64: A Guide to Supplements for Women in Midlife with Ange Clark

Welcome to Dear Menopause podcast, where we discuss the menopause transition to help make everyday life a little easier for women. Sonya Lovell, your host of Dare Menopause. I'm a menopause campaigner and I am a huge advocate for healthy eating and looking after our bodies from the inside out, which is why I invited on to today's episode one of my most favorite guests ever, angelique Clark. Angelique Clark is an absolute legend in this space of menopause and perimenopausal nutrition. So today we are talking supplements. This is a juicy, juicy topic And if you hang in there right through to about the 40 minute mark and gets really, really fired up about the supplement industry, you are going to love this episode. Angelique Clark, welcome back to Dare Menopause. It is such a delight to have you with us today.

Thank you, Sonya. Thanks for having me back. I'm excited about this chat.

I am super excited, even though my voice probably isn't giving away how excited I am. I am suffering from a winter cold flu virus. Whatever It got me good this week And, as a result, my voice isn't quite as perky as I would like it to be. But our schedules are so ridiculous. We had to take this opportunity to get this episode recorded, because we'd already pushed it and rescheduled it once because you were sick. We are sitting down today to chat about supplements, so we're talking about supplements for women in midlife, perimenopause, postmenopause, but we're going to throw into the mix some supplements for immunity because, hey, it's a hot topic right now. But before we get into all of that, for anyone that hasn't come across you before on my podcast, why don't you give us all a little intro about who you are and why you, in particular, are here to talk about supplements today?

Oh well, first and foremost, my official title is an advanced accredited sports dietitian and I also have a degree in exercise physiology. But where I practice now and where I sit is helping active and also I always say an everyday active, so generally getting women to encourage them to exercise, and I help women in midlife. So the perimenopause transition really nourish a hyperbolic lifestyle. So, specifically, looking at the ways in which we can use food and nutrition and maybe perhaps supplements to enhance this whole transition, and I think it's a particularly imperative time And I have a really big passion for supplements because for a lot of time I took a lot of shit and it didn't work and I spent a lot of bloody money. So I'm here to sort of set the record straight. I have done a masterclass previously that was really popular and women were just dumbfounded at the stuff that they had literally wasted so much money on that. I think we just need to set the record straight as it relates to supplementation.

I'm with you. I also have taken so much shit over the years because it was trendy, because somebody else was taking it and it sounded good. Yeah, emotive.

Yeah, the sports grows.

Oh my gosh. there is so much that we can clear up here today as well as give really good evidence-based advice for women that is specific to women, which is, i think, one of the things we want to get really clear on, and where is the best place for us to start?

Well, i think, first and foremost, we need to think about who would actually benefit from taking supplements. So the first thing we need to consider is do you have some clinical blood work or value that would indicate that you would be at an extra need for adding more on top of what you're currently doing in your lifestyle? So that's the first question I'd always ask. And if there is a clinical blood value, just like a blood test where you can see some of those levels of micronutrients, vitamins, minerals, these types of things, perhaps you've been deficient in iron in the past, maybe you've gone to your GP and your bone mineral density has been questioned because you are aging now, maybe issues are lowering and may have might have possibly mentioned things such as calcium. So there's often a lot of talk in and around deficiencies, but true deficiency we really only take a little bit more seriously with a blood value And unfortunately that's it's kind of a last resort, which is not great, because I think we can always talk about prevention and that's always really good, but often it's not until we have a problem that we go and get our bloods done and then we find, oh, we're deficient in this, so what can we do about it. And then people come in and, as a dietitian, obviously people bring their results in and say, oh, my GP and my doctor has suggested that I need to look at my nutrition in order for me to get these vitamins and minerals. And so that's kind of the first place I would consider Okay, we've opened up the supplement conversation. The next point I'd always sort of look at and it's funny because when you look at the people that purchase supplements and I've looked at the statistics, i'm not going to tell you how much a billion dollar industry it is multi-multi-billion dollar industry Like there is a lot of people spending a lot of money on this. And people that are spending a lot of money on this are often women in midlife And once they're actually, funnily enough, really interested in their health, so they have a health value. And this is where we see a lot of people tend to look at supplements when they're already doing a lot of good, healthy behaviors, and then they start to go well, what more can I do? And so these are the things that they look to. Now a lot of people and sometimes people go to supplementation before they've even done that. They know that maybe their health should be a little bit better, but they may be trying to find a lazy way to sort of go about it. And then they want to find a magical unicorn in a pill.

I love that A unicorn in a pill.

And this is it I'll say to people sometimes you might be eating a lot of calories or energy, but your nutrition is actually kind of nutrient poor. So we need to determine the difference between, well, what exactly are the classified areas of supplementation? And there's a couple of different categories. So there's health supplements. So, as we've just mentioned, maybe it's a vitamin or a mineral or a cluster or a combination of that is how it's been presented in the pill or in the tablet or the drink or whatever. There are also sport related supplements. So there's definitely supplements that come in to help sport related situations, also called ergogenic aids as well. So things such as, maybe, caffeine or pre-workouts, these types of things. So there's a little bit of that sort of category. But the other thing I often find, particularly with the midlife woman, is that if there are symptomology so if they're coming in and they're now experiencing symptoms of menopause and menopause, transition, perimenopause, that undulating hormonal pattern is now giving them a little bit of trouble They often will look for these herbal supplements and sometimes they sit in a little bit of a separate category. So these are things such as neurotropics, which might help with our brain function, and then you've got the other subclass of those being adaptogens, which are a little bit different to supplements. So, in any which way, we kind of all look at these under a big, big, broad banner, but it's important to determine the difference between each of these classes and categories as well and the reason why we're taking it. So sometimes people will be getting lots in their diet but they might need a little bit of extra nutrients because they're not quite eating maybe the particular foods that might support or provide that, and that might be because maybe they can't have dairy And so they're missing out on calcium. So they tend to look for supplementation with that. On the flip side, i actually have worked a lot with women that are perpetually on diets, and I know we've spoken about this the last time we spoke. But of course, if you aren't eating enough for really chronic periods of time if you're a consistent diet, you're a yo-yo diet there are going to be really big chunks and periods of your life where you're not going to get adequate nutrition, then of course you're not going to get adequate micronutrients, in which case I would definitely be looking at supplementation in that from that perspective, and then maybe possibly some other clinical needs. So obviously we look at menopause as a transitionary time where our body actually requires a little bit more nutrition. Our calcium needs do actually go up. We are looking at things such as cholesterol markers So maybe supplementation can help with that And also things such as conditions such as PCOS, endometriosis, pregnancy as well. So, yeah, any of those types of scenarios where your body needs are a little bit more heightened. We want to be a little bit more diligent about where that nutrition is coming from, and often supplementation sort of comes into the conversation of how we can best get there.

