392: Thriving in Midlife: Empowering Women through Lifestyle Medicine | Dr. Rajasree Nambron

Maya Acosta  00:00

Dr. Nam Ron is a board certified physician in endocrinology and internal medicine and currently works with UT physicians where she focuses on diabetes metabolism and women's health. She will discuss how lifestyle medicine can empower women in midlife to take control of their hormones and their health. Let's listen in

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empowering women in midlife with lifestyle medicine. So the main objectives of this talk is, why is midlife important? Why do we have to optimize it? And using the pillars of lifestyle medicine, how we can thrive and not merely survive? Using life studies are the pillars of lifestyle medicine that I'm going to touch upon briefly. So midlife is that central pivotal period in life, because it's at that juncture of growth and decline. Because you culminate with all the gains and losses. I'll show you a slide on the midlife transition. The midlife in US studies the largest national longitudinal study, which showed that any person who has had that supportive social relationships exercise regularly and had that positive attitude about controlling midlife, has the better chance of functional health and the cognitive skills over a 10 year period. That's why it's important to optimize midlife years. And what is lifestyle medicine it's that evidence based approach using whole food plant based diet, regular physical activity, restrictive sleep, stress management and avoiding risky substances and having that positive social connection to prevent treat and reverse chronic disease. So these are some of the midlife transitions that you may be going through. It might be a child going away for education, children getting married, being a grandparent, a death of a pet or a loved one, getting that unexpected diagnosis beat cancer or chronic disease like diabetes, heart disease, taking care of your parents who are ailing elderly, divorcing, getting newly married, you might be setting foot on into the workforce after looking after your kids. Or you might be in your old job getting leadership positions. And you might be single or maybe single for long term, long time. And all this midst you're getting the symptoms of perimenopause, menopause, which are hot flashes, night sweats. So this is a picture that is from an article that was published in Guardian showing how midlife women that need there's a need to change or redraft the narrative around midlife women because we are not cultural underdogs, but we are seeing Steelers. So because women are living longer. So what is that healthy aging according to who it's the process of developing and maintaining a functional ability that enables a well being an older age. And as you all probably have seen that documentary on Blue Zones, and everyone is talking about Blue Zones today. So that long, and vibrant life is usually seen in those people who have been engaging with the community having strong relationships with their loved ones, and having that energy and ability to move around your environment. So the tool that we're going to talk about today is that paving steps which is a 12 step tool that will help you thrive and not merely survive. So before going into that tool, we'll just look at the definitions of each of these situations that might arise in midlife. So perimenopause is that stage in menopause transition, which is characterized by irregular menstrual cycle which can last from one to three years and symptoms can be from the declining estrogen levels. And menopause is that that transition that happens which is a natural event, and it is confirmed after one year of no menstrual period, and post menopause, that period where there is a permanent cessation of menses resulting from ovarian follicular function loss because of aging. And sometimes some of these some of you women might have that induced menopause, which might be a surgical removal of your ovaries and uterus, or could be isogenic from medications or chemotherapy, leading to cessation of that ovarian function and cessation of periods. So the median age in women in different articles, sometimes it's shown as it's 52 years or 54 years, and women tend to live longer these days. And most importantly, it's over 40% of their life stage is spent in menopause or post menopause and over 60% survive at least until 80 years. So it's important that you do not ignore the symptoms of hot flashes, night sweats, mood changes, urinary incontinence, vaginal