Exercise Tips Every Woman Over 40 Needs

Introduction to Exercise and Heart Disease 0:00

So hello and welcome back to the Reversing Heart Disease Summit. I'm your co-host, along with Joel Kohn for this summit. And I'm excited to talk about one of my favorite topics in the world with actually, one of my favorite people in the world. So we're going to really have a good time today and talk about the role of exercise in heart disease. And I know that we hear a lot. We hear like, you know, run and jump and walk and do all these kinds of things about exercise. But let's talk about really let's dive in with Deborah Atkinson.

She is a fitness trainer. She's online. She's written a couple of books. She specializes with women in menopause and exercise for women in menopause, which, guess what, is when the heart disease risk goes up? So let's jump in. Hey, thank you for being here. Yeah, I'm so excited to talk about this. And this is, you know, honestly, it's, it's a mistake. We're not talking about this enough. We're talking about signs and symptoms and we're talking about belly fat, but we're not talking about how is that related to our risk later.

So I'm so glad you're doing this. I am so excited to talk about the exercise piece because as you know, I'm an avid exerciser. I love exercise, and, I know that, you know, different ages and different stages, different kinds of exercise. But I want your opinion on what is the best, not just your opinion, your experience. Right. The best exercise for preventing heart disease, for improving cardiovascular function. Well, surprisingly, it is strength training above all. And and there's a big reason but I think for for women like you and I,

Why Strength Training Matters Most 1:51

you know, over 40 definitely it gets more important over 50 more so over 60 even more so. But that's not where our brains go. We go, we go cardiovascular or fitness or cardiovascular disease. We think cardiovascular exercise. Right. And and so I'm not arguing. No not that it's and and we just have to make sure we get the and but I would say if someone is compromised and they can't do much. One of the things that is going to empower them to do more is going to be taking care of that muscle, and taking care of the muscle will also take care of the bone.

Unrelated, necessarily to cardiovascular health, but cardiovascular health is going to be impairment and or imperative to how we get bone density. So it it is also inflated and integrated. So strength would be my answer to the question okay. So let's talk about what that means. And why does that mean women need to go to the gym and lift, you know, 50 pounds of weight overhead or what does that mean. And what's the mechanism for it? So do they need to go to the gym? No not necessarily. So they can get that done at home if they would prefer.

And you know for a lot of women, I think that's where they prefer to start because they feel less intimidated. It's more convenient. And and that's a big one. I think we all went through the pandemic and, and my hope for everybody is you've got a place, you've got a place now at home and you're you're never going to be without a place or an option. If you're in a hotel room or you're a guest in a bedroom, you've got something you know you can do. So the other question you asked, should they lift 50 pounds overhead?

I would say, please don't. And and here's the, the risk. I think we are seeing a lot more people doing overhead press. There's nothing necessarily wrong with that. And more of us are traveling and we're actually taking that suitcase and putting it in the overhead bin. And women want to be able to do that and or want to be able to say, you know, no, I don't need your help. I got this or can I help you? You know, I think that something. Like that would've been. Better that truly, we have to say over 40 certain things can go wrong because we've lived in this body a little longer.

We've had a good life. We've had some fun. We've done some things maybe we would have chosen not to do if we had it all over to do it again. But shoulders or knees can be the first things we have to look at. So we want to start certainly less than that. We want to start wise and with really good form. But we do need to reach muscular fatigue. So whether it's lighter weights and more repetitions, which by the way is where everyone should start and then you progress and you can go heavier. But we do it with criteria of I'm not feeling pain, I'm not feeling couch compensation.

Meaning I'm so tired or exhausted or sore I have to rest for a week. That's wrong.

How Strength Training Supports Heart Health 4:54

We should be getting more energy because we exercise. We should feel stronger, more resilient, more stamina, more desire to let's go for a walk. Let's let's play another round of golf. Let's do more things and participate in life more when we're exercising correctly. So yes, onboarding slowly and then progressively and smartly finding where's my space, where I'm safe doing this and getting the results I need. Yes. Yeah. So let's let's talk about the mechanism because we're we're in a summit now.