Going right back to the very start where you talked about the blood testing, And so perhaps you've been to your GP and they've recommended doing some blood tests and then they've gone. Okay, let's get you to a nutritionist because we can do some work here with your nutrition. If you were wanting to get a really good picture of what was going on for you internally with those values So getting a good look at your biomarkers Do you have a recommendation around what you should be asking your GP to test?

Yeah, i think it's really important just as a general health check. So they'll start with something if nothing's wrong, particularly So, firstly, we say symptoms. So that's another reason why I would look at supplementation. If somebody came into my office and said, look, i'm really suffering in terms of symptomology, i'd say, okay, well, there's some supplements that have a pretty good, robust amount of evidence. Let's look at you in terms of using that for your specific condition and population. But we're also not going to look at that unless we look at your overall intake from a food perspective as well. So if you did want to do just a general test, you might go in and say, look, i'm suffering from XYZ, can you please test? And they might do something a little bit more specific. But in general, it's actually really good just to get a blood test as a general annual health check. So if you just went, i just want a general health check that would probably give you a lot of data. It's not going to be specific to women, essentially, but if you want to add a few extra values to that. So first thing is a full blood count, and often this is generally bulk billed by your GP, which is fabulous. You don't have to pay for it, but there is a little bit extras and I call it the well woman check. So there's a couple of other things such as possibly thyroid. So that's something that we do see get impacted, particularly in midlife obviously a little bit more stressful and all the rest of it, but we often get women that do complain about the lowering or slowing of the metabolism. So often it's just really nice rule of thumb to check that out In a full blood count. You're also going to get your cholesterol markers And that's really important for us to be looking at these types of things in relation to preventing things such as high cholesterol, cardiovascular disease and these types of things that often happen and occur just simply as a result of estrogen lowering with that midlife transition. So thyroid, definitely. The other thing I really see, particularly in midlife, is a little bit more case of insulin resistance And this is as a result of the belly fat or the visceral abdominal fat gain, so that midsection belly fat is going to increase our likelihood to possibly contribute to things such as insulin resistance. So a fasting blood glucose test would be great. They might do an oral glucose tolerance test but like when you were pregnant, to see how quickly or slowly that sugar enters your body and how quickly you clear it out of the system as well. Sometimes you can get a bit of a ratio and get an insulin to glucose ratio and exactly what that looks like, just to predict Are you actually insulin resistant, which then affects how you metabolize carbohydrates? And so we really want to have an insight over those markers, because that makes it really important. Then we're making nutrition interventions that we've got a little bit of that visibility across what's happening as well. So they're probably the main ones that I can think of, particularly in the peri transition. I often look at iron and, in particular, a few other biomarkers of that. So a general blood test might not give you all the things that we're looking for. We definitely want to have a look at hemoglobin, but ferritin is really important, the storage form of iron. So just double check that that sort of thing is in there as well. And then anything in particular that you might be in response to, sometimes CRP. So C-reactive protein is what they're looking for as a marker of inflammation. You can get some cortisol levels, but I'm generally going to predict that most of the time we're really busy and it's going to be high anyway, and it depends on when you take that test as to where your cortisol sits as well. Sometimes just pure anxiety might elevate those levels a bit more as well. But it's nice just as an inflammatory marker, just to see where that is. But that would probably be the biggest ones, i think, off the top of my head, unless, like I said, you've got some specific concerns, in which case you direct you otherwise.

Yeah, I know from personally, i always ask for my vitamin D to be done. B12 is another one. I find, yeah, from an energy perspective and I know as women it kind of ties into that cortisol. We're busy. Often our B vitamins are lacking a little bit and that can also be diet related as well.

And it also helps in our carbohydrate metabolism. So we need B vitamins to help us process and metabolize carbohydrates, and if we've got a little bit of insulin resistance happening, it's often, yeah, a result of, yeah, not getting enough B vitamins as well. And calcium is calcium one that can be tested as well. Yes, so what we look at with that is because it's bone health, right. So this is the thing. Then increases in terms of risk factor management as we age. So bone health is really interesting. I would look at a couple of other factors in relation to that. It's vitamin D and calcium, absolutely, but then I would look at how much calcium we're getting in. So sometimes the other thing is to remember that you know, whilst you're getting clinical values and you might be within range, if you're looking at and this is where we do a dietary assessment and we go okay, well, generally, let's get a picture of and a feel for, kind of, how you habitually eat, because that's going to give us an indication of how much of those nutrients you're getting through your food. And if I can see that there's a hole there, then that's when we go in and really, you know, that's when nutrition becomes really prescriptive And we're like okay, we need to get you know. Calcium, for instance, generally it's about 1000 milligrams a day for our premenopausal women And then once we hit postmenopause it goes up to 1200 milligrams a day. So, at 12 to 1300 milligrams a day, so that's actually really difficult for us to get in from that instance as well. But, yeah, vitamin K is also another one that helps in that cofactor of bone health as well. So, yeah, all of these clustered in together is going to give us an indication and it is important, like we said, that that is should and starting to lower, that we definitely look for these sorts of things for sure.

