SPEAKER_01 0:12

Hello and welcome back to Empower Your Menopause. It's coaches James and Julie here. We help women 14 above power through the menopause transition. And we've got a really important subject today that we want to talk about. But before we dive into that, we've got quite the announcement. Julie, do you want to tell our listeners what happened this week? I think it surprised both of us, really, but why don't you fill people in as to what's what's been going on in our world?

SPEAKER_00 0:40

Yeah, I've I'm really excited about this development. We're really thrilled to announce that this week Fabulous Beyond 40 has been named Best Menopause Coaching Company in 2024, and we received the Client Service Excellent Award and this year's GHP, that's Global Health and Pharma Award. So the recognition is really important to us because it highlights our mission, which is empowering Women 40 Plus to thrive through paramenopause and menopause with evidence-based strategies and personalized support. So we want to thank our clients and our team and our partners, and of course, all of you listeners for being part of this journey.

SPEAKER_01 1:20

Okay, so self-congratulatory pats on the back over then. Today we're tackling an incredibly important yet often overlooked topic, and that is the connection between menopause and cardiovascular disease. Now, most people, myself included, before I did any studies into the menopause transition, always thought about heart disease as a man's issue. You know, we often hear about men having heart attacks, but the truth is that after the age of about 50, women's risk for heart disease actually increases massively and surpasses that of men's. And that's usually due to you know, our good old friends, the hormonal changes that happen during menopause. But the truth is that menopause doesn't actually cause heart disease, it does, however, increase all the risk factors that can lead to it. So today we're going to break it all down. We're going to talk about what's happening to your body and why this might happen, why it matters, and then we're going to give you some practice tips as ever to keep your heart healthy for years to come, as long as you implement them, of course. So, Julie, you know, this idea of doing cardiovascular disease in this episode was sparked by a client question we had in our club Fabulous Beyond 40 coaching membership. Why don't you just tell people a little bit about what that question was from that client, and then we can dive into some answers that would answer her question, but also any questions that the listeners might have.

SPEAKER_00 2:45

Yeah, sure. And this is really important. So the reason that we're talking about this this week is that we were recently asked a question in our club Fabulous Beyond 40 coaching group about a member who had just done some recent blood work and they'd showed that her cholesterol levels were somewhat elevated. So she was concerned. And we started talking her through some of the challenges here and then gave her some strategies to think about, which is why we thought it would be a good thing to get it here into the podcast, because we're guessing that she's not alone in these concerns.

SPEAKER_01 3:19

Sure. So let's let's dive in then to why menopause actually increases that risk of cardiovascular disease. What's happening with your body that means that after the age of 50, you are more likely as a woman to have heart issues than you are as a man. Well, first of all, there's our good old friend estrogen. Right, oestrogen, it is responsible for so many great things that happen in the body, but also once its absence starts to be felt, it's also responsible for a lot of the challenges that women over 50 have. So, first of all, let's say that estrogen plays a really protective role by helping regulate your cholesterol levels and preventing any fat buildup in your arteries. So when estrogen levels, two different types of cholesterol are changed. So I'll I'll dive into these a little bit more when we dive into some of the nitty-gritty and the details. But what is called LDL, low density lipoproteins, commonly people call this the bad cholesterol. That can increase when estrogen level drops, and then conversely, HDL, high density lipid proteins, that is also known as the good cholesterol. And for those of you who are listening rather than watching, I'm doing air quotes when I say good and bad cholesterol. We don't like to talk about feeling good or bad, but it has become part of common parlance to refer to them in that way. So HDLEO in inverted commas, good cholesterol can decrease. You've also got that challenge of you know, menopause leads to increased fat around the abdomen and the heart, and that can further increase the risk. And then the decline in estrogen also affects how your blood vessels respond, and that can lead to increased blood pressure. One of the things that we see a lot is increased blood pressure. In fact, I was talking to a client this morning about the fact that her blood pressure had increased and what she could do about it. And then if you are one of those women who hits menopause, and remember menopause is the day after you've gone 12 months in the absence of a period, that is natural, not medically induced menopause in any way, shape, or form. So women who experience that menopause day before the age of 45 are actually at an even higher risk due to the fact that the protective effects of estrogen aren't actually there for as long. Um, obviously, you know, if you get to 50-55 and you've still got the protective effects of estrogen, then you've got an extra 10 years on having those protective effects in place. So early menopause can be a challenge. So before we go any further, then I think we've outlined some of the background here of what might be going on and what the challenges are and things. Let's actually take a step back and talk about some definitions. You know, Julie, just talk us through what cardiovascular disease actually is, why it's relevant, and what some of the risk factors are in general. Sorry, in general.

