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Pause & Effect: The Role of Diet & Exercise in Lifestyle Medicine

8 dimensions of wellness lifestyle medicine menopause awareness weekly newsletter Oct 08, 2025

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Welcome back to our Menopause Awareness Month series! Last week we covered the history of World Menopause Day and introduced you to lifestyle medicine's six pillars. This week, we're diving into the two pillars that generate the most confusion, contradiction, and frustration: nutrition and physical activity.

If you're eating the same way you did in your 30s and mysteriously gaining weight, or you're exercising more but seeing fewer results, you're not doing something wrong. Your body's metabolic rulebook got rewritten during perimenopause, and nobody bothered to give you the updated version.

What's Actually Happening to Your Metabolism

Your body composition is shifting dramatically: visceral fat increases while muscle mass drops by up to 40%
Exercise becomes more important, not less: strength training directly combats muscle loss and metabolic slowdown
You have more control than you think: strategic nutrition and movement can counteract at least some of these changes

As estrogen levels drop, visceral fat increases to 10-15% of total body weight from 5-8%. Muscle mass can decrease by up to 40%. Your metabolic rate slows. Your body's ability to burn fat during exercise decreases while your sugar metabolism shifts, causing higher blood sugar spikes after meals.

The good news is that research demonstrates that both nutrition and exercise can counteract at least some of these metabolic changes. Improving your diet works directly by reducing blood sugar spikes and inflammation, or indirectly through supporting gut health. Regular exercise ensures metabolic health and reduces hot flashes, while resistance training specifically preserves the muscle mass that keeps your metabolism humming along.

Bottom line: Your body isn't broken. It's adapting to massive hormonal shifts, and you can work WITH it through both what you eat and how you move.

The Eight Dimensions of Wellness Connection

This is where my coaching philosophy diverges from the traditional lifestyle medicine approach. What you eat and how you move aren’t just physical considerations. Yes, nutrition and movement are physical, but it's also so much more.

Emotionally, your relationship with food during menopause gets complicated by brain fog, mood swings, stress eating, and the grief of feeling like your body betrayed you. Meanwhile, movement becomes a powerful stress management tool that helps regulate those same mood swings and combat anxiety or depression.

Socially, how you eat with others changes when you're navigating hot flashes at dinner parties or trying to explain why you can't drink wine like you used to. On the flip side, group fitness classes, walking with friends, or joining a gym provides connection when menopause can feel isolating.

Intellectually, separating fact from fiction becomes a full-time job when there's a new viral menopause "cure" on social media every week. The same goes for movement. Learning what types of exercise actually build bone density versus what just looks good on Instagram requires critical thinking and challenges your brain in ways that combat that dreaded brain fog.

Financially, quality nutrition isn't free and may not even be easily accessible where you live. Ditto movement. Gym memberships, home equipment, and personal trainers can be expensive, and even free outdoor activities can be limited by the weather or area you live in. The budget considerations are real for both.

Environmentally, you need to consider whether your kitchen is set up to support healthy eating or if your workplace triggers stress-eating patterns. Similarly, do you have safe spaces to walk? Is your home set up for strength training? Your physical environment shapes both what you eat and how you move.

Occupationally, brain fog during meetings and energy crashes in the afternoon affect both your work performance and your food choices. Regular movement improves focus and energy at work, combating those same brain fog episodes and afternoon crashes that tank productivity.

Spiritually and culturally, this transition challenges your sense of identity and purpose while making certain dietary observances difficult. Food can become either a source of comfort or another battleground. Movement, however, can be meditative and help you reconnect with your body during a time when you might feel disconnected from it.

Bottom line: You're not just changing what you eat or how you move. You're navigating how these changes ripple through every dimension of your life.

What Your Body Actually Needs

Protein becomes non-negotiable: your needs increase to prevent muscle loss
But Carbs aren't the enemy: menopausal women need carbohydrates, especially when increasing physical activity
Strength training is essential, not optional: resistance work increases bone density and helps preserve muscle mass and if your body can handle it, power training can provide even more benefits

Studies show that resistance training with high loading can actually increase bone mineral density. This isn't light dumbbell work. This is real, challenging strength training that has a positive effect on bone mineral density. Sounds great, but there is a catch. Because of course there is. The exercise program must be incorporated into a lifestyle change and be lifelong due to the chronic nature of bone loss.

A fascinating, albeit older, study found that power training (moving weights quickly with control, not just lifting heavy) was more effective than traditional strength training for maintaining bone mineral density. Which just proves there isn’t one right way to do this. The key is to start where you’re at and slowly build up.

Bottom line: Your body's needs have changed. Feed it accordingly, with compassion and curiosity rather than restriction and punishment. Lift heavy things. Move fast. Don’t give up.

Final Thoughts

The core of lifestyle medicine's nutrition and movement pillars is that they're not about perfection. They're about progress. They're about understanding that your body isn't broken, it's just operating under a new set of rules.

Your Practical Action Plan:

Start where you are: make small changes over time, not multiple all at once
Build your plate: make good choices as often as possible and you'll find it gets easier each time
Track your triggers: notice which foods or drinks worsen symptoms
Prioritize protein: include it at every meal
Move daily: whether it's dancing in your kitchen or walking the dog

Next week, we'll dive into stress management, because cortisol and declining estrogen are having a party at your expense. Until then, I want you to try something radical: approach food and movement with curiosity instead of judgment. Your body is doing its best to adapt to massive hormonal shifts. Give it, and yourself, some grace.

Until next time, honor your body, trust your voice, and keep your light shining bright.