Females and Fitness: An Interview with Dr. Juliet McGrattan
Welcome to the SYNC Your Life podcast episode #11! On this podcast, we will be diving into all things women’s hormones to help you learn how to live in alignment with your female physiology. Too many women are living with their check engine lights flashing. You know you feel “off” but no matter what you do, you can’t seem to have the energy, or lose the weight, or feel your best. This podcast exists to shed light on the important topic of healthy hormones and cycle syncing, to help you gain maximum energy in your life.
In today’s episode, I’m interviewing Dr. Juliet McGrattan, who spent 16 years working as an NHS GP and now uses her medical knowledge and love of running to help and inspire others to lead active lives. Her book, Sorted:The Active Woman’s Guide to Health, published by Bloomsbury, was awarded first prize in the Popular Medicine category in the British Medical Association Medical Book Awards 2018. Her second book Run Well: Essential health questions and answers for runners was published last year. She blogs, writes, podcasts, and speaks regularly on the topic of physical activity for health and is the resident Health Expert for Women’s Running magazine. She is the Women’s Health Lead, Master Coach and UK Director for 261 Fearless, a global, non-profit network which empowers women through running. We dive deep into subjects like overtraining signs in women, low iron/ferritin, perimenopause and menopause signs, and so much more.
You can check her out at https://drjulietmcgrattan.com/
Her book, Run Well, can be found here: https://amzn.to/3uHBee8
Her book, Sorted: The Active Woman’s Guide to Health, can be found here: https://amzn.to/3uLoBP4
If you feel like something is “off” with your hormones, check out the FREE hormone imbalance quiz at sync.jennyswisher.com.
To learn more about the SYNC Digital Course, check out jennyswisher.com.
Let’s be friends outside of the podcast! Send me a message or schedule a call so I can get to know you better. You can reach out at https://jennyswisher.com/
Enjoy the show!
Episode Webpage: jennyswisher.com/podcast
0:05
Welcome to the SYNC Your Life podcast. I’m your host, Jenny Swisher, certified personal trainer, nutritionist hormone health expert and girl mom. I believe all women should be able to understand how our bodies are designed to feel and I teach you how to sync your lifestyle to your cycle to reach maximum energy. You deserve to feel your best and this podcast is going to teach you how. Let’s dive in!
0:34
This podcast is sponsored by the SYNC Digital Course to take the free hormone imbalance quiz to see what your symptoms could mean about your health. Visit sync.jennyswisher.com That’s sync s y n c dot Jenny swisher.com
0:59
Hi guys, welcome to today’s podcast. I’m so excited to interview my friend Juliet McGrattan. She is a doctor who spent 16 years working as an NHS general practitioner and now uses her medical knowledge and love of running to help and inspire others to lead active lives. Her book “Sorted: The Active Woman’s Guide to Health published by Bloomsbury was awarded first prize in the popular medicine category in the British Medical Association medical book awards of 2018. Her second book, “Run Well: Essential health questions and answers for runners was published” last year. She blogs writes podcasts and speaks regularly on the topic of physical activity for health, and is the resident health expert for women’s running magazine. She is the Women’s Health Lead Master Coach and UK director for 261 Fearless, a global nonprofit network which empowers women through running. I’m so glad you’re here. Juliette, thanks for taking the time to talk to me today. Oh, you’re welcome. It’s really good to be here. Thank you for asking me to come. I’m so glad we made this connection. We got to have a little miniature pre call a couple of weeks ago, and I didn’t want that call to end, I had so many questions that I wanted to ask. And I thought no, I’m going to save them for the podcast. So here’s to hoping that we can get through everything that I want to touch on today. I know that you you said you’re an open book and you’re open to spontaneous questions. So I think we’re gonna have a good time, like nerding out, I guess on just women’s health, what it looks like to be a female runner, all these things. So can you just start off by giving us a little background of who you are? How you got into running maybe your medical background as well. That’d be great.
2:30
Yeah, sure, I’d love to. So I wasn’t always a runner, I didn’t run at school, like there was that dreaded cross country, I’ve tried my best to make excuses and get out of it. I tried running quite a few times when I was a junior doctor thinking, Oh, it looks really cool. I want to look like that and hated it. And I finally came to running. After the birth of my third baby, I had three preschoolers. And I was just feeling unfit and just not very happy with my body, or I didn’t know I was looking for something I don’t really know. Looking back, I don’t think I know what I was looking for. I just wanted something to be a bit different. And that’s when I actually started running. And at that time, I was working as a medical doctor, in a family practice in our community. And I, I’ve always loved my job. But the job was changing a bit or I was changing a bit, I’m not sure I’ve just been getting a little bit restless. And when I discovered the amazing power that running had to change me physically and mentally. I just thought this was better than any medicine that I was prescribing on my prescription pad. And I just wanted to know more about it, learn more about it, and tell everybody about it. And that started what’s now been well, actually 10 years now, I kind of a journey of of using my medical knowledge in a different way and directing it specifically towards helping people to get active, and particularly through running because that’s what I know the best. Yeah, just to try and get the word out about how amazing running is, but also try to help women in particular overcome the barriers that stand in the way of being active. Because there, there’s there’s many for everybody. But I think particularly for women, there are lots of extra barriers. And because I had that experience of sitting in the consulting room as a doctor and talking to women about their bodies, and women’s health, etc. I really just thought I kind of have to put the two together. And that that’s kind of what led me to where I am now. I never could have predicted that the journey that I’ve been on. But yeah, it’s been wonderful.
