of our ability to actually physically function and move, without muscle strength our skeleton can’t hold up. It’s a mainstay of all that we are as a being. Without that, we wouldn’t be anything at all. Increasing your strength, I do mean strength rather than size, there’s two very different elements in how we train muscle. We don’t want mass. What we want is highly activated, very strong tissue, which is functioning and able to keep doing all that you need to do and more. And that’s the high metabolising tissue as well. That will burn energy. That should be the the one thing you must, must do. The second thing, is probably quite equal. Second first, in a way, is doing zone two cardio training. So zone two cardio is that thing you must do every other day, four days a week of constant pace. It’s for most people, a fast walk or it’s say, sat in a bike in your gym, ticking along for 40 minutes. It needs to be one speed, one intensity, one pace and it should feel as though we’re having a conversation now and it’s fine. Should feel like we can have this conversation, but we are pushing ourselves a bit harder. Bit breathless. Heart rate’s about roughly 70% of your maximum capability. So it’s definitely overloading, you’re getting slightly sweaty, but you’re not exhausted and it’s sustainable for that 40 minutes. The reason why that’s important is what we’re looking for always is really good mitochondrial health. So mitochondria are the, they decide how cells kind of use energy in a way. So they decide how we utilise fatty acids. That’s how we utilise glycogen sugar and if they’re functioning badly we tend to a propensity towards using up, burning up more glycogen or sugars than we do fatty acids. These are marginal differences, but our insulin resistance then gets tweaked and adjusted and that causes problems. And we’ve got to train our bodies to become very efficient and zone two cardio, this sustained 40 minute spell without changing the intensity. Whether it’s walking or biting. Biking is great. It’s very sustainable, gives you very rapidly a very strong, healthy mitochondrial capability and your body gets very efficient and starts being able to really get used to that burn away and much more fatty acid as an energy source than it does sugar. So you’ve got to do those, those two things are your mainstays to focus on. There’s a whole bunch of other things as well actually, but those are the two things that you want to get right and how we use cardiovascular training, how we vary using cardio work to create cardio strength is different again, that’s interval training. How we give you muscle size if you want it is different again. That’s a very specific training programme, an eating programme to gain mass. In the main, it’s about giving you exercises that give you direct strength and off the bat to give you an idea of the numbers with this, when someone’s going to the gym or doing workouts at home, the amount of reps that you do defines your intensity. So if you can do a an exercise that you can do for around really 8 to 12 reps, that’s in the strength gain zone, you’re unlikely to build up a whole lot of size doing that kind of range. Eight reps. So with that you get really therefore high loading to be heavy enough that you couldn’t lift it more than eight times. That’s a heavy weight and we don’t want a weight that’s light that you do 12, 15, 20 times if you’re looking to try and create strength, gives you probably some strength, endurance, that’s different. We’re looking for direct, pure strength. Now, that means doing a pretty heavy loading when you’re doing a squat with some weights in your hands to the side maybe, or a bar in your shoulders or leg press machine in the gym. It means working up to a level. I wouldn’t say jump straight into this, by the way. You’ve got to work up to that level over some time and at that level where you’re doing 8 or 10 reps, you build such a huge degree of strength and you test the muscles and that’s where the tendons on the muscles and the tendons attached to the bones, you create really good bone density build and this gives everyone phenomenal abilities to burn away calories. It gives you a really amazing change in your glycogen usage and your insulin resistance. It gives you a far better use of sugar and your chances of becoming pre-diabetic are lessened if your muscles get stronger and utilise that programme more quickly. So it’s a must go to, it’s the thing you have to do to ensure we have functional strength, we’ve got therefore hormonal strength for guys who are listening as well. If you want to get some testosterone going and this is a big problem, you know the data on testosterone in males, it’s horrifying. The levels of this generation are less than their fathers before, and less than their fathers before them, which I think is horrifying. Staggering. We’re seeing that with male sperm counts as well. You know, 50% drop in some studies over a 40 year period. I mean, bad data, this is all based on us as human beings, not challenging ourselves in the same way as we need to. And females absolutely need to be physically challenged, need to be pushed. I think that we’ve got to focus on having a box ticking exercise. So in the course of a week in your programming, what do you need to do? We want to work on fundamentally strength first. Cardio fitness, second equal first. Mobility within that mix as well, some way of calming the system too. So within that, what are you going to choose to do? So for strength side, you kind of got to go to the gym, or you’ve got to have some weights at home and do some really big overload. The cardio you can work into a programme and think about if you go to do cardio, how does that work? If you’ve got a dog, well you’re doing it already, you walk in the dog. Are you walking fast enough with the dog to get your heart level to the level it needs to be? We can check it out. You find out, you can do a manual check or get a wearable. I wear a whoop device on my wrist, and look at your data. With the mobility work you do yoga. Yoga’s great example of a thing which is very, very good for us in lots of ways. Mobility, for flexibility, it’s good mentally as well. But it won’t take the box on the strength or on the cardio side and all data shows that as well. We need to do lots of stretching mobility work, but again, it’s not going to give you what you need for stretch, so if you’re choosing your week of workouts and I’d sort of would point towards people perhaps who focus on doing a lot of sessions and yoga sessions and so on and they’re working out. It’s great, but it’s not enough. We need to test you and challenge you and do those things because they’re also great, but they’re not the mainstay. So how you construct your week is about let’s get the box ticking done. Over, we have to do these things over here and the rest you can enjoy because you might not enjoy the weight training, but if you don’t enjoy and say well I don’t enjoy it, I’m not going to do it, that’s fine. But you are probably going to have some issues with the bones and with the hormones and with the muscle structure and shape as time goes by. So there’s a degree of let’s find the things you like to do, but let’s make sure we tick the boxes on and do you do the things you had to do as well. [00:22:38][515.8]