Other areas that I was really keen to hear from you about are things like magnesium. So obviously these are going to be picked up in our blood tests, but they're often, i guess, supplements that I hear are regularly recommended as being highly recommended for women in the menopausal transition. So where do you stand on that?

So, yeah, i mean magnesium. I think, in particular, most menopausal women will have inadequate magnesium levels, so we often see this. It does actually then put you at greater risk of poor health. Obviously, magnesium plays such a big factor in so many other processes cellular processes within the body, so I often will find that magnesium is an important factor when we're looking at women in general, but it can be obtained quite readily from food. So when I talk about supplementation, it's really interesting. I think what we need to remember is that let's talk about a cupcake, so let's talk about the base being the batter. It's what's majority of the cupcake is made of. This is basically going to be your biggest results driver, and your cupcake batter is really what we're looking at in terms of day to day nutrition, habitual nutrition. What you eat for breakfast, lunch, dinner, snacks on a regular basis, day in, day out. That's your first protocol from a nutrient perspective. Then, on top of that, we've got the icing on top of the cake. So the icing is looking at specifically what can we do around certain key times, for instance, exercise, to enhance our nutrition, and possibly that might require a little bit of supplementation. If you can't get it from your food. It's a little bit too busy, life's a bit hectic and we want a convenient lifestyle, so we might be able to add some supplementation in to maximize that window of opportunity when our bodies are more susceptible to taking on board nutrients, which is a beautiful reason as to why we want to get women training and being active. And then, on top of that, this is where these micronutrients sit, so they are the sprinkles on top of the icing on top of the cake. So if I'm going to look at the ratio we're looking at, 80% is really you're going to get a lot of this nutrition from your day to day diet. 20% is where we're looking at maybe those organic aids, maybe we're having a little bit of caffeine around training, or maybe we're using an adaptogen to help us a little bit more, because we want to reduce those adrenals, so we don't want too much caffeine, and maybe that's in and around that sort of performance aspect. And that could also be, like I said, brain performance, cognition, giving us a little bit more extra boost when we're thinking about okay, well, how do I function day to day at work? Do I need a little bit of extra focus and these types of things. Where are my adaptogens coming in. That might help with my symptomology. So this is about 18 to 19% difference. Right, and now some women will argue the supplement changed their life. I'm like, okay, we don't really particularly have evidence for that, but if you changed your lifestyle at the same time you took a supplement, it's probably likely 80% attributed to what you are doing in terms of health related habits. Right, like I said, 18 to 90%. Icing on top of the cake, the specific stuff that might actually help once your cake batter is built, and then the one to 2% is going to be added in terms of those sprinkles on top of the icing on top of the cake. So it might help, but it's not going to help anymore than trying to look for a beautiful, nutritious diet that is suitable for the perimenopausal or menopausal woman going through that transition. And I think that's the biggest key to remember is that, yeah, it's great. Love magnesium. Love it for active women, especially if they're losing their electrolytes, if they have problems with starting training and their muscles are really sore and things like that. So magnesium is great for sleep, it is a muscle relaxant, so I would often play around a bit with certain dosage. Again, don't be taking these things and going if a little bit's good, more is better in the way of supplementation. You really have to be careful with this sort of stuff. So you have to understand, okay, first and foremost, where can I get it from my diet? So that's the first thing I want to ask myself. Okay, if I'm getting an adequate level, whatever the RDA is for that particular nutrient, then I kind of don't need to add this. But if I'm showing symptoms, and particularly for my perimenopausal women, if they have a lot of PMS in that late luteal phase, if they're really struggling with that, i will actually add 300 milligrams of magnesium at night time to help them, with a bit of zinc, with a bit of omega-3. And that helps that particular moment in that cycle for them. But I'll do that for three cycles and then we'll take it away and see what the difference was. So remember, with supplementation the idea is that we weren't all born and then we got out, we ate food and then all of a sudden we needed supplements. So supplements have really been created. They're a very highly processed way of extracting nutrients from whole foods, which were beautiful to start with, and if we think about the food matrix itself. There's so much value and benefit in that as a whole, like it was naturally designed to be. I mean, nature is phenomenal, our bodies are phenomenal, so if we are lacking in one particular area or another, your body will adapt, it will learn to adapt. But what we're trying to do is we're trying to be at the forefront of that. We're trying to help it a little bit. So if we can give it and provide it with enough of the nutrients available, majority of times you don't need to be perfect. Nutrition is never perfect, right, but it will work with what it's got. And then if you are experiencing some symptoms on top of that, then we might look to supplement specifically. But test and measure, okay. So we're never on these things for long term as well. And the other thing I probably would use magnesium with is particularly headaches and migraines. So and again I'm looking at the research, i'm looking at what the strength of evidence is there for that particular person. Has the studies done it in menopausal women, you know? or the person or the client sitting in front of me, like, where is that from? So if there's some element of evidence there and it does no harm, then I'll say you know what? if it's worth the money, it's not going to do any harm and it's going to help improve your symptoms. Let's try it at the therapeutic dose. What the literature will tell us So often this is another big key factor when it comes to supplementation is little bits and pieces that you find in you know supplement stacks and stuff like that. They actually don't have enough based on the evidence in terms of reaching a therapeutic dose amount that's actually going to make a difference. So I think you've heard of the word placebo So often. When we are really brought into something, we're invested in that making you feel better, and this is where a lot of see I see a lot of those sort of supplement stacks being really quite poor with you know XYZ or you know whatever it is that's in there, this natural, you know amazing concoction of different stuff, and it actually isn't even ticking the marker of what the evidence would tell us would be of a therapeutic benefit. It really depends. It really depends.

What I guess, what I'm hearing, is that there is a massive marketing machine at play here when it comes to supplements and those shelves in your health food shop, in your pharmacy, that are laden with supplements for everything possible under the sun And potentially you're spending a lot of money on something that's just going down the toilet at the end of the day.

Yeah, and literally So. A lot of our water-soluble vitamins. If we don't need them, we'll just pee them out. So it's literally pee down the toilet. You're literally weighing it out.