4:39
I hear Yeah, I’m not not not thinking you should, you know, like, I think about my journey in particular. And I’m like, I never would have thought I would be talking about what women’s hormones view would have asked me about 15 years ago, but here we are. So I want to ask you specifically you just mentioned barriers that women are up against when it comes to this. Can you tell us what does that look like? What are those barriers that you typically see?
4:59
Sure, well I think again, there are physical ones and mental ones. I think if we think practically about the physical barriers, I would see women who stopped being active or didn’t want to be active in the first place because of problems like stress incontinence, leaking urine when they jumped or tried to run heavy periods, breast problems, you know, breast tenderness, breast pain when they were running pregnancy problems through the menopause, lots of you know, hormonally related things. But also mental barriers, which can be massive, and particularly when you’re starting out a fear of judgment or fear of getting it wrong of looking silly of not feeling like an imposter, not thinking that you’re sporty, and therefore, just not associating exercise with something that was fun. And I know full well that if you don’t enjoy something and think something’s fun, you’re not going to keep doing it. We know that exercise, you know, is so good for you. And it improves your health, you know, and never ending, never ending amount of ways. And women, they’re missing out. And I’ve just thought, No, you can’t have this. We’ve got to try and overcome some of those barriers, physical, mental, whatever they are.
6:10
Absolutely. I love that you said that, because I actually just had a conversation last night with some friends. And we were talking about what is it with women and this sense of perfectionism. Like, if we can’t do it, right, we just don’t do it at all right. And so I think that does hold us back when it comes to exercise. I think back to the start of my journey, my husband and I started with a home DVD program. And you know, I was a high school athlete at a small school, my husband was a division one all American runner, we’ve had that conversation. I’m sure we’ll talk more about running here shortly. But you know, I was, in my mind, he was the athlete, I was not an athlete. And so when we started working out together from home, I wanted him to stand in front of me, I didn’t want him to be watching me, I was so self conscious when I first started. And even if I go, if I rewind a little bit more, and I think about where I really started, I started on the treadmill at my corporate job. I started by taking these little yoga classes at my corporate job and stuff like that. But I was definitely by no means a runner. And I remember being so nervous at like, my first 5K’s like, can I really do this? Or, you know, like, is this really this is this who I am, you know, so let’s talk a little bit about that. Like, we’ve talked about what holds women back. But what can you know, finding the right activity for you do for you as a woman, because I’ve seen, you know, women, I have lots of friends who are runners, anywhere from 5k to half marathon marathon runner friends. And it seems like when they get into it, they really get into it. Like when they when they commit they’re all in, right. But I’ve also in my own experience, I’ve also come up against the fact that I just don’t enjoy running, but I do like strength training. And so it took me a journey of finding what it was that I like, and I enjoy. And that’s what brings me back every day. So can we talk about that briefly? Like what are your thoughts on finding something as women enjoys?
7:53
Yeah, definitely. I mean, and runners, I know, because I am one of them and surrounded by them, we can get a bit boring. You know, we tend to think that running is all there is. And at the end of the day, it doesn’t matter what the exercise is, as long as it’s something that you enjoy, because you’ve got you’ve got to keep doing it. And I think your questions to, you know, how does it change you, I think it can be completely transformational, it can change you physically, it can change you mentally. And I think for women, a lot of women do start, like you said, you know, on a treadmill, or somewhere private, I have a friend who started on a rowing machine in her kitchen, and is you know, doing amazing things. Now I have another friend who started running at 5am in the dark, because she didn’t feel confident and didn’t really want people to see her. So I think, you know, women often do start very privately. And one of the things that it really does give you is confidence, wherever exercise it is, if you can set yourself what you do with exercise little goals that you meet, then that goal setting and success just helps you to grow and self esteem, self belief, self confidence, you, you start to appreciate your body in a different way for what it can do, rather than necessarily what it looks like. Because we’re never happy with how we look when we respect our body and really think of the amazing things that they can actually do and enables us to do, then you can start to have a really good relationship with your body. So I mean, I think it can be all round, transformational, you know, alongside with my doctors hat on you know, reducing our risk of disease and type II diabetes and cancer and heart disease, etc, etc, etc. So, and I really think that it has amazing ability to transform personal health but you know, looking at wider global health and the huge problems that we have with with ill health and disease today.
9:42
Yeah, I think if you know if you’re a woman listening and you know, especially I’m thinking of my fellow moms of littles, right, I have a five year old and a one year old and one thing that I hear often from moms of littles is oh my gosh, I could never have time like I could never I could never have time to exercise or I hear this a lot People will say, Oh, I just don’t have your motivation, or I wish I was as motivated as you are, you seem so consistent. And I just want whoever’s listening that might be thinking that I just want you to know that there was certainly a time for both Juliet and myself where we both were like, no like line in the sand, like, I need to start moving my body, even if it’s just 15 minutes a day on a treadmill or 15 minute walk, because the people that you care about the most, and this is what I’m so passionate about. Your kids, your husband, your parents, your family, your friends, you can be your best for them, by taking care of yourself first and pouring into yourself, really allows you to kind of pour from that full cup. So I just wanted to interject, because I think a lot of times as women especially, we come up with these excuses, right, like so there could be someone listening that’s like, oh, well, that works for her, you know, she can do it. No, you can’t do so I just had to kind of interject with that. So I want to kind of direct us down this path of, of, like, we’ll talk specifically about runners, but I think it will also apply to just women who are training in some capacity. You know, this is something that interests me a couple years ago, I got into really wanting to understand the concept of cycle syncing and the concept of paying attention to our menstrual cycles. And regardless of like I said, regardless of what your physical activity of choice is, what are some common things as a doctor that you see, you know, that women are struggling with, when they do commit to training? Let’s say that they do say, Okay, now I’m going to get into running and they’re, they’re training for a half marathon. Let’s talk about some common pitfalls that you see women falling into and address that.
