Johnson, the subject of the Netflix documentary Don’t Die, says he’s on a quest to achieve the lowest possible “biological age” (also known as bio age).

He reportedly spends millions each year on anti-aging treatments—dozens of daily supplements, weekly acid peels for his skin, injections to boost collagen production, hyperbaric oxygen therapy, and plasma infusions extracted from his 17-year-old son’s body.

To determine what’s working, Johnson has undergone numerous tests to assess his bio age. Johnson says these tests show his age is now 5.1 years younger than when he embarked on his anti-aging quest.

Apparently, he’s aging in reverse.

Granted, not everyone’s buying it. A New York Times exposé, for example, claims Johnson’s biological age, in reality, has increased by 10 years.¹

Still, Johnson’s “don’t die” crusade is gaining traction.

Bio age tests are a frequent topic on popular podcasts by Peter Attia, Joe Rogan, and Andrew Huberman. Google “bio age testing” and you’ll see dozens of ads for mail-order blood or urine testing kits that claim to reveal your biological age, pace of aging, and more. With prices tumbling into affordability, it’s natural to wonder…

Should you or your client sign up for bio age testing?

If so, which test is best? Just as importantly, what should you do with the information?

In this story, you’ll learn:

• Five FREE ways to assess your overall health and pace of aging—from the comfort of your own home
• Doctor-approved bio age tests you may have already done without realizing it
• The research behind commercial bio age tests, and whether they’re worth your money
• The two biggest mistakes people make when chasing health and longevity

What is your bio age?

Your biological age (bio age) refers to how your cells function. It’s not necessarily the same as your chronological age, which refers to the number of candles on your birthday cake.

For example, let’s say Chang, a 50-year-old man, works at a desk, spends his free time in front of the TV, lives in the most polluted city in the world, eats a candy bar for lunch, and smokes. On the other hand, Jabari, a different 50-year-old man, hits the gym several times a week, lives in the mountains, doesn’t smoke, relishes his five servings of veggies a day, meditates, and spends most evenings in his garden.

Genetics aside, you’d be wise to wager that Jabari’s bio age is younger than Chang’s.

How do these tests measure bio age?

Bio age testing kits measure one or more biological markers of aging, also known as biomarkers.

For example, some tests focus on the size of your telomeres, the protective caps at the ends of chromosomes. Others measure DNA methylation, a physiological process that chemically alters DNA.

Once a company isolates and measures these markers from your blood or urine, it plugs the bio data into a formula that calculates your bio age.

However, if you see a doctor with any regularity, you’re likely already tracking some biomarkers of aging. For example, biomarkers such as blood pressure, cholesterol levels, and blood glucose can help predict your risk of future cardiovascular disease, a leading cause of premature death.

What’s the point of biomarker testing?

Biomarker testing can help you monitor your wellness proactively rather than waiting for disease symptoms to appear.

For some, it also serves as a motivator. If you learn you have the bones of someone 20 years older, this may give you the nudge you need to start strength training consistently.

In addition, biomarkers provide objective data, allowing you to track and evaluate various health-related actions quantitatively. By monitoring your blood pressure, you might learn that consistent exercise helps, but your late-afternoon energy drink does the opposite.

5 FREE biomarker tests

You don’t have to be a billionaire (or even a millionaire) to track biomarkers of aging.

In this section, we’ll cover several massively underappreciated, scientifically validated tests you can use to gain insight into your bio age—for FREE.

Before scientists developed high-tech blood-based bio age tests, researchers used these free tests to calculate the pace of aging in the people they studied.

FREE biomarker test #1: Get off the floor

People who are fitter and stronger tend to live longer.²

That’s because muscles do more than just move us around. They also secrete anti-inflammatory substances, help to regulate blood sugar, slow cellular aging, protect the lining of the arteries, and more. All this helps reduce the risk of age-related diseases, such as type 2 diabetes, high blood pressure, and heart disease, a phenomenon we explore in our article, The New Science of Muscle.

Related to strength, your ability to balance is also key. If you’re middle-aged or older and can’t stand on one foot for at least 10 seconds, your risk of dying in the next seven years is double that of someone who can stand for longer, according to a study of 1,700 people.³

The Sitting-Rising Test (SRT) is one way to assess both strength and balance at the same time.

People with low scores on this test have a higher risk of dying from cardiovascular disease, according to a 12-year study of 4,200 adults between the ages of 46 and 75.⁴

How to measure it

Lower yourself to the floor with your legs in a crisscross position. Then, with your legs in the same position, stand back up. As you stand, notice if you must use a part of your body—hand, shin, knee—as leverage.

To score yourself, start with 10 points. Then, for each body part you used to stand, deduct a point. Subtract a half point if you became unsteady or lost your balance.

Keep in mind that this (and other tests) serve as a proxy for your fitness. A low score indicates that your balance and coordination, muscle strength and power, and mobility may all require some attention.

FREE biomarker test #2: Squeeze a ball

Like the SRT test, your grip strength provides insight into your overall fitness. If the muscles in your hands are weak, the muscles throughout your body are more likely to be weak, too.

Poor grip strength can also predict future muscle weakness. In one study, people with a weak grip were more likely to walk slowly and be unable to rise from a chair, complete rigorous housework, or climb a flight of steps 25 years later.⁵

Low grip strength has also been associated with:⁶

• Low bone mineral density
• Increased risk of falls
• Poor nutritional status
• Depression
• Poor sleep, cognitive function, and/or quality of life
• Increased risk of heart disease, cancer, and premature mortality

According to one study, grip strength was a better indicator of longevity (or lack thereof) than blood pressure.⁷

How to measure it

Grab a standard tennis ball, and squeeze as hard as you can, for as long as you can.

If you can manage 15 to 30 seconds before your grip fatigues, you’re doing fine. Ninety seconds puts you well above average—anything over 90 ranks you solidly in the upper-third percentile.

If you’re below 15, keep in mind that this test is also just one indicator of your overall strength. (And squeezing balls to improve grip strength without training the rest of your body is unlikely to make significant improvements in your overall health and fitness.)

A hand-held dynamometer—available for use at most occupational therapists’ and some gyms—can also test grip strength. (If you’re willing to shell out some cash, you can buy your own for somewhere between $100 and $500.)

FREE biomarker test #3: Stand on one foot

An ability to balance on one foot for an extended period can help reduce your risk of falls, one of the leading causes of injury-related death among older adults.

In addition, many different bodily systems—the eyes, inner ear, skeletal muscles, and brain—must work together to help you stay upright.

Conditions like diabetes, heart disease, and cancer can all affect balance. As a result, an inability to stand on one foot can serve as a warning sign for eroding health and fitness.⁸

How to measure it

Stand near a wall or chair for safety. Keep your eyes open and hands on your hips. Then, lift your dominant leg and start timing yourself. Once you put your foot down, stop the clock. Repeat the test with your non-dominant leg.

Once you have your times, compare them to the following averages, from a study out of Duke University, to see how you did compared to your age-matched peers.⁹

FREE biomarker test #4: How you feel

Sometimes you know why you’re tired, such as the morning after binge-watching the last few episodes of a thriller. Once you catch up on your sleep, the weariness lifts.

That’s not the same thing as fatigue, which describes persistent exhaustion that worsens over time and interferes with life. In addition to feeling physically tired, someone who’s fatigued feels mentally dull and emotionally exhausted.

Think of fatigue as an early sign that something’s off, especially if you don’t know the cause.

Let’s say you’ve already ruled out the usual suspects like too much caffeine, dehydration, too much alcohol, medication side effects, chronic stress, or too much or too little exercise. What’s left is likely a sleep disorder or a developing health problem such as anemia, obesity, depression, cancer, or diabetes, to name a few.

If you’re 60 or older, fatiguability—or how worn out you feel after an activity—can also predict longevity.

According to research out of the University of Pittsburgh Medical Center, the higher someone scores in fatiguability, the higher their risk of death in the future.¹⁰ Other research has linked high fatiguability with declines in gait speed, walking ability, and other tests of fitness.¹¹

How to measure it

To measure fatigability, use a tool called the Pittsburgh Fatigability Scale. Using a 0 (no fatigue) to 5 (extreme fatigue) scale, rate how fatigued you think you would feel after completing the following activities:

If you score less than 15, you’re doing well. Scores between 15 and 24 are a warning sign. Anything 25 and above is regarded as severe, and worth mentioning to your healthcare professional.¹²

FREE biomarker test #5: Body composition

Despite popular belief, both too little and too much body fat can influence health for the worse, as we explore in our infographic, Is body fat good or bad for you?

Your muscle mass also plays a role, which is why someone’s body composition matters more than their weight.

The gold standard methods that estimate body composition—underwater weighing, air displacement (Bod Pod), and dual-energy X-ray absorptiometry (DEXA)—certainly aren’t free.

However, a recent study determined that a good old-fashioned (and cheap) tape measure can provide a comparably accurate estimate of body composition.¹³

How to measure it

To use a tape measure to keep track of your body fat percentage, measure:

• The widest part of your neck
• The narrowest part of your waist (For some people, this will be at the navel. For others, it might be slightly above the navel)
• The widest part of your hips

Ensure the tape is snug but not so tight that it cuts into the skin. Once you have your measurements, plug those numbers—along with your age, sex, height, and weight—into our FREE Body Fat Calculator, which will take it from there.

Doctor-approved biomarker tests

Depending on where you live in the world, the following tests may not be free. However, as part of routine preventative care, your insurance might cover them.

Doctor-approved test #1: Blood panel

If your primary care doctor recommends yearly blood work, it’s for good reason.

By keeping tabs on several blood markers, you can see if your health is trending toward type 2 diabetes or heart disease, both leading causes of premature mortality.

Many blood markers can also be influenced relatively quickly (within 6 to 12 weeks) through lifestyle changes, supplement protocols, or medications. This makes them practical tools for monitoring whether various lifestyle or medical modifications are working.

How to measure it

If you’re not already doing so, consider having the following blood markers tested annually. Then, talk to your health care professional about what your numbers mean. They might use the following numbers, along with your blood pressure, to calculate a cardiovascular disease risk score.

*Milligrams per deciliter of blood
**Milligrams per liter

Doctor-approved test #2: Bone density

When researchers study healthy super-agers aged 90 and older, strong bones are one of their defining features.¹⁴

That may be because, like muscles, bones are live organs that secrete substances that may be beneficial to overall health and longevity.¹⁵

For example, bones secrete osteocalcin, a hormone that plays a role in bone remodeling. When osteocalcin circulates in the body, it’s thought to play a role in everything from helping muscles to produce ATP to regulating brain neurotransmitters.

Because of these varied roles, it’s thought that, as bones wear away, osteocalcin levels drop, contributing to many age-related health problems, including diabetes, low muscle mass, and cognitive issues.^{16 17} (At least, that’s the theory. Most of this research has been done on mice.)

