In this episode, Dr. Eric Osansky sits down with fitness expert Debra Atkinson, founder of Flippin’ 50 and host of Flippin’ 50: The Stronger Way podcast, to discuss how women can stay strong and fit during menopause. Drawing on more than four decades in kinesiology and strength and conditioning, Debra explains why one of the biggest exercise mistakes is simply not moving enough—while women who do exercise can run into the opposite problem of doing too much without allowing adequate recovery.
Debra breaks down what an effective midlife exercise routine can look like, beginning with walking as a foundation and adding resistance training and appropriately dosed high-intensity exercise. She and Dr. Eric also explore the relationship between chronic stress, cortisol, blood sugar, and stubborn belly fat; why muscle becomes increasingly important as estrogen declines; and how nutrition—particularly adequate protein—supports strength and recovery. Debra also shares practical advice for progressing with resistance training and explains the potential benefits and limitations of weighted vests, rebounders, and whole-body vibration for supporting fitness and bone health.
Throughout the conversation, Debra emphasizes that exercise during menopause doesn’t have to mean spending hours in the gym or pushing yourself to exhaustion. The goal is to find the right amount and type of movement for your body, recover well, and build habits you can sustain for years to come. If you want a clearer, more balanced understanding of how to exercise for strength, metabolism, bone health, and longevity during menopause, you’ll get a lot out of this episode.
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Dr. Eric Osansky:
I am super excited to chat with Debra Atkinson. We are going to be talking about how to keep fit during menopause. We’ll be discussing some of the biggest mistakes women make when exercising, how to lose that stubborn belly fat, and so much more. Let’s dive into Debra’s bio here.
Debra Atkinson, founder of Flipping 50 and host of Flipping 50: The Stronger Way podcast, is a pioneer in supporting women with fitness solutions during menopause; supporting the musculoskeletal changes that occur due to menopause; and supporting optimal longevity for women, with a 42-year career in kinesiology and strength and conditioning. Welcome, Debra.
Debra Atkinson:
Thank you so much for having me.
Dr. Eric:
I’m really excited. This is going to be an awesome conversation. You had a short but sweet bio, which is great. I want to go deeper into your background. How did you get to the point where you are right now?
Debra:
You want the dirt.
Dr. Eric:
Exactly.
Debra:
By purely accident. I went away to school, and I painted and drew my way through elementary and high school. I thought I was going to be a graphic designer. I said it to so many people. By the time I went to college, of course this is my major.
Two years in, I realized that I had started walking with my mother the summer between high school and college. I was going to be a lifeguard. I had had a few too many pieces of graduation cake and cinnamon roll, so I wanted to look a little bit better.
By the end of the summer, I was a runner. I was jogging. For the first time, I was doing self-initiated exercise, not a coach or sport, but I really loved it. Gosh, I wish I would have had this internal motivation for sports in high school because it would have been so different for me.
I felt like I didn’t belong among graphic designers, who mostly smoked and drank and stayed up all night to work on projects. I was now really into health and shopping at the health food store when it wasn’t cool and popular.
I stuck one foot in the physical education department and left one foot in graphic design. By the end of the semester, I was sure I was born to be a teacher and to help people feel the way it made me feel, not so much for vanity, but be better parents, students, and at life. I wanted to pass that feeling on. I had some great instructors who probably swayed me that direction. That’s how it all started.
I was the youngest of four kids. My mom remarried, and she was older when she had me before that was also sexy. She married someone 10 years older. My parents were the age of my friends’ grandparents. I listened to music that was from the ‘60s because of my older peers. I liked to think I was doing research on baby boomers way before I knew I was doing research on boomers. That’s where the biggest change came for me.
I realized that when I was teaching in the department of kinesiology, and I was hiring and training instructors to work for me at a private gym as trainers, there was something missing. The really great trainers couldn’t survive because they didn’t know marketing and sales. It felt sleazy to them. I quit teaching at a university because I wanted to save these people we were losing from the fitness industry. I never set out to start a business working with women in menopause. Who goes to career day in elementary school wanting to do that?
What I realized in five minutes is if I’m going to quit to teach them how to build a business and do sales, not sleazy but so that the people who are looking for them can find them, I actually have to be doing it, or I am suddenly talking out of one side of my mouth, “Do this,” but not proving it works. I have to be demonstrating it as well as teaching them. I am going to pick a niche and show them how it works. Flipping 50 took off.
Today, I can say we’re coming full circle. We are teaching trainers and health coaches how to better support women in menopause because they get zero support in a four-year degree or basic certification.
Dr. Eric:
Awesome. You’re still practicing what you preach as well, not simply teaching it.
Debra:
Yeah. We have been 100% digital since 2013. We started the first and only exclusively made for menopause fitness membership in the world. When we did that, I was like, should I do this? Is there even demand for this? Today, we talk about menopause like it’s a household word.
Dr. Eric:
You said 2013?
Debra:
Yeah, that was the beginning.
Dr. Eric:
Wow, a long time. I’m sure since then, until this day, you see so many mistakes. I want to jump into some of the biggest mistakes women in menopause make when it comes to exercise.
