This is an installment of Good Fit, a column about exercise.
Earlier this year, I “fired” all my doctors. That might sound extreme, but I’d had it with all of them. My umpteenth primary care doctor had left the practice I’d gone to for 20 years, and the practice itself had been acquired by yet another health care network with a new online portal and passwords. My gynecologist, who I loved, had no front office support; this left me without a prescription refill that I needed to control my endometriosis. And there was another matter: I’d gained about 10 pounds seemingly overnight, and it was concerning me. I wasn’t sure if it had to do with my age (I’m 48), my thyroid (I have hypothyroidism), or something else. Nothing in my lifestyle had changed. I wanted to get fully checked out, and had no doctors to rely on.
I decided to commit to the New York University network of doctors and found a new primary care physician very close to home. (One upside of the gentrification of Brooklyn: There are doctors and dentists in places other than midtown Manhattan.) During my well visit, Dr. Andre took my concern seriously and suggested I visit an endocrinologist for a deeper look at my thyroid levels. I’d been on the same medication dose for over a decade. Maybe it was time for a tune-up?
So on May 1, I went to Dr. Patel, also at NYU. Like my PCP, she was young, kind, and efficient. She looked at my bloodwork and told me everything looked great; she even praised me for my vitamin D levels (I take a multivitamin). She told me to stop worrying about my weight—I was healthy and moving and all signs pointed to great health. But she did ask me one question: “Are you strength training?”
For a long time, I counted yoga as strength training, because it is weight-bearing exercise. But the truth is, I don’t practice enough, or with enough intensity, to really count it that way anymore, particularly as I approach 50. With menopause on the horizon, I learned, estrogen drops—and that drop makes it harder for us to make muscle the way we could when we were younger, which means we get weaker (and flabbier) as we get older. But if you strength train, you can build muscle, which in turn will help your overall health and stability.
My doctor suggested that I get a trainer at my cheap gym, just to learn the ropes, or try Apple Fitness+. I didn’t even know Apple had a fitness app; turns out I needed to upgrade my OS, and I’d get three months for free. I was intrigued. This seemed more doable than clean-and-jerks with the bros at Blink Fitness.
I ordered some basic hand weights and looked for 30-minute upper-body routines. Around this time, I had also started jogging on the treadmill instead of using the elliptical machine; my feet kept going numb as I went around and around, but I found I could do a 2-mile run, slow and steady, and feel great afterward. I wasn’t looking to overhaul my eminently manageable approach to exercise, and my overall goal stayed the same: to try to move every day, regardless of duration or intensity. But to make sure strength training was consistently in the mix, I got a new routine: yoga on Sundays and Fridays; a short run on Monday, Wednesday, and Saturday; and a home weight routine Tuesdays and Thursdays. I liked the variety, and none of it took more than an hour total.
But I wondered: Is this a good mix? Is there something I should tweak? What am I missing here? I don’t want to hurt myself; in fact, I want to do the exercises that will prevent me from hurting myself as I get older. Am I doing this right?
I asked Stephanie Creaturo, my strength- and flexibility-focused yoga teacher, for a consultation. I expected her to review my workout regimen and tell me to run more, or faster. Or to do more reps with my weights. But her focus actually shocked me. It wasn’t really on my workouts, which she told me were great (although she did tell me I needed to work with heavier weights and FEWER reps), but that I needed to pay more attention to what I was eating, and when I was eating.
She asked me if I eat before I exercise. (Nope.) Do I eat at all in the morning? (Nope.) Do I get enough protein? (Yeah, I think so!)
Boy was I wrong.
It was a lot to take in, and I mean that literally. According to a formula Stephanie sent me based on the work of Stacy Sims, a physiologist and nutritionist who focuses on women, I should be eating well over 100 grams of protein a day. (I wasn’t even close.) And the timing was important: consuming something protein-rich first thing in the morning would give me fuel to exercise. And it was important to eat a protein-rich meal soon after a workout, too. “Protein pulls your body out of the breakdown state that naturally happens after exercise, lowers cortisol, and kickstarts your body’s natural repair process,” Stephanie explained to me in an email. “That repair process puts carbs back into the liver and muscles and synthesizes protein into strong, lean muscle tissue. That helps improve your blood sugar and body composition.” It was also important to try to get most of this protein from actual meals, not just meat sticks and protein shakes. I am a meat eater, and consume a decent amount of chicken and some red meat. But fish became my new best friend for lunch. (This salmon recipe is so quick and easy, and is also great cold.)
I needed to share this gospel. I have a group chat with three other women who are all around my age, and I refer to it now as the “menopause lunch chat.” It features a lot of photos of dishes built around chickpeas. I just ate a can of tuna for lunch. The thing I did not expect was that actually eating all of this protein, instead of microwave lunches from Trader Joe’s, would make me feel a lot better: less snack-hungry, more energetic, less bloated. Sliced turkey is a fine snack! Cottage cheese, I am still struggling with.
Still, it’s not perfect. I don’t hit seven days a week every week of my workout regimen, but if I get four out of seven, I feel pretty damn good. And I eat pasta and pizza and all kinds of things besides protein, but I do drink (protein-rich) kefir before I go to the gym. I like Apple Fitness+ (I expect to keep it going after the free trial), and I’m working on extending my run to 2.5 and then 3 miles.
Perhaps the biggest change is that in all of this, I stopped worrying about my weight gain—and stopped weighing myself, too. If my new doctors tell me I’m in good shape, and doing things right, I’m going to trust them. And I’m going to listen to the way I actually feel, instead of undercutting that feeling because of a number on my scale that is higher than what I’m used to. I’m getting older—we all are—and our bodies change. The real goal is to work with that fact, and keep moving, ideally every day, even a little bit.