How is that supporting. How is added muscle and doing muscular strength training supporting our cardiovascular system. Well absolutely. We know it's been proven for decades that you're getting cardiovascular benefit when you're lifting weight. I mean, if you just think about it, think about what we've associated with cardiovascular exercise. Heart rate goes up, right. It goes up and stays up with strength training. It goes up and goes down. So maybe going up for a minute while you're lifting and then it goes down and it relaxes.

And actually that can be really beneficial to certain populations who actually can't induce sustained high stamina or loss. It's a great way to onboard with a certain degree of comfort. Like I, I'm not so threatened by that. I and I don't have to get uncomfortable, and we might be talking to anybody who might have depression or anxiety. It's hard to get started when you've got those things. So it removes the barrier. But you are using your heart and we are decreasing. We're helping to improve blood pressure.

So I should say decreasing, but it might be also increasing depending on who you are optimizing blood pressure and helping to optimize cholesterol levels, which are also related to heart health directly. So when we can do both of those things and we gain strength, we gain endurance, we gain stamina. Now we can choose to do more exercise. That also gets our heart rate up for extended period of time or the cardiovascular exercise we want. We've got more options we can purchase and get breathless if we choose to do so.

Yeah, so. So I know you specialize in women because you work with post-menopausal perimenopause women a lot and the specific concerns of that age group. But men, what about men? Is it the same benefits for men? And should men be careful about the overhead presses as well? More so actually, I would say more so to men. But you have to be careful about it offering help where people don't want help. So planting seeds is very important. But here's the status. I mean, men are more at risk than women because for women, estrogen is very protective of their heart health, at least until menopause.

So once that starts to decline, we evened out and we are as equally at risk as men are. So not great. So by the age of 60, when we're almost all of us

Exercise Guidance for Men and Women 7:57

post menopause and there's a there's a few outliers, outliers. But we're pretty even in terms of now our heart risk is the number one killer for both of us, not just one or the other. So, we want to be careful about that. But yes, men benefit as well from strength. They benefit quicker and more easily because they've got more testosterone to begin with. So they can go into a weight room, seemingly, and look around. They don't even need a lift. And they walk. And, you know, it's not quite that easy, but they do, benefit from it fairly quickly.

Men often need the opposite. So we tend to the traditional stereotypical. You walk into a gym and the women are on the cardio and the guys are in the gym. You know, the women are drifting and I'm really proud of that. I think our young women are getting the message. They're in the weight room and it's very cool to see. Yeah, but the guys I don't see doing so much cardio, you know, so they probably can use that. And notoriously you, you were a mom of boys. So you know this to probably be true. But when guys do cardio, you know, they'll go outside and they'll run a mile and then come back and that's their cardio.

I mean, they're done, like, you know, really quickly. That's not all bad, but doing some extended longer, walking a little bit more endurance work, it also would benefit men. So we need to kind of meet each other in the middle. Women need probably to do just a little bit more strength, not focus on cardio and importantly for women over 40, not focusing on the kind of cardio that we grew up with in the in the 80s. In the 90s, we were still very tuned into, you know, being that target heart rate zone.

Make sure you're not too high, make sure you're not too low about really what we want to do is highs and lows. At this point, women actually benefit more from improving their VO2 max directly. It's directly related to our cardiovascular risk. So if our VO2 max, which means the volume of oxygen or oxygen delivering and carrying capacity. So there's two things happening. If our heart's pumping enough oxygen, it's distributing it evenly throughout the body. And the cells in those extremities can extract it.

So we need both that measure of fitness. And when we increase our VO2 max, our longevity goes up, our mortality goes down. Women benefit more not from being in that middle zone that we all grew up as young adults thinking, but actually from underneath that. And that's them walking in the movement. We hear so much about zone two. It's below that point where you take a deep breath and then from high intensity interval training, from getting breathless and then alternating that with periods of rest and recovery in between.

So it's less that middle zone. We call that no benefit zone. There's a lot that happens there other than elevating your car is cortisol levels. So you know if you're more fit you're more conditioned. You can probably handle a little bit more of that and do just fine.

