ALTHOUGH we're getting better at recognising it, we are surrounded by diet culture. On social media, in magazines, on the TV, in the classroom and our everyday conversations - it's literally everywhere.

And children seem to be worrying about the way they look more and more. According to the Mental Health Foundation, a body image in childhood survey by Be Real found that 79 per cent of 11-16-year-olds say how they look is important to them, over half (52 per cent) often worry about how they look, and 35 per cent of 13-19-year-olds said their body image causes them to 'often' or 'always' worry.

So, what happens if your child asks if they can go on a diet, or start a food and exercise 'regime'? As much as we'd love them to know nothing about such things, there probably aren't many parents who haven't tried WW, Joe Wicks, fasting or some other diet or fitness fad in the hope of losing weight, being healthier or becoming fitter.

Children are like sponges, so every time you've voiced an unhappiness about your body or weight, felt fantastic after shedding some inches, or got grumpy about having to eat or cook in a certain way - they've soaked it all up.

So naturally, if they don't feel happy with their bodies, they're going to look to the tried and tested methods they've seen first-hand.

So, what exactly should we do when ugly weight, diet and body conversations crop up at home?

"If your aim is to raise a child with a long-term healthy relationship with food, who's in tune with their body, who has a positive body image and treats their body with respect and kindness - and treats other people with bodies that don't look or function like their own with the same respect and kindness - then the very worst thing you can do is to put them on a diet," says author and campaigner, Molly Forbes.

"There are many different factors which can influence a child's weight. But diet culture teaches us that our body weight is a behaviour, entirely within our own personal control, and that higher body weight is automatically unhealthy.

"This is perpetuated by many of the public health policies we're seeing at the moment."

LET'S TALK ABOUT EATING DISORDERS

Jumping from diets to eating disorders might sound extreme, but what starts off small can sometimes grow into a much bigger problem.

"Dieting can be dangerous for children who are still growing and developing, as they may not be getting adequate nutrition," says Martha Williams, UK eating disorder charity Beat's clinical advice coordinator.

"Sadly, dieting has become so normalised in today's society that some parents may believe they're doing the right thing by putting their child on one, but putting your child on a diet can increase their likelihood of developing an eating disorder.

"A lot of people we speak to tell us their eating disorder began with a diet that gradually got more restrictive over time, or that dieting negatively impacted the way they thought about food."

She adds: "Dieting tends to promote categorisation of foods into 'good' and 'bad', which can cause disordered eating habits.

"We also know that diets can lead to an increased preoccupation with food, which can make it hard to concentrate on other important things."

Intrusive thoughts about food, or increased cravings for foods that the diet doesn't 'allow' are also frequently experienced.

WHAT CAN PARENTS DO?

The most important thing any parent can do is give their child love. Adore every inch of them that's on the outside, as well as the inside.

"The very best thing you can do for your child's body image is to accept their body just as it is," advises Forbes.

"And then to really show your child that all bodies are good bodies - through representation (books are a great way to do this), conversations, and helping them to develop media literacy skills that allow them to think critically about some of the messages making them question their bodies, or making judgments of other people with bodies unlike their own.

"In the moments when a child might display body insecurity, or say they need to 'go on a diet', it's important to validate their emotions, rather than brushing it off.

"We all live in this high-pressure culture that makes it really challenging to accept our bodies as they are, so be honest with your kids about that, but let them know that while it might be hard to be friends with your body, it is possible.

"Body shame is not an inevitable part of life, however normalised it has become."

FIND OUT WHY

If a child tells you they want to be bigger, smaller or eat less, talk to them.

"It can help to try to get to the bottom of why a child is feeling this way - is there something else going on that may be bothering your child and making them seek control over food, that they may not have elsewhere, for example?" says Forbes.

"These are big things for parents to deal with alone, so my advice if anything like this comes up is to always seek professional help.

"Eating disorders are incredibly serious, and this could be a sign that your child is struggling, so seeking support is not something to put off."

Williams agrees, adding: "If a child is asking to go a diet, there may be underlying factors. We would encourage parents to approach these conversations sensitively and ask open-ended questions to establish the reasons for your child wanting to diet or increase their exercise levels.

"We also would recommend that parents be aware of the early signs of eating disorders."

SPOTTING THE SIGNS

People with an eating disorder often look perfectly 'normal' and weight isn't a reliable indicator. Beat says spotting the early warning signs involves looking out for changes in behaviour, such as social isolation, avoiding activities involving food or eating with others, difficulty concentrating, increased tiredness and irritability, low self-esteem and confidence, obsessive and/or rigid behaviour, perfectionism, increased amount of exercise, and disappearing to the toilet after meals.

The charity estimates that around 1.25 million people in the UK have an eating disorder, and all ages and backgrounds can be affected.

"Sadly, we have seen a rise in numbers of people suffering following the pandemic," notes Williams.

"There are lots of reasons for this - disruption of everyday routines, increased isolation, promotion of exercise during lockdown, and general anxiety about the pandemic.

"Due to increased numbers, services are currently struggling to meet the demand for those needing support and treatment."

So, if your child wants to go on a diet, shower them with love. Tell them they're perfect just as they are. Talk about diet culture and the unreal ways so-called 'ideal' bodies are presented. And teach them that everyone is different.

It is really, really hard to love your own body when we're bombarded with images and messages that tell us they're not good enough, but maybe you can learn how to do it together.

See the original post here:
Is it ever OK to put your child on a diet? - The Irish News

The National Cancer Institute recently awarded Yale Cancer Center and Yale School of Public Health a new U01 cooperative agreement grant to support research into the impact of diet and exercise for women with ovarian cancer.

The National Cancer Institute recently awarded Yale Cancer Center and Yale School of Public Health a new U01 cooperative agreement grant to support research into the impact of diet and exercise for women with ovarian cancer. Melinda Irwin, PhD, MPH, the Susan Dwight Bliss Professor of Epidemiology and Associate Dean of Research at the Yale School of Public Health, and Associate Director (Population Sciences) at Yale Cancer Center will lead the research project, Trial of Exercise and Lifestyle (TEAL) in Women with Ovarian Cancer. The grant funding will enable Dr. Irwin and colleagues to investigate ways to improve treatment outcomes via diet and exercise in women newly diagnosed with ovarian cancer.

Ovarian cancer is the most lethal gynecologic malignancy, with 90% of women diagnosed receiving chemotherapy. Timely and successful completion of chemotherapy is critical, as delayed or reduced chemotherapy dosage for ovarian cancer is associated with decreased survival; yet chemotherapy dose delays and dose reductions are common (~50% of ovarian cancer patients), with the primary reason for dose delays and reductions being chemotoxicity.