Osteocalcin aside, loss of bone density can, of course, lead to fractures, which can increase your risk of death for up to 10 years after a break.¹⁸

It’s especially important to keep tabs on bone health if you’re in any of these high-risk categories:

• You’re female and went through menopause before age 45.
• You’ve been sedentary most of your adult life.
• You take medications such as diuretics or stomach-acid blockers, which are linked with an increased risk of osteoporosis.
• You have a history of nicotine use or excessive alcohol consumption.
• You have a medical condition, such as diabetes or thyroid disease, that raises your risk.
• You have a family history of osteoporosis.

How to measure it

Dual-energy X-ray absorptiometry (DEXA) scans are a type of X-ray that measures the amount of bone mineral content packed into a square centimeter of bone.

Insurance often won’t cover these scans for people younger than 65 unless there’s a documented risk of developing osteoporosis. Out of pocket, the average cost is about $300.

When you receive your DEXA results, you’ll see a T-score that represents how your bone density compares to the average bone density of a young adult with peak bone mass. A T-score of +1.0 to -1.0 means you have normal bone mineral density for someone your age. Anything below -1.0 means you might have osteopenia (low bone mineral density) or osteoporosis (porous bones that are prone to fracture).

Commercial bio age tests

If you have some money to burn, you can learn an awful lot about your body.

Here, you’ll find a quick run-down on some of the more high-tech tests you can get and what they can tell you.

However, before we get into the details, we want to point out a few caveats:

Biological age can vary over time, and by organ. Someone may go through a period of accelerated aging—saying, during a period of intense stress—then their rate of aging may slow as they focus more on recovery. Additionally, organs can age at different rates. For example, someone with heart disease may have a relatively older heart than their kidneys. (Not all tests measure individual organ age, but it’s becoming more common.)

Commercial tests won’t always accurately reflect the changes you’re making. Until more research supports the reliability of these tests, evaluate your behaviors over isolated test results. If you’re eating more fruits and veggies, exercising more consistently, managing stress, and otherwise slaying the healthy lifestyle department, don’t sweat your results. Focus on doing the things we know improve health.

If a company pairs your test results with a hard sell for a proprietary and expensive supplement protocol, be wary. It’s better to share and discuss your results with a trusted health professional than take health advice from a profit-seeking stranger over the internet.

Commercial test #1: DNA methylation

DNA methylation is a biological process that chemically alters DNA. Because the rate of methylation accelerates with aging, it can be used to estimate someone’s biological age and life expectancy, finds research.^{19 20 21}

The Horvath Clock and DunedinPACE both measure specific biomarkers that can be used to better understand someone’s methylation rate. Scientists developed these tests to help other scientists study how various lifestyle factors, environmental exposures, and medicines affect aging. They didn’t develop the tests as a way for the average person to pinpoint their biological age. (Which hasn’t stopped companies from selling DNA methylation testing kits to the public.) They cost about $300.

If you decide to get one of these tests, keep in mind your results won’t give you a complete picture of your health and longevity. Aging typically occurs at varying rates throughout the body. Your liver might age faster than your heart or brain, for example. So if you measure DNA methylation in your blood, that’s all you know about. Put another way, a DNA methylation test isn’t a substitute for your annual wellness checkup or blood work.

Commercial test #2: Telomere analysis

Telomeres—the protective caps on the ends of chromosomes—wear away with age. The length of a telomere can predict how many times a specific cell can divide before dying.

Abnormally short telomeres are associated with several genetic diseases. For this reason, when physicians suspect someone might have inherited a genetic disease, they’ll order a specific type of telomere test—the flow-FISH test—to measure the telomere length in all the cells in a blood sample.^{22 23}

It’s more debatable whether telomere tests can predict aging in healthy people.

Just as importantly, the telomere test marketed to the public, known as the qPCR telomere test, isn’t used in research or medicine. These $100 tests are fine if you’re merely curious—just don’t base health and fitness decisions on your results.

Commercial test #3: VO2 Max

For years, only elite athletes cared about VO2 max, which describes the maximum amount of oxygen that your body can use during exercise.

More recently, however, some experts have suggested that VO2 max can serve as a measure for athletes and non-athletes alike to track the rate at which their bodies are aging.

People with high VO2 max tend not only to be more physically fit but also less likely to develop heart disease, diabetes, cancer, or stroke.^{24 25 26 27}

In an observational study that followed the health outcomes of 5,107 Danish men over 46 years, men with above-average V02 max during middle age lived an average of five years longer than men with below-average V02 max. Each unit increase in VO2 max was associated with a 45-day increase in longevity. The researchers suggested VO2 max may more accurately predict all-cause mortality than high cholesterol, obesity, high blood pressure, and insulin resistance.²⁸

You might think of V02 max as a canary and your aging body as a coal mine.

As you age, your chest wall becomes more rigid, the muscles that surround the lungs weaker, and the oxygen-carrying blood vessels calcified and less elastic. The heart also squeezes with less force, max heart rate drops, muscle mass and strength decline, the mitochondria in cells and muscles lose their effectiveness, among other differences.

In addition to raising your risk for many different diseases, these changes can also affect VO2 max, which tends to decline 10 percent per decade starting around age 30.^{29 30}

In the past, the only way to reliably measure VO2 max was in a fitness lab.

You would wear a metabolic mask and a heart monitor while you ran or cycled to exhaustion. The mask collected your expired carbon dioxide and monitored how much oxygen you sucked into your lungs. This lab-based testing is still the most accurate way to measure V02 max as well as other key fitness metrics such as:

• Max heart rate, or the highest number of times your heart can beat per minute during exercise
• Ventilatory threshold 1, or the point during exercise when the body switches from mainly using fat for fuel to using a combination of fat and glucose or glycogen (stored glucose) for fuel.
• Ventilatory threshold 2, or the point where your body moves away from aerobic metabolism (which uses oxygen) to anaerobic metabolism (which doesn’t use oxygen).
• Tidal volume is the amount of air inhaled or exhaled during each breath

Depending on where you live, you might be able to get your VO2 max tested for around $150.

However, if you don’t have access to a VO2 max clinic, three somewhat less accurate options exist.

The 1-mile walk test

Wear a heart rate monitor as you walk one mile on a flat surface, such as a treadmill or running track. As soon as you complete the mile, record your heart rate and walk time. Then, plug it into the following formula to calculate your VO2 max:

132.853 — (0.0769 × Weight) — (0.3877 × Age) + (6.315 × Sex) — (3.2649 × Time) — (0.1565 × Heart rate)

If that feels like too much math, you can also use a free online tool.

The smartwatch test

Many smartwatches will estimate your VO2 Max for you based on information the watch gathers from your workouts, sex, and age. Compared to in-office testing, smart watches can over- or underestimate V02 max, especially in people who are very out of shape or extremely fit.³¹

Because of this, you don’t necessarily want to use your smart watch measurement to determine your current state of health. However, it can help you to see trends. For example, does your VO2 estimate drop after a few weeks of skipping your usual spin class? If so, that’s good information to have.

The PR test

Fitness performance correlates with longevity. If you’re getting faster at running a certain distance or can go a longer distance than before, you’re getting fitter and increasing your chances of living a long, healthy life.

One way to test this: the 12-minute run test, also known as the Cooper test. (This is a validated way to estimate VO2 max—and shows about a 90 percent correlation with lab-based measurements.)

Here’s how it works:

Run as fast as you can on a flat surface, such as a treadmill set at a 1 percent incline or running track, for 12 minutes. After 12 minutes, record your distance. Then, plug it into one of the following formulas to calculate your VO2 max.

In lieu of doing math, you can also use a free online calculator.

How to change your biological age

Try to think of the information you gather about your body as just that—information.

It’s not a moral judgment of who you are as a person.

Just as importantly, it’s not a permanent situation.

• If you’re weaker than other people your age, you can grow stronger.
• If your cholesterol or blood glucose levels are high, you can take steps to lower them.
• If your body is aging faster than your birthdays, consider exploring key lifestyle changes that may help turn the situation around.

You have options. However, most people make two big mistakes when it comes to longevity-related lifestyle changes.

Mistake #1: Ignoring evergreen, big-impact strategies

It’s the simple, boring, “I’ve heard this a million times before” health practices that, when done consistently, add up to a long, healthy life.

We’re talking about things like…

• Eating more minimally processed foods and fewer ultra-processed foods
• Consuming more brightly colored fruits and veggies
• Moving your body regularly
• Getting enough rest and sleep
• Enjoying community, time in nature, and other activities that make life meaningful
• Keeping alcohol intake moderate
• Not using tobacco
• Wearing sunscreen
• Flossing

And that’s just a partial list.

According to thousands of studies, people who practice these and other high-impact strategies not only live longer, but also live better. They’re stronger, happier, and less likely to spend their later years disabled or in pain.

(If you’d like to see where you stand when it comes to big impact health and longevity strategies, check out our FREE Longevity Assessment.)

However, when it comes to health, fitness, and longevity, many people pursue options with minimal impact (at best). They reach for the latest, trendy supplement rather than taking steps to quit smoking, as just one example.

Here’s the thing: Big rock strategies require changes in behavior. If daily physical activity were as easy as popping a pill, walkers and cyclists would clog up the streets in your neighborhood.

(It’s precisely this reason why so many people need the support of a certified health coach who has undergone training in the science of behavior change.)

Mistake #2: Not turning data into action

The data gathered from biomarker aging tests can give you a sense of control.

However…

Data, in isolation, doesn’t lead to a longer life.

Gathering data without changing your behavior is like checking your reflection in the mirror, seeing spinach wedged between your incisors, and leaving it there.

You need to remove the spinach for the mirror check to be worthwhile.

Biomarker testing is the same.

If you don’t use your bio data to inform behavior change, you’re wasting your money and time.

Consider your biomarker data as a baseline or starting point.

Then, use it to assess whether various lifestyle changes or medical interventions are moving you closer to your goal of living a longer, healthier life.

References

Click here to view the information sources referenced in this article.

If you’re a health and fitness pro…

When your clients are stressed and exhausted, everything else becomes a struggle: going to the gym, choosing healthy foods, and managing cravings.

But with the right tools, you can help your clients overcome obstacles like chronic stress and poor sleep—leading them toward the lasting health transformations they’ve always wanted.

PN’s Level 1 Sleep, Stress Management, and Recovery (SSR) Coaching Certification will give you these tools. And it’ll give you confidence and credibility as a specialized coach who can solve the biggest problems blocking any clients’ progress. (You can join the SSR Early Access List for our biggest discount + exclusive perks.)

The post Biological age tests: Should you get one? appeared first on Precision Nutrition.