Zone 2, VO2 Max, and Interval Training 11:15

But if you just starting out, you don't want to go right for that middle. You want to do a lot of movement, do a lot of walking, get your steps in, move and get breathless several times a week. Got it. Okay, so hit training, interval training versus training. Tell us a little bit about that and how that works in my cardiovascular puzzle. Yes. So again it's the biggest return on your investment of time and energy. And what are the two most limiting features of exercise and why women or men for that matter don't do it.

We don't have enough time or we're tired. So it's one way to get a big return and get better fitness or quicker fitness without having to put in all the time that might throw you under the bus in terms of adrenal fatigue or cortisol. Anyway. So here's what it looks like. So we need to do a good warmup because whenever it's higher intensity there's more risk of injury. So long extend to warm up 5 to 10 minutes depending on who you are. And then you do bursts of maybe 15 to 30s of exercise that gets you breathless.

So that might be a sprint. It could be walking. It doesn't have to be impact. It could be rowing. Any exercise you enjoy could become intervals. If you push hard in a short period of time, and then you rest completely. So resting and knowing when you're ready is. My definition of that is is nose only breathing mouth closed. So if you do that you're, you're recovered and we don't have to look at what should my heart rate be. Because it may be slightly different. But if you're closing closing your mouth breathing comfortably you're ready for another interval.

Interesting. Interesting I mean you said, you said rest completely. I've heard that you can do bursts of it. So say you're running up a hill or walking up a hill, or quick up the stairs and then doing more slow movement for a few minutes. So what are your thoughts on that? Absolutely. So you rest completely if needed. And if you can keep moving, do. But I also want to revert back to what everybody learned. You know, in 1980s, what I taught in fact was I would say, don't stand still or your blood will cool falls.

So we now know. We didn't know then we we were very conservative, which is smart, but we now know it's okay the harder you work, the lower you can recover. You can stand still, you can catch your breath and that is perfectly okay. But you could do a protocol and there are many of them, but you can rest up to three minutes if you need it. Or you could do four minutes, 4.5 minutes of, you know, kind of an easy low to moderate level where you're very comfortable. And then you go all out sprinting for 30s and repeat that cycle.

Nice. That works. Yeah. And that works. And that's a good way to get well, it sounds like a good way time economy wise right. Good intensity. But also that's working your cardiovascular system running out. And it's like, you know, giving it rest and making it work and giving it a rest and not overworking it, but also not under working it. Exactly. And here's the thing. I think we all fell into Tabata. We thought Tabata. Was. Yeah. Not we should do 20s hard and 10s easy and we should do that eight times.

There was a four minute cycle. And you know, I think we forgot in the fitness industry forgot. So I apologize on behalf of all of us, the the whole idea of that was for elite cyclists who were working at like 170% their VO2 max. I mean, and that was you throw up in a wastebasket between set. It was that hard for them. None of us is working that hard. Not not any of us. And really, we don't need to work quite that hard. But what we do need to do is be sure we get breathless. And we've learned from some studies called high intensity repeat training

HIIT Structure and Recovery 15:18

that it doesn't matter how much rest you have between those intervals, provided you get the intensity when you do them, you get the benefits. So however that looks for you is okay. And I do think that there are certain people who feel like. But that was really hard. I must have worked really hard and thought really fit, but it feeling hard and you working at your full potential are two different things. Tell me, tell me. Yeah. So we can feel really tired if we deprive ourselves of the rest and recovery in between, but may not work at our full speed.

So if you're going to sprint, say, up a hill or even on a treadmill, if you were just tired, you'd be going as hard as you could and not be going at the speed that we know you're capable of. And if you want to get fit, you're going to be working at your best speed or against your best resistance, depending on what we were talking about. So you know, there is a big difference of feels hard versus, you know, did I actually get as many repetitions or did I, did I run up the hill as far as I normally do, up the hill in the same time frame.

So being able to look at and everybody has an off day. Right. But just because it feels hard, I mean maybe fooling you that you're working at your capacity. But if the an Olympic athlete wants to get better and faster to win a ribbon, you know, wear a medal, they're going to be working at their best speed on those high intensity days. They're not just going to be having it feel hard and then coming. So when we're talking about people who are who have hypertension, high blood pressure, who, already have had a heart attack or stroke and they're, you know, they're a few months past recovery, but there's some nervousness about exercise.