Tracy Crane, PhD, Associate Professor in the Department of Medicine at the University of Miami, is the co-principal investigator on the trial. Together, Drs. Irwin and Crane will work in collaboration with Yale Cancer Center members Elena Ratner, MD, Professor of Obstetrics, Gynecology & Reproductive Sciences, Peter Schwartz, MD, John Slade Ely Professor Emeritus of Obstetrics, Gynecology, and Reproductive Sciences, Brenda Cartmel, PhD, Senior Research Scientist in and Lecturer in Epidemiology (Chronic Diseases), Leah Ferrucci, PhD, MPH, Assistant Professor of Epidemiology (Chronic Diseases), and Tara Sanft MD, Associate Professor of Medicine (Medical Oncology), to execute the project plan.

The study will enroll 200 (100 non-Hispanic White and 100 Hispanic) women newly diagnosed with ovarian cancer and conduct a multi-site randomized trial over 18 weeks. The research teams hypothesis is that exercise and eating a healthy diet will improve chemotherapy toxicity and treatment adherence and efficacy, and in turn, improve ovarian cancer prognosis. Dietitians Maura Harrigan, MS, RDN, CSO and Courtney McGowan, RD, will be critical in helping with the diet intervention, and Linda Gottlieb, MA, CPT, CET, will assist with the exercise intervention.

Few studies have examined the role of lifestyle factors during cancer treatment and how lifestyle behaviors may improve treatment adherence, toxicity, and efficacy. We are hopeful that the results of this study will help to accelerate a paradigm shift where patients will routinely receive nutrition and exercise programming as standard of care in tandem with their cancer treatment, Dr. Irwin said. I look forward to launching the TEAL study with my colleagues in the coming months.

Originally posted here:
Yale Cancer Center and School of Public Health Receive Grant to Study Lifestyle Intervention in Women with Ovarian Cancer - OncLive

The prescription for wellness and being able to live an active and independent life is to keep moving.

Health is not just the absence of sickness, but it is an optimal balance of mental, physical, emotional and spiritual wellness. Most times, being healthy is a choice. While it is true that some have larger obstacles such as family history of chronic disease or obesity, lingering effects from past illness, or an accident or injury that may cause long-term deficits, we can and should take control of our own health.

A healthy lifestyle is a proactive approach to taking control of your health in an effort to improve your quality of life. Whether you are recovering from an illness, an accident, or working toward prevention and maintenance of good health, understanding the role physical activity and other healthy habits play is important.

Research from the Centers of Disease Control and Prevention suggests up to 80 percent of chronic disease cases can be prevented through healthy living. The CDC says we should strive to meet the following healthy-living factors:

Maintain a healthy weight: A BMI of less than 30 is considered healthy.

Refrain from tobacco use: Do not start smoking, and quit if you actively engage in tobacco use.

Be active: Get 30 minutes or more of moderate to intense exercise to equal at least 150 minutes a week.

Diet: Include fruits and vegetables, whole grains and lean protein sources in your diet

Following this guidance can decrease risk for diabetes, heart attack, stroke and cancers. Aside from prevention, exercise can also be used to rehab many illnesses, improve mental health, maintain weight, ease osteoporosis or arthritis, and much more. Exercise can also help those suffering from lingering effects of COVID-19 such as fatigue, shortness of breath or difficulty breathing, fast or pounding heartbeat, anxiety or depression, concentration, memory loss and joint discomfort.

As you begin to exercise, remember to start slow and monitor your progress while being aware of how the movement makes you feel. Start with a slow walk and gradually progress. Walking, biking and swimming are great ways to improve your cardiovascular condition and breathing. Once you feel comfortable with light to moderate exercise, more intense movement such as running, hiking or cardio classes might be appropriate.

Muscle strengthening exercises are also important. Sit to stands, squats, basic upper extremity movements and core conditioning is especially beneficial. Remember to stretch each muscle through its range of motion as this will ease joint discomfort and help improve general movement.

The Sam B. Cook Healthplex has a team of professionals that can help you get started in the right direction. Cardiac nurses, occupational therapists, physical therapists, athletic trainers and exercise specialists will work together to get you safely on your way to improved health through exercise and movement.

Whatever your reason, exercise is right for you! Think about it as insurance for good health.

Kay Benward is an exercise specialist and supervisor at the Sam B. Cook Healthplex Fitness Center in Jefferson City. She has been with Capital Region Medical Center for 30 years and inspired many people to lead healthy lives through exercise. She continues to teach classes and enjoys training the mature adult for balance, posture and functional strength, as well as educating her clients, staff and community on exercise as medicine.

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Get Moving: Exercise is insurance for good health - Jefferson City News Tribune

Jazzersize, the Theighmaster and Tybo have come and gone, but the exercise industry has a complicated and controversial history. And for women, a once exclusionary industry turned around to target them as prime customers.

Journalist Danielle Friedman explores the effects of changing exercise culture In her new book Lets Get Physical: How Women Discovered Exercise That Reshaped the World. She talked with Texas Standard about the era when boutique exercise was commercialized, and where the industry is headed from here. Listen to the interview above or read the transcript below.

This transcript has been edited lightly for clarity:

Texas Standard: There are generations now that couldnt remember because they werent alive a time when being athletic or working out was seen as unladylike, maybe even unhealthy. Could you take us back a little to the issues of that time?

Danielle Friedman: Thats right. My book begins in the 1950s, which was a time of very strict gender norms in the post-World War II era. And during that time, for women, the idea of breaking a sweat, of lifting weights, of cultivating strength for strengths sake was really considered quite radical. There were also a whole lot of myths and fears about what vigorous, strenuous exercise would do to a womans body for example, that it could damage her reproductive organs, make her uterus fall out. That was a favorite belief, or even turn her into a man. Women were told they would grow a mustache if they exercised too hard. So all of these, social factors served to really keep women pretty sedentary.

When did this shift to a more contemporary perspective of womens physicality actually happen and who was behind it?

It was a gradual shift that first got underway in the late 1950s and 1960s, and then in the 1970s, it just took off. And it was really thanks to a kind of perfect storm of social and cultural shifts. There was the rise of the womens movement, which pretty explicitly encouraged women to defy the idea that they were the weaker sex and to cultivate strength. There was also an emerging body of medical research that debunked some of those myths that I mentioned, and that stated it was actually really beneficial for women to exercise aerobically and to strength-train, even. So those factors combined with general changes in the cultural perception of womens potential helped to fuel the rise of the womens fitness industry in the 1970s. There was also Title 9 in 1972, which we mostly talk about in the realms of high school and college sports, but that also had an impact on opportunities that were created for women to move.

Im fascinated by the way the commercialization of the workout industry led to some rather big changes. The title of your book, I would suspect, borrows from that Olivia Newton-John song, right? And if anyone remembers the video by any chance, whats hilarious Is that she is whipping a bunch of guys into shape, right?

Thats right. Thats right.

What was happening about that period? Were talking about late 70s, early 80s, when things are really tilting much more in the direction of women and athleticism.

Throughout the 1970s, thanks to some of those social and cultural changes, a new generation of female fitness evangelists began launching many of the fitness movements that laid the groundwork for the way that we work out today.

You mentioned Jazzercise. Jazzercise was huge. It was created in 1969, and by the early 1980s it was the countrys second fastest growing franchise, right behind Dominos Pizza.