SPEAKER_00 6:16

Sure, of course. So cardiovascular disease, we all if you'll see it in um publications listed as CVD, um it's a group of conditions that affect the heart and all of your blood vessels. So you might that might come through as coronary artery disease, heart attack, or stroke. And it's relevant because it's the leading cause of death in women worldwide, but awareness of this is actually low. Most of the focus is on breast cancer when it comes to women, but heart disease is a big deal. So aside from the lowered protective effect that of estrogen that James was mentioning, there are some other risk factors involved too. So things like diabetes, type one or type two, smoking, um high blood pressure that's that's chronically high, your high HDL, um or sorry, high LDL, which is that um quote bad cholesterol that James mentioned, low HDL, which is the more protective uh form of cholesterol, obesity, an inactive lifestyle, and uh family history of heart disease actually is also relevant.

SPEAKER_01 7:26

Cool. So let's delve a little bit more into the cholesterols then. I think it's probably worth talking about that here. For many, many years, cholesterol has got a terrible rap in the health industry. I remember back in the 1980s where the health advice of a certain health minister here in the UK was to avoid eggs because they were absolutely laden with cholesterol, and you know, we were all going to suffer from huge uh bouts of heart disease. So cholesterol had to be be reduced, and eggs were a real component in this. And the truth is that cholesterol is actually vital for a huge, huge amount of function of the body. Okay, so it helps build cell membranes. So your cell membranes, each all your cells connect with each other, the membranes, the outer layer of those cells, by having healthy cell membranes, cells talk to each other better because the junctions between various cells are better when you've got that nice plump membrane around them. Um, it produces bile acids for digestion. So without cholesterol, you wouldn't be able to digest your fatty foods really well. And it really crucially, you know, we talked about the lack of estrogen there. Cholesterol actually forms the backbone of all your sex hormones. So estrogen, progesterone, testosterone. Without cholesterol, quite simply, your body wouldn't function properly. So it's really not a case of eliminating cholesterol altogether, it's more about having the right balance between the two different types that we talked about there. The inverted commas good and the inverted commas bad. So let's think about cholesterol then, instead of sort of like demonizing it and saying that we've got to take it out of our lives if you're a woman 40 and above, let's think about more of a kind of like in a Goldilocks kind of way that you don't want it to be too high, you don't want it to be too low, you want it to be somewhere in the middle. So we talked about HDL, LDL. HDL, high density lipid proteins, as I said, the good cholesterol inverted commas. This is like your cleanup crew, it goes around and it mops up all the invert commas, bad cholesterol from the blood, takes the liver to be processed and removed. So higher levels of HDL are actually protective against heart disease, and that is kind of what you want to be looking for when it comes to any blood test results and things like that that you might have. Then you've got those low density liver proteins. Well, as I said, the bad cholesterol is not inherently evil, it's necessary for certain sort of like things, so it helps transport cholesterol where it's needed around the body. The problem arises when there's too much LDL because that is when it can accumulate in your arteries, and that is the challenge that we have because that is when it forms plaque, and that is when it can lead to heart disease. So I think it's really important. I see this a lot when I do functional blood tests with some of our clients and with clients that I've done in the past. Sometimes you can see the total number of cholesterol where they're adding HDL and LDL together, and absolutely freak out because it is above the reference ranges as a combined number. What is actually more important is what are your levels of HDL like and what is the ratio between total cholesterol and HDL, that good cholesterol, and that is because a high HDL can offset that moderately high LDL. So if your LDL levels are creeping up, that's not inherently a bad thing as long as your HDL levels are really nice and high because that will help keep the risk lower. So, what kind of figures are we looking at? Well, some of you may have seen these figures on blood tests and things like that and be wondering what they what they mean. So when it comes to HDL, you want to be looking at a figure that in standard international units is about 1.55 millimoles per litre. That's considered to be protective, and then when you get your total cholesterol to your HDL cholesterol ratio, you want that to be ideally below five or below four to be optimal. So they're the kind of figures that you're looking at if you do a blood test. And just as a reminder, Julie and I offer functional blood tests that take into account a whole range, wide range of biomarkers, including cholesterol, HDL, all the ratios there, vitamins, minerals, hormones, etc. So if you wanted to work with us on this, we can dig into it in really, really fine detail. But I think we've kind of exhausted a little bit the science and the background and all that kind of stuff. You've probably sat there listening and thinking to yourself, just tell us what to do. So, Julie, tell us what to do. What are some of the lifestyle prote uh strategies that can actually help protect people's heart, protect their cholesterol levels during this stage of life?