Another area that I'm really keen to get your thoughts on is and I know that you're keen to talk about this is the green powders. So the whole add the greens to your smoothie in the morning kind of scenario. I know you did a little bit of a post on social media about this recently. Tell me your thoughts on this.

Yeah. So this went viral and I thought at one stage I was like, oh my gosh, athletic greens is going to kill me because I'm just. That wasn't my intention. So the idea with this is it's very interesting. So these were obviously made really popular because, of course, remember how we look and decide about different things, right? So a lot of the supplement market has been based on a mode of marketing. You'll see a ripped or like really spelt bigger, or you'll see a celebrity take something and you're like, oh my God, and you'll just automatically this is what our brain does. Our brain automatically associates that supplement because that person is holding that supplement, saying I'm here taking it because they've been paid to say that, sorry to break everyone's bubble, but they get paid big, big money to be seen with these supplements And of course, a lot of the athletic area are going to be seen doing these types of things And it's sponsorship, it's corporate ads and things like that as well that they go. This is the best form of advertisement. So if you then go, all right, well, that person is standing next to that. If I want to look like that, this is what our brain does. If I want to look like that I must have to take, that I have to say that that's not going to happen, first and foremost, but because we are so driven by emotion and because weight is such a and you know appearance, physical appearance is so prominent in our brain, a lot of the times we end up purchasing these types of things, and one particular one that has been very popular of late has been greens powders, okay, where they've apparently grounded up all the veggies and fruit and whatever else that is in there and popped it into a powder and said you just need to take this, you don't need fruit and veg Your veggies anymore, just take the powder And like, in theory, i mean that would be an amazing like as a choice. I'd be like, absolutely like. I mean, how hard is it to aim, prepare vegetables, make them taste good and then actually get them like, sauce them, and get them prepared and all the rest of it and then eat it like a lot, right? So this is what I talk about. There is no magical unicorn that you are ever going to find in a pill, a powder, a supplement of any description. So that isn't going to negate the day to day habitual intake of fruit and vegetables. And we'll talk a little bit about the gut microbiome and, in particular, what we call the East strobelone. So we've had, yeah, so that's a big word. It's a big word. It's a big word, but of course you know we talk about estrogen and the menopause transition and things like that, and of course our body is so amazing, right? I've said that before. So everything that we can need can be obtained from our diet. We don't need supplementation for this, but because we are living in a very fast paced world, we often don't have the time to be able to get this stuff in, and so this is where supplementation comes in. There are convenience options for people and they're marketed towards that, but when we actually looked at the studies and I'm talking about I was looking at studies from cognition to performance, to health as well, so these are all separate kind of outcomes of what we're trying to achieve And on every single front, nothing tripped between the greens powder and actually eating fruit and veg in a decent amount. It just didn't even compare, and so the problem is is that you can have a greens powder Look, it's not going to do you any harm, but it is substitute for eating fully and not eating your fruit and veg Absolutely not. So these are the things that we need to consider. So it might make you feel better, but at $150 a month, i think, is the membership. Like I had people go oh my God, i'd rather spend that on fruit and veg. I'm like, yeah, go and spend that on fruit and veg because the benefit by the literature is going to be far outweighing the benefit of taking a powder. So this is where the cost versus benefit. I want people to really understand the difference between that And, of course, it's not a lazy way of doing nutrition and being healthy. Unfortunately, you just can't get past eating fruit and veg And when it comes down to what we look at from a gut health perspective, there's been a lot in terms of, like, the gut space, probiotics, probiotics, these types of things. And, to be honest, then if I have a look at the research with that, there is some good, strong evidence that would point to enhancing a better gut microbiome. If we're looking at things such as prebiotic fibres But what we're looking at in a supplementation like that is things that we can't necessarily get from our diet or it's really hard to obtain. So these are things like resistant starches and prebiotic fibres, which is the undigestible part of the actual food that they're putting in there, things like Jerusalem artichoke, green banana fibre, like when's the last time you ate that, right, so you're not going to have that in your diet. I mean collagen we can talk about collagen as well. So these are the things that like. If you're not going to be eating that stuff out of your diet, then there is evidence to suggest that if you do have what we call gut dysbiosis, so gut bacteria isn't ideal. We know that this is the pinnacle of everything as it relates to immunity, as then it relates into general health And of course, then if we have our general health, then we're more likely to want to do and engage in other behaviours. Obviously, when we're sick, we're not training right, so, yeah, we don't have the energy to be able to do these types of things, and then our nutrition then by default reduces. So it is really tricky And I think this is why, often, a lot of time, we focus on good health for, you know, majority of times And then if and do we when we do fall sick and we can't, we can't, unfortunately, we can't prevent getting sick. All we can do is help our immunity by, you know, having a good focus on gut health, making sure we're eating those good fruit and vegetables, but also things such as the pre and combination of probiotic fibres that we can put into things such as supplementation might actually help, but getting a really broad base strain at the moment we're just not at the level where we can say OK for this ailment. This is the strain of probiotic that you need. But I would always recommend, if you are going through a bout of, you know, a period where you have had to take antibiotics, you drink, so these are the things that strip the gut microbiome. So actually, you know, take a lot of the good stuff out.

