How to improve strength and endurance in Menopausal Women

Now more people are living longer lives, which means more women are entering menopause and living longer after menopause. In fact, older menopausal and postmenopausal women are even competing in elite-level athletics such as CrossFit and marathons. Now menopausal women aren't just living they are thriving! Certainly, the question is how do menopausal women improve strength and endurance?

Women of all ages are amazing! But the changes that a woman goes through during menopause can affect several aspects of their lives including their fitness.

I recently received my Masters of Science in Nutrition and Human Development and did my Capstone paper on this subject. Obviously, I am not providing you with my full 15-page paper. I am going to tell you how to use exercise and nutrition to improve strength and endurance.

What is Menopause?

Women will experience menopause starting around the age of 50 years old. Menopause, by definition, is the termination of reproductive abilities in women, basically, they stop being able to have babies. The start of menopause involves changes in the functioning of the body. These include a reduction in muscle, cardiorespiratory fitness, strength, and quality of life.

Menopause causes a reduction in hormones like estrogen and DHEA and an increase in those that influence inflammation (8). Because of that, there are certain complications that come with menopause. Metabolism also tends to decrease during menopause as well. Subsequently, a slower metabolism combined with a lower muscle mass (roughly half-a-pound each year) leads to weight gain (10).

However, there are certain complications that come with menopause. Symtoms include:

  • Sleep troubles
  • Exhaustion
  • Aches and pains
  • Distorted cognitive functions
  • Osteoporosis
  • Sarcopenia
  • Pathological neurological complications
  • Cardiovascular issues increase

Menopause decreases estrogen that increases fat mass, reduces strength, bone mass density, and muscle mass. So we are going to discuss how to help improve strength and endurance.

The Effect of Exercise to improve strength and endurance

Regular physical activity aids in preventing weight gain, improves body composition, strengthens development and functional ability. The normal recommended physical activity is 150 minutes of moderate-intensity or 75 minutes of high-intensity aerobic work during the week or any combination of both.

Menopausal women, on the other hand, need higher levels of physical activity to experience these positive effects (Atapattu, Fernando, Wasalathanthri & de Silva, 2015). Generally, the loss in muscle mass is between 0.4 to 0.8 kg per decade, beginning at the age of 20 years old (Maltais, Desrosches & Dionne, 2009). It is found that low-to-moderate intensity cardiorespiratory exercise can reduce the width of the waist, improve blood sugar levels, and lower blood pressure (Earnest, et al., 2013).

On the other hand, resistance exercise is a better-suited approach to maintain muscle mass in postmenopausal women (Pollock, Graves, Swart & Lowenthal, 1994). Growing older is connected to a normal regression in physiological operations, involving a deficiency of bone mass density, muscle mass plus strength.

One study indicated that quality of life improved with the treated group in reference to physical ability and physical weaknesses. To clarify, as you can see in this table, cardiorespiratory fitness developed in the intervention (treatment) group from 31.7 to 32.6 ml/kg/min and diminished in the control group from 31.5 to 31.4 ml/ kg/min. And lean muscle mass grew considerably in the intervention group compared to controls (0.57 kg in versus 0.15 kg, p = 0.046) (Louto, et al., 2012).

Table V. Effect of aerobic training on hot flushes and quality of life—a randomized controlled trial

–Aerobic training-related variables (fitness and body composition) at base-line, after 6 months intervention, and change between base-line and 6 months (Louto, et al., 2012).

Vitamins, supplementation, and Macronutrient distribution to improve strength and endurance

Appropriate nutrition is key to sustain or inhibit the increased reduction of muscle strength due to growing older particularly during menopause. Nutrition incorporates several different aspects of daily intake including vitamins, supplements and macronutrient distribution. Increased protein for menopausal women helps to improve body composition, maintain strength and functional capacity. Macronutrients work together to provide optimal energy levels in the body, therefore menopausal women will need to consume higher protein levels, while still consuming adequate carbohydrates to maintain muscle strength and cardiovascular fitness.

Macronutrients

Proteins recommended intake for average adults (18-50 years old) is 0.8-1.0 g/kg/day. However, for menopausal women, the daily recommended amount of protein changes to 1.0–1.2 g/kg body weight/day. On the other hand, low carbohydrate consumption can cause muscle protein breakdown and reduction of muscle mass (Fink & Mikesky, 2019). Therefore they work together to maintain muscle mass. Eat 25-35% of their total daily calories from fat.

Supplements and Vitamins

Elderly adults usually are not eating enough of the following nutrients: calcium, vitamin D, dietary fiber, and potassium (Shlisky, et al., 2017). In fact, most postmenopausal women are deficient in vitamin A, vitamin D, vitamin C, vitamin E, folate, calcium, magnesium, fiber, potassium, and iron (Millen, et al., 2016). Supplementing with vitamins helps to maintain muscle mass in menopausal and post-menopausal women.