Debra:
The biggest one is not doing it. Can we say that? The statistics still shock me. When I was in 1984 sitting in that corner classroom, I remember my instructor telling me the statistics. 80% of people are not exercising enough for good health. We still use that today. Between 77-82% of people are not exercising the minimum amount they need for metabolic health. We are not talking better biceps or going sleeveless or vanity. We are talking about helping themselves avoid disease. They’re not doing it.
It’s very disheartening on one hand to say, I have been in it all this long, and we haven’t solved this. We haven’t cracked this code. What are we doing? We have had more trainers and health coaches than we’ve ever had before. The industry is exploding if you look at it from that standpoint. We have more people doing certifications and starting businesses, but we are not necessarily penetrating people. Starting is one way.
Voicing your opinion if you’d love to start, but you don’t know where or are afraid of getting hurt, so we know how to help you. I think we’ve let the public down there.
After that, I think the 20% that are exercising, we often overdo it. We are a diverse continuum. We are type As, and we want to do it, we want to do all of it, and we want results yesterday. We tend to just go gung-ho and think it has to take so much time, so much energy. We January 1 ourselves, as we call it. We get hurt and sore, and we are dropping out by the middle of the month or Valentine’s Day for sure. It’s either overdoing it or assuming it has to take a really long time or a lot of effort and hurt. Those are the biggest mistakes.
Dr. Eric:
Getting back to the first mistake, not exercising. For women who are walking daily, they take a 20-30-minute walk, but that’s all they do. Would you say that’s not enough?
Debra:
I would say that’s a great start. That’s the foundation. If we are thinking an equilateral triangle or a pyramid, at the bottom of that, that’s the anchor. It is the most important thing. it’s the foundation. That should be like brushing your teeth. Not flossing. I don’t do that as often as I should. We are not going to leave the house without brushing our teeth.
We need to walk like that because I don’t know about you, but I am going to confess right now. I’m sitting. I could be standing if I got in the right place. We sit a lot. We sit at keyboards. Even those of us who are activity-based careers, we are still sitting a lot for our meetings. When you look at pushing remote controls and how easy things have gotten, we have to walk to balance that out. We are balancing the convenience we have gotten over years. Yes, walking.
But walking is not enough when you think about the things you really want from your exercise. For women, #1 is bone density. We get scared about that. We should dive deeper into that. Bone density is not the only thing. It will never be tested unless you fall. We should put “not falling” before bone density. What are we doing, so we don’t even test it? I don’t want to know if my bones weren’t dense enough to test.
We also want metabolism. We want to maintain that metabolism. You wouldn’t maybe get up in the morning and say, “I need to work on my metabolism.” You would probably say, “I wish my waistline wasn’t so tight, or I want that belly fat not to be there.” We are really talking about metabolism. It is not just vanity. That is a heart health risk if it’s the wrong kind of fat.
Walking is a wonderful base. It is the foundation. If you are a gym-goer who does everything but walking, you’re not also getting your wings right away. You need to do both. We need the movement outside of the gym regularly throughout the day. Getting steps in or going for a walk, both are really important.
Dr. Eric:
We’ll talk more about bone density. I also want to talk about another mistake you mentioned as far as overdoing it. What are the consequences? Can that worsen menopausal symptoms? Also, how do you know that you’re overdoing it?
I’ll confess. As a man, I was overdoing it many years ago. I should have known better. Now it’s obvious, looking back. It wasn’t overdoing it by running marathons or triathlons. I was in the gym doing too much cardio. How can someone tell if they’re overdoing it?
Debra:
Really easy answer. If we go back to the statistics we mentioned. 80% of people are not doing it. If you’re exercising, when you walk into the gym, you should be the most energetic person in that room. People’s heads should turn. You don’t have to be Cindy Crawford for that to happen. The air of energy and confidence that people have when they are exercising in their sweet spot is different. People want to be around you. You’re kind of magnetic. Generally, we’re more optimistic, positive, resilient. That actually comes out. People can feel that. I am getting chills thinking about it.
This is why we do it. The rest of life gets better. There is that obvious thing. if you’re not more energetic when you’re exercising regularly than if you weren’t, that is a sign right there. A super simple one.
We go through an intake form that goes over a bunch of things. We do it on a really short scale. Zero, you’re tanking. That’s not good. 0-4. How is your sleep? How is your libido? How’s your digestion? Your elimination? Cognition? Focus? Memory? Concentration? A few other things related. Muscle tone? How do you feel about your body composition?
All of those questions give us some feedback about the exercise might be working against you. You’re often in a sweet spot when digestion is more optimal. It’s not as good if you’re doing too little, but it also doesn’t get better. It kind of gets worse if you’re doing too much. It’s probably more true in runners, who are jostling the gut when they’re doing too much. That’s great feedback.
Where am I on those numbers? I want everybody to be getting to a 3-4 on their sweet spot. I might have to refer them to someone else for a little help in another medical area or for hormone therapy if that’s an option for them. We can tell if someone is in their sweet spot because they feel better. Spontaneously, you start spending even more energy because you feel good. You will take the garbage out. Maybe not that. Let’s take the dog for a walk. Let’s play a few more holes.