So when you're sorry, just from stepping back there for a moment. When you talk about drinking and alcohol, are you talking about moderate to excessive drinking or just any alcohol consumption, any?

any in general. Yeah, ok, so we know that there is an element of the it being a toxin as such, our body needs to, you know, go through, the liver needs to work harder to get that out of the system, and so there is no benefit, i see, from that perspective. But we do know that you actually lose a little bit of that biodiversity when we're actually drinking. And, of course, with antibiotics we're going in there to kill foreign bacteria. Unfortunately, they don't know which one they're targeting, so it kind of strips everything that's in there as well. So in those types of situations and scenarios absolutely like in gastro, you know, like I just think, ok, there's been a lot that's gone through that really quickly in and out. And so when, when you're in these sorts of times where you're a little bit more compromised, often when you're travelling so now that we're travelling a little bit more, if we're going into environments where there's going to be more exposure to different bugs and things like that, we might want to be taking that, yes, as a little bit of a preventative. But also, if you actually have gone through a period of being sick or ill, it might actually help with that to recover you a little bit better and help restore that gut microbiome. So it's not only about the probiotics, so the good gut bugs that we want to put in there. So we want to make sure that they're in there. We also want to make sure the prebiotic fibre is in there so they can feed off and they can stay in that beautiful environment as well. So, yeah, that'll in turn help our immunity, help create that defence line and hopefully might make us the symptomology last a little bit less in terms of being sick for a little bit less time, but it won't stop us from getting sick, i'm sorry.

No, that's all right From an immunity's perspective. outside of prebiotics and probiotics, i will admit I've been eating a lot of garlic.

That's a great prebiotic fibre, along with Jerusalem artichokes. So eat your garlic, your onions, your spring onions leeks are amazing as well. Fantastic.

Well done, My poor husband. He just keeps going. Well, at least I know there'll be no vampires visiting us there.

Fun fact, what you can do is actually eat parsley when you eat garlic, because it neutralises the odour, and parsley is really high in vitamin C again another really good antioxidant, which helps when we're looking at getting better, and anti-inflammatories and things like that.

Vitamin C obviously is great when we're not well. Honey, things like that. What else can kind of like when we do get struck by a virus, something that we can't fight off with antibiotics, you do just have to let your system kind of run its course. What else do you kind of throw into the mix there?

Hydration, i think, is the biggest key as well. So often we're just, we reduce the good behaviours that we would normally be doing because our body is resting. And I think a lot of women come in and they're like, oh, i just won't eat. you know, i'm not exercising so I don't have permission to eat when I'm sick. Absolutely not That. If you think about your illness, that's an activity factor and that's what we would consider. If we give our body again all the nutrients that it would require it to be functioning at an optimal level, that might help. Now the volume of that might reduce. Obviously we're fatigued, we're tired, we might be snoddy and sniffly and we might have a sore throat. We don't necessarily want to eat as much. Things such as vitamin C are great. Zinc is the other one as well. That is quite good and has some good literature behind it, but again, so vitamin C, zinc omega-3 is actually really and vitamin D. So those ones, i think, in particular, are a nice little cluster that you might want to implement in the time where A people are getting sick around you. You might not be sick just yet. So a little bit more preventative, obviously, if you have been sick. And then the duration of the symptoms but then keep it on the shelf after that, like you don't have to have this sort of stuff routinely all the time and, if you think about it, is only always more managerial stuff. Two or three key refruits are going to give you most of your daily server vitamin D sorry, vitamin C anyway. So these are the things we want to get back to really quickly. But, if you can, one of my biggest tips is soups. So I generally will get my ladies to boil up a whole lot of vegetables and just put it in some veggie stock or some broth or whatever you've got, blitz it with a soup mixer and then just have some of that warm. It's just what your body kind of feels like and it adds hydration to it as well. So you've got the water, you've got the vitamins and the minerals, but it's just in a blended form and it's easier to kind of get down to. At least it's a way to sort of tick the box on the way to getting better.

Anyway, I actually did make some chicken broth. The other night I roasted up a chicken for dinner and it must have been on the day that I was starting to come down with something and I just looked at the bones and immediately went I'm making chicken broth, and so I do have jars of chicken broth in my fridge, so I shall be making chicken soup.

And this is the thing, the old tradition, you know. Like, if you think about our grandmas, you know people got sick, we went and gave them chicken soup, so you know there's some element of that. And finally, that you said that because there's a lot of collagen in the bones and the ligaments and that sort of stuff that you're boiling up, that becomes that broth, and so when we're talking about supplementation, things such as collagen are really, really touted, particularly in midlife, maybe for things like wrinkles, you know.

So things like that, and look I prefer to call my laugh lines.

I love those love lines. I'm finding a few more of them every year and I love it. Yes, and so these are the things that obviously ask. In elasticity changes as we age. There's a lot of more sun exposure, so my wonderful beauty therapist always tells me you know, have you got? have you got your zinc on? So essentially it's zinc, you know, your sunscreen and stuff like that. So these are protective markers, but we also need to be looking at things such as that are high in antioxidants as well, and again, our really bright coloured and deep purple and red coloured fruit and vegetables are going to be contributing to that. There's stuff that has lots of vitamin C in it but also has a lot of what we call the polyphenols, and so you can actually supplement with things like that. That's going to help that. But collagen going back to collagen, it does form a few of the building blocks that are associated with things such as hair, skin and nails. So you've got two different forms. Obviously, you've got a bovine or a beef collagen, which is a lot of what is touted in the supplement industry, which is that hydrolyzed peptides. They've just chopped it up a little bit more as a fancy way to say that And then, in combination with vitamin C, it has seen to be a period like to help with things such as joint and tendon related injuries, if we combine that and have that about 60 minutes prior to exercise. So again, remember what I said about supplementation. Is that something that you would need First and foremost? you know, do you have any joint or tendon problems? Maybe in midlife we do, so it might be a considerate factor. But the first thing to remember as well is like OK, well, can we look at weight management, like is that something, if we took some weight off, that we could actually look to alleviate some of the joint pressure? Could we exercise a little bit more in a gentle environment? Maybe we can do some swimming so it doesn't feel as bad, you know? So we can try and do these types of things. But if we are doing them just prior even if it's rehab related and you've had an injury, it's so beneficial. So the literature will tell us that if we add collagen into that mix So 15 grams of that plus a little bit of vitamin C 60 minutes prior to exercise that might actually help to repair the tendon and the joint itself. So in combination with that, i think I mentioned omega three before And I think it's really nice from an anti inflammatory perspective. Again, when we look at the disease markers and looking at immunity and things like that, often a lot of disease or disease is stemming from a poor gut health microbiome, so poor gut microbiome, and also, concurrently, inflammation, so an inflammatory state. When we're looking at internally and things such as our unsaturated fatty acids, in particular those marine forms of omega three fatty acids have been found quite robustly in the literature to help to reduce the inflammation over time, and a lot of the time they can be encased And hopefully, if you're not doing this already, you would be wanting to maximize the use of extra virgin olive oil in your diet, because that is another beautiful way. I know it's not a supplement, but often the best forms of omega three are actually encased in extra virgin olive oil, which actually helps the stability of the omega three to get to the body where it needs to go and help that beautiful cellular repair, and so by having these types of things consistently in our diet it also operates. Particularly a good quality olive oil will operate on the same pathway as ibuprofen, so it is a natural painkiller that you can get from your nutrition and from your food. But in combination with that omega three, we get a lot of omega six in our diet, not so much omega three, so we want to balance that ratio out. A little bit can help with things such as hot flashes. So we actually have seen that in the literature as well in terms of the menopause symptoms, and it's probably one of the staple things that I do with my ladies, is to really just boost that in there, because we just can't get a lot of it unless you're eating fish three, four times a week. It's a really good source of fish, like deep sea ocean fish. Can't get a lot of that in, you know in unless you go into a fish market or something like that.