The womens running boom took off in the 1970s, and another really key shift is that gyms became coed. Until the mid to late 70s, there were very few gyms that even existed for women or that let women in. But if they did, there would be special ladies days in the late 70s, early 80s, the kind of big health gym multiplex concept sprung up across the country and as gyms became coed, they also became social scenes and single scenes and fitness industry entrepreneurs realized there was there was potentially a lot of money in the scene.

A big part of this story and I think theres a show on Apple TV+ thats set in this era that touches on eating disorders and the role of the sort of exercise industry in perpetuating these issues, right?

Yes. That was sort of the central tension throughout my book and throughout this history is the way in which the rise of womens fitness has both liberated women and oppressed women because of the additional layers of body ideals and the additional pressures to look a certain way what those have sort of done to women. And so what I wanted to trace was how the beauty and diet industry and fitness industry became so intertwined. And theres a really long history there. Even in the early days in the 1950s and 60s. Some of the early womens fitness pioneers recognized that selling strength for strengths sake was never going to be accepted. So they sort of savvily recognized that if they sold fitness as a way to be more beautiful, more appealing to your partner, more feminine that that was a way to kind of get people on board. But it really unleashed a monster.

You take a look at the industry today. Where do we stand with momentum behind all of these changes? Has the industry, after booming, plateaued? Is it still continuing to grow? And what about issues of access?

Well, the industry is constantly evolving and it just sort of went through another paradigmatic shift, thanks to the pandemic, as brick and mortar studios had to shift to remote classes. But the shift that Im seeing that is the most encouraging right now is that I think were at the beginning of a shift where fitness is being sold more as a tool to cultivate mental health strength, overall well-being and less about changing our physical appearance. And again, I say that this is the very beginning of a change. But I spoke with many fitness industry leaders and professionals who talked about how some of the language they would use in class just five or 10 years ago focusing on changing your problem areas or getting ready for bikini season or anything thats kind of aesthetically focused they just they have completely stopped using that language. And I think whether its that the change is incremental and there might still be sort of an implicit message that youre there to shape your body. But we are we really are starting to see changes in the way that its marketed. And its very clear to me when I look at it in the larger arc of this history,

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The good, the bad and the groundbreaking: 'Lets Get Physical' explores the history women and exercise - Texas Standard

Thanks to TikTok and Instagram, peeking into someone's lifenitty-gritty food choices includedhas become absurdly routine. Trends like "what I eat in a day videos and mini meal breakdown vlogs allow us to see what our favorite influencers, home cooks, dietitians, and personal trainers eat on a daily basis. And considering the fact that the #WhatIEatInaDay hashtag on TikTok has over 11.2 billion views, its safe to say this trend is gaining traction.

Many creators of these short-form videos started out providing meal prep tips or recipe ideas for those in search of inspiration for new dishes to cook at home. But over time, what I eat in a day videos have become increasingly focused on providing nutritional guidance for viewers looking to improve their health through food or adopt an entirely new dietary lifestyle. "Sharing a photo or video of a recipe is one thing, but coupling that with nutrition advice is entirely another," says Christine Byrne, MPH, RD, a Raleigh-based dietitian who specializes in eating disorders and intuitive eating. While some creators choose to just film their food choices, others may layer on descriptive captions or voiceovers dictating the precise number of calories (or grams of protein, carbs, or fat) they consumed or how long one must exercise to 'work it off.' Other videos even appear as if they're going to show how to make a delicious-looking dish, and then cut to sharing how eating it can result in weight loss or be incorporated into an intermittent fasting regimen.

Indeed, what may start as a bit of voyeuristic intriguewho knew that my favorite professional chef loves eating Lucky Charms for breakfast? or I can't believe the most energetic Peloton instructor completely avoids caffeinecan turn sour the second you start to wonder if you, too, should adopt the eating habits of those you admire. And while there is certainly no harm in finding new recipes through social media or even being fascinated to see how an ultra-marathon runner fuels up before a race (Well+Good formerly had such a recurring series known as "Food Diaries," which focused on the eating habits of fitness professionals), relying on what I eat in a day videos to determine how you should be eating can cause you to dismiss your own nutritional needs and compare your food choices to others. "A simple recipe video can be a great way to share something you enjoy with others, but a recipe video with nutrition or diet advice attached is problematic because it becomes prescriptive'eat this if you want this result'and can be triggering," says Byrne. This, she adds, can easily lead to disordered eating.

Regulating your [food] intake based on what somebody else is eating can be harmful and make it difficult to honor your own bodys unique cues, says Isabel Vasquez, RD, LDN, an anti-diet registered dietitian at Your Latina Nutritionist. "The truth is that no one on Instagram [or any social media platform], even if that person is a dietitian or a doctor, understands your unique health situation. What's healthy for one person may not be healthy for another," agrees Byrne.

Here, three registered dietitians share their take on this growing trend, and share their thoughts on why these videos should not serve as nutritional guidance.

"Addressing your nutritional needs requires taking account of far more than just ingredients themselvesyour activity levels, health conditions, hydration levels, stressors, environment, and so much more all play a role in what your body needs," Vasquez explains. There's also your own personal taste preferences and cultural customs, which matter just as much as the nutritional makeup of a meal. "Relying on a short video for nutritional guidance often dismisses all of these important factors to be aware of."

Vasquez adds that using someone elses food choices as a means of determining what (and how much) you should be eating takes you away from connecting with your own body. Failing to take your unique nutritional situation and requirements into account may also worsen symptoms caused by digestive disorders, like irritable bowel syndrome (IBS), due to having different food triggers than other individuals. IBS food triggers can be different, so [uncritically] following someone elses food preferences fails to address your own situation as well as these triggers, adds Samina Qureshi, RD, LD, an intuitive eating registered dietitian and the founder of Wholesome Start, a telehealth nutrition coaching practice based in Houston, Texas. Healing, whether it be for IBS or strictly for your relationship with food, is a multifaceted process in which you have to think about other factors in your lifestyle that could be contributing to your digestive system or view on food.

Bottom line: Even if the person creating the videos experiences similar symptoms or is looking to accomplish a similar goal, your nutritional needs will most likely still be very different than theirs.

Getting an inside view of a persons food choices can breed comparison traps that leave you questioning your own decisions. Seeing a video clip [about someone else's eating habits] as short as 10 seconds can start to impact how you think about food, your body, and the choices you make, says Qureshi. Comparison truly is the thief of joy that can make you question everything you eat, as well as trigger disordered eating patterns.

Videos that fit within a very narrow moldwhich tends to be dominated by the eating habits of skinny white influencersmay also omit culturally relevant foods for communities of color, making it harder for members of these communities to view them as part of a balanced diet. Foods that carry history, tradition, and enjoyment can become quickly (and wrongfully) viewed as less-than due to the lack of representation. There is a significant lack of information out there about our cultural foods, which means many of my clients have to rebuild their relationships with their cultural foods. says Vasquez. [Cultural foods] are nutritionally valuable, and they also connect us to our families and our culture and that usually gets ignored or minimized in these videos.