This is according to the results of a study of nearly 2,000 people with irritable bowel syndrome (IBS).¹

In other research, people with IBS said they would take a medicine that carried a one percent risk of sudden death if it would cure their symptoms²—which can include urgent bouts of diarrhea, gas, or persistent constipation.

Some people with IBS experience bouts of abdominal pain they describe as worse than childbirth. These flare-ups can siphon concentration, interrupt sleep, and destroy work productivity.³

As a result, many people with IBS plan their lives around the availability of private, clean bathrooms. Fear of a sudden flare-up leads some to avoid restaurants, get-togethers, even exercising in public.

This pervading worry has a name—gastrointestinal-specific anxiety—and it can affect everything from social relationships to overall well-being. It’s also the main reason people with IBS report worse quality of life than people with other chronic conditions, including heart disease, diabetes, and end-stage kidney disease.⁴

If you or a client has IBS, there are ways to manage it.

PN Super Coach Sarah Maughan, certified through Monash University—a global leader in understanding the link between food sensitivities and IBS—has witnessed how lifestyle changes can prevent flare-ups, calm GI anxiety, and allow people with IBS to live the lives they want.

“My hope is for everyone with IBS to know they have options, whether that’s turning to a physician for medication and/or a health coach to learn about lifestyle changes and how to put them into action,” says Maughan.

In this article, we’ll hear more from Maughan. You’ll also learn:

• What IBS is, including why it happens and the different ways it can manifest
• What your poo can tell you about the health of your digestive tract
• Five evidence-based lifestyle changes that can improve IBS symptoms
• The best way to determine which foods trigger your or your client’s IBS symptoms (and which foods are usually “safe” to eat)

Plus, if you’re a health coach, you’ll learn how to support clients with IBS while safely staying within your scope of practice.

So, what is IBS?

Sometimes referred to as “spastic colon,” IBS is the most commonly diagnosed digestive disorder in the world, affecting about 14 percent percent of adults.⁵

Unlike Crohn’s and other inflammatory bowel diseases (IBD), IBS doesn’t alter the architecture of the gut. When healthcare professionals use diagnostic imaging, they find no infections, inflammation, damage to the bowel wall, or other evidence of disease.

Years ago, this lack of visible disease led many healthcare professionals to assume that IBS was purely psychological. More recently, however, this thinking has shifted.

Experts now view IBS as a functional neuro-gastrointestinal disorder.

That means the nerves between the GI tract and the brain don’t function optimally, causing the brain to deliver unnecessary pain signals and interfere with typical bowel function.

What are the symptoms of IBS?

IBS symptoms can come and go, with some people experiencing months or years of relief only to suffer a severe flare-up that can last hours to weeks.

In addition, not everyone with IBS experiences the same set of symptoms, which can make the condition challenging to diagnose.

The below illustration shows the range of IBS symptoms.

What causes IBS?

Researchers are still trying to understand why the gut functions differently in people with IBS. However, they do have a few theories.

According to one hypothesis, the nerve endings in the GI tract may be overly sensitive in people with IBS. This can lead to two different sets of symptoms.

Hypersensitive nerves communicate pain signals to the brain, causing people with IBS to notice digestive processes that other people wouldn’t feel. Tiny gas bubbles may be severely uncomfortable for someone with IBS, for example, but not bother someone without the disorder.

Overreactive nerves can trigger GI muscles to contract with too much force, leading to gas, bloating, and diarrhea. If they underreact, the same muscles don’t contract forcefully enough, which slows the passage of food through the intestine and leads to constipation.

Another theory blames disturbances on the gut microbiome, which helps to explain why some people develop IBS symptoms after first having a severe GI illness like the Norovirus.

How is IBS diagnosed?

If you or your client suspect IBS, see a credentialed health professional.

The symptoms of IBS overlap with several other gastrointestinal diseases and health conditions that can require medication, surgery, or medically-supervised lifestyle changes. These include infections, inflammatory bowel diseases, celiac disease, cancer, and food allergies, among others.

It’s especially important to see a medical professional if you or your client notice any of the following:

• Rapid, unintentional weight loss
• Rectal bleeding, blood in stools, or vomiting blood
• Bouts of diarrhea that disturb sleep
• Diarrhea with fever
• Continuous abdominal pain
• A sudden onset of GI symptoms after age 50

IBS Types

In addition to ruling out other GI conditions, a healthcare professional will also ask detailed questions about you or your client’s symptoms. This information allows them to pinpoint which IBS “type” you or your client might have:

• IBS-D, which means someone predominantly has diarrhea
• IBS-C, which is characterized by constipation
• IBS-M, which means someone has alternating periods of diarrhea and constipation
• IBS-U, which means someone’s symptoms don’t neatly fall into any of the above categories

You or your client’s IBS type will inform what your healthcare professional recommends.

A healthcare provider might suggest a short course of antibiotics and antidiarrheal medicine for IBS-D. On the other hand, for IBS-C, they might recommend a fiber supplement, non-habit-forming laxative, laxative-like medication, or other medicine that reduces the perception of pain and regulates bowel movements.

How to prepare for a medical appointment: Your pre-appointment checklist

In order to get the most out of the visit, you can help your client (or yourself) prepare for a healthcare appointment.

A healthcare professional will likely ask the following questions, so consider the responses beforehand:

• How long have you experienced these symptoms?
• Did anything change around the time your symptoms began? (Stress levels? Dietary habits? Recent travels?)
• Did you recently have food poisoning or gastroenteritis?
• How much fiber do you consume?
• How is your sleep quality? How many hours do you usually sleep at night?
• How often do you exercise?

Another way to prepare for your first appointment?

Well, you might not like it, but it’s a good idea to…

Look at your poo

Consider keeping a poo diary for a couple of weeks before your appointment.

In the diary, track the frequency of bowel movements and other symptoms. Use the Bristol Stool Chart (below) to take note of the quality of your poo. This information can help your healthcare professional assess whether you have IBS and which type.

(To learn more about the clues your poos can hide, read: 6 reasons you should care about your poop health)

How to help IBS: 5 strategies to support bowel health and function

In recent years, the U.S. Food and Drug Administration approved several new prescription medicines for IBS, along with a medical device that stimulates the cranial nerves behind the ear.

In addition, thousands of research papers have looked at the interaction between IBS and various lifestyle habits, with many promising findings.

Here are five evidence-based ways to reduce the symptoms of IBS (and bonus, many of them are great for enhancing overall health too).

IBS relief strategy #1: Add exercise

People with IBS who exercise regularly tend to experience fewer symptoms and flare-ups than people who don’t exercise.

When researchers asked people with IBS to walk moderately for an hour three times a week, study participants experienced significant relief from bloating and abdominal pain within 12 weeks.⁶

How exercise soothes IBS isn’t fully understood, though.

According to other research, exercise may reduce stress and improve mental health, which, in turn, may help improve communication between the gut and the brain.^{7 8}

Another theory argues that exercise helps encourage the growth of health-promoting gut bacteria, which may help to break down food more efficiently and decrease inflammation.⁹

IBS relief strategy #2: Work on stress management

Anxiety, stress, and depression all activate stress hormones like norepinephrine (noradrenaline) and cortisol, which can:

• Amplify gut-based pain signals
• Alter the balance of bacteria in the gut (known as the gut microbiome)
• Increase intestinal permeability—potentially allowing harmful substances into the bloodstream^{10 11 12}

Of course, stress doesn’t come with an on/off switch.

Simply telling yourself, “Stop getting so stressed out!” won’t likely help—and may even paradoxically lead to more stress.

That’s why Precision Nutrition-certified coaches like Maughan help clients learn to focus on what’s within their control—such as practicing self-compassion, or experimenting with nervous system regulators like yoga, breathing exercises, and gentle walking.

As the image below illustrates, clients can control how they perceive, respond to, and anticipate stressors—but not always the stressors themselves.

Either way, when clients focus more on what they can control and less on what they can’t, they often feel calmer and more capable.

(If you want to help a client figure out just what’s within their control—and what’s not—try out our free worksheet: Sphere of Control Worksheet)

(Assess your current stress load by taking our free quiz: Do you have a Stress Bod?)

IBS relief strategy #3: Slow your eating pace

PN coaches have long appreciated and advocated slower, more relaxed eating.

Yes, slow eating helps people fill up on fewer calories—but it also tends to help clients reduce or even eliminate GI woes like acid reflux, bloating, and pain.

For one, slower eating often translates to more chewing. In addition to mechanically mashing food into a pulp, increased chewing also allows the mouth’s digestive enzymes to pre-digest food. As a result, the stomach and intestines have to work less hard.

Plus, eating in a relaxed setting often lowers stress hormones like norepinephrine and cortisol, making it less likely that they will intensify GI pain signals.

According to Maughan, this can be especially important for young parents, as it’s not always easy to eat undistracted and peacefully when tending to little ones.

(Sounds simple, but slow eating is more challenging than people think—and a lot more impactful. Learn more: Try the slow-eating 30-day challenge.)

IBS relief strategy #4: Troubleshoot sleep problems

According to research, people with IBS experience more shallow, less restorative, and more interrupted sleep.¹³

Because of poor sleep quality, many people with IBS sleep more hours overall than people without IBS—yet feel less rested.

Fatigue can then set off a vicious cycle. When people don’t sleep restfully, stress hormone levels tend to be higher, which can exacerbate gut pain.¹⁴

Unrested people also tend to feel hungrier during the day. Cravings for fats and sweets also intensify, driving people to reach for the very foods more likely to trigger IBS symptoms—and wolf them down too quickly.

Stopping this cycle can be challenging.

As with stress, you can’t simply will yourself to sleep more restfully.

However, the first three strategies—exercise, stress management, and slower eating—can all help.

Some PN clients have found that consuming a smaller dinner earlier in the evening gives their bodies more time to digest before bed. Other clients tell us that a relaxing pre-bedtime routine—a few minutes of foam rolling, a guided meditation, a bath, or some journalling—tends to help.

(Find out the best practices for getting better sleep by checking out our infographic: The power of sleep)

IBS relief strategy #5: Investigate your diet

While there’s no one-size-fits-all IBS diet, experts have identified several food categories that are more likely to be problematic for many people. These include:

Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols (FODMAPs), which are a family of carbohydrate-rich foods that are poorly absorbed in the small intestine. Even in people without IBS, these foods tend to slow digestion and attract water. When gut bacteria ferment them, they produce gas, which can stretch the intestinal wall. For most, this slowed digestion and gas isn’t especially noticeable; In people with IBS, it can lead to intense pain. High-FODMAP foods include wheat, rye, barley, onions, garlic, beans, dairy, honey, cashews, some processed meats, and many fruits and vegetables. (More about FODMAPs in the next section.)