Dr. Eric:
When it comes to the types of exercise, do you mostly recommend resistance exercise? Walking falls under that cardio category. For those who are used to working out, going on the elliptical or exercise bike, is that okay to do that in addition to resistance exercise?
Debra:
Yes, and that is where we would go. If someone is just starting out, I would say if you’re doing nothing, let’s get you started walking. Let’s get you walking on a regular basis, most days of the week.
The next one is weights. At least twice weekly resistance training for major muscle groups. For a lot of women, that is better done, and we now know the minimum is twice, total body, or split routine is okay. You might do different body parts on different days. Twice a week, hitting all those major muscle groups is the minimum.
For a lot of women going through perimenopause, going through really busy times in their lives, it’s also the optimum. Sometimes, we hear minimum, but you think you are going to be an overachiever. “I am going to do more because that must be better.” It’s really going to backfire on a lot of women in midlife, even though they may have been that person.
I was. I was guilty of that, too. I loved it. I think when you do like it, you tend to do more. You can get away with it. You will suddenly realize in midlife maybe, maybe not. If your hormones change, if you don’t change with it, you may not get the same results. It will be different. You have to realize, that changed, so your strategy has to change. Different team here we are playing against.
It’s important to say walking first, then weights. Then if you want to do cardio, here’s what I’d recommend. We all learned this as young adult women. This moderate range. For years, we have still heard everything in moderation. Moderate exercise. That is the least likely zone to give you benefits. It can, if you do it for too long a period of time, give you negative results, where cortisol is concerned.
I know this is a delicate topic. Some people say, “Stop, there’s nothing wrong with cortisol.” I am not anti-cortisol. Cortisol is stress, but it is also the energy hormone. We wouldn’t function well without it.
If we have it chronically high, and it can be chronically high because of exercise, or you’re caregiving to an aging parent, and your career is at a peak. Peak usually means there is a lot coming at you at once. It could mean your career is tanked, and there is a lot going on there, too. No matter what it is, you can’t separate these things. “Exercise is good for me.” Yes, it is.
But if we can say exercise is medicine, that is a term coined by the joint entities of the American Medical Association and the American Council of Sports Medicine. In the early 2000s, they got together and said, “Exercise is medicine.” If we treat it like that, you don’t take penicillin whenever you want it. You don’t take all three pills at once because you won’t have to remember them otherwise. We take it at the right time at the right amount. We do better when we do that. That is the way it is with exercise.
Every one of us has to be in our sweet spot for what we need right now. When you’re really stressed with the rest of your life, it may be a little less, or less of this and a little more of that. What that is, we all have to try.
High intensity interval training is the other piece. We can put it under the cardiovascular umbrella because it is breathlessness, and circulation gets going. We call it anaerobic work. We don’t need a physiology lesson here so much. Getting breathless a few times a week can be super helpful for your cardiovascular fitness without inspiring the cortisol negatively. We sneak it in there and then totally recover. We sneak another one in there and totally recover. That’s the way we’re meant to use cortisol. We have to gear up for a speech we’re going to give. We’re nervous and sweaty. We give the speech, and it’s all over. That high and low is really how cortisol is supposed to be rhythmic in our lives. Short term for exercise or a speech in looking at a tough week.
We often today are connected to our phones. We’re constantly on. We never really put things down. The way we exercised in our 30s is probably not going to work as well in our 50s and 60s if we keep trying to do that thing. Doesn’t mean we can’t be as fit as we were. We can be more fit potentially, some of us, as we were then, if we stop trying to do the same thing we did then or got away with then.
Dr. Eric:
To confirm, minimum twice per week, whole body. If someone wants to do upper body and lower body on separate days, that would be four times a week?
Debra:
Absolutely. The first place I go with someone who loves to exercise and says they want to do it more often is instead of those two total body, let’s do one total body, and later in the week, do an upper and a lower. Now you have three. Let’s see how you recover.
That’s the big key. That’s where we get it wrong. That question of what is the biggest mistake in the beginning is if people are exercising often, it’s not giving the due recovery time and habits that we need. For women, we’re often not eating enough. We are thinking we will exercise, and we often do that as a stimulus for weight loss. It’s often a really poor one by the way. It’s not the best motivation to exercise. It can be a habit starter. It can be proactive in doing that for you. We often don’t give ourselves the fuel we need to rebuild and repair the muscle and give us the opportunity to have the fitness that we deserve from the exercise.
That or sleep disruptions that happen during menopause particularly make us a little bit more vulnerable. We struggle to recover, even if we’re trying to.
Dr. Eric:
Great point. HIIT is fine, but if you overdo it, you mentioned cortisol. If you have cortisol that is chronically elevated, that could be one mechanism as far as the stubborn belly fat that I wanted to talk to you about.
Let’s get into that because that’s a big problem with a lot of women. What are some of the other things besides making sure you’re not overtraining? You mentioned the importance of sleep right now. What are other things women can do to help with that stubborn belly fat?
