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Katie: Hello and welcome to the Fit Bottomed Zone Podcast. I’m back with Jessica Brown today and and this episode covers all things menopause and cardiovascular disease risk and how especially we can reduce our risk, and be aware of it naturally with tools that are at our disposal. And Jessica gives us some very evidence backed strategies to do this, as well as talks about the staggering statistics about the number of people who have some marker of metabolic or cardiovascular dysfunction, even as early as our twenties, and what we can do about that. As well as some tools that you might not have considered for getting accurate ways to monitor your cardiovascular disease risk.
She explains that women’s risk goes up to that of men’s after menopause, and some of the reasons this is the case. And that while we often talk about cancer, one in three women will actually die of cardiovascular disease. So this episode tackles how to make that risk go down for you in particular related to your own factors.
And Jessica is an absolute wealth of knowledge. She is a stand for certified compassion teacher, clinical nutritionist and author. She has done this work for over 25 years and helped thousands of people heal physically, emotionally, psychologically, and spiritually. And she is a creator of The Loving Diet, which is one of the first mind body programs supporting those with autoimmune disease.
And I got some practical takeaways from this episode, I know that you will as well. So let’s join Jessica.
Katie: Jessica, welcome back. Thank you for being here again.
Jessica: Hi, Katie. Thanks for having me.
Katie: Well if you guys missed it, Jessica and I had an amazing first episode together about some of the really core work that can actually be related to so many things in your life. Including emotional eating and disordered eating, and really touches on core needs from childhood and how to reparent yourself.
It was absolutely phenomenal. And in this episode, we’re going to switch gears a lot and talk about another area that you have a lot of expertise that I think will very deeply serve some of our listeners today. Which is the concept of menopause and increased risk of cardiovascular disease. And especially most importantly, how to understand that so we can know how to best support our bodies and move through that with minimizing that risk as much as possible.
And I find it fascinating that from at least my understanding, women’s cardiovascular disease risk rises essentially to the rate of men after menopause. And I know for a lot of years, it was kind of just accepted that that was part of it. And there’s been so much debate about things that you can or can’t do and hormones, if they’re good or bad.
And there’s seemingly a lot of confusion still around this topic. So I would love to bring some clarity to that today. Can you start off by maybe explaining what are some of the reasons that we see our cardiovascular risk rise as we go through menopause?
Jessica: Well, the biggest reason is the loss of estrogen. So a really big thing happens when a woman goes into menopause to their heart. Their heart gets stiffer and smaller. And when a woman’s heart gets stiffer and smaller, there’s consequences to that. So women lag from men, because everybody knows that heart disease affects men.
That’s so ingrained in our culture, but it’s not known that women catch right up to men. And their rates of disease match men’s as they go into menopause, which I think is a pretty important statistic that almost 50%, 44 percent of women do not know the seriousness of cardiovascular disease. You know 45 percent of women who are age 20 and above have some form of cardiovascular disease. So, it’s not like women just sort of putz along and all of a sudden they hit menopause, and then this really big dramatic thing happens. The loss of estrogen is sort of the tipping point.
But what we know is that women are getting sicker earlier, and the rates of cardiovascular disease are happening earlier. But it’s when a woman loses estrogen at menopause that it sort of all comes to fruition. And that’s when women match the death rates. One in three women are going to die of cardiovascular disease. That’s more than all cancers combined. But when you sit down with your girlfriends and you talk about why do we think, what are the reasons why women die? For me and my friend group, it’s cancer, breast cancer, everybody goes and gets their mammograms, but we are not looking at our cardiovascular risk.
And so I was… this is a really near and dear thing to me because I started getting heart palpitations when I was starting to go into menopause. And they were getting so strong that my husband encouraged me to go to the doctor.
And I mean, I’m a nutritionist, I eat well, I exercise and I went in and I was dismissed for having anxiety. And it turns out that I do have cardiovascular risk and there was something there, and I did go to a cardiologist. But that was really what got me motivated was, I think that women do not understand the seriousness, and they’re not being taught at younger ages how to discover if they actually have cardiovascular risk, because remember, some of this risk starts happening in your 20s.