11:31
Yeah, I think a big one is energy levels. Because you there’s a temptation to just keep going and going and getting better and better and doing more and more and further and further and faster or faster, when more classes or heavier weights. And I think that’s, of course, you will get that through as you follow a training program. But I think we have to also realize that there is so much more going on in our lives. And alongside that we are juggling all those other things. And those other things change and the demands of those really, really change. So I think we have to really be careful that we don’t fall into the sort of habit of compartmentalizing our training is one thing, and the rest of our life is another thing. And we have to look at it more sort of holistically, because the training is going to make us tired. The other thing is it gonna make us tired. And it’s not always necessarily getting a balance, because sometimes you have to put more end to unbalanced things for a little while. But actually, I think it is just being kind to ourselves and looking at the whole picture and trying to understand if we don’t have energy in a particular training session we’ve got why is that? You know, is it just one of those things? Is it our cycle, is it that we’ve got other stressors that are really big in life at the moment and really try to look at things more holistically, because energy levels really do fluctuate, and it’s tight, all those things are trying to do a very, very tiring. And I think people don’t often take enough rest to account for that they maybe don’t get as much sleep, perhaps because of small children are perhaps just because they don’t prioritize it. But they also don’t necessarily have it easy weeks. And I think it’s really important to sort of maintain our energy levels that we do have, you know, we work hard for three weeks in our training, then we have a week where it’s a little bit easier. And then we go again. And then we have another easier week. So we can be really sort of flexible, adapt to how we’re feeling. But always look at the bigger picture.
13:23
Yes, I think that, you know, it’s so common for women to just be like when you do get into an exercise routine, like you said, like to just really go all in. And sometimes even I see it often as a personal trainer, you know, women getting really obsessive about it, right? Like they get really obsessed with their Orangetheory classes or their marathon training or whatever. And the one thing that I’m constantly finding myself coming back to, especially with the women who take my course, is really encouraging them to listen to their body and educating them on what that looks like. Because, again, I mean, and I can I can raise my hand and say that I’m not as much of a victim of this as anybody else, right? Like I, I can really get into a groove with a fitness training plan or a calendar or something that I’m set to follow, right? Like whether it’s training for the big race for somebody or for me following a 60 day program calendar. And if the calendar says that today is a day to do this, it’s hard for me to say, oh, but my legs are really tired and I slept bad last night. My baby was up all night. Like maybe I should just do some yoga instead. Right? So what are some ways that you could encourage women to pay attention to their like, what signs should they be looking for? What are ways to look at perhaps overtraining signs or low energy availability? I know we talked about reds. Talk about that for a little bit for the woman who is a training woman.
14:46
Yeah. So overtraining is very, it’s very easy to do without actually meaning to there’s overtraining syndrome, which is a specific syndrome, which is quite serious. And that really is more in women that are at elite athletes, you know, in elite sport, and for people like myself, who would you sort of more recreational runners or just enjoying sport on a lower level, we’re unlikely to develop sort of pure, serious overtraining syndrome, but we can still overtrain. And we can notice quite a few things that change. I mentioned energy levels. So it could be that it could be that you just haven’t got the energy. But again, that can be difficult to identify as to what the cause of that is, is that overtraining, or is that just life. But sometimes, if you’re not making the progress that you would expect to make, so you are following a program, but you just can’t crank up the distance, you just can’t crank up the weight, you just can’t crank up the the miles or whatever the change is on, you’ve stopped, you’ve kind of plateaued, you’ve stopped seeing gains and improvement. And that can sometimes be that your body needs a bit of a break, and that you’re just maybe overtraining a little bit and expecting too much of it. The other thing is, as I said, feeling tired, but sometimes you you sleep, and you get loads of sleep, but you don’t feel refreshed by it. So you are having rest, and you are taking rest, but it doesn’t seem to be making any difference. And that’s an important sign of overtraining. Conversely, sometimes actually, you can stop sleeping, you’re very, very tired, but your sleep becomes affected and you can’t get off to sleep or you keep waking up frequently. So sleeps are really a really good marker, I think it’s to the sort of quality of it. And is it being refreshing Is it is it, giving you sort of restoration and allowing your body to heal and adapt? Something else a good sign of overtraining is if you, you notice that you’re, you’re losing your motivation, it can affect you mentally, as well as physically, as well as sort of feeling tired and not performing, you can sometimes actually lose your drive, you can become a little bit low in your mood, you can become irritable. And notice that you may be even more anxious, sometimes those overtraining does come out in your sort of psychological way, rather than a physical way. So that’s an important one. And also, if you’re frequently getting ill, or you’re frequently getting injured, those kind of if niggles happen all the time, you keep getting injury after injury, you get virus after virus, and you just can’t seem to stay well, because exercise is good for you. But it does put some stress on the body. And if you’re doing too much of that, then and your body isn’t able to look after itself and nurture and heal and restore and strengthen, then you do sometimes find that you’re getting recurrent error over currently injured. So that’s a good a good marker of overtraining as well. And those are kind of very concrete things that you, you can notice, you can look at your stats, you can look at your heart rate variability and your resting heart rate in the morning, and you might notice changes in those. But that can be quite advanced in time to pick up you need long times picking up patterns, to see a difference where there’s other things I mentioned, quite a sort of concrete and everybody can spot those.
