One simple addition to going Keto-Green can help you drop fat pounds, tone your whole body, and trim your belly. The secret is my 16-minute fitness plan, which combines the calorie burning of cardio with the body sculpting of strength training in one very short workout.
This fitness plan is designed not only to firm you up but also to help you take control of your hormones, so that you can burn fat even more efficiently. Hormones are very involved in both building new lean muscle and burning fat, so it’s important to have an understanding of which ones are impacted directly by exercise.
As we’ve seen, insulin can cause fat to be stored in the body instead of being used to fuel muscle activity. Fortunately, exercise prevents this kind of fat buildup. It makes muscle cells more receptive to insulin. So when insulin arrives at cells to usher in glucose for energy, the cells welcome them both. This stabilizes your blood sugar and prevents insulin from piling up in the bloodstream and promoting fat storage.
When too high for too long, this stress hormone quickly takes over and brings on food cravings and weight gain. So cortisol levels are something we want to rein in. One important way to do this is by reducing stress, and there’s no denying that regular exercise is a great stress reducer.
Have you ever noticed that you’re more affectionate, you’re more compassionate, and you feel better about yourself and others when you exercise regularly? These wonderful feelings are all because of the production of oxytocin while you are moving and exercising. Exercise helps activate the release of oxytocin, which in turn energizes us to move even more, in all kinds of healthy and loving ways. Although oxytocin is not an endorphin per se, when oxytocin is released by the pituitary gland, it stimulates the production of endorphins, the “feel-good” hormones most of us have already heard about. The release of more oxytocin also lowers cortisol. (This is probably the reason I am so much happier when I leave the gym!)
The pancreas releases this hormone in response to low blood sugar. Once in circulation, glucagon stimulates the release of fatty acids from fat stores and increases blood glucose levels, both of which help fuel exercise activity. So not only do you burn more fat, you access more energy to exercise harder—which in turn revs up your metabolism.
This muscle-building, fat-burning hormone is stimulated by high-intensity exercise such as strength training and cardio workouts. Once released, growth hormone (GH) initiates muscle protein synthesis, or MPS, the process involved in developing nice, firm muscles. If you think of muscle like a brick wall, each brick is a protein. MPS is the addition of new bricks to the wall. GH is like the brick mason who helps build that wall.
Estrogen helps metabolize fat, but it also puts fat where it is supposed to go—like on your breasts and hips. When estrogen levels drop off with menopause, your body starts storing fat around the abdominal area, which increases your risk for heart disease. But by building more muscle with exercise, you increase your metabolism, which in turn helps fight fat all over your body.
On the other hand, we’re exposed to harmful estrogens in everything from plastics to pesticides in the environment. This can lead to estrogen dominance starting at around age thirty-five. Too much estrogen in the body is a risk factor for breast cancer. Exercise helps lower this risk.
Like growth hormone, testosterone is also responsible for muscle protein synthesis and the repair of muscle damaged by exercise. Therefore, it plays a significant role in helping develop body-firming muscle and attractive curves. Exercise, especially strength training, stimulates the production of testosterone.
The bottom line is that regular exercise is more important than many of us may think, and just moving your body a little each day does wonders for helping balance your hormones. With a regular exercise routine, you may even feel more centered and grounded than you ever have before.
So what’s the best exercise to balance these hormones? All exercise is beneficial as long as you enjoy it. Personally, I love to do yoga, walk, do weight training, play tennis or pickleball, and box—and I do one of these practically every day.
There was a point in my life when I believed that working out for 45 to 60 minutes or longer a day was the best way to lose weight and get fit. But with my crazy schedule as a physician, I found I didn’t have time to work out that much, and when I did, I felt draggy and not so great. In fact, I felt old! And I was only in my early forties.
It wasn’t until I took up boxing for exercise that I realized that less is more. Boxing workouts typically last no more than 20 or 30 minutes and involve a combo of cardio and strength moves. I was surprised to discover that this shorter workout allowed me to inhabit a body that looks and feels better than ever.