Debra:
Understanding what’s causing it and how exercise can play into being a negative piece of it. I experienced this myself. It is almost like I said to the universe, “I’m teaching women in menopause how to exercise properly.” The universe said, “We’re going to teach you a lesson first.”
I love endurance exercise. I was training for an Iron Man, which is about as endurance as you can get. I had done several previous to that, no problem. Really loved it. Not this one. I got right to the point where I had a critical mass amount of hormonal change, and nobody can see that coming. No woman knows exactly when that’s going to happen, when you’re tipping the bucket. Nope, not going to happen for you this time. I know how bad it can get. During that particular training, I put on 12 or 14 pounds of what I call my cortisol pack. People want a six-pack. I got a cortisol pack. It all went right to the belly.
Insulin and cortisol together team up to relocate things to the belly when our estrogen levels drop. We no longer have that protection of hourglass figure. We lose that. Instead of pear shape when we are in our reproductive years, we become more of an apple shape. We start putting it in the waistline. That becomes more devastating. Nobody likes pinch an inch. That’s inconvenient, but it’s a whole lot more vanity than if you’re tight, taut, and you can’t pinch an inch.
We know that fat and expansion is visceral body fat. It’s wrapped around internal organs. It puts you at far greater risk for heart disease, cancer, and diabetes. We want to look at that as not just wanting to lose that for vanity’s sake. What is it? Why is it? A big piece is stress. We could say exercise is great.
We should all be learning box breathing. Taking a few deep breaths, putting our shoulders down and out of our ears before we eat. Getting used to the parasympathetic nervous system and learning some vocabulary so we understand how to really relax and unplug. Look at nature if you can’t be out at nature. A lot of things will help.
One reason walking is so amazing is that we know that if we are going to exercise, you and I will go to the gym and do a workout. If we are going to gear up and do something hard, your body is going to release cortisol because we’ll use it for fuel. It’s going to release cortisol. That will release glycogen from the muscles. We will work harder.
Walking is low enough intensity that it doesn’t inspire an elevation in cortisol. There is no release of glycogen. We don’t need it. We can just go at a self-selected pace. If there is no release or increase of cortisol, what happens is the circulating cortisol we have because we are awake gets used for the energy for the exercise.
Walking is proven to decrease our cortisol levels. If exercise is medicine, every time you get into an argument, go for a walk. If you get tense because you just had a terrible commute, go for a walk before you go into the building. If you get a stressful email, go for a walk. The answer is always go for a walk. That will help decrease the cortisol level.
Inevitably, moving your body, almost everybody by now has heard of this study, I’m sure. You do 10 air squats every 45 minutes throughout your eight-hour workday. It means you’re getting up and out of your chair. Your blood sugar level is so much better by the end of the day that it’s better results than if you had gone for one long walk in the morning.
If belly fat is your target, you may want to say instead of that 45-minute walk, maybe I’ll do a short one, but throughout the day, I will try to walk several times for a few minutes. That actually may serve you better. It’s support for blood sugar.
For women who hit menopause, when estrogen goes down, it was protecting your blood sugar. It was helping regulate blood sugar. When you don’t have that, we know that women’s blood glucose goes up above five counts higher than it was pre-menopause, just because they punched their ticket to go on that menopause ride. You can’t get out of it. You’re on the rollercoaster no matter what.
We just have to pay a little more attention to the movement we do throughout the day. The more muscle you have by doing that strength training, the bigger bank you have for blood sugar when you eat meals to go in. Or when you get stressed, and blood sugar is released, it has to go somewhere. The bank of muscle is a really good place. The other place might be your liver, which is already bogged down working too many jobs. The third place is hips, thighs, back of your arms, and your belly.
Dr. Eric:
Can you talk about the importance of nutrition? Everybody has a different perspective as far as how much protein someone needs. I’d love to get your perspective.
Debra:
Oh gosh. This is a hard conversation to have with people. Protein is emotional for a lot of people. Right on this belly fat track, little things you can do. This is research borne. Everybody attributes the Glucose Goddess, the famous Instagram influencer, for this. She pulled this out of research studies. She has done a great job of making it mainstream.
If you don’t want to have the conversation about changing what it is you are eating, try changing the order of the foods you eat. Just say, okay, whatever I am eating, I will put my carbohydrates last. I will have my veggies and plants, things that have fiber in them, and my protein first.
By the way, I would say if you struggle to eat all your protein because you get full easily, especially if you might be on a weight loss medication, have protein first, then the veggies, then carbohydrates last. They are more recreational, but we can also decrease the impact of those carbs on your blood sugar elevation by 75% just by changing the sequence that you eat things in at your table.
If you go to a restaurant, and they bring you the bread basket or the chips at the Mexican restaurant, you should say, “Bring those for dessert.” You have to say, “No thanks.” It’s the worst time to do it. Your blood sugar will spike if you are on an empty stomach, and you’re having carbohydrates.