17:59
Absolutely, yeah. And I would just add on to that, you know, that you’re paying attention to your cycle and any changes in your cycle to right, like, all of a sudden your cycles are becoming longer or they’re becoming shorter, or maybe amenorrhea starts to happen for you and your period goes missing, that’s a really big sign right? That that something’s off or that maybe overtraining is at play.
18:17
So I think period is really is really important. If you’ve normally had a regular menstrual cycle and your your period stop. That’s it, that’s important, you know, that there’s hormonal because the physical stress of the training then causes hormonal changes in the body, which interacts with you hormones in your brain, but also your hormones regulating your menstrual cycle as well. So that’s a really important one.
18:42
Yeah, one of the best investments that my husband and I made this year was for Christmas, we got each other the Oura Ring. And the Oura Ring is a sleep tracking device and kind of helps me geek out a little bit. But it’s really been helping me just create more self awareness around my sleep, it will actually like if I log into the app, it will tell me like, hey, you know, your bedtime should actually be around now. Like, basically, like get off the phone, it’s time to go to bed. It’ll tell me when my when I went to sleep too late, because I fell asleep really fast. Or it’ll tell me this morning, when I opened it up, I’ve actually had three pretty intense training days this week in a row. And this morning, when I opened the app, it said recovery index is low, like please pay attention to your recovery index, because it of course, monitors my heart rate and all that kind of stuff. And it says you know, because of your temperature variability during your sleep and your heart rate variability, we were suggesting that you take an active recovery day, and it’s just helpful because it’s like, okay, you know, I kind of was sensing that I was feeling a little extra tired today. But that was almost the that, you know, not the validation, but the verification that I needed to say, let’s let’s listen to my body today, and maybe you know, and sometimes I shouldn’t say sometimes most of the time, it means that by taking a step back for a day and listening to your body and doing that rest will actually allow you to come back stronger tomorrow. And that’s what sometimes I have to tell myself to is like, it’s okay that the calendar says X. Tomorrow, I can really crush x as opposed to just slugging through it today. So I love that. So I want to talk a little bit about transitions for women in life, right? Like perimenopause, menopause. How when it comes to training, especially for a runner, like, what does that look like? How does that change? Or does it change? When you’re kind of going through those changes? What does that look like?
20:27
It can look very different for every woman. Some women don’t notice any changes at all. I was speaking to a friend the other day and asking about her experience with perimenopause and menopause. And she said, I had one hot flash, and I don’t know, I didn’t notice anything else. And then I know through my work is when I was working as a doctor, I would see women who were complete bits, you know, their life was upside down, they didn’t know who they were, they changed everything. And they physically and mentally just called themselves a mess. So I think it can look very different for every woman. Most of the time, things happen very subtly, and quite slowly. And sometimes you don’t actually realize that that’s what it is. Because the average age average age of the menopause when periods have stopped and been stopped for a year is 51. In the UK, I imagine it’s similar in the States, and the perimenopause can start 10 years before that. So you know, we’re talking about women in their late 30s, sometimes early 40s, where if they’ve got symptoms, then they’d then menopause isn’t necessarily even on their radar. So sometimes things happen very gradually. And very slowly. Some of the things that frustrate women that are exercising around that time that they noticed that kind of impedes their exercise is that their weight starts to change. So despite eating the same exercising the same, they find their weight is going up, particularly in terms of their fat content and fat and body weight around the middle of their body, which they don’t like a lot of women really, really complain about this. And they noticed this and that and because of the weight gain, they then noticed that they’re not able to train as well. And they sometimes find, again, that they’re like I said, with overtraining sometimes but for another reason, you know, their progress seems to plateau out and they don’t feel like they’re making the games that they were or they just can’t do it. They just feel awful. temperature regulation, the body, the body’s thermostat goes a bit haywire around perimenopause as well, you know, we talk about hot flashes, night sweats. And generally that’s just the thermostat of the body. And the falling estrogen levels around that time seems to sort of mess up the thermostat and the brain starts sending out strange messages. And when you’re active, and your body’s trying extra hard to kind of regulate your body temperature, that can throw things sort of haywire, as well. So you find sometimes you sweat a lot more than you ever used to, when you were exercising, maybe even flush more when you’re exercising, and some women feel quite self conscious about that. So that that’s something else that that often happens. I mean, there’s endless list. But I mentioned a couple more joint aches and pains, joints, and muscles can just feel stiff, and achy, either when you’re exercising or afterwards the next day, so you seem to take longer to recover, which can feel quite frustrating. And, and the other thing that women often sort of say is that they, they just they could lose their competitive drive, not to everybody. And we think that’s partly because of falling testosterone levels, because as well as estrogen falling in the perimenopause, testosterone falls to and we know that sort of competitiveness is often linked to the testosterone, which is a hormone that’s higher in men than it is in women. And a lot of women who’ve always felt competitive, sometimes lose that. And then they their relationship with their sport becomes a little bit tricky for a while and they sometimes stop it, which is a shame, or they just find a different relationship with it. So if it’s running, for example, they stop competing, but they start enjoying running for being scenery or for socializing, and with friends, etc. So I mean, there’s endless numbers, but those are just some of the ways that it can change.