Then I began reading a lot of research showing that shorter bouts of exercise—particularly high-intensity interval training or HIIT (discussed later in this chapter)—are more effective, especially for fat loss and hormone balance. No wonder I was feeling stronger, younger, and healthier!
Australian researchers, for example, found that women who did intervals—they alternated just 8 seconds of high-intensity cardio exercise with 12 seconds of low-intensity, slower activity for 20 minutes three times a week—trimmed down faster than steady-paced exercisers who worked out twice as long. The interval exercisers dropped up to sixteen pounds of fat, shrank their bellies by 12 percent and their thighs by 15 percent, and developed, on average, 1½ pounds of metabolism-revving muscle in fifteen weeks—without dieting.
Something else I learned: Too much exercise is bad for our hormones! For instance, overexercising can really do a number on increasing stress hormones like cortisol, leading to fatigue. It can also increase the risk of muscle loss, increased infections, and injury.
I started hearing from patients and clients that they were busy and couldn’t find the time to exercise. With my commitment to shorter workouts deepening, I became determined to create a routine that was fast but that delivered results. It had to provide cardio and sculpting, plus work abs and core. And it had to be short—with no wasted minutes or effort—so that it could fit into anyone’s day.
What I landed on was a 16-minute fitness plan based on high-intensity interval training.
HIIT is a type of short workout that has been shown to burn fat more effectively than regular bouts of steady aerobic exercise. As well as strengthening your lungs and heart, it also increases growth hormone, which tends to decline rapidly as we age. HIIT also improves insulin sensitivity, a great result for your waistline and risk of serious disease. The boxing I do is a form of HIIT.
With HIIT, you can reap the benefits of cardio and strength while maximizing your fat burn in a short amount of time. The “intervals” in HIIT involve alternating between short bursts of hard effort and short periods of less effort.
The alternating intensity resets your metabolism so that it stays high long after you’ve stopped exercising. This is a phenomenon known as excess post-exercise oxygen consumption (EPOC). It means you burn calories long after you’ve finished your workout. HIIT accomplishes EPOC better than working out at a continuous moderate pace, according to a 2017 study published in the European Journal of Applied Physiology.
HIIT is really powerful during menopause. Falling estrogen causes your metabolism to slow down. The magnitude of that change is that you burn about 50 fewer calories a day. That might not seem like a lot, but it can add up over time if you don’t exercise intensely enough—you could put on a pound of fat every twelve weeks.
That fat tends to be of the dangerous kind. Rather than sticking to your hips and thighs, it tends to relocate around your belly, surrounding your organs and increasing the risk of heart disease and diabetes.
Here’s where HIIT comes to the rescue: It gets your metabolism back in shape, strengthens your muscles, and burns fat all over, especially around your waistline. Many doctors and fitness professionals are now saying that HIIT may be the perfect exercise for women in menopause.
So if you’ve got just 16 minutes, you’ve got time for this killer HIIT workout. It doesn’t take hours a day to get in great shape—in only 16 minutes, this workout will deliver fat-burning and muscle-toning benefits.
You might be wondering if you can really get results in 16 minutes. The answer is yes. The secret is in the combination of strength moves with cardio moves, done in quick intervals. You’re getting a cardio workout for your heart and for torching fat, while sculpting your entire body with resistance exercises that use weights, your body weight, or exercise bands. It is intense, but 16 minutes goes by fast—about the time it takes to do laundry, clean your kitchen after dinner, or wait in line somewhere. Note: For this HIIT workout to genuinely qualify as high-intensity interval training, the effort you put in has to be really intense.
Now let’s get sweaty!
You can literally do this routine anywhere. I’ve included moves that target every major muscle group, including the glutes, quads, hamstrings, abs, core, shoulders, and back. Moving through the exercises at a fast pace with little to no rest ensures you’ll keep your heart rate elevated, getting a fat-burning cardio effect to boot.