By the way, I’m not saying carbs are bad. We go to the extreme sometimes. We are trying to drop weight quickly. Then we stay on that forever with very low carb. I see a lot of women really exhausted, trying to exercise with no fuel, no carbohydrates for recovery. I think we’re making a big mistake there, too.
In terms of the protein conversation, I am a fan of a user-friendly way of doing it. A user-friendly way is looking at what your ideal body weight is. About 1g of protein per pound of your ideal body weight. What would that look like? Track yourself. What are you doing normally? A lot of people don’t know how much or little they’re eating of protein. They have no idea. Track what you’re doing first. Find out how many grams of protein on average you are getting. Know that number. If you were eating for your ideal body weight, what would that be, if you were eating 1g per pound of ideal body weight?
I wouldn’t say do that tomorrow. Start closing the gap. Tell me if you notice you have better energy. I have had women say yes within a week. Adding a little. Closing the gap, maybe five more grams of protein at breakfast. Little things made a difference. They sleep better as well.
I do think from Dr. Donald Layman, a pioneer in geriatrics and protein, that no less than 100g a day of protein for almost all body weight and sizes is his recommendation, just for metabolic health, just to maintain lean muscle, not necessarily gain it. A lot of women are not doing that. They are somewhere between 40-60g.
First, get intimate with what you’re doing now. What are the results? You are a result of this lab experiment you’ve been doing, and the habits you’ve had recently have given you the body you’ve got right now. Are you happy with them? Are you healthy with them? Do you want to change them? Start looking at that.
I think it’s a crime to have people go on social media and hear they should be eating so much protein or lifting heavy and have it be so discouraging. That’s where we’ve gone wrong. It needs to be start where you are. Make a little change. Get the feedback. See how you do. Either keep going in that direction if it feels good, or let’s pivot.
Dr. Eric:
Awesome. Especially with the protein, if someone is only eating 50g of protein, and someone now says minimum 100g, it sounds overwhelming. “I have to make this change tomorrow or next week.” You’re saying to gradually increase the amount of protein until they get to that point. That’s wonderful.
Let’s talk more about building muscle and bone density. You don’t want to overdo it. Same thing. You want to go gradual as well with that, too. Especially if you haven’t been lifting. This is more of a question. You don’t want to go too light if you’re building muscle as well as bone density, right?
Debra:
Right. But we all have to start light.
Dr. Eric:
I don’t mean starting. The end point. Another question, and then I’ll be quiet and let you answer. How long should it take for someone to reach that point? Are we talking about a month, three months? I know everyone’s different, but a ballpark.
Debra:
When you say, “reach that point,” what point is that?
Dr. Eric:
Let’s backtrack. Let’s say someone is walking 20-30 minutes every day. Now they want to do some lifting. They will start very light. A better question then. I’m always challenging myself. It’s not like I reach my goal, and that’s it. Maybe that’s the same with a lot of women and people in general. How slowly or quickly should they progress as far as building up that resistance?
Debra:
Let me see here. In terms of starting, those of you who are just starting, I’m jealous. You’re a virgin. You will see results from almost anything because you’re not doing anything, so you have nothing to lose and everything to gain. Let’s say that.
The longer you have been doing it, the fewer changes you will see, but it’s a really exciting time if you’re just starting out. You’ll see and feel strength gains within probably a couple of sessions. I’m not saying the soreness that you might anticipate. Generally we can keep that minimized.
Here’s typical results. I think you might have been asking this question. A long time ago, Dr. Wayne Westcott did a lot of research through the Y in Maine. Typical results for somebody just starting out. The first month, if you are regularly 2-3 times a week strength training for major muscle groups, you would gain three pounds of lean muscle mass, and you could lose four pounds of fat.
If you were just looking at the scale, it’s a better idea to get a bioimpedance scale. You won’t get a significant amount of weight loss, but you have probably lost inches. That one pound you’re losing is fat though because we changed fat more than we changed muscle. You can expect that over the first three months.
After that point, your body is probably going to catch on. It will get a little bit wise. Fortunately, you’re no longer a virgin. It will feel different and not quite the same. Results will happen a little bit slower. You will continue to change.
Like you’ve alluded to, even after 44 years of consistent exercise, I still go in and reach muscle fatigue. I need to do that. You need to do that in order not to slip backward, in order to maintain. The body is so darn smart that we will reach maintenance. If we keep doing the same thing that got us here, we’re not even going to hold onto that. We still have to keep going and surprise and challenge it, so we hold on to what we’ve got. Maybe we’re making those micro changes in strength or in power and agility and reaction skills. Those kinds of things will continue to happen. It gets slower.
It’s a lot like weight loss. If you had 25 pounds to lose, a lot of that will come off fairly quickly at first. The closer you get to eight more pounds or five more pounds, it gets harder and slower to lose those last ones. The body is trying to say, “No, no, no. I really like that homeostasis. I like that place we were. Let’s get back there.” You will argue with it the whole time.
We still have to continue to change. Changes happen fairly quickly. We’ve done four-week-long programs, and that is by no means long enough to see a consistent, long-term pattern. People see and feel change within that.