Unfortunately it's not as easily accessible as it is not as easily accessible.

No, and in consideration of like joint ache and pain, the only other thing that I would probably be mindful of is maybe there's some good research to support curcumin in combination with pepperon. So that's the really the black pepper component And then the tumeric component. The therapeutic dose of that in terms of reducing inflammation has been seen quite nicely in the literature to be of good form when you supplement it. So, yeah, definitely, definitely eat that sort of stuff, like your curry powders and things like that, but unfortunately the bioavailability of that is actually a little bit better in supplementation form.

So yeah, a few little things to consider, and just going back to the extra virgin olive oil, is that bioavailability change if you use it in cooking as opposed to if you drizzle it on your salad?

That is an absolutely fantastic question And it's a myth we're going to bust right now. Yay, let's go. Yeah, because often people would shy away from using olive oil in cooking because they have been told it doesn't have a high smoke point. So it goes to Branson When you heat it absolute BS. They've done the research on it And I can absolutely guarantee that a good quality extra virgin olive oil So that's a really one that you want to be looking out for. If you can get a first cold pressed extra virgin olive oil looks a little bit green. So when you actually pour it out, you'll start to see that that is because of the antioxidants and in the skin of the actual olive itself. So that's what keeps it stable enough to actually be able to heat up to 200 degrees Celsius, and you're probably not going to cook above that, unless you're deep frying, in which case nobody goes really above 200 degrees. If you think about roasting vegetables in the oven or just heating oil on a pan, it is absolutely fine And in actual fact, it actually helps to break down things like cellular walls of, say, tomato, which actually releases and makes more bioavailable The big, big carotene that's associated with tomatoes as well, which is, you know, those beautiful vitamins and minerals that we speak about. So adding extra virgin olive oil into your cooking is actually really beneficial. It'll break down that cellular wall. It'll let those nutrients escape a little bit quicker, so our body can assimilate and absorb that a little bit better as well. So please cook with it and please edit cold. However you want to do it. It should be a staple in your pantry.

That's awesome because I use EVO to cook with always have, even though I had heard behind not using it because of a high smoke point. But that also really ties into the whole Mediterranean diet thing as well, doesn't it? What you were talking about there, like, if I think about the Mediterranean diet, i think about extra virgin olive oil and I think about tomatoes and you know, and they, that's not just Omega 3. And the fish and yeah, so it's really interesting because you know that really is from. If you want to talk about diets, that is the weight of eating. That is is is recommended as the most beneficial for longevity and health and Absolutely And and for reducing menopausal symptoms.

So there's actually a beautiful UK study that's come out now saying that legumes So again Mediterranean legumes are things such as chickpeas, kidney beans, lentils, these types of beautiful things, All the yummy things. Yep, I know, but nobody knows what to do with them. So, oh God, come to my house, i know And this is the thing I've made a point of now going. Ok, i need to add this into my recipe People, examples of how you can bring them to life, because often if they're afraid of cooking with something, it's often because it's they don't know what to do with it, and so we need to break that area down. We need to get lots of legumes into our diet and things such as oily fish in particular, my favourite one, sardines, the cheapest I know And everyone goes. I've got a really, really good recipe That I put in lots of lemon zest and I can dull down like the strength of the flavour of it. But things like that is going to be. They actually have said this report is looking at It can actually delay menopause by three years, like and delay menopause by three years. And you studied Wow, that's huge, massive And like it's in the dose response. And that's the same with the greens powder and the veggie. So up to 600 grams of fruit and veg daily was on par, if not exceeded, what a, what a powder did, actually didn't even come close. So that was the recommended minimum dose And then exponentially, every 200 grams upwards of that, up to 800 grams actually increased all your performance elements, your cognition, your gut health, yeah, everything Well.

I need to learn to like sardines.

I know, ok, all the fish in general. So you know mac, salmon, tuna, so that's still good, i can learn to live with that, ok. And you know salmon, even the tin salmon with the bones in it has, because you're eating the bones. So you know all these sorts of wonderful things that we tend to go on. I want to supplement that. I want to supplement. There are so much wonderful aspects. Again, if we look at that cake batter, that whole, first food first approach, sorry, food first, supplement second Only if you've got symptomology and not just because, because I think, particularly in things such as iron, people would go. And I've had this happen before. I can't get this. I've had a client come in and she said I was just complaining, i was a little bit tired, so my trainer at the time said I think you need iron, so go and supplement iron. She went and got ferragrad C and started supplementing with iron And I said, oh my God.

I wish people could see my face right now, so I am horrified that a trainer would recommend that 100%, And you know.

And then if you look at the diet, there was no carbohydrates and no diet. I'm like I'll give you a little bit more of a reason as to why you're tired. And why would we be supplementing with iron unless we had that clinical value to it?