Caffeinated beverages and foods, especially coffee, which trigger the release of stress hormones, stimulate the production of stomach acid, increase muscle contractions in the colon, and irritate the lining of the intestine.¹⁵

Alcohol and spicy foods that irritate the gut.^{16 17}

High fructose corn syrup and sugar alcohols such sorbitol and mannitol, which have been linked to gas, bloating, and diarrhea in susceptible people.^{18 19}

Fatty, greasy foods, which can slow digestion and attract water, leading to loose stools, bloating, and gas.^{20 21}

If the idea of giving up all the foods and beverages on the above list has you in a cold sweat, know this…

Not everyone with IBS is sensitive to the same foods and beverages.

“Everyone can have different triggers,” says Maughan. “That’s why it’s so important to figure out what makes your body feel good and what doesn’t.”

Some people struggle with apples but are okay with berries. Others can drink green tea but not black. One person might be able to consume five to eight ounces of beer but not 12. A gluten-free diet may work great for some but not others.

Similarly, many people find relief by avoiding certain high-FODMAP foods. However, you may only be sensitive to some FODMAPs and not others. If so, eliminating all FODMAPs would be unnecessarily restrictive and difficult to follow consistently.

For this reason, it can be helpful to try an elimination diet to see which foods and beverages are problematic—along with the quantities you can safely tolerate, says Maughan. You’ll learn more about elimination diets in the next section.

(Want someone to walk you through exactly how to do an elimination diet? Read: How and why to do an elimination diet.)

Elimination diets for IBS: How and when to try them

Elimination diets do what the name suggests: They exclude certain foods for a short period—usually three weeks. Then, you slowly reintroduce specific foods and monitor your symptoms for possible reactions.

Elimination diets work a lot like a science experiment that helps you identify problematic foods.

The phrase “elimination diet” may sound scary and off-putting, as if you’ll be living for months on bland food you have to slurp through a straw.

However, there are many different types of elimination diets, with some much less restrictive than others.

Here are a few versions.

Elimination diet “lite” for IBS

This is an excellent option for people who suspect they already know which foods and beverages trigger symptoms.

It goes like this: You eliminate up to four foods for several weeks. Then, slowly reintroduce them one at a time to see if your symptoms return.

Let’s say, for example, from experience, you know you feel bad whenever you eat dairy. On the lite elimination diet, you’d eliminate just dairy for three weeks. Then you’d reintroduce it to see how you feel.

Elimination Diet “medium” for IBS

If you’re unsure of how food interacts with your GI tract—but aren’t ready for a super restrictive eating plan, our Precision Nutrition elimination diet is likely the way to go.

Created by PN and approved by several registered dietitians, the plan removes many of the foods most likely to cause problems, while still including a variety of vegetables, fruits, starches, legumes, nuts, seeds, and meats, so you can continue to eat a well-balanced diet.

To learn more, download our FREE Ultimate Guide to Elimination Diets. This ebook has everything you need to be successful, including an at-a-glance chart that helps you easily follow the diet, along with recipes, meal ideas, and tip sheets.

The FODMAP diet for IBS

Over several years, researchers at Monash University in Australia have developed and extensively studied a low-FODMAP elimination diet for people with IBS.²²

Unlike other types of elimination diets, the FODMAP diet is a highly specialized form of medical nutrition therapy. The FODMAP diet’s list of problematic foods (shown below) is anything but intuitive, and the reintroduction phase is more complex than other elimination diets.

As a result, if you’ve been diagnosed with IBS and suspect you have a FODMAP issue, seek the expertise of a FODMAP-certified practitioner. You can also download Monash University’s FODMAP Diet app, which will help you navigate low-FODMAP eating.

The power of health coaching

In isolation, more knowledge doesn’t always lead to more power.

For example, there’s a difference between knowing that dairy messes with your gut and doing something with that knowledge.

Similarly, you might know that you feel better when you eat a small dinner earlier in the evening, but you may struggle to plan your life so an early dinner happens regularly.

This is where a certified health coach can help.

“Many of my clients already have an idea of the foods that tend to cause them problems,” says Maughan, “But they’re nervous to know for sure because they fear that the knowledge will make eating more challenging.”

That’s why Maughan assures clients…

Even if you do an elimination diet and you learn your favorite food is contributing to your IBS, you don’t have to do anything with that information.

You can choose to continue to eat your favourite foods if you want, AND you can choose to avoid them when it’s really important for you not to experience IBS symptoms, she says.

“With knowledge, you have choices,” says Maughan.

References

Click here to view the information sources referenced in this article.

If you’re a coach, or you want to be…

You can help people build sustainable nutrition and lifestyle habits that will significantly improve their physical and mental health—while you make a great living doing what you love. We'll show you how.

If you’d like to learn more, consider the PN Level 1 Nutrition Coaching Certification. (You can enroll now at a big discount.)

The post Over a Tenth of Your Clients Are Dealing With IBS—And Here’s How to Help appeared first on Precision Nutrition.

From TikTok to bestseller lists, vegetable oils—a.k.a. “seed oils”—are a big topic right now.

To be fair, folks have debated the merits of vegetable oils dating back to when they first entered the marketplace.

More recently, however, with the advent of the carnivore diet, vegetable oil hate has roared back into the socials. Maybe you’ve come across posts that refer to these cooking oils as “toxic sludge,” “motor oil,” “the hateful eight,” and “the biggest cause of chronic disease that nobody knows about.”

The anti-vegetable oil logic goes something like this…

Animal fats have been with humans for thousands of years. Vegetable fats, on the other hand, were invented during the last century when profit-seeking companies wanted to find a way to sell cheap-to-grow foods to unsuspecting consumers.

Another argument: Like margarine, vegetable oils were marketed as healthier alternatives for butter, and yet, people argue, these oils are worse than butter, raising your risk for obesity, anxiety, depression, ulcerative colitis, and more.

In contrast to the above line of thought, other experts will tell you that vegetable oils are harmless, potentially even health-promoting—and absolutely better than butter.

So, who’s right?

Like so many nutrition topics, the truth is too nuanced to fit on a meme.

In this story, we’ll help you sort the science from the pseudoscience so you can make informed decisions about the oils you choose to include in your diet.

What are vegetable oils?

Sometimes called “seed oils,” vegetable oils start, as you might suspect, from the seed of a plant. The most common ones you’ll find in a typical grocery aisle include:

• Canola oil
• Corn oil
• Safflower oil
• Sesame oil
• Sunflower oil
• Soybean oil
• Grapeseed oil

By the way, if you feel like there’s a bunch of oils missing from that list, it’s probably because those oils come from non-seed plants (such as olive, avocado, palm, or coconut oil, which all come from fruits, and aren’t considered vegetable or seed oils).

How are vegetable oils processed?

Non-vegetable oils—such as olive and avocado oil—are derived from naturally fatty foods. In fact, olives are so oily that you could theoretically make your own olive oil at home. (Just Google “how to make olive oil from scratch,” and you’ll find a number of videos walking you through the steps.)

The same can’t be said of most vegetable oils, which mostly come from foods with a relatively tiny fat content to begin with.

Case in point: A cup of green olives contains about 20 grams of fat,¹ whereas a cup of corn has 2 grams.²

As a result, manufacturers must use an extensive multi-step process to extract this small amount of oil from these non-oily foods. These steps include:

• Crushing: A machine uses high pressure to press oil from the seeds.
• Refining: The seeds are heated with a solvent, such as hexane, to extract more oil.
• Deodorizing: To create a neutral taste and remove unwanted compounds, the extracted oil is then cooked at 400 F (204 C) for several hours.

During this process, health-promoting polyphenols and other stabilizing nutrients are lost, and small amounts of unsaturated fats are transformed into trans fatty acids (also called partially hydrogenated fat).

(Interesting fact: This also happens during deep frying. When vegetable oils sizzle in a restaurant’s deep fryer for hours, the trans fat content of the oil increases.)

To call these processed oils “toxic” might be an exaggeration. However, nutrition scientists generally agree that people should avoid trans fats in the diet, and in 2018, the Food and Drug Administration banned manufacturers from adding trans fats to processed foods.^{3 4}

What cooking oils should you eat?

At PN, we’ve created several visual guides people can use to make informed decisions about what to eat.

(We’ve also created a shopping list, which you or your clients can print out and take to the grocery store. Check it out: Healthy Fats Shopping List)

In these guides, we’ve placed a few vegetable oils—expeller-pressed canola oil, high-oleic sunflower, and safflower oils—in the “Eat Some” section. For us, “eat some” is another way of saying that these foods will neither improve health nor harm health—when consumed in reasonable amounts. In some cases, like in the example of dark chocolate, when consumed in small amounts, they might even improve health.

The rest of the vegetable oils, along with butter and other saturated fats, fall into the “Eat Less” category, as the image below shows. You’ll find vegetable oils in bold.

We’ve gotten hate mail from folks who say certain vegetable oils—especially cold-pressed canola oil—should appear alongside olive oil in the “eat more” category. Plenty of others say all vegetable oils belong in the “eat less” column, and that butter belongs in “eat some” or even “eat more.”

To understand the scientific reasoning behind our recommendations, let’s explore some head-to-head matchups.

Extra-virgin olive oil vs. expeller-pressed canola oil

These oils are the least refined of their kind.

To make extra virgin olive oil (EVOO), manufacturers grind and mechanically press olives, without using any heat. Similarly, expeller-pressed canola oil is made by mechanically pressing rapeseed, without the use of heat or chemical solvents.

The case for extra virgin olive oil (EVOO)

Olive oil is richer in heart-healthy monounsaturated fatty acids (MUFAs) than almost any other cooking oil.

In addition, unlike the more refined “light” olive oil, EVOO maintains most of the olive fruit’s original polyphenols. These plant-based substances help to combat inflammation and protect cells from damage.

Perhaps most importantly…

More studies vouch for EVOO’s health-promoting qualities than for any other cooking fat.

For example, researchers asked 22,892 adults from Southern Italy to self-report their olive oil consumption. People who consumed the most olive oil (more than two tablespoons a day) were 20 percent less likely to die over the 13-year study than people who consumed the least olive oil (less than one tablespoon a day).⁵

Other research has linked the consumption of olive oil with a reduced risk of:

• High blood pressure⁶
• Heart disease
• Type 2 diabetes⁷
• Dementia⁸
• Cancer⁹

Consumption of olive oil is also associated with reductions in LDL cholesterol, especially when used to replace saturated fats like butter and coconut oil.¹⁰

The case for expeller-pressed canola oil

One of the more affordable cooking oils on the shelf, canola oil, is made from a Canadian-made hybrid of the rapeseed plant.