dryness, and also ignore it do not ignore any other symptoms that may arise around it and to seek professional help to improve that physical and mental well being. So the tool that we use today's using the self coach approach, which is using your curiosity, openness, compassion, appreciation and honesty, to see if you are doing all these pillars of lifestyle medicine to keep that healthy, vibrant life. So these are the, these are the 12 step tool, I'm not going to really read it out, but we're going to touch upon it briefly. So firstly, attitude. So your you can, your attitude can influence your actions and interactions with others. And that the attitude that you project aligns with what you want to say to the other people. So you always want to give yourself that grace and compassion, check in with yourself to instill a growth mindset for that positive attitude in midlife. So it's always important to get that accurate information and education as to what you're going through and reminding that you're not alone and that many women around you are going through the same thing. It's important to have that compassion to yourself and your body and engage in self care. I think we already got that talk on self care and express that gratitude and by by doing that self talk, so that you get that improve physical and mental health, reducing your anxiety and depression because body dissatisfaction can lead to anxiety and depression. And always remember professional help is available. Some of these activities that can induce positive attitude in midlife, like how others touched upon is either volunteering in the community, reading an uplifting book, or listening to an uplifting podcast, doing something fun with the people around and trying to get your own tribe and, and live in with their presence by doing activities with them. Always go out and be one with nature. Activity again, aging and reduction in that estrogen level can lead to a change in your glucose tolerance, and might impair or change the cholesterol pattern. And also the there is a factory distribution and that's why you may gain weight and have these chronic conditions like heart disease stroke type two diabetes can also lead to wear of your bones so leading to osteoporosis and can get other diagnosis like cancer and dementia as well. Along with that there are these symptoms which are related to perimenopause, menopause, which are mood changes, fatigue, muscle aches, hot flashes, night sweats. And because of the weight of the bones, you can have false risk and there is a loss of lean muscle mass, these all can lead to stress as well. So physical activity can improve all this. And there is need to be a commitment to being fit and how you can have that commitment is by prioritizing making an appointment with yourself and schedule your day and get that aerobic activity, the strength training, or if you cannot do any of these is at least having the joyful activity. That's something that you like a fun activity that you can do like dancing or hula hoop. And you can also adapt some of my patients I have three jobs I'm going from I mean, I'm driving my kids around so you can adapt in between while you're cooking, you can lift foot cancer, just 15 to 30 seconds every hour or half an hour you can do that break for some activity. And you can do this the guideline is actually 150 to 300 minutes per week of aerobic activity and with two non consecutive days of strength training, if you can incorporate that and that you can get that vitality and youthfulness. So in midlife, what is more important is the pelvic floor strengthening, which is usually you do this Kegel exercise and you can do that anytime when you're sitting in your office chair when you're driving. So that's the Kegel exercise and core strength is important for your abdominal and back muscles, which can help you improve your posture and thereby your self confidence and self esteem. And bone strength is by doing that stretches and doing some weight based training, jumping, skipping resistance training. You have to include some variety in your life. And variety is usually seen by either you can volunteer learn a new dish, you know cook a new dish, learn a new skill, and using this variety in your life can improve your cognition brain health and reduce the need to binge eat or substance use. The one thing I always tell my patient is to incorporate if you're doing any kind of mundane activities and even I do this by doing laundry or doing dishes you can listen to a podcast or you know doing some singing if you sing