Dr Louise Newson: [00:22:39] Yeah, it’s so important. And it’s the a lot of it doesn’t take that much time. You know, I’ve got free weights at home, which makes it a lot easier so I don’t have to factor in, if I factored in going to a gym, coming home from a gym. That’s probably as long as it is to actually do the exercise. And so it’s very easy to take, make the excuses, you know, depending on, you know, I’m quite happy exercising on my own. I don’t need to be surrounded by other people, whereas other people do need that motivation. But it’s having something that definitely is varied that’s right for you. And, you know, one of the things I see a lot in the clinic is women who are fit and active, but then their fitness falls off a cliff because their hormones drop. And it’s very easy to say to a hormonal woman, you just need to exercise and then you’ll be better. But actually, these women and I found eight years ago when I was perimenopausal, I stopped exercising because I had such muscle and joint pain. I had reduced stamina. I had loss of muscle strength as well. And I knew I was putting on weight, especially in my midline. And so tell me, oh of course, just exercise. Actually I couldn’t physically and I found it really hard. But we know that all three hormones, oestrogen, progesterone, testosterone build muscle as well as bones. But I’m very interested in mitochondrial function. So as you’ve already mentioned, the mitochondria, the powerhouse of all the cells, we have receptors for oestradiol, which is a nice form of oestrogen, progesterone, testosterone on every single mitochondria. There’s a good study showing that our mitochondria work better, especially with respect to sarcopenia and bone strength in the presence of hormones. And so it’s a combination. Obviously our muscles will produce hormones as well as our brain and our ovaries. But it’s that whole thing so often people are told, well, if you exercise, you’ll feel better, but they’re not addressing the hormones. And, you know, hormone prescribing is half of what it was 20 years ago. And no wonder that people are less fit, more obese because, you know, it’s trying to run a car without diesel or oil or whatever, it doesn’t matter, or electricity, depending on your car. But it’s very hard. You’ve got to be looking and, you know, you mentioned about what we eat is crucially important. So many women I speak to aren’t having enough protein. They think they’re eating well, but they’re not. And then they haven’t got hormones, but they’re still trying to exercise and then they end up feeling like failures. And it’s no surprise. And that’s where your work is so important as well, because it’s looking throughout, it’s looking at every single factor. Whereas I think so often you can just be siloed thinking hormones are going to control everything or exercise is going to improve everything. And of course it’s not. It’s a combination, isn’t it? [00:25:23][164.1]