Katie: Wow, yeah, those stats are pretty staggering of the women that I didn’t realize that already have some marker of cardiovascular disease. It reminds me of how almost, like, over 90 percent of people now have some marker of metabolic dysfunction and many don’t know it. And how this can affect so many areas of life, of course.
And it also makes me think of the sadly way too common story of women being dismissed within conventional medicine. I know that happened to me within the thyroid realm and for years I was told everything was normal. Of course, we’re not testing the other markers. You’re fine, this is just part of being a woman.
You’re tired because you have babies, like, et cetera, et cetera. So sadly, this sounds like a very common story, but especially understanding that the actual risk begins much earlier. What as women can we be aware of and look out for at earlier ages than we might have ever thought to think to keep like to kind of have early warning signs and to be able to start doing something when it’s easier to affect change early on?
Jessica: That’s a great question. And so there’s two things. One is to understand what your metabolic risk is. So metabolic risk is a constellation of different factors that women should be looking at starting in their twenties. 50 percent of everyone in the United States has high blood pressure right now, 50%. High blood pressure is a metabolic marker for cardiovascular disease. Only one in four people actually are on blood pressure medication.
So we need to educate women to start looking at these risk factors. So one is, what’s your insulin? How much… are you becoming insulin resistant? The answer is more yes than no these days. So we want to know are you insulin resistant? What’s your fasting glucose? What is your hemoglobin A1C, which is your blood glucose over a three month period of time? What’s your blood pressure? So that’s important. So that number one is, start tracking your metabolic markers.
Doctors aren’t doing this the way that I think that they should be. They’re not looking for insulin resistance, they’re testing blood glucose and that’s it. And then the second thing for women to understand is what is your visceral fat? And that’s something that in my classes is not on people’s radar, and they don’t understand the importance, and they don’t know how to track it. Visceral fat is metabolically active fat that is belly fat. And what we know now is that in America, we have higher and higher levels of visceral fat. So if we took just for a moment to explain this to women. So we have basically two kinds of fat on our body as women.
We have adipose fat and we have visceral fat. Adipose fat is like on your arm, like pinch an inch. Visceral fat is metabolically active fat that spills inflammatory compounds into our body that drastically increases our risk for cardiovascular disease and actually all cause mortality. Visceral fat starts getting built on our body when we have saturated our reserves of adipose fat. What I call the personal fat threshold. That is not a term that I coined, but personal fat threshold means that you have a bucket and you can fill it with this adipose fat. But then, when the bucket’s full, it spills over and it starts padding internal organs like our liver. Non alcoholic fatty liver disease, which is starting to happen earlier in earlier ages.
Hearts; women’s hearts are now covered in fat. Knowing your visceral fat, which is very easy to do, going and getting a DEXA scan. It’s $100 and it shows you exactly how much visceral fat you have on your body. And I recommend all women who are perimenopausal start tracking their visceral fat because when you go through menopause and you lose estrogen your body will naturally start producing more visceral fat to the tune of like two to three percent per year that women build visceral fat after the age of menopause.
Katie: Yeah, I feel like there is not a lot of mainstream talk about visceral fat and like you said, it does go up in menopause. And I actually have a DEXA machine in my office that right now is a personal use DEXA machine until I open. But I’ve enjoyed doing that with athletes because they’re trying to track muscle growth and I enjoy that part too. But I find the visceral fat part really fascinating and that’s been something I’ve watched, especially as I healed my thyroid and lost weight and now like have my visceral fat in, I believe under 200 grams.
So it’s like very low now, but it was not always the case. And so I feel like I, that’s a metric most people don’t even know to track. That’s so helpful because from my understanding, even if you carry like a healthy weight of body fat. If you are very low visceral fat, you actually have a much lower risk of heart issues.
And it’s not just the fat itself, but where it’s distributed, which a DEXA can tell you. And from what I’ve read, even for women, it’s common and good and actually healthy to have some amount of healthy fat on your legs and your glutes and things like that. And it’s the visceral fat that you really want to be aware of.