(The word “canola” refers to the first three letters of “Canada” with a fun “ola” added to the end for marketing purposes.)¹²

Among vegetable oils, canola is the richest in heart-healthy monounsaturated fats (though several non-vegetable oils have it beat) as well as alpha-linolenic acid, a plant-based omega-3 fatty acid.

In addition, canola oil contains plant substances called phytosterols that help influence blood cholesterol for the better, especially when used as a substitute for butter, research has found.^{13 14 15}

The winner

Extra virgin olive oil is the clear winner.

The body of research in support of EVOO dwarfs the body of research in support of expeller-pressed canola.

In addition, EVOO has a more favorable fatty acid profile. By the way, so does avocado oil, which is why you’ll also find it in the “eat more” column.

However, you can buy roughly twice as much expeller-pressed canola oil for half as much money as EVOO. Because of this, expeller-pressed canola can be a good budget-friendly choice. In addition, because of expeller-pressed canola’s more neutral flavor, many people prefer it over EVOO for baking.

When used in moderation, expeller-pressed canola can be part of a healthy diet. It is likely to be at least health neutral, if not somewhat health beneficial.

Expeller-pressed canola oil vs. refined canola oil

This match-up comes down to how processing methods affect the end product.

Expeller-pressed canola oil

An expeller press is a machine that squeezes oil out of seeds.

It’s able to do this without the use of solvents or heat, which helps preserve beneficial compounds such as alpha-linolenic acid and phytosterols.

Refined canola oil

Refining removes some protective alpha-linoleic acid while adding small amounts of unhealthy trans fatty acids. This results in a product that is proportionally lower in omega-3 fatty acids and higher in omega-6 fatty acids.

The winner

Expeller-pressed canola oil wins, but only by a small margin.

That’s because canola oil starts with a less controversial fatty acid profile than many other vegetable oils, as the chart below shows. Soybean oil, for example, has less heart-healthy monounsaturated fat and much more theoretically inflammation-contributing omega-6 fat.

Refined vegetable oil oil vs. butter

This is the match-up that triggers the most arguing on the interwebs.

Let’s cover the major claims from both sides—plus what the research says.

The case for butter

Butter proponents argue that saturated fats have been unnecessarily vilified. They point to nutrition recommendations during the 1980s and 1990s that recommended people replace butter with trans-fat rich margarine.

(We all know how that went.)

Margarine aside, others claim the research in support of reducing saturated fats is thin at best.²⁰

However, excessive saturated fat consumption (beyond 10 percent of total calories) does seem to boost cholesterol levels and may increase your risk of heart disease.²¹

Some research has found that replacing 5 percent of the saturated fats in your diet with monounsaturated fats could reduce the risk of heart disease by 15 percent. Similarly, replacing 5 percent of the saturated fats in your diet with polyunsaturated fats (with most of that coming from refined vegetable oils) reduces the risk of a future heart attack by 10 percent, according to an analysis of eight studies involving 13,614 people.²² Many other studies support this finding.²³

But not all saturated fats affect blood cholesterol equally. In some dairy foods, a membrane—called a milk fat globule membrane—surrounds the saturated fats and seems to limit their cholesterol-raising properties.

However, butter is low in this protective membrane, and consequently raises blood cholesterol more than other high-fat dairy products, like full-fat milk, cream, yogurt, or cheese.^{24 25 26}

The U.S. Dietary Guidelines recommend capping saturated fat at less than 10 percent of your calorie intake. A tablespoon of butter contains 7 grams of saturated fat—a third of the recommended daily limit in a 2000 Calorie diet.

So, while you don’t necessarily need to eliminate butter, it’s worth moderating your intake.

(Interested in learning about all the nuances of saturated fat consumption? Read: Is saturated fat good or bad for you?)

The case for refined vegetable oils

Due to their chemical structure, polyunsaturated fats are inherently less stable and more prone to oxidation than saturated or monounsaturated fats.

During the refining process, protective phytochemicals and antioxidants are stripped, making these oils more prone to oxidation. The theory is that this oxidation increases inflammation in the body and elevates the risk of various health conditions.

There’s some evidence to suggest that diets rich in polyunsaturated fats, especially from refined vegetable oils, are associated with increased levels of oxidized blood lipids, lipid peroxidation, and other markers of inflammation.^{27 28}

If you only use refined corn or safflower oils to lightly coat veggies before roasting them, you likely don’t have much to worry about.

However, for the vast majority of people, the biggest source of refined vegetable oils isn’t home-cooked meals—it’s ultra-processed foods.

The extra processing and repeated heat exposure used to create ultra-processed foods further oxidize these oils. Additionally, these foods are often loaded with potentially harmful ingredients like added sodium and sugars, and low in beneficial nutrients like fiber, vitamins, minerals, and phytonutrients.

Plus, they’re incredibly calorie-dense and difficult to stop eating, which can raise your risk for obesity. (Find out exactly why highly-processed foods are so “addictive”: Why you can’t stop eating ultra-processed foods.)

Most ultra-processed foods list one or more vegetable oils as one of their ingredients. Even ultra-processed foods that you wouldn’t think of as “fatty” contain small amounts. You’ll find them in store-bought cookies, chips, crackers, sauces, frozen dinners, meal replacement shakes, boxed macaroni and cheese, salad dressing, boxed rice blends, and more.

In a large review involving nearly 10 million people, the consumption of ultra-processed foods was associated with a higher risk of premature death.²⁹ In addition, studies have linked high consumption of ultra-processed foods with the following health problems:^{30 31 32 33}

• Heart disease and heart attacks
• Stroke
• High blood pressure
• Depression
• Overweight and obesity
• Diabetes
• Reduced HDL cholesterol
• Cancer

You don’t have to abolish ultra-processed foods.

But your health will benefit from capping your consumption to about 20 percent or so of your intake, with the other 80 percent or so from mostly minimally-processed whole foods.

This alone will naturally lower your refined vegetable oil intake to a safer level, without much fuss. Plus, consuming refined vegetable oils in the context of a diet that’s rich in colorful plants, fiber, phytochemicals, and antioxidants may help offset the concern of oxidation. (For example, by putting a reasonable amount of commercial salad dressing on a large, colorful salad.)

The winner

This match-up is a draw.

Ultimately, both should be limited in the diet, and neither are health-promoting.

Most refined vegetable oils are lopsidedly rich in polyunsaturated fatty acids compared to monounsaturated fats, and are stripped of many protective compounds. As mentioned earlier, some experts argue that these omega-6-rich fats may contribute to inflammation (but the evidence here is mixed). Because of how they’re processed, seed oils also contain some of those trans fats that everyone agrees we should all minimize.

In contrast, butter is low in omega 6s but high in saturated fat, which can be problematic in higher amounts. Especially since it’s so low in the protective milk fat globule membrane. However, compared to refined vegetable oil, butter is less processed. Like olive oil, it’s one of those fats you could theoretically make at home.

Some final parting advice

This might be obvious from the head-to-head matchups, but we’ll say it anyway.

If you like it and can afford it, EVOO is a great choice.

Cold-pressed avocado oil and walnut oil are also great options, as both are rich in antioxidant compounds. Like EVOO, avocado oil is a rich source of MUFAs. Walnut oil’s fat primarily comes from polyunsaturated fats, so it’s best used as a dressing rather than used for cooking (as it’s less heat stable).

However, like EVOO, avocado and walnut oil tend to be expensive. If you or your client are budget-conscious, expeller-pressed canola oil is a solid runner-up.

Similarly, high-oleic sunflower and safflower oils are richer sources of monounsaturated fats than their high-linoleic cousins. When substituted for saturated fats like butter, high-oleic oils have been associated with cardiovascular benefits.^{34 35}

Regardless of what cooking fats you or your client choose, you’ll also want to do the following:

Prioritize minimally-processed whole foods.

Whole and minimally-processed foods—such as nuts, seeds, avocados, olives, and salmon—are more likely to feature health-promoting monounsaturated (MUFAs) and omega-3 fats. They also come packaged with a wide array of other good-for-you nutrients such as fiber, protein, minerals, and antioxidants.

In contrast, ultra-professed foods are generally devoid of everything you keep hearing you should consume more of. These foods also tend to be calorie-dense, highly rewarding, and hard to stop eating.

If you’re not sure whether packaged food is minimally processed or highly processed, take a close look and consider:

• Does anything in nature resemble this food?
• Does it look like it came from an animal or a plant?
• If you look at the list of ingredients, do you see animal or plant components?

If you answer “no” to most of the above, the food is likely highly processed.

Limit deep-fried foods.

It doesn’t matter what source of fat is used to fry them.

Sort all fried foods into the “eat less” category.

Get most of your fats from food, not oils.

EVOO is associated with longer, healthier lives. However, that doesn’t mean you should be doing shots of it.

As a general rule, you’re better off getting most of your fat from foods like avocados, olives, nuts and seeds than from any cooking oil.

Whole food fats are rich in fiber, phytochemicals, vitamins, and minerals, and are generally less calorie-dense than oils. (But having one to three servings of oils or butter per day is reasonable.)

And if you want personalized advice to suit your body, your eating preferences, and your goals, check out our Nutrition Calculator to figure out how fats fit into your overall diet.

References

Click here to view the information sources referenced in this article.

If you’re a coach, or you want to be…

You can help people build sustainable nutrition and lifestyle habits that will significantly improve their physical and mental health—while you make a great living doing what you love. We'll show you how.

If you’d like to learn more, consider the PN Level 1 Nutrition Coaching Certification. (You can enroll now at a big discount.)

The post Are seed oils bad for you? Vegetable oil vs. olive oil vs. butter appeared first on Precision Nutrition.

It’s like my thoughts were under a pile of garbage.

On a Friday night, as my husband and I tried to figure out where to eat, a typical conversation would go like this:

Me: Do you want to go to that restaurant?

Him: What restaurant?

Me: I can’t think of the name. We’ve eaten there before. It’s that place with the peanut shells on the floor? It’s next to… You know… It’s on that road where we used to take the dog to the vet. Do you know the one I’m talking about??

It was as if certain details got lost in a pile of sludge in the deep recesses of my brain. Then, hours later, the details would escape, and I’d shout into an empty room…

“Texas Roadhouse!”

Sludginess with proper nouns is typical for people who are middle-aged and beyond.

However, what seemed to be happening to me, increasingly in my late 40s and early 50s, felt far from typical.

Not only could I never seem to spit out the names of various restaurants or people or books or movies or so many other things, but my brain was also pooping out during the workday.

I’d sit in front of my computer screen, stare at a document, and will myself to do something constructive with my fingertips. Everything seemed hazy, like those first few moments in the morning when you’re awake enough to turn off the alarm but too sleepy to do basic math.

I had my good moments, usually in the morning, when I attempted to pack eight hours of writing into the two or three hours I possessed mental clarity.