I’ll tell you right now that I’m a pusher. I want people to become codependent. I want you to get started and stick with it long enough that you get hooked. You realize, “I feel better when I do this than when I don’t.” That is the real win. When you’re consistently doing it, you will continue to see patterns of “Life is better. I am stronger.”
The benchmarks of “I live in a seasonal climate right now.” You get your golf clubs out in the spring and realize, “I’m hitting it a little further because I was strength training all winter.” You start shoveling again in the winter and realize, “This doesn’t hurt my back anymore.” You feel differently and see those little benchmarks continue to happen. It can happen quickly at the beginning.
We do know that moderate level weight training- We do this with higher repetition. I wouldn’t say we will start with five pounds and go to 10. If you’re listening, you need a different weight. The only way to know is you have to go pick some up. We prescribe exercise differently than medicine. We would say, “I want you to fatigue somewhere between 15-20 reps.” That’s a higher number of reps. You will pick up a fairly light weight for yourself. That’s a good starting position. It’s not so many that we can get wear and tear on the joint. We can go too high as well, and that’s not necessarily a better plan, especially if you have arthritis of either kind.
Then I want you only to be able to do 10-15. You have to pick up a heavier weight to do that. That’s called progress. At some point, we say, “Are you still feeling okay? Shoulders good? Knees good? We will go a little heavier. I only want you to do eight. No more than that.” What’s that weight? We can push that.
If you find that stuck point because you have an old or current injury, or you were in a car accident and have a condition, you may find certain joints are not happy going heavier. Now you know it without having gotten there with an injury. You’ve just gotten there slowly. Nope, that one’s out for me. Here’s my playground where I’m safe, and I can still challenge myself.
Dr. Eric:
Before we started chatting, I mentioned how I wanted to get your perspective when it comes to vibration plates, rebounding, weighted vests. A lot of people are wearing weighted vests. I have one, too. I mentioned I got a rebounder. What are your thoughts about those three modalities when it comes to especially building bone density?
Debra:
I think they’re great tools. I want to say this to anybody who is thinking about getting started. “Oh my gosh, I have to go buy this and invest in that.” If we think of this like a bull’s eye, a bull’s eye for walking is a good pair of shoes. It’s dumbbells. We got really creative during the pandemic and put books and weights in backpacks. We put sand and pebbles in water bottles because there was a dumbbell shortage. It doesn’t have to be a big investment. The fewest things you need are three pairs of dumbbells of different sizes and walking shoes, so you can go outside and do your walking. That’s it. Then you’re good to go.
When you get to “I want something else,” or you’re limited because your knees hurt, and you can’t do impact, or even walking might bother your knees, that’s where you might look at another tool that could help you be more active or get the results if you were more active. That’s where these tools come in. They’re in the outer loops of the target and a lot of fun. They all have a place.
Starting at the top: the weighted vest. First of all, its greatest asset is it’s there for postural awareness. You put that on and have to resist it. You’re using your skeleton in the way it was probably meant to. I just sat upright a little more talking through that. That’s how big it is. We all sit here and melt a little bit if we’re not thinking about it. The metabolic expenditure, the cost of exercise goes up. If you and I go for a walk, maybe per mile we burn 100 calories, we go for a walk with a weighted vest, and maybe we burn 115 calories for that mile. That adds up. You go for a 2-3 mile walk every day. That adds up. A lot of good things are happening.
I know I was humbled the first time I went for a walk. I was used to walking uphill to my neighbor to pick her up. Walking in the weighted vest was terrible. “I wonder if I can leave her at this house when I go for a walk. I’m a professional. I can’t let her see that.” It’s really great.
People question if that is helping their bone density. It’s not hurting it, but it’s probably not your first line of defense when it comes to helping your bone density. I like putting a heavier one on and holding the weight. If I’m doing it at home, it helps me get closer to overloading my lower body. The two combined are now better. It’s not actually adding bone density to your skeleton or spine because you’re wearing it. You only want to be within 10-15% of your body weight of that weighted vest and err on the conservative side.
I will say this. To females who hold their tension up here, that is about 99% of us by the way, holding the weight of the world on our shoulders, get used to your weighted vest. Start with a lighter weight one. Find a vest where you can put the weights in and take them out. They sit in little pouches. You start lighter. Get used to your vest while you’re doing dishes or making dinner. You’re wearing it for 5-10 minutes at a time. If you’re wearing that weighted vest, you’re used to going for 30-minute walks. Then you wear it. You will probably come back tense, and those shoulders are not used to it yet. It can be great but over time work your way up to wearing it on that full walk. Don’t do it all at once. I love them.
Rebounding. If you’re curious, I just did a YouTube video in response to rebounding versus whole body vibration. What do they do? I did a podcast recently on this, too. I love both tools. The rebounding can be great if somebody needs a softer landing, say knees are degenerated. You have arthritis. For some people, we lose padding in our feet. We put it elsewhere. How wrong is that?