24:04
Yeah. Yeah, you know, one thing it’s, it’s interesting because I, I have dominantly women who are cycling women in my course, because that’s the course is all about cycle syncing. And but I do have a few women that during my beta launch, they’re close friends of mine, and they were going through the menopausal transition or recently menopausal and they were like, I want to do your course. And we talked about the fact that okay, this is a cycle, syncing course. So the people, the women who are gonna get the most benefit are women who are going to be able to sync up their fitness nutrition, but they were like, we just kind of want to kind of come along for the ride. And so they hopped in the course. And the one piece of feedback that I have received from each of them is oh my gosh, I wish I would have known a lot of this stuff sooner. I wish I would have paid more attention to my hormone health when I was 35 when I was 40. Because now I’m realizing, gosh, it probably really could have helped me during those transitions and stuff. The other thing that I hear from them is we have sort of like a cycle syncing fitness plan where I teach women like these are the days of your cycle that are best strength training. These are the days of your cycle that are best. You know, for active recovery or for hit training, I’ve noticed that the perimenopausal menopausal woman typically will say I need more recovery, I need more rest. And so one of the things that we’ve built into the program is, you know, if you are a menopausal woman, we want you to do two days on one day off, because your body really does need that extra rest, that maybe a woman in her 20s or 30s Doesn’t necessarily need or require. So I love that you just you call out those, those specific things, because I think it’s so important. And the other thing that I wanted to mention, and I wanted to touch on is this concept of nutrition and women. And this is something that we could probably spend an entire podcast talking about. But I’ll just speak from my own experience. You know, here we are at the start of a new year, I decided to kind of reassess my macros I follow. I follow guidelines from Sara Gottfried, MD, and Dr. Stacey Sims, who are both really hormone health conscious research doctors. And both of them are in alignment, as far as how much protein you know, you need based on your your kilogram of body weight. And so I reassessed my macros, right, I’ve always kind of followed this plan. And now I’m in my late 30s. And I’m starting to see exactly what you just described, where I’m not having like a large amount of weight gain, but I can just kind of feel my body shifting, and I can feel my energy levels shifting a little bit. And so I was like, I want to reassess this. And I realized when I did, how much I have sort of really not been consuming enough healthy protein and healthy fats. And so the intentionality that I’ve had to put behind my nutrition, I’ve always been intentional with my food. I’ve always eaten a really heavily plant based diet. But this year, I’m like, I’m really gonna focus on my protein and my healthy fat. And so the intentionality that I’ve had to put behind that in the last few weeks makes me think, okay, if I’m struggling to get this much protein in and to get this much healthy food in my body, I know the average woman is not eating enough of the right foods. So I want to talk about that. I want to talk about, you know, nutritional deficiencies. I want to talk about, you know, we could talk a little bit about iron deficiency. I know that’s a big thing with runners, people who train women who train heavy. So what are some things that you maybe you’ve dealt with personally, or in your medical practice, or whatever the case is, like, when it comes to nutrition and women, especially women who are training? What are some things that you would call out for us?
27:28
Yeah, I’m glad you brought up the protein because I think that is something which is becoming more and more understood about how important it is, particularly, we’re talking there about perimenopause or menopause women, you know, we know that after the age of around 30, you lose a little bit of your muscle mass every year, while every day, but a tiny, tiny amount. And once you get to about 50, you can lose about 1% of your muscle mass every day. And that’s why the strength training becomes increasingly important as we get older, particularly when we hit perimenopausal and the menopause year and postmenopausal years. Because we need to maintain muscle mass, we need muscles because they make us healthier, they release myokines which anti inflammatories which reduce our risk of disease. And of course, they keep us balanced and stable so that we’re able to remain independent and don’t fall over. But if we’re not eating and giving our body the building blocks that it needs to make those muscles then we’re not helping ourselves. And to make muscle you need protein. So one thing that that women can do, particularly as I say perimenopause onwards, is to look at increasing their their protein. So they’ve got those building blocks there to make muscle because we just, you know, we really don’t understand how important muscle is something I’ve learned a lot about over the last few years, and you have to make conscious effort to build it, which runners really hate, because they just want to run. And yeah, running will build up some leg muscles, but you know, it’s not looking at, it’s rarely doing very much for your arm muscles, we might not have very many core muscles. So it’s something you have to make a specific intention to actually to actually do. So I think the protein is the one, the big one. And the other thing around that time as well as the body’s metabolism does change. And partly because we’re losing muscle, our basal metabolic rate is reducing. So that’s the the amount of energy our body needs just to keep ticking over. And muscles use more energy than fat. So as we’re getting older, we’re naturally losing muscle. So we’re losing some of that calorie and energy sort of requirement. So you carry on eating the same, but you’re you’re not using up as much even when you’re asleep. So therefore you find that one of the reasons anyway that you tend to sort of gain weight a little bit. So by increasing your muscle mass, you can give your basal metabolic rate at a bit of a boost. But women often find that they just become pretty sensitive is maybe the word but a little bit more sensitive to carbohydrates. So they often crave it more because of the hormonal changes that going on, but the body just doesn’t seem to tolerate it as well intense to hold and store it as fat. So simple things you can do is just to reduce your very starchy carbs a little bit, look at having some more protein in your diet, because those two things can make quite a big difference to keeping you well going forward. Yeah, and you mentioned healthy fat there as well, which, you know, we’re all we’ve all been growing up while I’m about 10 years older than you so grown up to fear fat. And actually, there are some amazing benefits from from the healthy fats so we mustn’t be afraid of those and, and include plenty of those in our diet as well.