Supplements are intended to fill the nutritional gaps to enhance optimal health that people are missing from their normal dietary intake. However, eating more green leafy vegetables will help increase intake of dietary fiber, certain fruits will increase their potassium, and increasing dairy products will help increase calcium and vitamin D.

Supplementing with vitamin D and calcium combined has been revealed to decrease the likelihood of bone fractures and support protein synthesis maintaining muscle strength (Agostini, et al., 2018). By supplementing with Isoflavone, postmenopausal women were able to increase muscle mass in 24 weeks with no other interventions (Maltais, Desroches, & Dionne, 2009). Isoflavones have an effect on body composition and cardiovascular health. To clarify, Isoflavones are found naturally in soybeans, legumes and soybean commodities.

Consequently, with supplements, the key thing to remember is that they do not replace a good diet, they can react with certain medications to create negative side effects, and mega-doses can be toxic. Most importantly, it is known that the advantages of using scientifically studied supplements, no matter if they are taken to improve performance, slow down fatigue, change physique, or augment health, depend on an acceptable healthy diet to work.

Combination of Exercise and Nutrition on strength and endurance

While some studies look at exercise and nutrition separately, several look at the combinational affects to maintain strength and cardiovascular fitness.

One study conducted at the University of Freiburg, Germany examined the effect of specific collagen peptides on body composition in pre-menopausal women following a 12-week resistance training program (Jendricke, et al., 2019). A significant difference in the hand strength, amount of fat-free mass, and fat mass between the two groups (Jendricke, et al., 2019). Collagen is a protein found in the body that makes up cartilage, bone as well as skin and has been found to potentially strengthen muscles.

Also, the isometric strength of the upper and lower extremities was calculated in the study. Each person who participated was advised to eat as they normally did, meanwhile, some were given the collagen peptides, and some were given a placebo.

Creatine along with resistance training displayed an enhancement in muscle strength in adults 55 years and older (Andres, et al., 2017). Minor negative side effects of consumption are gastrointestinal pain as well as muscle cramps that were detected in postmenopausal women after the use with 7 g of creatine per day in two doses for 12 months (Andres, et al., 2017).

Conclusion

Low to moderate resistance and cardiovascular exercise combined with vitamin D and calcium supplementation, increased protein intake, and decreased caloric intake can improve both strength and cardiovascular fitness in menopausal and postmenopausal women. However, more studies are needed for obese women, as most studies reviewed excluded them from participating. Overall, a healthy lifestyle, a healthy diet, consistent exercise, retaining a proper body mass, and applying other preventive procedures will help enhance cardiorespiratory fitness and strength in menopausal and postmenopausal women, especially those with early-onset menopause.

While strength and cardiovascular fitness are important factors for life, there are certain studies that propose power is more significant than isometric strength for accomplishing events of normal day-to-day life, for instance regaining one’s balance, getting up from a chair, and going up stairs, as well as showing that power declines greater than isometric strength with maturing.

References:

  1. https://doi-org.bigbrother.logan.edu:2443/10.3390/nu10081103
  2. https://doi-org.bigbrother.logan.edu:2443/10.1002/mnfr.201600772
  3. https://www.archivesofmedicine.com/medicine/menopause-and-exercise-linking-pathophysiology-to-effects.php?aid=7062
  4. https://doi-org.bigbrother.logan.edu:2443/10.1016/j.amjcard.2013.02.037
  5. Fink, H. H., &; Mikesky, A. E. (2019). Practical applications in sports nutrition. Burlington, MA: Jones &; Bartlett Learning
  6. https://doi.org/10.3390/nu11040892
  7. https://doi-org.bigbrother.logan.edu:2443/10.3109/07853890.2011.583674
  8. http://www.ismni.org/jmni/pdf/38/02MALTAIS.pdf
  9. https://doi-org.bigbrother.logan.edu:2443/10.3945/an.116.012120
  10. https://doi-org.bigbrother.logan.edu:2443/10.4103/0976-7800.92524
  11. Pollock, M. L., Graves, J. E., Swart, D. L., & Lowenthal, D. T. (1994). Exercise training and prescription for the elderly. Southern medical journal87(5), S88–S95.
  12. Shlisky, J., Bloom, D. E., Beaudreault, A. R., Tucker, K. L., Keller, H. H., Freund-Levi, Y., ... & Meydani, S. N. (2017). Nutritional Considerations for Healthy Aging and Reduction in Age-Related Chronic Disease. Advances in Nutrition: An International Review Journal, 8(1), 17-26.

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