SPEAKER_00 12:38

Sure. There there are lots of things that we can can we can do, and we have more control over this than than we may think. Um, diet, of course, is going to be your number one focus. Even though dietary cholesterol doesn't translate necessarily into blood levels of cholesterol, it's a really good place to focus for your health, generally speaking, and it will keep your heart healthier along the way. So focusing on foods that support your health, um, your heart health berries, things like oats, cruciferous vegetables, fatty fish like salmon, olive oil, um beans, and legumes are really good. Of course, those are also very high in fiber, which we need. Um, reducing saturated fats, especially those that are not naturally saturated. Um, trans fats, especially should not be part of your diet ever, ever, ever, if that's at all possible for you. And uh reducing sodium levels because it's it tends to be in a lot of the packaged and processed foods that we eat. Um, and as I said, fiber-rich foods, whole fruits, vegetables, and whole grains are great. Exercise is a big one.

SPEAKER_01 13:44

Go on to exercise, Julie. I think it might be worth just highlighting there. You and I had a discussion about this the other day, didn't we, about the recommended amounts of fiber? And I know we've got listeners in both America and in the UK. And I think you shared that in America the recommendation is 25 grams a day. Is that right? I think.

SPEAKER_00 14:01

Yep. Typically, yes.

SPEAKER_01 14:03

Yeah, yeah. Whereas here in the UK, it's 30 grams a day. And I think we both came to the conclusion that 30 grams of fiber a day was was probably a better overall thing to aim for, right?

SPEAKER_00 14:16

Yes, totally, especially at this phase of life, because our bodies are changing, constipation is a real thing at this phase of life. So more fiber is going to help, of course, as long as you're drinking enough water along with it to help it flush through your system.

SPEAKER_01 14:32

Sorry.

SPEAKER_00 14:33

So yeah. It's okay. Um, but the next one, of course, is exercise. So we want to look for at least 150 minutes of moderate aerobic exercise, um, walking, swimming, dancing, tennis, you know, whatever, whatever it is that you enjoy doing, and including strength training to maintain your muscle mask is really important to support your heart health. And along with that, a lot of people exercise to try to burn off the calories they've eaten, which isn't really the best approach. Um, and you can talk to us about that for more details. But weight management is really critical also. So losing even just five to 10% of your body weight can really reduce your cardiovascular risk. Of course, avoiding smoking, it's a major, major risk factor for heart disease. And alcohol can also um play a big part in that because it can raise not only your blood pressure, but also your cholesterol levels. Um, sugars generally are not so good for cholesterol.

unknown 15:36

Yeah.

SPEAKER_01 15:37

And then, of course, there's our good old friends as well, aren't they? Stress and sleep that seem to come up in almost every episode of Empower Your Menopause. We're talking about the need to reduce stress levels and improve sleep as well. So two other factors that are huge to think about, yeah.

SPEAKER_00 15:57

Yeah.