Supportive athletic or walking shoes
A watch with a second hand or timer or smartphone timer
A resistance band, or two dumbbells that you can lift comfortably for the first several repetitions but then require more effort during the final repetitions
An exercise mat or a spot on the floor where you can get to work
Quick note about resistance bands: They’re versatile and provide enough resistance to make any workout insanely effective. Lightweight and portable, bands are also perfect for traveling or when you’re on-the-go.
If you have any health conditions or don’t exercise regularly, check with your doctor before trying these routines. But if you’re cleared to get started, here’s what to expect.
During lower-intensity portions of this workout, you’ll be doing strength moves with your own body weight or with your resistance band. With these intervals, you should be able to easily carry on a conversation.
When you kick it into high gear with jumping jacks or marching in place, push yourself to the point in which talking is nearly impossible.
Each segment of this workout lasts 1 minute, for a total of sixteen segments and 16 minutes. My general rule of thumb is to just listen to your body. If you find that you feel energized and amazing after a workout, then keep up what you are doing. If you’re totally fatigued and feel depleted, it’s time to dial things back a bit—reduce the intensity, and go a little more slowly.
30 seconds of marching in place to get warmed up
1 minute of jumping jacks, modified jumping jacks, dance with light jumping, or jumping rope
1 minute of push-ups (chest, arms, shoulders, lower back, and core)
1 minute of marching in place
1 minute of squats (thighs)
1 minute of marching in place
1 minute of biceps curls with a resistance band (biceps)
1 minute of jumping jacks, modified jumping jacks, dance with light jumping, or jumping rope
1 minute of triceps dips using a chair (triceps)
1 minute of marching in place
1 minute of side lunges (inner thighs and buttocks)
1 minute of jumping jacks, modified jumping jacks, dance with light jumping, or jumping rope
1 minute of overhead presses with a resistance band (shoulders)
1 minute of marching in place
1 minute of back rows with a resistance band (back)
1 minute of jumping jacks, modified jumping jacks, dance with light jumping, or jumping rope
1 minute of crunches (abs)
30 seconds of marching slowly in place to cool down
Before you jump into the routine, please read over these instructions very carefully. Practice each exercise until you have mastered it. Then you’ll be ready to perform the entire workout sequence.
Stand with your feet together and your arms at your sides. Jump both feet out to the side while raising your arms overhead. Move as fast as you can. If a regular jumping jack feels hard on your knees, do a modified jumping jack by stepping out side to side instead of jumping while raising your arms.
On your exercise mat or the floor, get into a high plank, with your palms flat on the mat, arms extended and straight, hands shoulder width apart, and your fingers facing forward.
Slowly lower your body toward the mat, keeping your head aligned with your spine, until your chest or chin is close to the ground. Press back upward with your arms until they are fully extended at your elbows and you’re back in the plank, at the top of the push-up position. Repeat the downward and upward movements. If you can’t complete a traditional push-up, try doing them with your knees resting on the mat.
Place your feet a little wider than hip width apart on the floor and point your toes out at a 45-degree angle. Keep your weight in your heels, your back flat, and your chest upright. Bend your knees and lower yourself until your thighs are parallel to the floor. Hold for a moment, then push back to the starting position. Repeat.
Stand on the resistance band with your feet placed hip width apart. Grasp a handle in each hand. Alternatively, hold a dumbbell in each hand. Keep your back straight, head straight, chest up, and abs tight. Begin with your arms straight down with your palms facing forward and elbows at your sides. Bend your elbows and pull the handles or dumbbells up to chest height. Lower and repeat.
With your fingers pointing forward, place the palms of your hands on a sturdy chair or a low bench, with your back to the chair. Extend your legs straight out in front of you. Bending from your elbows, lower your body as far as you can, then press up to the original position. You should really feel this exercise in the backs of your arms.
Stand with your feet hip width apart. Keep your body weight in your heels. Step to the left in a deep lateral lunge, keeping your knee above your toes. Come back up to starting position, and do the same to the right. Alternate legs.
Stand with one foot slightly in front of the other. Stand on the band with your front foot. Grip a handle in each hand. With the band in front of your arms and palms facing forward, press your arms straight up over your head and together until your arms are almost fully straight. Slowly lower to the starting position and repeat.