Although the main intention of what I eat in a day videos is to highlight a persons meal choices throughout a 24-hour period, the opening scene often consists of a body shot of a thin and/or "fit" body. And because trim, toned bodies are perceived as healthier in American culture, viewers are primed to consider these people as healthy-eating authoritiesdespite the lack of schooling or extensive knowledge in dietetics. "When you take nutrition advice from an influencer, it's really hard to tell whether the advice is evidence-based or not," says Byrne. "An influencer might cite a study saying that X food helps with Y health issue, but who knows how rigorous or conclusive that study was? Plus, a single study doesn't make something evidence-based. An evidence-based recommendation is one that takes all studies on a particular topic into account."

Taking extreme, unhealthy, and unsubstantiated diet tips from anyoneespecially someone who is not a nutrition professionalcould easily cause a person to start fearing certain foods or having a disordered relationship with food, adds Qureshi.

Even if these videos advocate for intuitive eating, which calls for listening to (and responding to) your hunger cues and needs, they can still promote disordered eating. Intuitive eating is, in essence, all about breaking free from food "rules" and restrictions. It emphasizes nourishing yourself by tuning into what your body wants and needs to eat at any given moment. Rather than trying to follow a strict eating plan or co-opt an influencer's dietary habits, the goal is to be in touch with what your body is signaling physically, mentally, and emotionally at all times, and making food choices accordingly. Intuitive eating is designed to help people get out of the diet cycle and heal their relationship with food, rather than fixate on the food choices of another.

Theres a big difference between highlighting certain meals or approaches to nutrition for recipe inspiration and giving advice in the format of here's what I eat in a day.' The latter is basically a form of tracking, which is generally not supportive of intuitive eating, says Vasquez. To her point, even if a video host rallies against, say, counting calories, any form of closely monitoring one's own food intake (including the filming and breaking down of every morsel that went into one's mouth that day) is not considered intuitive eating. "Many of these videos are created by folks who have a disordered relationship with food. Someone who has a truly healthy relationship with food probably doesn't feel the need to post what they eat in a day, or to give unsolicited diet advice on social media," says Byrne. Again, comparison is the thief of joy, and it certainly goes against the healing ethos of intuitive eating.

Learn more about what healthy intuitive eating looking likeaccording to a dietitianby checking out this video:

Despite what you may see online, body diversity naturally exists, points out Qureshi. Even if we all ate, drank, slept, and exercised in the same way as one another, we would still have people living in a wide variety of shapes and sizes, she says.

[Seeing a persons body in these videos] can be so problematic because its furthering this idea that your body should look a certain way and it is further promoting the thin ideal, agrees Vasquez. It ties your eating directly to how you look, even if its not explicit. The correlation between your body and the food you consume often dismisses uncontrollable factors (like genetics) and can leave you comparing your body to others, resulting in feelings of dissatisfaction or body shame.

Despite the harmful impacts of this trend, it is one that is most likely not going to disappear anytime soon. But there are different ways to reduce the chances of coming across this trend on social media, such as unfollowing or blocking accounts that feel triggering and following accounts that promote intuitive eating from an authentic space.

Vasquez also suggests simply spending less time on social media. And when you do open the apps, she recommends creating a safe space to process your emotions after being triggered to help. I would advise noticing what thoughts these videos bring up for you, she says. If youre having thoughts about how you should change your eating habits or shame about your body, then self-reflect on those, says Vasquez. Self-awareness can make it easier to reframe your thoughts in a more positive light, whether it be celebrating cultural foods or showing compassion towards yourself. Speaking to a counselor or therapist may also be beneficial for those feeling triggered.

On the other hand, if what I eat in a day videos are helpful ways for you to discover new dishes, then thats also okay. The underlying message is to find a balance between inspiration and determining (or shifting) what you assume own body needs based upon another person's food choices. Ask yourself how hungry you are, what access to food you have, when was the last time you ate, what foods will satisfy you now, and start thinking about your own needs, Qureshi says. The answers to these questions can help you treat your body with compassion and address your unique nutritional requirements.

Additionally, Byrne emphasizes the fact that food choices should not dictate your happiness or self-worth. "The underlying assumption that eating a certain food or following a certain diet will drastically change your life for the better is a huge red flag that I see with influencers who give nutrition advice," she says. "That is a massive oversimplification, and it's just not true. Our overall health, and how we feel from day to day, is about so much more than what we eat. In general, nutrition advice on social media doesn't honor the fact that health and wellbeing are about more than just food."

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Why Experts Affirm That What I Eat in a Day Videos Should Not Be Anyones Guide to Nutrition - Well+Good

Do you ever go a bit red after exercising? Well, it turns out the same might be true for a certain type of bird!

New research shows that male crossbills grow redder feathers when they exercise harder.

Crossbills are a type of finch and have a beak - or bill - which is crossed over at the tip, giving them their name. This crossed bill is used to extract seeds from conifer cones.

Scientists from the Spanish National Research Council in Madrid have found a link between how hard a male crossbill has to work to fly, and how red his feathers are.

The bright colouring of some birds comes from things they eat in their diet - they take in special pigments from their food and use these to make the vibrant colours seen in their feathers.

For example, flamingos are born with grey feathers but the more they eat certain foods, the pinker their feathers get!

In an experiment to test this, between October 2019 and February 2020, scientists captured 295 male crossbills in central Spain, taking measurements of their colour, size and weight.

The researchers clipped some wing feathers from about half the crossbills to make flying more physically challenging.

When the team caught and checked the birds later on, they found that the birds with clipped wings had redder feathers.

This led the team to conclude that red feathers were partially a result of exercise and not just because of a bird's diet and foraging skills.

"We might conventionally assume that birds with impaired flight are 'lower quality', but here they are growing redder feathers," says Rebecca Koch at the University of Tulsa, Oklahoma, adding that study's approach is "breathing fresh life" into work on feather pigments.

Go here to see the original:
Crossbills: The bird that gets redder feathers, the more it exercises - BBC

In the majority of individuals, type 2 diabetes occurs related to metabolic syndrome, i.e., in the context of overweight/obesity, ectopic fat accumulation, metabolic inflammation, and insulin resistance [1]. However, alternative pathophysiologic processes, unrelated to metabolic syndrome, can also lead to this disease [1-4].

Historically, type 2 diabetes was viewed as irreversible and progressive. However, recent research showed the opposite, at least for type 2 diabetes related to metabolic syndrome. As first demonstrated after bariatric surgery, this disease subtype can be brought into remission by substantial weight loss [5,6]. As shown later, such weight loss can also be achieved through lifestyle intervention. The Counterpoint study, for example, demonstrated that short-term caloric restriction leads to rapid metabolic improvement in subjects with type 2 diabetes related to metabolic syndrome [7]. Furthermore, theDiRECT study applied a similar approach in a routine care setting. In that trial, a 46% remission rate of type 2 diabetes related to metabolic syndrome was achieved after 12months of a lifestyle intervention that started with a period of a very-low-calorie formula diet [8].