Matt Roberts: [00:25:24] Yeah. So a few points there, absolutely. I think that firstly with the point of when someone is going through perimenopause, menopause and they don’t feel like being physically active, damn right you don’t. I mean, it’s something which is as a male, it’s only an understanding. looking at someone gives me symptomatic feedback. You can see why someone would not feel like doing a great deal. And the answer to that is your pick and choose your moments because some days are better than others. On those days when you feel good, fine use that day. That’s great. And the days when you just don’t feel like that, there’s no way you can push yourself and you’ve got to choose the things on those days that will make you feel a sense of personal wellbeing, personal satisfaction. Feeling whether you want to get some increase in vitality, get some calm, find some time, whatever the thing might be. You find your exercise and your routine to suit that thing. But on those days when you can do something, then you know make the most of that moment. But it might be they’re one in ten or it could be one or two. And that will vary enormously. The prescription of hormones. It’s a minefield, I think something which, you know, you’re a huge expert in this area and one thing from a point of view of me working with clients who go to see specialists is there’s still a great deal of uncertainty over people wait, and they kind of do it without, Can I sort of find another way? Is there a way to do it naturally? And so on and the answer in I think most cases is there’s not. I think that there needs to be intervention. And that’s where the regular testing, the regular consultation, the regular updates and symptomatic checks are vital and there needs to be constant adjustments. I think that the, from my point of view, a way to keep on just micro adjusting over extended periods seems to make absolute sense in response to symptoms, in response to things that we see with performance in people, their ability to be energised in their workouts, in their life, how they’re sleeping, all these things. If you’re sleep is out clearly you can’t do anything. You’re knackered. So the intervention with hormones is vital for males as well as women. So females obviously have much more time, with males. You know, TRT is without question is a huge and positive intervention for lots of males. We’re seeing some new data on males that, as we know personally in our testing in the clubs, but broadly is poor. So we have to have that and combined with that right now, the issue we have increasingly with females who are going through the menopause is the concern over the weight gain, has… point whether they’re using Ozempic and Wegovy and Mounjaro to try to lose weight and it’s just fighting with the wrong tool. And I think they’re an interesting medication, I think they have a place clearly. I think they have some great upsides when used phenomenally tightly within a brief at a low dose, there’s a good chance it gives people weight loss only if they’re doing a very specific strength training programme and only if, as you said, their protein intake is high enough to sustain themselves and their muscle. Otherwise it’s a one way street downwards. And I suspect and I’d love to get your feedback on how much that increased use of the GLP-1 agitators which these products are, is affecting hormone health. It must be surely? [00:28:34][190.2]

Dr Louise Newson: [00:28:34] Yeah. I actually don’t prescribe them and I’m too concerned about the long term risks actually that I wouldn’t be rushing and prescribing them. They probably do have a role, but I’m more concerned about or more interested in prevention actually. But also a lot of women, when they have their hormones optimised, all three hormones actually can really make a difference because obviously menopause is a cardio metabolic problem. People’s metabolism changes. But a lot of people, if they don’t have adequate oestradiol, that active nice form of oestrogen, they’ll produce more oestrone in their body and the fat cells produce oestrone as well as all sorts of other inflammatory cytokines, chemicals. And you know, oestrone is not good, but it’s made in fat cells so people then put on weight because they’re producing more fat. And so I’ll often work very hard with patients to optimise their hormones properly in a physiological way. Think about how they exercise, really look at their nutrition, even, you know, looking at their sleep and mental health, because that can make a difference to their metabolism as well. And then weight because it can take three to six months to really have an effect. [00:29:45][70.3]

Matt Roberts: [00:29:45] Yeah. [00:29:45][0.0]