You can use dumbbells instead. Grip the weights in each hand. Hold them at shoulder level, elbows bent, and palms facing forward. Press your arms straight up over your head and together until your arms are almost fully straight. Slowly lower to the starting position and repeat.
Sit on your mat or floor. Wrap the resistance band under your feet and sit up straight. Grasp the handles in each hand. With your arms extended forward, pull the band back as far as you can toward your abdomen. Hold momentarily as you squeeze your shoulder blades together. Release and extend your arms back out to full extension. Repeat.
To use dumbbells instead of the resistance band, do the following standing exercise: Grasp the dumbbells in each hand. Bend forward slightly, with one foot slightly in front of the other. Bend your elbows and hold the weights close to your sides. Then row upward, squeezing your shoulder blades at the top of the movement. Slowly lower the weights until both arms are fully extended toward the floor. Row back up and repeat.
Lie on your mat or on the floor with your feet extended and your elbows bent with your fingers just cupping your head on each side. From this position, lift your upper body up off the floor, using the strength of your abs, until your shoulder blades are off the floor. Then slowly lower yourself down again until your back is once again flat on the floor or mat. Repeat.
Tackling our weight and hormonal issues with exercise is not limited to just HIIT. There are many other activities you can try in order to mix it up and avoid exercise boredom—and still work on getting your hormones back in balance and your body at its happy weight.
Often described as “meditation in motion,” tai chi is an ancient Chinese practice that involves a series of movements performed in a slow, focused manner and accompanied by deep breathing.
A detailed review published in Worldviews on Evidence-Based Nursing in 2017 reported that tai chi improved many symptoms related to fluctuating hormones: bodily pain, general health, vitality, mental health, and spinal strength. Many health clubs and gyms offer tai chi classes, which might be worth checking out if you’re struggling with symptoms associated with hormonal imbalance.
Here’s a do-anywhere activity that relieves symptoms and builds health. A study of 157 women found that walking with long strides three times a week or more had an awesome impact on PMS symptoms. The women slept better, were less irritable, had fewer joint or muscle pains, were more energetic, and had better sex. They also lost weight, especially around their bellies. The study was published in the journal Menopause in 2014.
If you’re new to walking, begin your first week by walking just 20 minutes three times a week. The next few weeks, increase your time to 30 minutes. Try to walk a little faster each time. As you feel stronger and more fit, add more walking to your weekly program. Make it your goal to walk five times a week, for 30 to 45 minutes each time.
You can also turn walking into a HIIT workout by alternating periods of jogging with periods of slower walking.
This is a type of weight-bearing activity using weights, resistance bands, or your own body weight, in which your muscles are challenged to work harder each time they’re exercised. It develops not only muscle but also bone strength, therefore preventing osteoporosis as you get older.
A 2009 study published in the European Journal of Applied Physiology involving forty-two perimenopausal women offered proof of the benefits of strength training. The women worked out with weights for 60 minutes three times a week. Each week they got stronger, developed more muscle, and strengthened their VO2max, a measurement of the body’s ability to consume oxygen. The better your VO2max, the more oxygen goes to your muscles for a more intense exercise effort.
Findings from the Study of Women’s Health Across the Nation (SWAN), a study of ten thousand women as they go through menopause, showed that 20 to 30 percent of forty- to fifty-five-year-olds had difficulty performing simple physical tasks such as climbing a flight of stairs or carrying grocery bags around the block. Even putting clothes on over your head or clasping your bra strap can become difficult. If women are that weak then, what will happen to them at eighty?
Fortunately, various studies show that engaging in just two strength-training workouts a week increases strength in women over fifty quite significantly. The sooner you start, the better you’ll feel and look!
Lift weights, use strength-training machines, use bands, or perform body weight exercises at least two days a week. Do one set each of ten to twelve moves that strengthen your major muscle groups—arms, shoulders, chest, back, abdominals, hips, and legs. If you’re beginning, choose a lighter weight you can lift at least 15 to 20 times. Once this gets comfortable and you are over the soreness, increase the weights to where you can do a maximum of only 10 to 12 reps.