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just touching upon the nutrition And I think we got a good nutrition talk this morning. So basically this is the whole food plant based plate, where you have the blade to serve with fruits and vegetables, and 1/4 of the plate with the plant proteins, legumes nuts. And then there is this whole five whole grains which with fibers. I also tell my patients like when you're drinking water, you can use some turmeric, phenol or sage to help you know in their water to help with the flavor and also improves their symptoms, adding herbs and spices in there cooking. The protein needs in women, about 46 grams daily fiber is like 21 grams per day and including prebiotics in their diet. I think we'll have a GI Talk soon. And probiotics fluid intake 60 to 90 ounces and calcium of 1200 milligrams per day. The best is the diet sources and the vitamin D and low salt. Some of these foods that are encouraged as you can, as you know from from morning is the whole foods, rainbow of plant foods. Eating fruits and vegetables, herbs and spices, legume seeds not sent in increasing the intake of soy with soy milk tempeh at the moment tofu and what is not encouraged is these fried foods, ultra processed foods foods that are added sugars, meat, especially the processed meats and avoiding alcohol intake. Always has different food pyramids, for that fits different cultures. So this is one for the vegetarians. And then there are we also need to include foods that support the hormonal balance which mainly are pumpkin seeds, flax, chia seeds, almonds, the green cruciferous vegetables, and needing you might need some supplements of vitamin D and B. But otherwise, generally you get everything else from the diet. And plant proteins at least three servings, which are mainly the soy milk, edamame as a snack, the legumes nuts, some of the cooling foods Apple celery, watermelon to include in your diet again cruciferous vegetables as well. Then hot flash or hot flashes, that sudden sensation where you get that whoosh of feeling of heat in the body, which can last maybe one to five minutes can happen any time of the day and multiple times. So sometimes the symptoms can last seven to 10 years. It's one of those communists symptoms that happen in perimenopause and menopause. So how you can try to do some changes in your daily activities is by having that omega three in your diet. Dressing in lighter clothes, lighter layers, adjusting the temperature, avoiding alcohol, no smoke, smoking and maybe less than one cup. I mean one cup or avoiding coffee, caffeine can increase hot flashes and night sweats. Someone has talked about purpose. So purpose and goals are connected. So make that smart goals Specific, Measurable, Actionable, Realistic, time sensitive goals. First, you should identify what your Northstar or that purpose is and then celebrate each of these small achievement of these goals. And the small achievements as towards your goals as well could be celebrated. Someone's talked about stress as well. So basically, trying to practice that mindfulness. Taking that deep breath talking to a loved my loved one, going out in the nature watching a funny video. And always trying to see what you can commit to delegate get help from others. Be one with nature and having that spiritual practice is whatever you believe. Always want to know that time is precious tribe time is finite. Having that time journal and ideal time is to that timeout it's not that negative feeling it is that timeout is that time when you can reflect, regroup and reorganize. It's one of those empowering tools. And it's important that taking that mindful timeouts during a hot flash can make you in control. Some of the examples of timeouts or like for example is coming to this retreat. 10 second, deep breathing, making that five minutes of prayer or mantras, walking, jogging 20 minutes conference, conversing with your friends or family. Sometimes people always talk about to do list and there's always people you know, going from one job to the other doing things and getting so many things in their plate, but there should be also a no list day. So how can you do that is by setting clear boundaries. Help us for helping you want things. Think before you commit and then you shouldn't say start saying no to something So this is a way to know about your energy. It's measured as spoons. Again, it's Christine, Missouri and Dino who, who is actually a blogger and writer who was going through lupus described energy as spoons. So you want to see what your energy boosters are, what your energy drainers are trying to journal it and prioritize activities be around uplifting people and place, take breaks. And energy also has this connection with your purpose. So this is a journal for, again, what your purpose is trying to write down what your goals habits are. It's like writing your own biography autobiography. And so basically jotting down your mission statement based on your beliefs on your spirituality and that you know, helps you to fix what your purpose is, and helps you to get that energy and set your goals. Again, sleep it's very important, you have to get ready, get your enviornment ready for the sleep. Basically, sleep or bed is used only for sleep and sex. And you have that regular time. Again, so many of my patients they have this time, they're just watching watching TV at night. So again, I say no screen, at least an hour before you know trying to wind down that sleep hygiene, bedroom lights, music, you can use music but no devices, staying hydrated doing that activity exposure to sunlight during the day. And always if there is worse problems with your sleep, you can always use cognitive behavioral therapy for insomnia. So night sweats again, the same thing, eating those soy foods, colorful foods, taking that gentle extra gentle yoga stretches. And then the room the quiet room. social connection smells are the most positive things to have most important thing with the predictor of human happiness and also improves the blood pressure and heart rate. So some some of the unexpected diagnosis cancer, you can always want to eat more of those anti inflammatory foods, antioxidant foods, and use moist methods of cooking and more fiber more fiber than what is recommended. These are some of the resources that are used blue zones. Next Level is a book that you can see if you want to know more about exercise in menopause and perimenopause activity that you need to do and then paving women's path through menopause. So all of this work is from Dr. Tollefson. This is one of those journals How to know how you can score what you have done using the lifestyle pillars. So basically, take action if you're not already doing or if you're doing continue to take that Action for Healthy Body Joyful Heart and peaceful mind. Thank you.

Maya Acosta  17:59

Friends I hope you enjoyed this lecture, please share it with a loved one who can also benefit. Thanks again for listening. You've been listening to the healthy lifestyle solutions podcast with your host Maya Acosta. If you've enjoyed this content, please share with one friend who can benefit. You can also leave us a five star review at rate this podcast.com forward slash H L S. This helps us to spread our message. As always, thank you for being a listener.