On my worst days, however, I awoke with a haze I never managed to shake. Work was a non-starter. Nor did I have enough bandwidth to read, or do much of anything, really.

I sought medical advice.

Three healthcare professionals recommended antidepressants. I tried one, and felt even worse. I tried another. I tried yet another at a higher dose. Still, I felt like a zombie. Another professional gave me a sleeping pill. It left me feeling even more drugged.

Someone tested my thyroid. There was nothing wrong with it. Nor was I anemic. I tried supplements, mushroom coffee, and just about any product with the word “think” somewhere on its label.

Finally, after nearly two years of seeing a revolving door of doctors, I made an appointment with a gynecologist for my yearly exam. I mentioned vaginal dryness. That information triggered her to ask a string of questions that had nothing to do with my undercarriage. How was my sleep? Mood? Energy levels? Was I experiencing hot flashes? How about brain fog?

“Funny you should mention brain fog,” I said in my usual hazy monotone. “I feel like I’m barely alive.”

By the end of the visit, I understood that I’d likely never had depression.

What I “had” was menopause.

My gynecologist sent me home with prescriptions for estradiol and progesterone.

Within days, it was as if someone had flipped a switch.

I could think again. I could type words again. I could follow conversations. I could work past noon.

And, for the first time in years, I could sleep more than two hours without waking.

Now, menopause isn’t a medical condition.

Nor is it a disease.

Instead, like puberty, it’s a life stage—a transitional moment to be precise.

Once you’ve gone 12 consecutive months without a period, you’ve reached menopause. And from that moment onwards, you’re officially “postmenopausal.”

As women approach this transitional moment, hormone levels fluctuate and fall, triggering dozens of symptoms. Weight gain and reduced sex drive get a lot of attention.

However, during and after menopause, roughly 40 percent of women report increased irritability, mood swings, anxiety, fatigue, and trouble concentrating, according to the American College of Obstetricians and Gynecologists.^{1 2} As the following image shows, it’s also one of the most vulnerable times in a woman’s life to develop depression,³ particularly if they’ve struggled in the past with it before.

Before starting hormones, I often found myself sobbing for no reason. Other times, the world’s stimuli felt too… stimulating.

Normal everyday sounds—like the buzz of traffic or people at the mall—literally hurt. I was jumpy and irritable and felt anxious about situations that had never bothered me in the past, such as driving over bridges or through construction.

It’s not completely clear what drives these cognitive and emotional symptoms.

Fluctuating hormone levels likely play a role, as do typical age-related changes in the brain.

In addition, during this stage of life, women often deal with several issues that siphon cognitive capacity faster than a thirsty vampire drains a carotid.

During their 40s and 50s, for example, many women have reached the peak of their careers, with responsibilities that follow them home and keep them up at night. They may also be parenting angst-filled teens, caring for aging parents, adjusting to an empty nest, questioning their marriage, or trying to wrap their bank account around the latest statement from the college bursar or hospital billing department.

However, one of the lesser-known and talked about triggers for cognitive discontent has nothing to do with aging or life stress and everything to do with that hallmark menopausal symptom: the hot flash.

Anatomy of a hot flash

Hot flashes, which happen during the day, and night sweats, which occur at night, fall under the category of vasomotor symptoms. (The word “vasomotor” refers to the constriction or dilation of blood vessels which, in turn, can influence everything from blood pressure to sweating.)

During a hot flash or night sweat, norepinephrine and cortisol levels rise. Blood vessels dilate in an attempt to shed heat. Blood pressure and heart rate increase.

Depending on the severity of the hot flash, your skin might redden as sensations of warmth spread through your face, neck, and chest.

You might sweat, experience heart palpitations, or feel anxious, tired, or faint.⁴

It’s not entirely clear why hot flashes crop up around menopause.

According to one theory, falling estrogen levels affect the hypothalamus, the area of the brain involved in temperature regulation. The brain’s internal thermostat gets wonky and occasionally thinks your body is too hot or cold (when it’s not).

How vasomotor symptoms change the brain

For many years, experts thought of vasomotor symptoms as mere inconveniences or sources of embarrassment.

(To be honest, so did I. During all of those fruitless visits to various healthcare professionals, it never occurred to me to mention them.)

However, an increasing body of research has revealed that hot flashes may do more than make us uncomfortable or force us to change our sheets in the middle of the night.

They may also affect our blood vessels and brains—and not for the better.⁵ For this reason, an increasing number of experts now consider vasomotor symptoms to be a treatable medical condition.^{6 7 8}

Hot flashes and brain lesions

In one study, researchers asked 226 women to wear monitors that tracked when they were experiencing a hot flash. The women also underwent magnetic resonance imaging (MRI), filled out sleep diaries, and wore smartwatches that recorded how often they woke at night.⁹

As researchers looked at the brain images obtained from women who experienced the most hot flashes, they noticed an abundance of patchy areas called whole-brain white matter intensities.

These lesions were once thought of as a typical consequence of aging. However, neuroscientists now believe that the presence of whole-brain white matter intensities is predictive of future cognitive decline.

People with an abundance of these brain lesions are twice as likely to get diagnosed with dementia and three times as likely to have a future stroke.¹⁰

The blood vessel connection

It’s thought that the increased presence of whole-brain white matter intensities may stem, in part, from changes taking place in the blood vessels that feed the brain.

A three-year study of 492 women supports that theory. It determined that women who experienced frequent hot flashes also tended to experience unhealthy changes in their blood vessels, such as an inability to dilate to accommodate increased blood flow.¹¹

Other research has linked frequent hot flashes with increases in the following:

• Thickening in the carotid arteries that supply blood to the brain, face, and neck¹²
• Body fat
• Total and LDL cholesterol
• Insulin resistance^{13 14 15 16}

The sleep connection

In addition to directly affecting the blood vessels, frequent hot flashes may also affect the brain by disturbing sleep.¹⁷

Interestingly, many women don’t necessarily know that hot flashes are disturbing their sleep.

They may instead—as I did—assume they have insomnia or sleep apnea.

That’s because night sweats aren’t always sweaty.

By the time a surge in cortisol and norepinephrine jolts a woman awake, the hotness of the flash may have dissipated. So, it can feel as if she’s repeatedly waking, over and over and over again, for no discernable reason.

These frequent awakenings may interfere with the brain’s ability to consolidate memories, metabolize toxins, and store all the names, dates, and facts one encounters daily.

It can also lead to lost connectivity in the hippocampus, a part of the brain that’s important for learning and memory.

Sleep loss also means the amygdala, a part of the brain involved in emotion, becomes more reactive, causing people to feel more easily stressed, anxious, irritable, frustrated, or enraged.^{18 19}

All of these brain changes can set in after just days to a week of lost sleep. So, imagine what happens when you’ve been waking over and over again—for years.

Why it can be hard to get help

To diagnose depression, healthcare professionals use a tool called the Patient Health Questionnaire (PHQ-9) depression scale. If you check off four of the nine symptoms on the scale, you’re considered depressed.

However, four of the symptoms on the checklist also overlap with the symptoms of menopause-related sleep deprivation:

• Little interest or pleasure in doing things
• Trouble falling or staying asleep
• Feeling tired or having little energy
• Trouble concentrating on things, such as reading the newspaper or watching television

Check off those four items, and you might be diagnosed with depression, even if what’s really ailing you is the battle with sleep you’ve been waging since you turned 47.

A lack of menopause-specific training

Another problem: On surveys, 80 percent of medical residents admit they feel “barely comfortable” talking about menopause.²⁰ In addition, few residency programs—including ob-gyn residency programs—offer training in it.²¹

Given the above, it’s no wonder so many healthcare professionals never think to ask about hot flashes or sleep disturbances when people like me show up complaining of fatigue, lack of gumption, and an inability to focus.

In addition, even when it’s clear that vasomotor symptoms are leading to cognitive and emotional symptoms, many healthcare professionals still shy away from prescribing menopausal hormone therapy (also called hormone replacement therapy, or HRT), often telling women that supplemental hormones are “not safe” or “too risky.”

These professionals are practicing what Michigan-based menopause-trained gynecologist Jerrold H. Weinberg, MD, calls “defensive medicine.”

“It’s one of the first reflexes doctors have when they recommend a treatment,” says Dr. Weinberg. “They worry they’re going to get sued.”

What the research actually says about hormone therapy

These worries are based on research done several decades ago that linked the use of certain types of hormones with a slightly increased risk of developing breast cancer or stroke.²²

However, according to more recent research, that small increased risk seems to depend on several other factors, such as age, dose, the type of hormonal preparation, and the duration of hormone use.^{23 24}

As long as you’re younger than 60 and have been postmenopausal for fewer than 10 years, many experts now say the benefits outweigh the risks for women with moderate to severe menopausal symptoms.²⁵

It’s also counterbalanced by health benefits such as reduced risk of developing Alzheimer’s disease or osteoporosis, says Dr. Weinberg, who confirms the health benefits of menopause hormone therapy far outweigh the risks for most women.

Because some antidepressants can lift mood, improve sleep, and reduce hot flashes, some healthcare professionals turn to them instead of menopause hormone therapy. As with any medicine, antidepressants have their own list of side effects. However, for someone practicing defensive medicine, they often seem like a safer bet, says Dr. Weinberg.^{26 27 28}

How to advocate for your health

If you or your client are on what seems like a never-ending quest to find a healthcare professional who understands menopause, use the following advice from Dr. Weinberg and Helen Kollias, PhD, an expert on physiology and molecular biology and science advisor at Precision Nutrition and Girls Gone Strong.

Seek care from a menopause-trained health professional.

Usually, these professionals list this training and interest in their bio. For example, they might list “menopause” as an area of focus.

You can also search this database for practitioners who have earned a certification from the Menopause Society.

Document your symptoms.

Write them down. That way, if you feel foggy or nervous during your appointment, you can lean on your notes.

This information can also help you judge whether MHT or another medicine is working. Based on your symptom data, you and your healthcare professional may decide to switch to a different medicine or change your dose.

Consider tracking:

• How often you get hot flashes
• The number of hours in a typical day you find yourself battling brain fog
• How often you experience fatigue, anxiety, rage, or some other symptom
• How often you wake up at night

Be as specific as you can during your appointment.

Saying something like “I don’t sleep well,” is less likely to get you the right kind of help than saying, “During the past seven days, I’ve only gotten four uninterrupted hours once. I wake, on average, five times a night. On a typical night, my longest stretch of sleep is three hours.”

If you use a smartwatch, come ready to fire up your health app, so your healthcare professional can see the data.

Talk about the pros and cons of treatment.

There’s a concept in medicine known as “shared decision-making.” Part of that process involves frank discussions about the benefits and risks of a given treatment. Then, patients and clinicians work together to make decisions based on those benefits and risks.