The word “yoga” actually refers to a union of body, mind, and spirit, an alignment of the physical and nonphysical parts of yourself. It’s not an overstatement: If you practice yoga, not only will you find that your health and well-being improve, but every area of your life will benefit.
Yoga is particularly important for stopping or reversing osteoporosis, which can strike during the years after menopause. A 2016 study, published in Topics in Geriatric Rehabilitation, found that 80 percent of older participants, most of whom had osteoporosis or its precursor, osteopenia (low bone density), who practiced certain yoga poses for just 12 minutes a day, holding each pose for 30 seconds, improved the bone density in their spine and femurs.
I wasn’t too surprised by these findings. Yoga plays a vital role in preventing fractures by building stability, flexibility, and agility. This means you’re less likely to fall and break something—and if you do start to fall, your flexibility is likely to help you catch yourself.
Yoga is a wonderful stress reliever and health builder—a fact proven by hundreds of studies. A 2017 review of forty-two studies, published in Psychoneuroendocrinology, offered some dramatic proof of yoga’s power. Yoga was shown to do all of the following:
Reduced levels of evening cortisol. This was significant, since we want cortisol to be low in the evening so we can get a good night’s sleep and let the body repair itself. Many people who are stressed out are victims of high cortisol at night.
Lowered blood pressure, resting heart rate, and LDL cholesterol—signs of a healthy cardiovascular system.
Elevated heart rate variability (HRV)—the beat-to-beat fluctuations in heart rate. When you’re feeling calm and relaxed, HRV goes up, and you can more effortlessly manage stress. In healthy people, HRV is high. A high HRV is a positive factor in cardiovascular health, your fitness level, even your longevity. I have found consistently low HRV in clients under chronic stress and with PTSD.
Reduced fasting blood glucose—which means blood sugar and insulin are under good control.
Yoga is absolutely for everyone! Classes are available at practically all gyms, fitness centers, and community centers, so you should be able to easily enroll in a class that meets your needs and level of experience. No matter how time-crunched you are, you can create time for yoga. In fact, yoga will create more time for you.
This activity involves the use of resistance devices or elastic bands designed for use in a pool, usually performed under the guidance of an instructor. It can be very easy on the joints, and is an excellent form of exercise if you have osteoarthritis or other joint issues, or want to build strength.
A study in the European Journal of Physiology reported that when forty-six postmenopausal women took part in a twenty-four-week aquatic resistance class, they lost body fat, increased muscle, and lowered their blood pressure.
Water exercise is a great way to get fit, especially if you don’t like to swim. Check to see if your gym, health spa, or local YMCA offers aquatic exercise classes.
You’re never too old to kick up your heels—and get fit in the process, plus improve your quality of life. According to a 2016 study published in Menopause, fifty-two sedentary postmenopausal women were randomly assigned to receive either dance therapy or participate in a non-dance control group. The dancers completed two months of dance therapy, three sessions weekly. By the end of the study, the women in the dance group had improved their balance, mobility, cardiac fitness, flexibility, and energy levels significantly, compared to the control group (which had no such improvements).
Dancing is also good for mental health, because the act of remembering steps and coordinating them to the music is an excellent way to “exercise” your brain.
Many YMCAs, community centers, and gyms offer dance and dance exercise classes. Consider joining up and being a part of the fun.
So there you have it—lots of ways to not only get more fit but also help rebalance your hormones for weight control. Fitting some daily movement into your life is one of the best ways to support both physical health and mental health. With the combo of both, achieving better hormone balance may be more possible than you think.
Whatever type of exercise appeals to you, please, please get active! Numerous studies demonstrate that many of the changes—both physical and mental—that we associate with aging and menopause are partly the result of inactivity. Many of the women I have worked with over the years—women who began exercising before and during menopause—tell me that it changed their lives. Let exercise change yours!