On that note, how, what are ways we can support our body and not accumulating visceral fat, especially understanding how important that is?
Jessica: Well, one is to go on hormone replacement if you can, and if it’s appropriate for you. So when we lose estrogen, that rate of visceral fat just increases pretty exponentially. The other thing is to look at what our lifestyle is. So when we consider that… well, let me back up for a second. I’ll say that when I encounter women who have high amounts of visceral fat, there’s usually a host of things that they’re not aware of that they can do to decrease their visceral fat. One is to let go of the idea that visceral fat is about body size or weight. Women who go on hormones and keep building muscle as they age are literally building a life insurance policy for themselves. The more lean muscle that you have on your body, the less insulin resistant you are. The more insulin resistant you are, the more visceral fat you’re going to accumulate.
So the loss of estrogen, age, inactivity, and the loss of lean muscle all tick up those markers that make cardiovascular disease much higher in individuals. And so learning practical ways that you can decrease those, which isn’t like calorie restriction. A lot of times it’s just about learning how to work out in a way that builds muscle for you and what exercise routines you like that is going to help prevent that.
Katie: I love that. Anytime I get to talk about building muscle for women, especially as we get older, I’m all about stepping on that soap box. And I’ve had other guests like Dr. Gabrielle Lyon say, you know, muscle is the organ of longevity. And especially for women, we do not easily just build dramatic muscle and look like bodybuilders.
It’s about learning, like you said, what works for your body, putting in the work regularly and making that a consistent habit and essentially like in every category, the more lean muscle, the better. Some ways that I do this that I’ve found helpful and it was experimentation to your point is like regular strength training in the gym with actual progressive overload.
Like I stopped trying to get toned and actually did the things that I used to be afraid of would make me bulky, which ironically helped me get toned. As well as walking with a weighted vest. I started just like every day, if I have to take a phone call or zoom, put on a 60 pound weighted vest now, and I just go out in the sunshine and walk.
And it’s amazing. That’s good for your bone density too. Any other tips around that or around things like, another one that seemingly was helpful for me and seeing DEXA results get better was eating enough protein within the right window and also really maxing my micronutrients. So not just thinking about calories, but also thinking of how could I maximally nourish my body? Which of course helps build muscle and strengthen bones and all these things I’m becoming aware of as I get older.
Yes, all of those things are important. And then I’m going to mention one that might be a curveball: micro-dosing GLP1 medications. So we know now there’s been a lot of fear about using GLP1 medications that you lose lean muscle and lean mass. But what we know is that losing visceral fat as you age, especially after menopause, is really challenging to do, And there are studies that are coming out now that are showing two important things that are happening when you go on a GLP1 medication. And by the way, I’m using the word microdosing because it’s off label and I’m not a doctor, so you would need to talk to a doctor about this, but I can talk about the research. And the research is that women lose visceral fat on GLP1s because it creates an environment when you are optimizing insulin, that you are lowering your risk of metabolic disease, of gaining visceral fat, which is such a huge contributor to cardiovascular disease.
And you are, it’s almost like giving yourself a prevention for metabolic disease. And if you microdose with the GLP1 medication, you’re also working on your immune cells. GLP1 medications work on immune cells, and there’s new research that’s coming out that they lower cytokines. Heart disease is an inflammatory disease. Autoimmune disease, an inflammatory disease. Just like when you have an autoimmune disease, you’re producing inflammatory cytokines.
The same thing is happening when you have a lot of visceral fat, those metabolically active chemicals, and then also with cardiovascular disease and insulin resistance. So, I think that we’re going to be coming into a period of time where women are going to want to have the choice to be able to optimize their metabolic state because we live in a world that is so toxic. It’s so full of processed foods, there’s lots of microplastics, lots of air pollution, our water isn’t as clean as it was, and we’re not producing GLP1 in the gut like we used to.