30:47
Yeah, I always I have to, I have to I always tell women, you know that your hormones come from your from your cholesterol. So we you know, healthy fat is so, so important. I love what you just said about bringing up the subject of carb sensitivity during perimenopause and menopause especially. And that’s something that for myself, I’ve noticed, like I said, at the end of last year, I knew I was a little bit carb heavy, like on my on my on my food intake. And I’ve always had a really high metabolism. But I started to really see this sort of shift right with my hormones. And I’m a Dutch tester. So I’m somebody who tests my hormones twice a year. And I saw these shifts happening and I thought, Ooh, okay, let’s adjust. And so just in these first three to four weeks of the new year, following a higher protein, less starchy carbs, of course, I’m still eating lots and lots of cruciferous vegetables and fruits and vegetables. But I have seen almost a five pound drop just in the first month of this. And I know it’s just a matter of sort of getting my body regulated back to that good, you know, metabolic rate. And the one thing that I would say that I was noticing I was I was noticing, not just these sort of dips and energy, but I would call them like blood sugar crashes. So I would I would have breakfast and then two to three hours later, I would feel like I was starving again, or I would feel lightheaded. And I would grab a protein shake or something which would help. But I was like, I was like still craving those carbs, right? And it wasn’t until I would grab a slice of toast or something that I would feel like oh, my energy is back up. And so you realize, you know, for me, like even somebody who studies nutrition, and this is something that I I teach like you really can fall into that trap of like your body is craving those carbohydrates, because it’s it’s craving that quick sugar, that quick energy. But like I said in just transitioning to a higher protein diet in the last few weeks. I feel so full. Like I was telling my husband last night I was like I can’t eat anymore. Like I’m so full, I’m satiated. I’m not having those blood sugar crashes. I’m more focused. I’m not as moody right? And so it does make such a huge difference. So, okay, so
32:50
Something else I’ve noticed that personally, that goes along with that is actually sensitivity to alcohol and caffeine. And both of those things can have a really big effect on your your energy levels. And personally, I gave up caffeine, I think it’s about three years ago now. And I was amazed. I just I don’t have that afternoon slump. You know, about four o’clock, I’d normally be like, ah, do I need a cup of tea, because I’m in England to have a cup of tea. And I’d needed it. And once I’d actually got rid of it. And I was starting to get sort of some palpitations and sort of feeling on edge. And I assumed Well, this must be perimenopause. But actually, I wonder if some of its caffeine because I was working from home so I suddenly a lot more caffeine than I would normally. So I thought, right, I’m just going to go cold turkey and get rid of it all. And definitely that has made a lot of difference to stopping that kind of up and down feeling through the day and sensitivity to alcohol as well. And that’s really common as in women through perimenopause that just can’t drink. It brings on hot flashes, and they just feel horrible the next day. And yeah, so cutting back on alcohol alongside all those other things you mentioned can be really helpful as well.
34:01
Yeah, alcohol was exactly where I was gonna go next. Because I just finished Sara Gottfried new book. And I know she’s a big proponent of ditching alcohol entirely. And she supports that with all the scientific evidence. And it’s interesting because my friend and I, who we kind of consider each other like sisters, like as far as our hormonal patterns have been very similar through life. And so we joke because, you know, we used to get together for wine on the weekends, and we were sort of really into wine and our 20s and 30s. And we were talking recently, and she’s like, I just can’t drink wine anymore. She’s like, I feel like if I have wine in the evening, I don’t sleep. She’s like, I have hot flashes, or I wake up at two o’clock in the morning and I can’t fall back asleep and thanks to this good old Oura Ring. I’m learning that I’m the same. The nights that I’ve had wine two times in the month of January so far, just like glass and the next morning I wake up and my REM sleep is under an hour. It’s just the only thing I can attribute to is the alcohol like it’s the only difference in my day. So I do think obviously there is evidence to back that up. And I think it’s I know there are women, like you’re telling me to give up my coffee, and my wine, like, that’s just they’re gonna shut us off. They’re gonna shut us off right now and say that’s it.
35:12
Well, I found a really nice decaf coffee and decaf tea. So I don’t feel like I’m missing out. It tastes so, and I love wine. And I still love wine. And I will still drink wine. But I know that I can have a glass tolerance. Yeah, and I can have more, but I know that I’ll pay for it. So I’ve kind of stopped wanting it. So you get there, you get there on your own. And in the end, and to me now it doesn’t feel like I’m depriving myself it actually just feels like I’m really enjoying the glass that I have. And I know, I’ll, I’ll appreciate that in the next day. Yeah, I do have more. What do you do? Sometimes I just have to accept that. I’m gonna pay for it.
35:48
Right? Absolutely. Yeah, sometimes it’s worth it. Right. So okay, so I want to talk I’ve mentioned it briefly. But I want to come back to this idea of like low iron, low ferritin. In training athletes, is that something that you can touch on for me and kind of what you’ve seen and common things and ways to overcome?