What do you what do you say to those people? Yeah, I would absolutely say we want to lay a foundation first. Right. So we want movement on a regular basis first. We want it at a low level. So, you know, for a lot of people and almost everybody, it's we want to go to the edge. We don't need to go over it. So go to the edge, feel successful, feel like you stop. And you think, I feel like I could have done a little bit more. Okay, great. Next time let's do 1 or 2 more minutes led to work up to the time frame.

And then once we're at the time frame, let's work up the intensity. Maybe we we increase the incline on the treadmill by 1% next time. So is a bit more difficult. Or we alternate a minute at 1 in 1 percent incline and then back down to flat. So it's baby steps. But over time, if you do that, you will find within a month even making those incremental increase in time or duration by two minutes a week, you've increased by eight eight minutes your session, or you've increased the time you spend at, say, a percent incline where it's much harder than it was before.

Training Safely After Cardiac Events 18:30

And that will gradually increase your resilience, increase your confidence, which is what we want to get back first. Yeah yeah yeah yeah yeah. And I will I will throw in the caveat. If you have had a heart attack stroke or have, you know, documented cardiovascular disease, always, always, always check with your doctor to make sure before you start any kind of exercise program, even if it's just walking around the block to make sure that you're cleared to do that. You said something a little bit ago, and it's something that I share with people.

You said the just the time between those intervals. And I've read research that, you know, and I look a lot at the insulin levels and the growth hormone and all the hormonal levels, that you can actually get better results by doing a larger space between the intervals. And because it allows the growth hormone to go higher at each stage. Have you noticed that? I've seen that. Yes, absolutely. And I think there's some research that also would argue the opposite, that that the the harder you come at it and the more short duration that you do higher is also beneficial.

But I think you have to consider who are we talking about, what's the population or what as as you as an individual where are you and what are you doing? But I'm a huge fan of, you know, giving ourselves a hall pass, making it easier. And I think if we all know, we can go hard for 15 to 30s, we can do that. As long as I know I'm going to, I'm going to get recovery, I'm going to get a rest period. I'm I'm getting that back and this is it. You know, you will recharge. What typically happens, we want to do about 4 to 6 intervals.

By the way. We've kind of left people hanging on that. But yeah 4 to 6 is a great number. You don't necessarily need more than that. Less than that is still beneficial by the way. So something is still better than nothing. But if you can do that, you know you're going to bump up your stamina, your VO2 max, and you've had a great training session. So I think absolutely. Yeah, absolutely. And the other thing it gives permission that, you know, a busy lifestyle you're working. Anybody can stop for 30s and run up and down the stairs and then you back to work.

Right. And you can do that multiple times a day. And that helps you to get in a pattern of something is better than nothing and is actually quite beneficial to do that. So beneficial to your brain too. And I'm sure you do that when you, you know, you can get up and go to the go to the kitchen and fill up your glass and get more water and take a bathroom break. And there's a, there's a break there. But when you actually, you know, really stimulate high intensity interval training is much more related to brain neurotransmitters firing and cognitive problem solving being better.

So you may just release your creativity and feel

Final Advice: Start Moving Today 21:30

far more motivated the rest of the day because of it. Absolutely, absolutely. So we've been talking to Deborah Atkinson and she is, an amazing fitness trainer. You can find her on YouTube and Instagram and she does amazing videos. So I highly recommend you check her out and check out her her links. But is there anything else you want to leave people with who are concerned about cardiovascular disease, whether it's reversing the existing or preventing it from happening? Just a few words of wisdom related to exercise.

Well, I think for decades it's been said that, you know, the biggest difference that you're going to make is from getting off the couch and going from low to moderate fitness level, low to moderate activity is going to get you so much more benefit than from where you are in the world opens up to you. So if you can just think about that and benefit, you know, there is some evidence that shows getting from moderate to vigorous, you're going to get a return, but it's not as big as a one from the couch to simply getting started and getting moving.

So just take a step. Yeah. Yes. Do it like Nike says. Just get started and get off the couch. And it's that inertia overcoming the inertia that makes the huge difference. So thank you so much for being here with us today Deborah. This is the been the Reversing Heart Disease Summit. And I look forward to seeing you on the next one. Bye now.