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How to Optimize your Muscle Health

 

The metabolic and hormonal changes of menopause mean that midlife is a particularly important time for women to prioritise their muscle health. There are two main factors contributing to muscle health; muscle mass and muscle function. 

 

The backbone of maintaining healthy muscles is protein + resistance training. If you have no contraindications, menopause hormone therapy (MHT) is also proven protective for muscles. This is something to discuss with your doctor (5). 

 

Dietary protein

Protein is a kind of macromolecule made up of chains of small subunits called amino acids. 

Proteins are known as the building blocks of the body, and they are a requirement for life. The most widely known function of protein is to act as the complex microscopic scaffolding of muscle, and for that reason they are related to muscle growth. But protein does a lot more than offer structural integrity to all of our body tissues. Human life, at every level, relies on millions of tiny reactions that occur between the millions of atoms and compounds in the human body. Proteins are responsible for accelerating those reactions, necessary for sustaining life.

The body creates protein by stitching together amino acids. There are a total of 20 different amino acids that make up the proteins found in the human body. 11 of these are manufactured in the body, and 9 must be ingested through the diet. These 9 are often called ‘essential’ amino acids (EAAs).

The EAAs include: histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine (1) Of these EAAs, 3 are subcategorised as ‘Branch chain amino acids’ or BCAAs. These are valine, leucine, and isoleucine. BCAAs are known to have ‘protein anabolic properties’ which means that they have been highlighted to play an important role in synthesising muscle (2).

 

Consuming enough protein on a regular basis is important for growing and maintaining muscles. A study of 24,417 women aged 65 to 79 showed that higher protein was associated with a reduced risk of frailty (3). But how much? A study from 2010 demonstrated a clear benefit of consuming up to 1.2g/kg per day (84g per day for a 70kg person). Consuming 1.2g/kg per day was associated with a 32% lower risk of frailty. For the purpose of maximising muscle protein synthesis, intake of up to 1.5g/kg per day was recommended by the same study, acknowledging that more studies are needed to clarify the risks associated with older subjects with kidney disease. 

 

Here are a list of common protein sources and how much protein they contain: 

The best way to be aware of your intake is to read the labels of the food you are consuming and familiarise yourself with foods high in protein. This can be done by simply looking it up online, or using an app like MyFitnessPal that has a database of foods alongside a breakdown of their macronutrients.. 

 

Exercise - Resistance training 

A meta analysis of randomised controlled trials (AKA top tier evidence!) concluded that
“Exercise effectively improves muscle mass and strength in menopausal women. Resistance training with 3 sessions per week, lasting 20–90 min for at least 6 weeks, is most effective” (4). The study specified that this regime should be continued for at least 6 weeks for benefit.

But what actually is resistance training?

Resistance training uses weights, resistance bands, or body weight to challenge and strengthen muscles. By gradually increasing the weight or resistance used, muscles adapt and grow stronger. 

Examples of resistance training that you may like to try:

  • Lifting free weights (like dumbells or kettlebells) 
  • Using weight machines 
  • Resistance bands 
  • Joining a club that leads groups through strength sessions 
  • Pilates (with an emphasis on increasing resistance/weights overtime)  

To learn more about the vocabulary and basics of resistance training, we suggest having a look at this resource: https://www.betterhealth.vic.gov.au/health/healthyliving/resistance-training-health-benefits 

 

Menopause Hormone Therapy (MHT) 

For those going through menopause, research shows that Menopause Hormone Therapy (oestrogen replacement) can also have beneficial effects on muscle mass and function, particularly when combined with lifestyle changes. It's important to discuss this with your doctor, to determine whether it is right for you. (5)

 

References: 

  1. National Research Council (US) Subcommittee on the Tenth Edition of the Recommended Dietary Allowances. Recommended Dietary Allowances: 10th Edition. Washington (DC): National Academies Press (US); 1989. 6, Protein and Amino Acids. Available from: https://www.ncbi.nlm.nih.gov/books/NBK234922/
  2. Holeček, M. Branched-chain amino acids in health and disease: metabolism, alterations in blood plasma, and as supplements. Nutr Metab (Lond) 15, 33 (2018). https://doi.org/10.1186/s12986-018-0271-1
  3. Beasley JM, LaCroix AZ, Neuhouser ML, Huang Y, Tinker L, Woods N, Michael Y, Curb JD, Prentice RL. Protein intake and incident frailty in the Women's Health Initiative observational study. J Am Geriatr Soc. 2010 Jun;58(6):1063-71. doi: 10.1111/j.1532-5415.2010.02866.x. Epub 2010 May 7. PMID: 20487071; PMCID: PMC2924946.
  4. Tan, TW., Tan, HL., Hsu, MF. et al. Effect of non-pharmacological interventions on the prevention of sarcopenia in menopausal women: a systematic review and meta-analysis of randomized controlled trials. BMC Women's Health 23, 606 (2023). https://doi.org/10.1186/s12905-023-02749-7
  5. Chidi-Ogbolu Nkechinyere , Baar Keith. 2019. Effect of Estrogen on Musculoskeletal Performance and Injury Risk. Frontiers in Physiology. Vol 9. Available at https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2018.01834