In the DiRECT study, remission of type 2 diabetes was defined asglycosylated hemoglobin (HbA1c) of less than 48 mmol/mol (6.5%) in the absence of glucose-lowering medication. Reaching this target of partial remission in a large percentage of study participants was a great success. Nevertheless, this remission target falls short of normalization of plasma glucose in real life and thus of a state in which glucotoxicity and beta cell stress would be minimized. Such a normalized state, however, seems necessary for the long-term maintenance of metabolic health. In contrast, partial remission to a prediabetic state is probably set up for failure and rapid reoccurrence of type 2 diabetes [9].

Currently, different devices permit obtaining a real-life glucose profile. Some transmit data continuously, while others rely on intermittent scanning. All, however, measure subcutaneous, interstitial glucose levels in short intervals. These devices are already established as valuable tools to guide insulin therapy. They provide detailed insights into glycemia that go beyond the information obtained by punctual plasma glucose measurements or HbA1c [10]. Additionally, a normal range for real-life glucose profiles has now been established through the study of healthy populations [11].

Given this level of development of continuous monitoring, real-life glucose profiling could be an ideal tool to evaluate the extent of type 2 diabetes remission. In this pilot trial, we, therefore, attempted to provide proof of concept that complete remission of type 2 diabetes related to metabolic syndrome to the point of a normalized real-life glucose profile can be achieved.

The monocenter lifestyle intervention study PiREM (Pilot study for individualized REMission induction of type 2 diabetes) was conducted at the diabetes center of the University Hospital, Ludwig-Maximilians-Universitt (LMU) Munich, Germany. Participants were recruited between January and June 2020 through the local diabetes outpatient clinic as well as through advertisements on public transport and online diabetes information portals.

Eligible participants were 18 to 64 years old, had been diagnosed with type 2 diabetes within the previous sixyears, suffered from metabolic syndrome, and were motivated to participate in the lifestyle intervention. The diabetes diagnosis had to be confirmed by an HbA1c 48 mmol/mol (6.5%) plus one elevated blood glucose value (fasting glucose 7.0 mmol/l, random blood glucose 11.1mmol/l, or 2-hour glucose in an oral glucose tolerance test 11.1 mmol/l). Furthermore, the glucose profile at baseline had to be diabetic (at least two time points with fasting sensor glucose 7mmol/l or any sensor glucose value 11.1 mmol/l).

Exclusion criteria were autoantibodies to glutamic acid decarboxylase 65 (GAD 65), tyrosine phosphatase 2 (IA-2)or zinc transporter 8 (ZnT8) >1.1 times the upper reference limit, fasting c-peptide<0.27 nmol/l, recent on-record estimated glomerular filtration rate less than 30 ml/min per 1.732 m2, current or planned pregnancy within the following 12 months, scheduled surgery within the following 12 months, myocardial infarction or stroke within the previous six months, known malignancy, severe or unstable heart failure ( New York Heart Association classII), previous bariatric surgery, hospital admission for depression within the previous 12months, substance abuse, or participation in another clinical trial. The current use of anti-diabetic medication, including insulin therapy, was not an exclusion criterion.

Written informed consent was obtained from all participants and the protocol was approved by the Ethics Committee of the Ludwig-Maximilians-Universitt (project number: 19-182). The study was preregistered at the German Clinical Trials Register (drks.de; study ID: DRKS00020453).

The study was designed as a single-arm pilot trial to test the feasibility of complete diabetes remission, defined as a normalized real-life glucose profile, after lifestyle intervention. The intervention period lasted six months. In one case, it was prolonged to nine months due to study interruption and in one case, it was concluded after five months due to personal reasons.

The primary study endpoint was the degree of improvement of glucose metabolism at the post-intervention visit. Complete remission was defined as normalization of the real-life glucose profile without glucose-lowering medication over at least five days (see below for further details). In case no real-life glucose profile could be obtained, an HbA1c value of less than 39 mmol/mol (5.7%) plus a fasting plasma glucose less than 5.6mmol/l without glucose-lowering medication were accepted as an alternative definition. However, this alternative definition of complete remission did not have to be applied.Partial remission was defined as an above-normal real-life glucose profile but an HbA1c in the prediabetic range of 39-47 mmol/mol (5.7-6.4%) without glucose-lowering medication.

Secondary endpoints were changes in body weight, BMI, waist and hip circumference, insulin resistance (calculated as homeostatic model assessment of insulin resistance (HOMA-IR)), insulin secretory reserve, whole-body, liver and pancreatic fat, systolic and diastolic blood pressure, serum lipids (triglycerides, cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) cholesterol), and changes in the prescribed medication.

The three main study visits were a screening visit, a pre-intervention visit, and a post-intervention visit that included measures of fasting plasma glucose, HbA1c, and serum lipids (triglycerides, cholesterol, HDL, and LDL cholesterol). Further, a real-life glucose profile, anthropometric measurements, MRI, and an arginine stimulation test were obtained during the pre- and post-intervention visits.

In weekly in-person visits during the first two weeks of the intervention, a study physician assessed the participants motivation, adherence to the diet, blood glucose profile, weight, exercise patterns, and possible side effects. After that, contacts were every other week in person or via telephone.

For participants with type 2 diabetes related to metabolic syndrome, all with a BMI25kg/m2, the lifestyle intervention started with a very-low-calorie formula diet (Optifast 800 or Optifast Professional, Nestl Health Science, Vevey, Switzerland, respectively; 815-865 kcal per day, distributed over five ratios of 163-173 kcal per day, 34-46%carbohydrates, 32-36% protein, 7-11% fat, and 5-7% fiber) for one to three months, depending on the individual progress. Only vegetables with negligible calorie content were permitted in addition to the formula diet. Participants were also advised to drink at least two liters of water or unsweetened tea per day to prevent constipation, which had been described previously in similar trials [8,12]. Further, participants were asked to monitor their plasma glucose and blood pressure. Glucose-lowering and blood pressure-lowering medications were reduced as indicated.

After a maximum period of three months, regular food was reintroduced, accompanied by regular nutrition counseling. The aim was to reach a maintenance diet that permitted further gradual weight loss or was at least isocaloric with an approximate composition of 25% carbohydrates,25%protein/fat, 40% vegetables, and 10% fruits [13]. Besides nutrition counseling, participants were coached regarding physical activity, exercise, psychology, and behavior change. To support physical activity, pedometers were distributed. The exercise target was at least 150minutes of moderate-intensity activity per week, preferably combined with muscle-strengthening activities [14].

Height, waistcircumference, and hip circumference were measured using a measuring tape to the nearest 0.5 cm. Body weight and body fat percentage were determined by bioelectrical impedance analysis (Tanita BC-418, Tanita Corporation, Tokyo, Japan). Resting systolic and diastolic blood pressures were obtained on both arms in a seated position and the mean out of two measurements on the arm with the higher systolic pressure was recorded.