For some people, walking is not comfortable. It feels like there is pebbles in our shoes constantly. The rebounder can be good for that as well. Yet it is not the ideal if your primary goal is bone density. You have to have the really firm surface, and you have to pretend that surface is going to touch the ground. It’s not necessarily jumping on a trampoline like you did when you were a kid. That is great exercise. I shared the science about this. There is not a lot of science to say it improves bone density. It doesn’t.
However, if you’re coming off the couch, and you’re doing this and were doing nothing, it probably improves your bone density a little bit. We can’t argue that. Something is better than nothing.
If you have limited time and energy, and you really want bone density because that is important to you right now, that would not be my first choice for you. I want you walking, weight bearing, jumping on the ground, and doing weight training.
If you’re not exercising, and you hate it, and you put that on with some music, and you love it, you’re consistent. People came out of the woodwork to say, “Don’t discourage anybody from exercising.” I said that wasn’t my point, but I hear you. I’m in total agreement of that. If your mood improves, your cognition improves because you’re moving more, you have circulation, there are obvious benefits for it for sure.
What was the third? Whole body vibration. I’m a huge believer in that for bone density. For anybody especially who is limited in their ability to hold heavy weight or cannot jump, which are the first two lines of defense for bone density benefit, some of us are limited because of arthritis, fibromyalgia, a multitude of things, and can’t do either/or of those things.
Whole body vibration has significant research behind it showing that within six months, either three times a week for 15 minutes or five days a week for 10 minutes, using the plate, doing easy things like squatting up and down or sitting in a squat, kind of a chair pose. If you’re a yoga person, you know what I mean. Very easy things to do, low effort. You can significantly improve bone density, particularly in the total hip and lumbar spine. It’s a gamechanger.
I can lift heavy. I do. I can jump, and I do. Even I had osteopenia. Sometimes, you can’t outrun your past. Whether it was too many Diet Cokes in grad school and probably not enough other things. You go through periods of time. Maybe you didn’t have great gut health. There are a lot of things that conspire against you maybe in bone density. It’s nothing you’ve done wrong necessarily.
I found after nine months of use, I reversed the osteopenia in three locations myself. That’s also great testimony for each of them. There’s lymphatic flow, increasing circulation, recovery from other exercise that is more strenuous. Both rebounding and whole-body vibration are great for those as well.
Dr. Eric:
You did a follow-up DEXA scan to look at bone density and saw that the osteopenia had greatly improved. That’s wonderful. Is it true that all vibration plates aren’t equal? I don’t know what type you have, if you don’t mind sharing what you have.
Debra:
I don’t mind. I have the PowerPlate Move. What I like probably most about it is the platform size. It’s big enough that balance is not an issue for me. If it were for somebody, that would be my biggest concern.
The ones that are a little more budget-friendly. I have done a study- That is probably not the right word because it alludes to the fact that I was the primary researcher, and I wasn’t. I pulled together all the research on why are you using it? Know that. Am I using it for bone density? My target weight loss? Cellulite? Is it muscle stimulation because I can’t lift, and I’m looking for an alternative? Is it recovery from exercise?
We pulled all of the studies that were successful, the hertz levels, the vibration levels that were necessary in getting that. Somebody who was going shopping for a different model or brand could go say, “I need to make sure I have between 20-30hz.” That is the most used for bone density, by the way, success. If you’re shopping for this is what I’m looking for, and I have to have that, then you can at least safely say, “I know I’m investing in this for this purpose, and I’m going to get it.” That’s the biggest thing you want to make sure you’re doing. They’re all not created equal. Just because it is cheaper does not make it a bad option. Just know what you’re looking for.
Dr. Eric:
This has been awesome. Anything else that I should have asked you that I didn’t ask you? There are so many other things. I meant to talk with you about your HALO Method. We might have to have you back to talk about that.
What is one piece of advice for someone who is sedentary and wants to start somewhere? I guess you gave that answer earlier. Just start light. It doesn’t have to be actual weights. It could be bands. It could be their own body weight.
Debra:
Absolutely. The secret is sometimes not feeling- We have said this. Total body. We did this erroneously and did not realize it. This is where all of us well-intentioned can go wrong. We make it overwhelming. When we say, “total body workout,” that’s where we want to get to.
If you are just starting out, how about we try three strength training exercises on two different occasions this week, and we do two sets of them? That’s it. I just asked you for 10 minutes at a time.
The most important thing when you start is technique, strategy, feeling the muscles in the right place, knowing that you’re feeling a little more coordination and a little more confident doing it. We can’t rush what happens in the first eight weeks anyway, which is the brain’s signal to the muscle is getting stronger. Going heavy quickly doesn’t really help that.
Learn the exercises. Let’s do three exercises: one push, one pull, and for your lower body, and do them twice, two different times during the week. Make it super easy when you’re starting strength training for the first time. No soreness required.
Dr. Eric:
Debra, thank you so much. Can you let everyone know where they can find out more about you?
Debra:
We hang out at Flipping50TV.com. That’s on most social media accounts. I host the Flipping 50: The Stronger Way podcast. If you want to hear a little bit more, I’ll whisper in your ear if you take me on a walk.