Dr Louise Newson: [00:29:46] Rather than taking today’s drugs, which someone told me a few days ago, actually, I’m not going to mention names, of course, but a menopause specialist she had seen, she’s absolutely you wouldn’t look at her and think she was overweight. She said oh I’ve got a bit of belly fat. And I went to see this doctor and they said, we could just give you a low dose of, you know, one of these drugs. And I’m like hang on, no, they shouldn’t be used first line. Absolutely. And I think it’s so easy to just do this, whereas actually you want to put in habits that are sustainable, that are going to really make a difference. And also you want to build muscle and you still need fat, as in good fat as well. Whereas I worry about some of these drugs, what they’re doing to bone density, what they’re doing with fat in the brain and the cells as well, and what they’re doing to hormones actually, are they having a negative effect on hormones in men and women? There’s so much we don’t know. And if we don’t know, then it’s actually better to think about the basics. And actually, it’s interesting when people say they want to manage their menopause naturally because it is actually more natural to have hormones than not. It’s not actually natural to live without hormones. So we just need to think, and even for men, testosterone has been labelled or mislabelled because sadly, a lot of men are using testosterones that are synthetic, which are chemically altered, which are not the same, they’re anabolic steroids, whereas the pure testosterone, of course, it isn’t an anabolic steroid, it is a natural hormone that we produce. And a lot of men don’t have it as they age for all sorts of reasons. So there’s a lot we need to think about. But I think the big message of this podcast, Matt, is about individualisation. And that certainly to me as a doctor, every patient is different. Everybody’s journey is different. And when you’re thinking about exercise, everybody’s coming from different beginnings, but also they’ve got different end points. And so making sure everything’s tailored is crucial. So it’s the new year, people are thinking hopefully more about the exercise, movement being healthier. So just before we end, three tips for those people that might be sitting here thinking it’s all very well for them to talk like that, but what am I going to do? So what are the three things that they could do that’s going to start for them to continue? [00:32:01][135.2]

Matt Roberts: [00:32:02] Well, very simply, I mean, the one thing you should definitely be doing fundamentally, because it’s very easy to do, is going doing that zone two cardio we touched upon. So if you can make a goal for yourself for each week, don’t make it too onerous, make it that three days in the next week and thereafter you’re going to to do a 40 minute long, fast paced walk with the level being about that seven out of ten. So you got that slightly puffy feeling and do that. That’s one for sure, because anyone can do that, that’s straight forwards. I want you to think about as well making sure we build on that strength. So let’s choose to do four or five key exercises, simple ones. So probably a squat, probably a lunge, maybe a step up, possibly a form of a press up and you can make the easy versions could be on edge of a table. It can be on the edge of a bench in the park, anything you like and some form of a pull test. Now, that could be ideally some form of a pull up exercise because in the gym it’s a pull down exercise, choose four or five things for the big muscle groups. And when you’re doing those, think as we discussed before, the intensity. Are you doing a level where going to about ten reps roughly is a struggle? Is that where you’re at if you’re starting from afresh, different, fine If you’re into this already a little bit, are you doing that degree of overload for four or five sets of that, that high volume, the four or five sets, ten reps and the last two reps, you’re thinking, I can just about do this and rthat should be a second go to, those things easy twice a week is all I want. If you can do more great, do more, but twice a week and I want you to then focus as well on mobility and the mobility section is straightforward. You choose just probably three or four key exercises. If you only stretch out your thighs and your hamstrings and you do some spinal flexion, lying on your back, pulling your knees towards your chest and some rotation where you put your knees to one side lying on your back. Those four stretches alone give some spinal mobility, some stretching in towards the limbs in the quads and hamstrings. And those alone give you a good start. So you’ve got a little bit of strength work in there, the cardio work in there and your mobility in there. And those are the simplest ways you can do something, beyond that, you can do much, much more. If you do in the next week, the cardio three times, the strength work twice and mobility three times, perhaps post the walking, then you’re doing a pretty good start to your year if you’re doing nothing else. [00:34:27][144.8]

Dr Louise Newson: [00:34:28] Perfect. Great advice and actually hopefully achievable. So thank you so much for your time Matt. It’s been a great pleasure having you on my podcast. [00:34:35][7.9]

Matt Roberts: [00:34:36] My pleasure. Thanks for inviting me. Great to see you. [00:34:38][1.8]

Dr Louise Newson: [00:34:43] You can find out more about Newson Health Group by visiting www.newsonhealth.co.uk and you can download the free balance app on the App Store or Google Play. [00:34:43][0.0]

END