36:04
Yeah. Yeah, so I’m not really a big supplement taker, the only supplement that I take everyday is vitamin D. Because we know that, particularly in the UK, when we have very little sunshine through the winter, that we’re not getting enough of it. So that’s the only supplement that I take every day, but the only one that I do sometimes take is iron. And I tend to take that when I’m training hard. Now, we it’s tempting to think that every you know, why doesn’t every woman just not take iron, but you need to be a little bit careful with it. Because you can mask significant medical problems by just taking iron if you feel tired, and you think you might be short of iron, or even anemic, where you’ve got low numbers of red blood cells, then you should always see a physician before you make that decision, and get some blood work done before you make that decision to take iron. Because if you’ve got low iron, and you’re anemic with it, then it needs possibly to be investigated. So that’s why there’s not a blanket. Yeah, everyone should take iron. But if you’re otherwise well, and you’re a woman who maybe has heavy periods, which can happen with any cycle, or it can happen in the perimenopause periods and symptoms get a bit heavier before they stop, then it’s not a bad idea to be taking an iron supplement to top up your your levels. And equally, if you are training hard, then you it’s a good idea to take a little bit of extra iron every day. Simply because we know that there are there is some evidence that hard training athletes do have lower iron levels, and that they can reduce their ferritin, which is stores of iron in the body. And low ferritin. And low iron stores can make you feel tired as well. So sometimes if your iron levels are normal, but your ferritin levels are low, so you’re not anemic, but you’ve got low stores, then there’s some evidence that actually taking some iron can actually help you feel a little bit better. So it’s a tricky one. And you say always want to be careful not to just say yeah, yeah, feeling tired. Yeah, takes mine do you need to get that checked out first with a blood test. But it’s definitely worth considering if you are having heavy periods. And you’re training hard one or the other, or both, that you do address iron, and you can get plenty in your diet. But you can look at taking a supplement as well. And those if I’m all on in all honesty, those are the only supplements that I take. I tried to get everything else through my diet and I and you can you know, you don’t need to take lots of supplements, you can get what you need from a good healthy diet. But living in the real world. Sometimes we don’t all have a good healthy diet because life’s busy and we have to use convenience foods and you know, can’t plan unnecessarily and eat everything exactly perfectly the way we would like to. So there are some situations where you know, a multi vitamin or something broader in supplements is a good idea. But generally, you can get most of it from your your diet, but I would personally I take vitamin D and then I add iron when I’m on a sort of a training program.
39:06
Yeah, yeah. It’s interesting because as someone who came from I mean, we talked a little about my story on our pre call. But you know, I was a migraine stuffer and spent years in what I would call the sort of modern medicine hamster wheel of doctor visits, testing, you know, MRIs, surgeries, like all kinds of things that really weren’t working for me. And it wasn’t until I had a functional medicine doctor, take me off of everything pharmaceutical and say, Hey, try these you know, estrogen detoxifying supplements, basically like broccoli in a capsule. You know, try that and try some bioidentical progesterone cream. It was just a complete life changer for me. And so, absolutely yes, like you can get what you need supplementation wise through your diet. It takes again it takes intentionality it takes knowing what it is you need and how much of it you need to actually supplement any deficiencies. But there are also cases where, you know, I look at like what we call the SAD diet, right, the standard American diet, pun intended, you know, and the average woman is not, is not eating up to eight cups of cruciferous vegetables and vegetables a day, right? Like, it’s just it’s not happening. And so, in those cases, supplements can help vitamin d3 Right now, especially in the middle of this pandemic is also obviously proving to be helpful for immunity, especially because none of us get enough sunlight, right. But I love I also advocate magnesium for a lot of women’s since magnesium is not something that’s found plentiful in our soils anymore. So there are so many things that could potentially help you. But it’s so it’s so dependent on you, it’s so dependent on what your bloodwork says is so dependent on what your practitioner you know, says that you need, but I love this. So I want to talk to you just really briefly, because I’ve had struggles off and on in the past with low ferritin. My iron has been usually in the normal ranges, but it’s the ferritin stores that drop. And so I want to talk like let’s talk about you mentioned it, but I want to say what is what are the differences between the two. For me, personally, I noticed I went through a brief period of time in my late 20s, where I just ditched all meat, like I just was like, I’m gonna go vegan. And it was fine. And I did drop a lot of weight. During that time, I was super lean, but I was also quite miserable inside. So I learned about myself that my body thrives on animal protein. But during that time, I got extremely low ferritin numbers. And I was really struggling, I had what my doctor called exercise intolerance. Like I couldn’t strength train, I couldn’t I would exercise and be completely out of breath. I felt like I was running uphill, when I would do something really minor. So can you tell us like I know, you mentioned that your ferritin is your iron stores? But how does that you know, cuz I think in the US what I’m seeing as a lot of women, they get standard testing through their doctor. And the standard testing looks at iron, but it doesn’t look at ferritin they have to ask for the ferritin to be checked. So I want to I want to make that discrepancy. Can you help us with that? Since you have?
42:03
Yeah, so the first thing that the doctor will do will be to check your full blood count. And part of your full blood count will be the numbers of white cells, numbers of platelets and the number of red cells. And you need iron to make red cells. So if the red cells are low, then it suggests you’re anemic. And they would definitely go on to check iron. Now in the UK, and you go and see your GP, you, they wouldn’t necessarily check your iron unless there was a reason. So unless your red blood cells were low, in which case, they’d say, all right, gosh, right, let’s let’s check the iron. Unless you were somebody who had a long term disease or an illness where maybe food was not always absorbed properly from your gut. And then you might get the whole range of sort of nutritional vitamins, you know, sort of tick by tick. So it’s not always it’s not always a standard test. And you have to ask specifically for ferritin to be done. It’s not, if you just take iron on the on the check box on the blood form, you’re not, you’re not necessarily going to get ferritin and ferritin is your like, say your body’s store of iron. So what you’re, what you’re consuming, and what you’re eating, some of it will get used and some of it will get stored. So if you’re in a condition where you’re using lots of iron, so if you’re pregnant, for example, your body will use what it’s got, they’re readily available, and then it will start using up your stores. So by the time you get to the end of pregnancy, you can have really quite low stores have ferritin, low stores of iron, and need quite heavy and sometimes even be anemic and then need sort of quite heavy iron supplementation. And I think that’s the thing that can can happen with with with lots of women, they’re kind of just about, okay, they’re maybe eating almost enough, they’re using what they’ve got. And some days they’re using a little bit more. And they gradually without necessarily realizing it kind of go a little bit overdrawn in the in the in the ferritin. And the bank balance just sort of drops ever so slightly and gradually and so quietly, that it’s not something you’re aware of, you can’t know what your ferritin stores are just by kind of feeling it. So I think the important thing is that when women are supplemented with iron, that they take it until they’re they’re not anemic anymore, and their iron levels are normal, but you you actually carry it on for two or even three months after everything’s fine to then replenish the iron stores so that you’ve got that nice bank balance back into the normal range. And I think that’s sometimes what happen. People take it but then they don’t touch top off their stores.