Yeah, Okay, how about? why don't you go and see your GP and have a conversation about where your health might be and maybe get some testing done, and then we can look at your diet?

Whoa, this is common. Like you walk into any supplement shop and I can guarantee you the person that's behind that counter is not qualified to be able to give you nutrition advice. And yet, oh, here's all these supplements. You so much as, say, one or two ailments, there's about five million choices that you have right there. How do you filter that? And I've often had women come in and, of course, now health related, health focused they've got active kids now And they're like, oh, okay, i went and bought my son this vegan, get this vegan protein powder. And I said, okay, well, what did you do that? So I always ask why, right? So what is he vegan? I need to start with Exactly So I don't know, because, like you know, protein powder isn't that good for, like, active teenagers. He's doing a lot of sport and the packet was like brown, so I thought it was healthier going vegan more than like wait. I wasn't too sure And I'm like okay, first and foremost, supplements stand position, stand on adolescents and supplementation, absolutely not. No adolescent athlete or not need supplementation. It's generally the athletes Cause again, they're looking at those people that are ahead of them in elite sport, that are doing all of them and being promoted with all these supplements.

Going right back to what you said at the very beginning of this conversation, And so they're so impressionable at that age.

But now you're getting parents that are trying to make informed decisions and they actually have no idea how that's happened or what are the protocol to go through with. The other incident where that has happened, this wonderful client of mine, her son, no fault of her own, before she met me, was in the hospital with liver failure. So his biomarkers of liver were off the charts and they're like what drugs has he taken? What has he eaten? How much alcohol has he had? And she's like oh, my goodness, nothing. I don't understand. It took her two months to figure out. It was a vegan protein powder that had been recalled in the States but not in Canada, and so this is another example. So I'm going to tell you something about the supplement industry. Mostly it is unregulated. So I'm not just talking about vitamins and minerals now, i'm talking about the whole gamut of stuff, right, pre-workouts, post-workouts. We can talk protein powders, you know So, and I'm not anti Like. I actually really love protein powder for perimenopausal women. For menopausal women, our protein needs are elevated. Right, it's very difficult for us, when we're working with a calorie budget, to not increase the weight gain because they're losing muscle at the same time. But we also want to provide a beautiful amount of amino acids in their diet. So I will often rely on a protein powder of good quality supplementation in order to hit that box, and that's not necessary, but it's bloody easy So it's convenient, right? So, as you're starting to build and develop these beautiful, wonderful nutrition and lifestyle habit and behaviors, a little bit of supplementation might actually help you get there a bit quicker. It might make you feel better about what you're doing. It might give you a little bit more commitment to the cause, so your consistency can then pay off. So, from this aspect, if I have a look at these types of things like the supplement, industry is a really interesting industry. So what has happened now is that there is a system called Inform Sport Tested, and so if an athlete, let's take an athlete, for instance, but I think this works across the board. So really, if you're ever going to take any supplement, you need to make sure that you understand where the source of the supplement is coming from, how much is contained in, obviously, the therapeutic dose, and how much you should be taking and whether you should be taking it at all. So questions, big questions to have, but if you did want to have like a kind of first sort of glaze over in terms of the sport-related supplements, you should be looking for an Inform Sport Tested logo. So some are Inform Sport Batch Tested, so that will often do. Every single supplement that comes out of that supplement line will be tested And so if an athlete takes that, they are guaranteed that they shouldn't. I mean, it's never 100%, but they shouldn't fail a drug test because a lot of this unregulated industry, because of the weight of the ingredients that they were putting in, they were often processed in completely different, manufactured in areas where you had no idea, and they weren't required by law to put that on the label. So we would often find that if we and there's been studies where they pulled heaps of supplements off the counter they've tested them for multiple different things amphetamines and everything And there's been some things that they pulled up there that went. They went. Holy crap, this stuff. You know fat burners, you know it might work if it's laced with amphetamines. Do you know what I mean? Oh, so you have to, and I don't mean to alarm anyone, but But be aware, be aware, be aware. So look for that InformSport tested logo. It's a little kind of running man with a little.

I might do a link in the show notes through to what that looks like. Yeah, yeah.

So you can get ones that are fully InformSport, you know, with that tested logo on it. And there are others that are still reputable in terms of the brand but they might not test everything because it's very expensive. It's a bought logo as well, so it actually needs to go through a robust level of testing. Do it? Yeah, exactly right, but it costs money to do that. So there are other supplements that will sort of kind of every you know three or four batches do a test on one.

So, again.

So if you're not an elite athlete, that's probably okay to get and look for as well. There's a couple of different things. There's a green one and a yellow one. So the traffic light system right Yeah, but aside from that, that's probably a really big place to start, particularly when you're looking at that sort of supplementation for sport-related supplements.

So this would be if you were looking at, like you know, your protein powders, your creatine, your pre-workout, post-workout, those sorts of things. Yeah, okay.

Yeah, absolutely, and like things like creatine want to hydrate, like I mean the evidence that's associated with that, particularly for women, like we have around 70 to 80% less storage capacity of creatine compared to males, and so when I look at that, we can store creatine in our muscles, but we also store a little bit in our brain. So, from a cognition effect, and we now look at the literature in you know what, at what stage would this be beneficial for women? Mastral cycle, pregnancy and Hello puzzle, i was post-menopausal. So these are the things, as I said that, but how we use them. So then you go great, i need creatine, want to hydrate, And it's, you know, again that could be in a stack. So you've got to ask is it creatine, want to hydrate? Is it the simplest form and the most extracted form of that nutrient possible, not put with any other fillers? So another thing to be aware of things that say proprietary blends, run, run from the hills. Oh, really, because you have no idea If it's a proprietary blend, they don't know.

Like you're like, so is that kind of like a secret recipe 100%.

So if something, if a product is not going to disclose exactly what's in there?

Yeah, you don't want to know what's exactly in there. No, that's exactly right.