Many healthcare networks encourage clinicians to use shared decision-making, as it seems to reduce patient complaints as well as malpractice lawsuits.^{29 30}

For this reason, shared decision-making can help shift a healthcare professional out of the “defensive medicine” mindset.

You might ask questions like:

• “I’m interested in seeing if menopausal hormone therapy might be helpful. Could we discuss if I’m a good candidate?”
• “I’ve read that menopausal hormone therapy could slightly increase my risk of breast cancer. Could you help me understand my personal breast cancer risk based on my family history, age, body weight, and lifestyle?”
• “Osteoporosis runs in my family, as does dementia. I’ve heard that menopausal hormone therapy might help to reduce the risk for both, in addition to helping me sleep. Could you help me weigh the pros and cons?”

How to improve mental and emotional health during menopause: 9 lifestyle strategies

The lifestyle habits that improve mental and emotional health during menopause aren’t terribly different from the lifestyle habits that improve overall health—for any person, at any stage of life.

Other than avoiding caffeine, alcohol, and spicy or hot foods, there’s no special diet for people with vasomotor symptoms. (And by the way, tofu and other soy products don’t seem to help with vasomotor symptoms as much as once thought³⁰—though they’re still nutritious.)

Strategy #1: Lean into fundamental health strategies.

Healthy behaviors don’t necessarily change during middle age.

Nutrition, physical activity, stress management, sleep, social connectedness, and a sense of purpose matter just as much during the menopausal transition as they do when we’re younger. However, these fundamentals are even more important to dial in as life progresses.

So consider:

• Are you setting aside enough time for sleep and rest?
• Are you physically active?
• Are you eating a diet that’s mostly minimally processed and full of brightly colored produce, healthy fats, lean protein, fibrous vegetables, and legumes?
• Do you regularly connect with other humans in ways that help you buffer stress and feel supported?
• Do you find ways to experience awe, joy, curiosity, peace, and purpose?

If you answered “no” to some or all of those questions, consider why that is. What’s stopping you? How might you remove barriers or shore up support to make those fundamentals easier?

Strategy #2: Experiment with creatine.

In addition to helping to blunt age- and hormone-related losses in muscle and bone mass, creatine may also help bolster mood and brain function while reducing mental fatigue.

It also seems to counter some of the negative effects of sleep deprivation. ^{32 33} Research shows a daily dose of 5 to 7 grams of creatine monohydrate is effective.

Strategy #3: Get regular about light exposure.

In addition to helping you feel alert, sunlight helps to set the internal clock in your brain that makes you sleepy at night and spunky in the morning. Morning and late afternoon light exposure seem particularly potent.

In a study of 103 people, exposure to morning sunlight predicted better sleep quality the following night. When people spent time outdoors in the mornings, they fell asleep more quickly, slept longer, and experienced fewer awakenings the following evening.³⁴

Sunlight may also improve mood and concentration.³⁵

Strategy #4: Go easier at the gym.

If you’re already worn out, long, intense exercise sessions will likely make you feel worse.

For one, injuries crop up much more easily at middle age than during our 20s and 30s. In addition, it takes longer to recover between sessions.³⁶

String too many overly zealous workouts too close together, and you’ll not only likely start to feel achy but also more irritable, tense, and tired.

However, much like a cold shower, short bursts of exercise may help you to feel alert during the day.

If you’re falling asleep at your desk, encourage yourself to take short movement breaks such as a 5- or 10-minute walk outdoors or a quick set of pushups or squats.

In addition, you may find gentle exercise—such as yoga or stretching—helps you relax before bed. Just don’t make it too intense, or you’ll trigger a release of adrenaline.

Whenever you exercise, tune into how your body feels, especially after a particularly bad night of sleep.

We’re not saying you should never exercise vigorously or try to beat your lifting PRs. However, depending on your sleep and recovery, you might want to pare things back, especially if you’ve traditionally hit the gym hard.

You can still do intense sessions—just balance them out with more moderate sessions, as well as proportionate recovery.

Depending on how you feel, you might decide to go all out, as usual.

However, you might also decide to do a zone 2 training session instead of an intense run. Or, if you’re resistance training, you might still do your planned session, but reduce the number of sets, reps, or volume lifted.

Strategy #5: Investigate Cognitive Behavior Therapy for Insomnia (CBT-I).

This research-based therapy for insomnia can help you develop skills and mental reframes that encourage sound sleep.

For example, a CBT-I therapist will help you develop the skill of getting up at the same time every day, regardless of how badly you slept (or didn’t sleep) the night before.

(Read more: Three CBT-I skills that can transform how you sleep.)

Strategy #6: Get real about stress.

You may not have the energy (or desire) to do everything you did when you were younger. (When you were 36, your daily checklist defied time and space.)

As a result, you might benefit from looking critically at your current responsibilities to see which ones you can shrink or downsize. For several days, track how you spend your time and bandwidth. Then, analyze your data.

Ask yourself:

• Is this how you truly want to spend your time and energy?
• Does your current schedule allow you to rest, recover, and tend to your own needs? Or, do you spend nearly all of your time and energy caring for and providing for others?
• What changes could you make to prioritize rest and recovery?

If you’re a coach, use the Wheel of Stress Assessment to help clients identify different dimensions of their life that might be draining their mental and emotional capacity. (When you know specifically where your stress is coming from, you have a better chance of resolving it.)

If it’s demands from other people that prevent you from prioritizing self-care and recovery, you might like to read: How saying “no” can seriously change your life.

Strategy #7: Experiment with cooling technology.

You might find you sleep better and experience fewer night sweats if you sleep in a cooler environment.

Try turning down the thermostat a couple of degrees, using a fan, or investing in an electric cooling mattress pad.

Strategy #8: Take frequent breaks.

When you feel the fog take over your brain, it’s not likely you’ll be doing “your best work” anyway.

So, for a block of time—say, 20 minutes—permit yourself to do nothing. You might:

• Relax with a cold beverage
• Cuddle with a pet
• Gaze out a window
• Sit outdoors while listening to the birds
• Call a friend

If you need a quick “refresh,” you can also try a 5-minute mind-body scan.

Get your body into a comfortable position. For example, you might use the yoga “legs up the wall” pose or lie down and place a pillow under your knees.

Then, close your eyes and bring your attention to physical sensations in your body. Start at your head, and work your way down to your toes.

Don’t judge or rush to change anything. Just observe, like a scientist. You can also scan your mind, for example, by noticing thoughts.

When you’ve completed the scan, consider:

• What are you feeling physically?
• What are you feeling emotionally?
• What are you thinking?

You don’t have to “do” anything with the information you uncover, just notice.

Strategy #9: Follow a diet that promotes healthy circulation.

The foods that protect the blood vessels around your heart can also protect the blood vessels in your brain.

For example, both the MIND and Mediterranean diets are associated with a reduced risk of Alzheimer’s disease and depression.^{37 38} These eating patterns are rich in vegetables, fruit, whole grains, olives, beans, fish, and other minimally-processed whole foods.

In addition, nitrate-rich foods like beets and dark, leafy greens may help to dilate blood vessels, temporarily improving memory by helping more blood to reach the brain.^{39 40}

(For more on how our diet can support brain function and emotional regulation, read: Nutrition and mental health: What (and how) to eat)

The upside of menopause

It’s frustrating when you feel like you can’t do it all.

Believe me. I know.

However, this stage of life presents a hidden opportunity, forcing you to re-evaluate what’s most important.

Before going on hormones, as my ability to type coherent words and phrases diminished, I was forced to ask an important question:

Do I really need to be doing this?

It was more of an existential question than a career-related one, and it allowed me to reassess how I wanted to spend my limited mental resources.

Given that I was self-employed, I didn’t actually need to be working eight hours a day. That was a gift, wasn’t it?

Maybe I also didn’t need to cook dinner six nights out of seven. Maybe the recipes I chose could be simplified, too.

Finally, maybe saying “no” a lot more often and without regret would allow me to continue to say yes to the things that mattered most.

Things like visiting my aging parents.

And picking up the phone whenever my kid called from college.

Or meeting a friend for a meandering walk around town.

Thanks to the hormones and life tweaks, I now have energy again. I’m also clear-headed most of the time. However, I still tend to end my work day around 3 p.m.

Why?

Because I can, and I want to.

References

Click here to view the information sources referenced in this article.

The post Menopause and mental health: The science of the menopausal brain appeared first on Precision Nutrition.

At some point in my mid-40s, the scale started climbing.

A pound or two turned into five, then 10, then 20.

It seemed as if I was doing all the right things: Eating less, moving more, rinse, repeat. Yet, the harder I worked, the less the scale seemed to respond.

Had perimenopause destroyed my metabolism?

It sure felt like it.

However, after asking my doctor to run a series of tests, I learned that my metabolism was, in fact, fine. Instead, like the vast majority of midlife women, the true causes of my weight gain stemmed from several subtle issues that I would have sworn, at the time, didn’t apply to me.

If, like me, you or your client are currently stuck in what feels like an eat less, gain more cycle, this article is here to help.

In this story, you’ll discover:

• Several reasons women gain weight at midlife that have nothing to do with a “slower metabolism”
• Why intense exercise and strict diets can backfire after menopause
• 11 crafty ways to get a handle on midlife weight gain

First, what is menopause?

Many women refer to midlife hot flashes and inconsistent menstruation as “being in menopause” or “menopausal.”

However, menopause isn’t a phase as much as a transitional moment that separates menstruation from non-menstruation.

Once you’ve gone 12 consecutive months without a period, you’ve reached menopause. For most people, that moment arrives somewhere between ages 46 and 56.

The hot-and-dewy months and years leading up to that 12th missed period are technically known as “perimenopause.” 

Perimenopause means “around menopause.”

Some people refer to this time as the menopause transition. This is when estrogen levels fluctuate. Menstrual cycles lengthen and shorten and, at times, disappear, only to return a few months later. For many people, this marks the beginning of symptoms like hot flashes, sleep issues, vaginal dryness, mood changes, and, yes, creeping weight gain.

(For a thorough overview of the many changes that can happen during this time, read: ‘What’s happening to my body!?’ 6 lifestyle strategies to try after menopause)

How much weight do women gain during menopause?

Many women think of menopause and weight gain the same way many young parents think of two-year-olds and tantrums: Inevitable.

However, not all women gain weight during the menopause transition, explains Helen Kollias, PhD, who is an expert on physiology and molecular biology, and a science advisor at Precision Nutrition and Girls Gone Strong.

On average, in the West, women gain four to six pounds during the three-and-a-half years of perimenopause, or about one to two pounds a year.^{1 2}

That’s double the rate of weight gain in pre-menopausal women, though it’s roughly the same amount men gain at midlife, notes Dr. Kollias.