Study participants were invited to participate in a whole-body MRI to determine pancreatic and hepatic fat levels via a low-fat fraction map technique (3 Tesla System, Ingenia or Achieva, Philips Health Care, Best, Netherlands). The MRI study protocol has been described in detail previously [15]. For two participants, baseline MRI data were missing due to scheduling conflicts.

Insulin secretory reserve was tested in an arginine stimulation test. The test protocol was adapted from Teuscher et al. [16] and Robertson [17]. Subjects with glucose-lowering medication were asked to pause their pharmacological treatment from the evening before testing. The stimulation test started after an overnight fast of at least eight hours. Fasting samples of plasma glucose and insulin were drawn, before a bolus of arginine (5g arginine HCl, given as a 0.29 mol/l solution; B. Braun Melsungen AG, Melsungen, Germany) was injected over 60seconds with time 0 set at the beginning of the injection. Further blood samples for insulin measurements were drawn at 2, 3, 4, 5, 6, 8, 10, and 15 minutes. The acute insulin response to arginine (AIRArg) was calculated as the mean of the three highest insulin levels obtained within five minutes after the start of arginine injection minus the pre-stimulus insulin level [18,19].

To obtain a real-life glucose profile, a FreeStyle Libre 2 device (Abbott Diabetes Care, Alameda, CA, USA) was used for 2-14 days at a time. The sensor was inserted into the upper arm adipose tissue.

Interstitial glucose values were measured every minute and stored in the sensor memory every 15 minutes. For validation, occasional capillary plasma glucose measurements were implemented. Participants were advised to scan their sensor at least every eight hours to avoid losing any values stored in the sensors temporary memory. However, they were not supposed to use the sensor values to guide any lifestyle decisions.

A real-life glucose profile was obtained at least twice during the study, at the pre- and the post-intervention visit. An additional profile was obtained during the intervention period as needed to guide the intervention or to decide about medication.

Reference values for a normal real-life glucose profile have been published previously by Shahetal.[11]. According to this publication, we classified a profile as normal when glucose concentrations remained between 3.9 and 7.8 mmol/l at least 96% of the time. To display and analyze the real-life glucose profiles, we used the web-based diabetes management system LibreView (Abbott Diabetes Care, Alameda, CA, USA), and the glucose values were stored in the sensor memory every 15 minutes.

Plasma glucose was determined by the hexokinase method (Glucose HK Gen. 3, Roche Diagnostics, Mannheim, Germany), serum insulin by chemiluminescent immunoassay (DiaSorin LIAISON Systems, Saluggia, Italy), plasma HbA1c by high-performance liquid chromatography (HPLC) (VARIANT II TURBO HbA1c Kit, Bio-Rad Laboratories, Hercules, CA, USA), and serum blood lipids (HDL cholesterol and triglycerides) by enzymatic caloric test (Roche Diagnostics, Mannheim, Germany). LDL cholesterol was calculated by the Friedewald equation. For antibody determination, enzyme immunoassays were conducted (ZnT8: Medizym Anti-ZnT8, Medipan GmbH, Dahlewitz/Berlin, Germany; GAD65: Anti-GAD-ELISA (IgG), Euroimmun Medizinische Labordiagnostika AG, Lbeck, Germany; IA-2: Anti-IA2-ELISA (IgG), Euroimmun Medizinische Labordiagnostika AG, Lbeck, Germany). The HOMA-IR was calculated from fasting samples according to Matthews et al. [20]: HOMA-IR =glucose0(mg/dl)*insulin0*(IU/ml)/405.

Due to the small group size, variables were treated as non-normally distributed and are presented as median (first quartile-third quartile). To compare pre- and post-intervention measurements, the Wilcoxon signed-rank test was used. Fishers exact test was used for the comparison of categorical variables between visits. Two-sided p-values < 0.05 were considered statistically significant. Statistical calculations were performed using the statistical software program IBM SPSS Statistics (IBM SPSS Statistics for Windows, version 25.0, IBM Corp., Armonk, NY, USA). For graphic representation, GraphPad Prism was applied (GraphPad Prism version 6.0 for Mac, GraphPad Software, La Jolla, CA, USA).

Ten participants with type 2 diabetes related to metabolic syndrome were included in this study. The participants' median age was 52 (43-56) years, they had a median BMI of 33.1 (32.1-37.7) kg/m2, and the median time since diagnosis was 1.5 (1.1-5.3) years (Table 1).Of these 10 participants, seven completed the study. Two dropped out due to unwillingness to follow through with the nutritional program and one because of a long-term stay abroad.

At the end of the study, one participant reached complete remission, three achieved partial remission, and three displayed improved glucose control still in the diabetic range (Table 2 and Figure 1). Additionally, body weight, BMI, waist circumference, hip circumference, body fat percentage, and HbA1c decreased significantly in the whole group. Fasting plasma glucose, fasting insulin, HOMA-IR, liver fat, pancreas fat, systolic and diastolic blood pressures, triglycerides, and total cholesterol depicted non-significant downward trends. LDL and HDL cholesterol, as well as the AIRArg, remained unchanged (Table 3 and Figures2-5).

This pilot trial demonstrates that complete remission of type 2 diabetes related to metabolic syndrome to the point of a normalized real-life glucose profile is, in principle, possible through lifestyle intervention. However, this trial also illustrates that fully effective lifestyle change is difficult to achieve.

We consider the trial results a sufficient proof of concept for our hypothesis despite the fact that only one out of 10 participants reached the set remission target. This participant had been diagnosed with type 2 diabetes 1.4 years before study entry and had a baseline HbA1c of 51 mmol/mol (6.8 %) while taking metformin as glucose-lowering medication. Therefore, we believe that truly complete remission of established type 2 diabetes occurred in this case. Furthermore, three other trial participants reached partial remission with real-life glucose profiles in the normal range of 60-85% of the time.

As in previous studies, glycemic improvement in our trial was linked to weight loss,a reduction in hip and waist circumference, and whole-body, liver, and pancreas fat [7,21,22]. Due to the small sample size, not all of these changes were statistically significant, but the trends nevertheless appeared clear. Additionally, we observed other expected benefits of weight loss and lifestyle change, such as trends toward lower blood pressure and reduced serum triglycerides.

To avoid hyperglycemia after glucose administration, we conducted simple arginine stimulation tests to determine the insulin secretory reserve [18,19]. The median AIRArg remained stable over the study period, indicating unchanged stimulated insulin release. However, a more differentiated assessment of beta cell function may provide additional insights in future trials.

As in most lifestyle intervention trials, success in weight loss and glycemic improvement was variable between participants, despite intensive and individualized counseling [23]. This observation highlights the need for further improvements in intervention protocols for the induction of type 2 diabetes remission. We also want to reiterate that our findings and those of previous trials [7,8,21,24] only concern type 2 diabetes related to metabolic syndrome, not unrelated type 2 diabetes subtypes [1]. In those subtypes, remission by lifestyle change may be illusive or, at least, effective approaches have not been found yet.