So the more dysbiosis we have in our guts from living in a toxic world, even if we’re healthy people, the less GLP1 we’re going to produce. If we were to give ourself small, small amounts, not enough to put us into a catabolic state where we would lose our hair and lose our lean muscle mass, we’re talking about very small amounts. I think it’s going to start, the research is going to start showing how well this is going to work to help prevent cardiovascular disease in women as they age. Paired with the lifestyle factors like keeping lean muscle mass. Does that make sense?
Katie: It does. And I think that’s an important caveat because I had another guest also talking about the massive drop in inflammation that people can see from microdosing GLPs. And it seems like a very American thing that we have this idea that if some is good, more is better. And maybe that’s where we’re seeing a lot of these problems coming into play. Especially if maybe people are doing those in such a degree that it fully suppresses appetite. And now they’re not hitting baseline calories, protein nutrients, which of course puts a whole other form of stress on the body.
And I love that this whole episode is really about like, what tools do we have easily available access to that can really shift that needle as far as risk factors and that are within our own personal control.
I say so often that we are each our own primary healthcare provider and that at the end of the day, the responsibility lies with us in the driver’s seat. Hopefully working alongside a practitioner who can help us navigate the nuance, but that we hold the ownership of that. And thankfully now there’s so much access to tools and data to help us really navigate that.
Are there any other lifestyle based tools and or supplements or things that women especially can do and be aware of from as early of an age as possible when it comes to menopause and cardiovascular disease risk?
Jessica: Well, I actually created the menopause heart project, which is a four week program where I take people through how to do everything. So I have everyone test themselves metabolically so that they can get the baseline. They can have an understanding of what their metabolic health is. These are tests that I’m not finding, unfortunately, doctors are doing.
Understanding what your ApoB is, you know, that’s an LDL particle that’s highly related to cardiovascular disease. Having my clients go through and do a DEXA scan. What kind of diet is the right one? Well, there is no right diet. It’s really dependent upon each person. What kind of exercise should they be doing?
It’s really dependent upon each person, but it is important to know how to track your heart rate and what exercise puts you in heart rates and why that reduces cardiovascular disease. So there is no exact blueprint for how to navigate cardiovascular disease risk except for moving, tracking, and understanding.
And so I created a four week class, really for myself. I did it by myself for a year to see how can I lower my cardiovascular risk because I was at high risk. I didn’t understand all of the factors that I needed to blend together. And so I created the menopause heart project so that women could take control of their risk and lower it and have conversations that their doctors should be having with them, but unfortunately they’re not.
Katie: Amazing. Well, and I’ll link to that in the show notes as well. And I’d love to touch on a few other points if possible, especially ones within women’s control. A topic that is definitely recurring on this podcast is again, the topic of sleep and especially light exposure. I just got to do a super deep dive into light exposure, natural light versus sort of internal artificial junk light at night and how those impact hormones.
And I feel like I often hear from women, especially in perimenopause and menopause when sleep becomes an issue, and we know that sleep is so vital to every area of health. I’m curious if you have any tips specific to getting better sleep, longer sleep, better quality sleep, not waking up, and really optimizing that factor because it seems like it’s so tied into hormones as well.
Jessica: One of my favorite sleep supplements is magnesium L-threonate, which crosses the blood brain barrier. So it was developed by some scientists at MIT, and what we know is that people who age have less magnesium in their brains. Magnesium is really hard to get into our brains. You can’t really get magnesium into your brains very well from just taking a supplement like magnesium glycinate or magnesium citrate, which helps you poop. So magnesium L-threonate has been shown to increase cognitive ability over time, and it really calms the brain. So I take magnesium L-threonate every night before I go to bed. There’s also a product that I really like from Apex Energetics called Adrenacalm and it has Phosphatidylserine.
And using that, on your skin, it’s like a topical cream, before you go to sleep at night is awesome because it helps take short term memories and put them into long term memory storage. And it also helps us sleep. It’s very calming to the brain as well. So I would say those two supplements are my favorite. And then my favorite hormone for sleep is of course, progesterone. So, you know, that’s something that all women should look into if it’s age appropriate and their doctors think that they are candidates to go on that hormone. It’s really helpful for sleep.
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