44:45
Yeah, absolutely. Yeah. So if you’re a woman listening to this, and you’re thinking, Gosh, I wonder if this applies to be like maybe your workouts are sluggish. Of course that could be time of your cycle. It could be you know, whatever. But also if you’re seeing the pattern that you’re really winded through those workouts are you really are lacking energy that you used to have. Having that ferritin checked, in addition to your iron could be really helpful. So but that’s something that you have to specifically ask for just like, just like you have to specifically ask for specific sex hormone testing, or it’s, or else it’s not in your traditional bloodwork that your doctor will pull. So that’s, that’s good information. So tell us so you have a couple of books out there in the world. You’re obviously you’re a blogger, you have your own podcast, I want you to make sure you direct people to all of your stuff. But I’d also like to, I’d also like to hear you know, what’s next for you? Like, what are you what’s in your 2022 plan.
45:37
So interestingly, from what we’ve just been talking about, I’m actually just working on a little video course at the moment specifically about running through the menopause, looking at some of those barriers that I mentioned, that seem to crop up the changes that you might notice, and actually just trying to understand what’s going on in the body so that you can then take some action. And, and also, as part of that, what actually needs to take and how to do it, because it’s very easy to just sit there and tell someone what to do. It’s just how to incorporate it into your life, are there easy ways that you can sneak it into make it a habit? And really just Yeah, trying to get women to look at themselves, every woman is different, see what might work from them, but also to be prepared to know what’s ahead. What might be coming, because if you’re forewarned, then you’re forearmed for is that the right way around? Prepration is key you. So if you if you know what’s ahead of you, then you’re sort of all ready for it. And you can add, yes, I knew this might happen. So I can do X, Y, and Zed so that you can feel much more confident. And women often particularly with running, find that they just lose their way and they fall out of love with it because of the perimenopause and the symptoms that they’re getting. And I just don’t want that to happen. I don’t want women to lose the enjoyment from something that they’ve always loved because of it. So that’s the main thing I’m really working hard on at the moment to get that out and the next within the next couple of months, hopefully. And then I’m looking at maybe a third book, but you know, they, they’re there, they are very all consuming. So it’s a bit like children, you need even a little bit more of a gap. Put yourself through the pain of doing it again, even if they’re lovely when you’ve got them. So yeah, the first the third book is brewing, it’s bubbling away. It’s not quite been conceived yet, but it’s, yeah, it hopefully that will be on the way too. And then the other thing I do is work with 261 Fearless, which is you mentioned at the beginning, it’s a global women’s running network we’re trying to reach particularly women who are, don’t exercise or don’t think they can run, taking them by the hand and showing them the massive sense of empowerment they can get through being active through running through being part of a community. And that’s that’s really exciting that’s growing around the world as clubs in the US and five continents now. So that takes up a lot of my time. I lead it in the in the UK. And then I use my Women’s Health hat to help the global network, inform and educate them and do yeah, all sorts of bits and pieces. So that’s really exciting this year as well.
48:03
Yeah, I loved I loved hearing about this organization. Where can people find more information about 261? Fearless? Yeah, at 261fearless.org. The websites there it shows you where the clubs around the world and all the programs education programs that we’re we’re running and the backstory of Catherine Switzer, who was the marathon running legend in Boston in 1967, who kept going despite the fact that the race director tried to throw her off the course because she was a woman. So she’s gone on to use that number to six one was on her bib in Boston, as as a force for good and to help women all around the world to get empowered and educated and feel the improvement and the opportunities that come through moving your body and transformational power of it.
48:46
That’s amazing. Well, one thing that I am all here for is women empowering women. And I am so grateful that you took the time out of your day and your life to educate us and to talk to us today. I know people will find this valuable. Where can people find you specifically your podcast or website? Whatever you want to share? Yeah, sure, just go to DrJulietMcgrattan.com. And all my social handles are on there. And my books are on there. And my blog is on there. Every week I write a new little new little post, you can sign up and get that into your email. And that’s the best place for me at Dr. Juliet mcgrattan.com.
49:22
Perfect, and I’ll have all that linked up in the show notes. So anybody listening, you could just tap on your show notes to find those links. Thank you again, Dr. McGrattan, for being here today and for sharing your expertise and knowledge. Maybe we’ll have to do a part two sometime I’ll have to come up with some some more things for us to nerd out about when it comes to women’s nutrition and training because I’ve I’ve certainly loved this conversation and I’ve loved meeting you. So thanks again. Thank you very much. Thank you.
49:54
Thanks for listening to this episode of the SYNC Your Life Podcast. Hope you found value from today’s episode. If you did, please share it out to your friends or leave a review. Remember your cycles are your superpower and by aligning with them you can live your life with all the energy you need to be a mom, Wife, Daughter and friend to those you love. Until next time!