Dr. Eric:
Thank you so much. This was a wealth of information. I learned some new things, and I’m sure my audience learned a lot as well.
Debra:
Thank you so much for having me.
***
Dr. Eric:
That was an excellent conversation with Debra Atkinson. With some of the biggest mistakes women make, not exercising versus overtraining. It’s not a surprise that there are a lot of people, not just women but men, too, but the focus here is on menopausal women. A lot of menopausal women are not exercising or maybe just doing some walking but not doing any resistance exercise.
Then you get the other extreme: menopausal women who are overdoing it, overtraining. I am not a menopausal woman, but many of you know my backstory about when I was diagnosed with Graves’. Prior to being diagnosed, I was overdoing it. I do see this from time to time with people I work with as well. You don’t have to be running marathons or triathlons to be overdoing it. I was just doing too much cardio at the gym, working out too intensely.
I will say this. If someone is dealing with hyperthyroidism especially, you want to be careful. Maybe you’re going to start out with doing some light walking. It depends. If you have the symptoms under control, I do think that resistance exercise can be beneficial. A lot of people with hyperthyroidism lose muscles mass and bone density.
For those with Hashimoto’s, the Hashimoto’s itself, I wrote an article in 2019 that the autoimmune component of both Graves’ and Hashimoto’s, the inflammation associated with the autoimmune component has a negative effect on bone density. Resistance exercise isn’t necessarily going to overcome that inflammation. It won’t completely neutralize it. But if you are going to lose bone density, lose muscle mass, you want to try to do as much as you can to combat that, to prevent that. I definitely recommend, if you’re able to, to do some resistance exercise. When it comes to cardio, you don’t want to overtrain.
Cortisol and belly fat. Debra spoke about the impact of stress and high cortisol on losing weight, how that’s a big issue. There’s diet and exercise. Both of those are important. If you’re sedentary and eating a lot of inflammatory foods and overdoing it with carbohydrates, it will be difficult to lose weight. There are people who are doing everything right from a diet perspective, and they are exercising regularly, and they can’t lose weight.
There could be other factors. The health of the gut microbiome plays a role. Blood sugar imbalances, which go hand in hand with insulin, the relationship between insulin and cortisol. Sex hormone imbalances can play a role. Cortisol also will affect the sex hormones. Healthy adrenals definitely play a big role when it comes to having a heavy weight.
Protein. Increasing protein gradually. Debra does recommend 1g of protein per pound of body weight. I can’t say that I agree with this. I don’t think everybody needs that. In The Hyperthyroid Healing Diet, I talk about consuming 75% grams of protein compared to one’s body weight. For example, if someone is 120lbs, consume at least 90g of protein. 75% of 120 is 90. She recommends 1g of protein per pound of body weight. I forgot who she mentioned, but someone she follows recommends at least 100g of protein per day.
She mentioned to increase it gradually. If you are only eating 40-50g of protein per day, even if you are trying to build up to 90g, if you are doing 75% of your body weight in grams of protein, it might take some time to make that transition. Don’t feel like you have to do that overnight.
We also spoke about vibration plates, weighted vests. She does have some information on her podcast. We also spoke about rebounding. I can’t say I use my rebounder as much as I would like to. I do have an infrared sauna, which I use regularly. I also use the weighted vest three days a week. She is a bigger fan of vibration plates.
I admit that I have a lower cost vibration plate. The reason why I invested in a lower cost vibration plate is as I just mentioned with the rebounder, I don’t use it. It’s been many months since I used the rebounder. The really good vibration plates are a few thousand dollars. Am I going to use the vibration plate?
I will say I have been using the less expensive vibration plate. It might be helping with lymphatics. It definitely shakes my body. It definitely shakes me more now than it did in the beginning, which isn’t a good thing. I know it’s not as good quality. When I had it in the first few months, it seemed like very low intensity shaking.
I would also like to get a PowerPlate Move. She mentioned that. That is something I will eventually look at. I will probably wait for a sale because I think full price they are $3,700. If I absolutely had to do that- I know they have 20% or 25% off sales. Eventually, I’ll get it.
The one thing I will say is you don’t need everything. I need to tell myself that, too. It’s not like I need to get every single gadget out there. I don’t have a hyperbaric oxygen chamber and probably won’t be getting one of those. Some people listening to this might have that. I do have a sauna. I do have a rebounder I don’t use. I do have a weighted vest, which is pretty reasonable. Getting a good rebounder is maybe not cheap, but it’s also not crazy expensive like an infrared sauna or vibration plate. We’re talking also from a bone density perspective. It does help with lymphatics. Rebounding, too. Walking helps with lymphatics.
Like I said, I need to convince myself that I shouldn’t go out and spend $3,000 on one. I’d like to have one. Do I absolutely need to have one, or could I put the money somewhere else? We’ll see. Maybe I’ll wait until Black Friday and see if they have a greater sale.
Anwyay, hopefully you enjoyed the conversation I had with Debra. I will be on her podcast soon as well. Hope you enjoyed this. Look forward to catching you in the next episode.