SPEAKER_01 15:58

Okay, so that's the kind of like main lifestyle tips then that Julie's just gone over. I think it's worth just highlighting, you know, it's keeping an eye on this. And I know that unless you're getting your GP to do it, I had to laugh the other day. I got a blood test result from a GP. It looked like it'd been written on uh an old school typewriter from the 1950s. One of our potential clients had been sent to have some blood tests done, and they'd literally done a blood draw, and the only two biomarkers that are tested were oestrogen and testosterone. And it blows my mind that on the health service they've gone to all that sort of expense of actually getting somebody there doing the blood draw and only looking at two biomarkers. I think it's really, really important that regular testing, if you want to stay on top of your health and you want your health to be optimal, is really really important. I think blood testing is certainly one that I would recommend. I think we're going to do an episode on testing because you know there are a lot of companies out there that do things like urine testing for hormones and stuff like that, and I'm not always convinced by their efficacy, but I am convinced by the efficacy of blood testing because your blood doesn't lie when it comes to what's going on in your body, right? It's an absolute open book, it's the international language of medicine actual um blood testing. So I think knowing your numbers is really, really important. As I said, if you can't get your GP to do these kind of tests for you, come to us. We're kind of offering a whole wide range of blood tests from fingerprint tests to actual full blood draws where we look at 120 biomarkers and kind of give you a real roadmap from what's going on on the inside of your body and and how to put it right from by using that that roadmap. So I think knowing your numbers, knowing what your LDL is, knowing what your HDL is, keeping an eye on that total cholesterol to HDL ratio is really, really important. I think keeping an eye on blood pressure is also probably really important as well. You don't want your blood pressure to be getting too high, so about 120 over 80 or 12 over 8, depending on how you express it and where you're from, is kind of ideal. And then looking at blood sugars as well and checking out there's a biomarker called HBA1C, which is your marker for diabetes risk. And again, if you did some blood tests with those HBA1C is included in there as well. So just keeping an eye on all those figures, what's going on, and so you can be informed and make sure you're heading in the right direction when it comes to this kind of stuff. I think it's worth just touching on. You know, Julie and I aren't endocrinologists. Um, HRT, we uh know about it. Uh it's not in our um competency levels to give advice about HRT, but it's worth highlighting the things that we do know. And we know that uh HRT, some studies have shown that it affects heart health really positively, and some show that it can be more negative, depending on the individual's actual uh risk factors. So I would always say if you're concerned about your cholesterol levels and what HRT might be doing to them, discuss that with your healthcare professional, whoever it is that's looking after you from an HRT perspective, whether it's your GP or you've gone to a specialist, uh menopause, functional doctor, it's worth discussing with them just to make sure that the HRT that you're on is appropriate for you on an individual level. So I think we've kind of gone through everything we wanted to go through here. Julie, do you would want to just do a bit of a recap of the of the main points then before we before we close this one out?

SPEAKER_00 20:01

Yeah, of course. So we talked about how menopause is a critical time to really start paying attention to your heart health if you haven't already, because hormonal changes are may increase your cardiovascular risks. Um we talked about some practical steps like a heart-healthy diet, staying active, and knowing your numbers and how those things can make a big difference. Um and then remember it isn't none of this is about being perfect, as we like to say all the time. It's about making small, consistent changes that add up over time. Because if you keep doing some massive change and then quitting, you're gonna get a lot, a lot less far than if you do some small changes that you can maintain over time. So, and of course, as James mentioned, we have some amazing functional blood testing available. If that's something that interests you, reach out to us and we can tell you about it. And then I'd also encourage you to join our Facebook group, which is a fabulous Beyond 40, the Facebook group, and join us in some fun challenges and a great supportive community where you can get advice and talk to other women who are going through the same kinds of things.

SPEAKER_01 21:12

Yeah. I think it's worth saying with the Facebook group as well, is that in 2025, it is 2025 next, right? I sometimes forget. At the end of 2024, and I'm only just used to writing it, and I'm gonna have to learn a whole new year. Um, so in 2025, we're introducing a whole host of things like monthly challenges, extra support in the Facebook group. So if you're looking for some low-level, low touch but high value uh touch points with us that will be free to access for as long as that Facebook group is going, then that is definitely the place to go. And we will put the uh the URL for that in the show notes as ever, so you can just click on it and go direct to the Facebook group. There's a couple of questions there that you need to answer to um to get access, but once you do, you'll have um access to all the good stuff that's in there, as well as that amazing community of other women that's there as well. So, Julie, do you want to do the closing line this week?

SPEAKER_00 22:16

Of course, because we are James and Julie, and we want to remind you to stay strong and stay fabulous.

SPEAKER_01 22:23

We will see you next week. Thanks so much for listening and take care. Bye now.