So yeah, so look at the dose amount. So you know when we're thinking about, okay, well, how much do I take? and that sort of thing. So again, this is why an assessment with a dietitian but even a sports dietitian, like a lot of people, don't understand a lot of these think about. You know, women think about this as being sport related products. They could actually be so beneficial for our everyday health that we can put these sorts of things into, because we've now got the research to support that in this population they're seeing a really interesting benefit. There was also a two year trial with menopausal women looking at bone health and creating want to hydrate. So again, there's something like that that can be taken now long term, we've got long term studies that have revealed, whilst it didn't increase bone mineral density, it helped the markers of what would support strong bones. So you know, again, it's in combination with can we get our protein right? Yeah, we might need a protein powder, but just day to day, can we get our protein right in terms of our food? Can we add to that with creatine? want to hydrate? So it's all about building that cake batter. You know, from the cake batter, it's all about building the layers, and that's what we want to do, you know, have first and foremost dietary assessment. Can we get it from food? where we can't, then we can use and rely on supplementation to help us through that. And then, of course, you know, if we want that second tier, that other level, we can go to the next level after that as well.

Okay, angel, to finish things up, i think it was one final area that I was really hoping we could touch on, and that is sleep. It's an area that I know so many women in this transitional period struggle with. What do you recommend or what have you come across that can be most beneficial for women?

Yeah, and again, like I said, the literature is really poor. We understand that things are still emerging, but what we can deduct from what we do know and what we can trial again and just see if it makes an effect, is something like a tart cherry concentrate. I've seen and used with my menopausal ladies. That actually helps at nighttime. It's just a concentrate of a sour cherry, so it's not the sweet one, unfortunately, and it's not just like cherry juice. So just be really mindful that it's a concentrated, momentary cherry is what you're looking for. So we take about 30 mils of that in a little bit of water. It's quite tart and we have that around dinnertime and that helps to, we think, increase melatonin, which is that wonderful hormone that helps us to fall asleep. But in combination with that, we also need to look at some other things that we might want to think about in terms of sleep hygiene. In and around that In particular, i would often say what's your caffeine levels? because that's definitely, if we're talking about a supplement, caffeine is a supplement and it is an ergogenic aid as well. It does help us to reduce that perception of effort. It delays that sort of fatigue response. But on the flip side of that. The unfortunate part of that is that it does keep you more alert and more awake. So often, looking at caffeine, of having about a six, four to six hour half life, so it will take around about that time for it to get half out of your system. We want to have that well before, or switch caffeine off well well before 12 o'clock and getting to bed a little bit more on time. So, yeah, other than your kind of normal sleep hygiene routine, i would definitely consider maybe a tart cherry concentrate. But again, if sleep disturbances are things that are happening, indication that you are going through that perimenopause transition, we've got some undulating hormones that are happening here. Don't discredit having a chat to your GP about hormone replacement therapy, because I think a lot of the times that is it's because of the fluctuation of estrogen and, of course, the lowering of those hormones over time. If you're really struggling, because we know that if we don't sleep it's going to affect our appetite hormones and our glucose metabolism And then that's going to have some consequences and some flow on effects with so many other levels. I've looked at things such as chromium with helping sugar levels as well. Yeah, yeah, so there's some evidence within that that might actually help in terms of that insulin resistance and a nostril as well. Particularly, that's been used and heavily looked at with PCOS, but obviously we're seeing insulin resistance in that menopause transition as well. So they're the two things that I think. Whilst it's not helping sleep as such, the effect of poor sleep is going to mean that it's going to affect your appetite hormones the next day and then that could have an influence on your blood glucose levels and things like that as well. So remember, we do have a circadian rhythm, so it is important that when we're looking at food there is a certain time zone that is probably best. Our gut bugs actually like to eat food in daylight hours. So if we can try to avoid eating big meals late at night, that's going to help our sleep as well and to push that up a little bit earlier in the day And hopefully that will help with sleep as well. So I know it's not supplement related, but again, whole picture Yeah, that's okay, absolutely.

And just going back to the tart cherry, is that something that's readily available? Do you need to find that online? Is it something people can pick up, kind of like locally?

Yeah, you can get it. It's probably easy to get it online. I have seen it in a few kind of health food shops as well, so Cherry Active is one brand. that sort of comes to mind.

Amazing And thank you so much. We have covered off so much in this chat. We've managed to dodge most of my coughing fits in a lot of hitting the mute button as we've traversed this conversation while you're doing amazing things in the world, so thank you for all that you are doing for all the amazing women that get to work with you. I will share in the show notes links to everything that we've talked about today, including how women can work with you, because I have worked with you personally. I have friends that have worked with you and I always highly recommend your program to anybody that says to me that they are looking to work with someone. From a nutritional standpoint, you are the bee's knees when it comes to women's nutrition in this menopause transition. More women we can send you away, the better the world will be.

And you know what, the more we start to change the narrative, the more we can empower women. You have permission to eat. We don't need to plan supplements all the time, but sometimes they help. But yeah, just get some qualified advice. So, if anything, just question everything first.

And for anybody that is listening to this and hasn't listened to the first episode that we recorded with Ann way back in 2022, which was just on nutrition for women going through perimenopause menopause I will link through to that in the show notes as well, and then you can listen to another whole other thing that one's almost actually an hour and a half. There's a whole hour and a half there of edge and I just talking about nutrition, so you can listen into that one as well. Okay, and thank you for your time. It's been an absolute pleasure, as always.

Thank you, Sonia. Thanks for having me back.

Thank you for listening today. I am so grateful to have these conversations with incredible women and experts And I'm grateful that you chose to hit play on this episode of Dare Menopause. If you have a minute of time today, please leave a rating or a review. I would love to hear from you, because you are my biggest driver for doing this work. If this chat went way too fast for you and you want more, head over to stellarwomencomau slash podcast for the show notes And, while you're there, take my midlife quiz to see why it feels like midlife is messing with your head.