The main limitation of our study was its small sample size. Nonetheless, we could demonstrate that complete remission of type 2 diabetes to the point of a normalized real-life glucose profile is possible in principle. Moreover, every participant completing our intervention improved his or her glycemic status and gained health benefits. Another limitation of our study was that we could not obtain baseline MRI data from two participants. Given the already small sample size, this missing data are probably responsible for the non-significant results regarding ectopic fat in the liver and pancreas despite the importance of these fat depots, which has been demonstrated in previous remission trials [7,21,22].

Excerpt from:
A Normalized Real-Life Glucose Profile After Diet-Induced Remission of Type 2 Diabetes: A Pilot Trial - Cureus

Its one thing to play Superman on screen, but its another thing entirely to walk around looking like a Kryptonian in your everyday life. And the first thing youre likely to notice when staring at Henry Cavill on Zoom are his shouldersnot even his Clark Kent jawline can distract from the small mountain range erupting from his humerus and clavicle. None of this is exactly news, given the multiple high-profile roles in which Cavill has transformed his body forThe DC universe, The Witcher, extremely buff Sherlock in Enola Holmesbut you truly cannot prepare for how mesmerizing those deltoids are.

Which is why Cavills latest role, as an ambassador for the supplement company MuscleTech is perhaps the most natural line on his resume. GQ caught up with the 38-year-old actor to find out how supplements influence his diet, his thoughts on pre-workout, and just how many meals a day you need to eat if you ever want shoulders like his.

GQ: Supplements are such a huge part of the fitness world, but I think something that can often be misunderstood, especially when youre first starting out. What was your journey with using supplements like?

Henry Cavill: It's an interesting thing, because I've been very fortunate over my career to have pros guiding me. As useful as that has been when it comes to physical results and how the body looks when I'm taking my shirt off on camera or whatever the case may be, it does certainly hinder my growth in knowledge. And so over the past couple of years, I've been trying to quiz my trainer, Dave Rienzi, more and more about the why of everything. Why is that going in? Why this rather than that? Aren't they both carbohydrates? Why this protein versus that protein? What does it mean when you do this before or afterwards? And so my journey is still very much in process.

Once you started asking those questions, was there anything that you were surprised to learn?

So I have a protein shake before bed, and there would be times where Id go, you know what, I want to lose a few more pounds, so I'm just going to cut the pre-bed shake out and not tell my trainer Dave. And itll be fine, because I'll be losing a few pounds and then I'll get back to showing progress photos and people will be like, Oh wow, look at the progress you made! But if I took three weeks off, when I would send Dave a progress photo, he would go, Okay, cool. So are you still taking the pre-bed shake? And I go, No, because I wanted to lose a few pounds.

That's when I started asking these questions because he then informed me that the problem with that logic is that, yes, you do have fewer calories going into your body, but you also go into a catabolic state with how hard you're training and how hard you're working. So actually what you're doing is you're losing muscularity while you sleep. So your body won't be looking as good. And almost immediately when I went back to the pre-bed shake, I was like, Yeah, the body looks better already. And for me, that was a massive learning point and a real shock. I thought, I need to start asking more questions and stop thinking that I can pull a fast one and pull the wool over his eyes.

I love that Dave instantly knew, too. Like, Hey, are you skipping that? But I think that's the preconceived notion, right? Don't eat before bed.

Absolutely. The protein shakes before bed, they are a real lifesaver for me. Especially with the amount of work, with the amount of output I have. It's important to make sure that all the right stuff is getting in at the right time so you don't lose anything and you're not wasting any time at the gym.

So youve got the protein shake right before bed, but what does a typical day of eating look like?

Read the original:
Henry Cavill Is Happy to Eat the Same Thing Every Day - GQ

For those who work out, protein supplements are a part of their life. Protein intake may vary from person to person, but a diet is incomplete without it.

Medical researchers advise against protein supplements for an average person, because the amount of protein every person requires depends on factors like age, sex, health and activity level. Ideally, your daily food should provide you with the required protein, say Dr Sanjay Shah, general physician, Fortis Hospital, Mulund and Shweta Mahadik, clinical nutritionist, Fortis Hospital Kalyan.

But many sports trainers continue to push them on amateur athletes.

The question then arises of whether you need protein when you exercise, particularly when you try to build muscle through weightlifting or other forms of resistance training. The doctors answer in the affirmative. The process of building muscle involves causing damage to muscle filaments and then rebuilding them, and this requires more protein, they say.

Why do we need proteins?

Protein is an essential macronutrient made up of amino acids. These chain-like compounds can be broken apart and put back together in a nearly endless variety of patterns which are used to create different kinds of cells.

Your body can make some of these amino acids on its own, but not all of them. The complete proteins found in animal products are your best sources of the essential amino acids that your body cannot produce.

But keep in mind that you shouldnt consume extra protein. Dairy products are also high in protein, as are certain green leafy vegetables and legumes. Too much protein can put a strain on your kidneys, so if youre using protein supplements to lose or maintain weight without working out, you need to balance your diet with fresh fruits, vegetables, whole grains, healthy fats and 1-2 litres of water per day. Tofu, soya milk, lentils, chickpeas, pinto beans, almond milk, nuts and oil seeds like sunflower, pumpkin seeds, sesame seeds etc., are rich sources of protein for vegetarians and vegans, they explain.

Consuming proteins in the right way

A healthy individual needs 1g protein per kg body weight per day. When training, however, they need about a half gram of protein per pound of body weight.

If you want to slim down or need more protein in your diet, feel free to have a protein shake on your off-training days. For example, if you skip breakfast or have a meeting to rush to in the morning, drinking a protein shake can provide you with the energy needed to function optimally. These, however, cannot replace meals; their role is to supplement your diet only, the experts say.

The risk factor is that all food and beverages provide calories. Protein supplements in the form of shakes and bars are no exception. They work best when used as part of a training program since they fuel your muscles into growth and increase fat burning.

Keep in mind

The doctors say that incorporating protein supplements in your diet with no workout at all is not recommended. If you go overboard, you may end up gaining weight especially if you have a sedentary lifestyle. You may also develop hyperaminoacidemia (excess of amino acid in the bloodstream) with nausea and diarrhoea symptoms; other health concerns may include kidney problems. Extra intake will slow down the kidneys metabolism.

If you need to consume more protein, but you do not exercise, it is best to have natural sources of the macronutrient as mentioned above coupled with minimum exercising. Remember to keep the nutrition factor high, and the calorie counts low if you arent exercising to burn off extra calories.

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The protein count: Do you need supplements even if you dont work out? - The Indian Express

Sometimes your body notices things before your mind does: you might think youre so far away from the menopause that a hot flush is just a thing you can fake to get out of a boring situation, but your midriff knows better. Lucinda Meade, 57, is a physiotherapist and personal trainer. She has trained many clients through the menopause and says it tends to start with surreptitious weight gain around the middle, which they then cant shift. It may be accompanied by aches and pains in smaller joints, and an unappetising smrgsbord of mood changes, sleep changes, annoying visits to the GP to be given antidepressants.

All this makes perfect sense from a hormonal perspective, as another trainer, Sarah Overall, 51, describes: Oestrogen governs so many of your bodily processes, and one of the things its involved in is water regulation. Its a lot easier for tendons and ligaments and joints to become dehydrated. And that can also lead to a resurgence of old injuries. Plus, when your female hormones decrease, you go from having a gynoid shape, carrying fat on your hips and thighs, to android obesity, abdominal fat, which is a male shape.

But what are you supposed to do, fitness-wise? Should you power through the aches, pains and lethargy, or just give up on being fit until you are out the other side? Are there adjustments you can make to the way you exercise and eat? Can you make it any better by working up to it beforehand? Finally, are there any upsides to the menopause, or is it just an irksome creep towards death, only ameliorated by the fact that it happens to (half of) everyone?

Arj Thiruchelvam, a personal trainer who coaches elite athletes, says of this power-through or take-a-break dilemma: Always make the decision on a macro, rather than a micro, level. In macro terms, to give up exercise during your menopause would be a disaster as your muscle mass decreases with age at the rate of about 1% a year. For menopausal women, its much more substantial than that. You need muscle mass to protect your bones, not to mention, as Meade says, the fact that it decreases cell death, increases stem cells and decreases fat cells, which are a secretor of inflammatory markers. Ageing is all about chronic, low-level inflammation.

On a micro level, though, Thiruchelvam says, if youve had hot flushes throughout the night and not slept, its probably worth listening to your body and giving yourself a rest. Overall has a 10-minute rule: If I wake up and I dont feel like a workout, I think, Ill do 10 minutes and if I still feel rubbish, Im going to stop. Thats the biggest piece of advice I can give anyone 95% of the time youll feel fine after 10 minutes.

Its also important to have weekly rather than daily goals, and be flexible (mentally as well as physically): use your energy when you have it, rather than beating yourself up about the times you dont. This will mean prioritising yourself and flaking out of other obligations, but thats fine your oestrogens dropping, so hopefully youll be less of a people-pleaser, too.

Now all you have to do is completely change your perception of what kind of exercise you need and enjoy. Meade explains: A lot of women have done a lot of yoga and running and they really need to be coaxed into weight training. This will probably be different once millennials are menopausal, since they have a huge iron woman culture and are all over calisthenics (building strength using your own bodyweight). But women now in their late 40s and 50s will have had their formative years in the 1980s, when exercise was all about looking skinny and weight-training was unpopular. Younger readers may not believe it, but magazines were absolutely full of the perils of muscle-building, and how once youd given yourself huge beefy shoulders, thered be no going back.

But there is more than one way to skin this cat. Dancing, rock climbing, climbing trees, anything: find the thing that works for you, says Meade. But there must be some strength element. Elite athletes, being so body-literate, often notice sooner than the rest of us that something has to change. Jenny Stoute, 56, represented the UK in the Olympics in Seoul and Barcelona, taking bronze in the 4 x 400m relay, before she became Rebel, the Gladiator, in 1996. Her menopause started two years ago, and now she says she cant even jog. If I went out on the road, springing up and down, my hamstrings would be history. I know my lower back doesnt like too much impact. So Ill do weights and body-bearing stuff, go on the rower, go on the cross-trainer. To be fair, I dont really want to run 100 metres. I had my time. All I want to do is look after my body to the best of my abilities.

Its a really good idea to get ahead of this if possible. People go into the menopause like some ghastly blind date where you know its going to happen but you hope its going to be OK, Meade says. Everyone in their 40s should be thinking about getting themselves in tip-top shape so that when it happens, its as fine as it can be. Dont treat it like a lottery and dont wait until youre feeling crap and then try to make decisions in that state.

Besides strength training, what does this actually look like? Work on your diet, so that your blood sugar isnt fluctuating too much: this can stave off the worst of the hot flushes, and will also help with mood swings. Dont try a ketogenic diet but do use a protein calculator, as protein-rich meals can help in maintaining muscle mass. You might want to adjust your portion size to suit your reduced basal metabolic rate (this is the amount of energy you use at rest, doing basic tasks like breathing and keeping warm) or you might think, sod it, one thing at a time. Take vitamin D and calcium supplements, and omega-3s the first two for bone health, since the loss of oestrogen often causes osteoporosis, the third for mood.

Work on the dehydration, not just by gulping water when you remember but by learning to recognise your personal signs of being dehydrated, and figure out when in the day its at its worst. A lot of menopausal women say they suddenly have no tolerance for alcohol and start to see wine, especially, as a kind of kryptonite. But its essentially just that the concentration of alcohol in your blood is higher. Im not saying you have to drink just that, if you stay really well hydrated, maybe you can.

If you havent got a sympathetic GP, see a pelvic health physiotherapist. Your pelvic floor muscles weaken regardless of whether youve had children or not, so bladder control becomes an issue as well, Overall says. Trampolining is a famous no-no for the menopausal, but running can also highlight bladder-control issues. I personally wouldnt sweat it. Youre probably going to have a shower when you get home anyway. And thats not even the worst of it: A lot of women will have had untreated issues from childbirth and then the menopause hits, on top of maybe a tiny little prolapse vaginal atrophy is a nightmare, Meade says. Pilates, generally, and Kegels in particular will help. In addition, its a good idea to find out what your family history is, particularly with osteoporosis. The more likely you are to get it, the more important it is that you do the strength-building work that will protect your bones.

Everybody I speak to is of one mind on HRT: if it works for you, do it, and start as soon as you get symptoms dont wait until they are unbearable. There is a certain reticence about starting HRT, a misplaced stoicism, a sense that you only need it because youre weak. Most of the perceived risks of HRT are historical and have been substantially reduced by developments to the drug regimen; there is a negligible rise in the risk of breast cancer, for instance, with oestrogen-only HRT.

Menopause symptoms interact with one another in unhelpful ways: sleep deprivation because youre too hot doesnt help with the mood swings, and a low mood makes things look worse than they are. So many menopausal people, including fitness experts, take a harsh view of their changing bodies. The bloating is terrible, Overall says. People are looking at me for their fitness and I look like a Michelin man. Stoute says her own athletic past has made her more of a wreck. Anyone who used to be top of the tree in the sporting world is thinking, My whole body feels like its falling apart. Its almost like the fitter you are at your peak, the worse the other end becomes. I look her up on Instagram (@gorgeousfifties), and find she still looks incredible. Be kind to yourself sounds like a cliche, but its worth doing anyway.

And finally, is there anything good to be said for the experience? Meade delivers this rousing statement: Its a wake-up call. Youre likely to live until youre nearly 90. How do you want it to be? How do you want to feel? Make a plan for that. Its a reminder that you can make choices and change your life for the better. Dont be a victim; you can fix it. Im much fitter than I was before.

Overall agrees: Im not there yet, but friends whove come out the other side say its absolutely brilliant. You dont have to worry about periods any more, you dont have hormonal fluctuations, you feel great. Nobody has ever said to me, This is rubbish. I miss periods.

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Work your muscles and rethink your diet: how fitness can help you through the menopause - The Guardian