In other words, the menopause transition may not be solely to blame for those extra pounds on the scale. Aging may play a significant role, as we explore below.

The real reasons the scale climbs

Several factors conspire to add pounds to your frame during the menopause transition.

You’re not sleeping as well.

Maybe this sounds familiar: You wake repeatedly with sweat pooling under your breasts and sheets that are uncomfortably damp (or soaked).

Even if you don’t have night sweats, plenty of other issues might keep you awake.

First, there’s worry—over aging parents, teenagers with car keys, money needed to replace that leaking roof, some strange bodily sensation you’re worried might be cancer, the colonoscopy or mammogram you don’t want to schedule but also don’t not want to schedule, the sex you’re not having, and so many others.

Plus, if you’re like me and you have osteoarthritis in multiple joints, your body hurts. Or your skin might itch. Or your legs are restless. Or you’re bloated.^{3 4 5 6}

My point: Problems that make sleep uncomfortable can multiply with age.

Because of this, I’ll sometimes wake four or more times a night, as the red sections of this readout from my smartwatch show.

These bad nights often set up a vicious cycle:

The following day, I feel as if I’m two inhales away from death. So, I keep myself going with caffeine, which makes the next night just as bad or worse.

Lack of sleep indirectly adds pounds to your frame in several ways:

• When you’re sleep-deprived, it’s harder to cope with negative emotions, which may mean you turn to food for solace.
• In addition, your decision-making gets compromised, so it’s harder to choose an apple when a chocolate chip cookie is also available.
• Plus, sleep deprivation intensify both appetite and cravings (which we’ll discuss more in the next section)

(Want to get a handle on some of the sleep challenges unique to this transition? Check out: How menopause affects sleep, and what you can do about it)

You’re hungry, and not for celery.

True story: When I was in my early 30s, someone once told me about her intense cravings, and I thought, “Cravings? What are those exactly?”

(Don’t hate me.)

Those days now feel foreign to me. Post-menopause, I spend most of my morning wondering how soon I can eat lunch, what I might have for lunch, whether it’s okay to have a snack now, and, if so, what it should be.

After lunch, I go on to spend the afternoon thinking about dinner.

It’s as if my appetite never flips off.

For the longest time, I thought something was wrong with my brain or metabolism.

It didn’t occur to me that the increased hunger, appetite, and cravings likely stemmed from my repeated awakenings each night.

Until I checked out the research.

In one study, people who were sleep-deprived reported higher levels of hunger and a stronger desire to eat. When provided access to snacks, they consumed twice as much fat compared to days when they weren’t sleep-deprived.⁷

In another study, when healthy, young study participants slept four hours a night, they consumed 350 more calories the following day.⁸

You’re moving less.

As humans age, we develop chronic low-grade inflammation and weakened immune function. When combined with the crummy sleep we mentioned earlier, along with other biological changes, this can interfere with the body’s ability to recover from intense exercise.

The result: If you do too many vigorous workouts too close together, you’ll start to feel run down, sore, and unmotivated.^{12 13 14}

Other issues that crop up around midlife can also interfere with movement, like chronic injuries or joint pain.

(A personal example: Due to osteoarthritis in my feet and spine, I switched from running to walking. This is easier on my body, but isn’t as efficient at burning calories.)

Finally, due to those pesky time-sucks known as full-time jobs and caregiving responsibilities, you might not be as active in your 40s and 50s as you were during your 20s. Plus, over the past few decades, multiple inventions (hello, binge-watching) have conspired to keep people on the couch and off our feet.

So, can you blame your hormones for anything?

Other than messing with your sleep which, in turn, messes with your appetite and energy levels, fluctuating estrogen and progesterone likely aren’t behind your extra pounds—at least, not directly.

If they were, menopause hormone therapy would help people stop or reverse weight gain. (It doesn’t.¹⁵⁾

However, shifting hormonal levels are responsible for where those extra pounds appear on your body. As estrogen levels drop, body fat tends to migrate away from the thighs and hips and toward the abdomen, even if you don’t gain weight

Old tactics may stop working after menopause

The “Rocky” weight loss method was my go-to when I was younger.

Whenever I wanted to drop a few pounds, I imagined I was a character in one of those “couch potato gets super fit” movies.

In addition to walking and running, I embraced the sweat-til-you-vomit workout du jour. (Remember Tae Bo?) I also cut out foods, food groups, or entire macronutrients. A couple of times a week, I skipped lunch or dinner.

It worked.

Until, of course, it didn’t.

Now, whenever I push too hard in the gym, I either get injured or feel so unbelievably tired that I must take four days off from all forms of movement. If I try to do anything extreme with my diet, I eventually eat every crunchy or sweet thing I can find, including stale crackers.

For these reasons, after midlife and beyond, the countermeasures for weight gain aren’t strict diets (looking at you, intermittent fasting) or barfy workouts.

Instead, to limit weight gain after menopause, you need to get wise about finding ways to tip calorie balance in your favor without triggering overpowering hunger, cravings, and fatigue.

Regardless of age or stage, fundamental nutrition and fitness strategies still apply—and work.

What changes after menopause is how you tackle these fundamentals.

Experiment your way to better results

The best menopause plan will look different for each person.

That’s why experiments are so important.

Precision Nutrition coaches often use experiments to help clients discover essential clues about what they need (and don’t need) to reach their goals. Based on the results you get from each experiment, you can make tiny tweaks, test them, and decide whether they work for you—until you find something that does work for you.

How to run an experiment

Health experiments are no different from the scientific method you learned about in middle school.

• Choose a question to answer, such as, “Would I feel less munchy at night if I ate a protein-rich snack every afternoon?”
• Run an experiment to test your question. In the above example, you’d track your hunger and cravings before adding the snack—to get a baseline—and then continue to track them for a couple weeks after adding the snack.
• Assess what you learned. Did your ratings of hunger and cravings drop? Remain the same? Go up? What about your actual nighttime food consumption? This information can help you determine your next steps.

Below are 11 experiments worth trying during and after menopause. We’ve separated them into three categories: sleep, hunger, and energy.

(And if those 11 options aren’t enough, we’ve got more ideas here: Three diet experiments that can change your eating habits)

Experiments for improved sleep

Below, you’ll find a mere smidge of the many sleep tweaks you can try and test. For more ideas on potential sleep experiments, check out our 14-day-sleep plan and story about cognitive behavior therapy for insomnia.

Experiment #1: Reset your body’s circadian clock

As you age, your body starts to behave like an old clock that continually runs slow.

Even if you used to be a morning person, you might wake groggy, as if your body doesn’t know it’s morning. Or, your body might tell you “time for bed” at weird times, like the middle of the afternoon. Then, after spending several hours fighting the urge to nod off during work meetings, you find that, when it actually is bedtime, you’re staring at the ceiling in the dark.

This is why it’s helpful to experiment with zeitgebers, which are environmental and behavioral time cues that help to set your body’s internal circadian clock.

These experiments might include the following:

• Get up at the same time every day, regardless of how you slept the night before.
• Spend 10-20 minutes in the sunlight as soon as possible after you wake.
• Take a cold shower at the same time each morning or a hot shower or bath at the same time each evening.
• Get outside frequently during the day, especially whenever you feel sleepy.
• Exercise at the same time daily. Try first thing in the morning or 4 to 6 hours before bed. Bonus points if you do it outdoors.
• Eat meals, especially breakfast, at the same time every day.

Experiment #2: Remove “I’m uncomfortable” from your sleep vocabulary

How you run this experiment will depend on what’s causing discomfort. We’ve listed a few possibilities below.

• If you tend to wake feeling uncomfortably hot: Experiment with cooling technology. This might range from the very affordable, such as turning the thermostat a degree or two cooler or using a fan, to the more expensive, such as cooling electric mattress pads.
• If you wake feeling bloated: If you’re constipated, try some prunes, a small daily serving of beans, a little psyllium fiber, or just extra water to get things moving. Or, you might try consuming a smaller meal or avoiding fatty foods in the evening.
• If an uncomfortable “I need to move” sensation creeps into your legs at night: Talk to your doctor about restless legs syndrome, a condition that tends to worsen with age and/or iron deficiency. A physician may also give you ideas to cope if itchy skin or joint pain is keeping you up.

Experiment #3: Time caffeine strategically

We know we’re almost picking a fight with this suggestion. However, it’s worth investigating, especially if you consume caffeine in the afternoon or evening.

If you’re like most people, it will take your body about five hours to clear half the caffeine from your system. That means about half of your 4 p.m. latte is still energizing your system at 9 p.m.

But here’s the thing: Some people metabolize caffeine much more slowly than others, taking roughly twice as long to clear it from their bloodstream.¹⁶

Interestingly, even if you had no issues with caffeine when you were younger, you might have issues now, as caffeine clearance tends to slow over time.¹⁷

To see if caffeine is a problem, you’ve got a couple of options.

• Try slowly shifting your consumption earlier by 30 to 60 minutes. (If you usually have your last coffee at 4 p.m., cut yourself off at 3 p.m., then 2 p.m., then 1 p.m., then noon.)
• Switch to a lower caffeine source. (Try a bean blend that’s half decaffeinated. Or, you could switch to a lower-caffeine beverage such as green tea or maté.)

(Yet more solutions to common problems: The five top reasons you can’t sleep)

Experiments to reign in hunger

The tactics below likely won’t surprise you. After all, they form the bedrock for solid nutrition and good overall health.

However, before you disregard them with a “been there, done that!” consider: How many of the below are you actually doing consistently?

Experiment #1: Add a protein serving

It may seem counterintuitive to add a serving of food to your meals when you’re trying to eat less.

However, this one tactic may help reign in appetite and hunger.

Protein takes longer to digest than does carbohydrate or fat, so it helps you feel full and satisfied for longer.

In addition, you may find, as I did, that you’re not consuming anywhere near as much protein as you think. (Find out how much you need here: ‘How much protein should I eat?’ Choose the right amount for fat loss, muscle, and health)

Try one or both of the following:

• Consume at least 1 to 2 portions of lean protein at every single meal
• Prioritize snacks that contain protein—hard-boiled eggs, turkey sausage links, Greek yogurt, cottage cheese—instead sweets or chips.

Experiment #2: Choose high-fiber carbohydrates over lower-fiber ones

Fibrous plant foods can help fill you up with fewer calories.

To see the difference, you might monitor how you feel after consuming a near-zero-fiber food, such as your favorite assortment of snack chips. The following day, when it’s time for the same snack or side dish, opt for something with more fiber, such as roasted nuts, a side of beans, a salad, or a piece of fruit. Notice how the fiber-rich option affects your appetite and hunger for the next few hours.

Another experiment worth trying: Include one to two portions of produce with every meal you consume. Track your sensations of hunger to see if they make a dent.

Experiment #3: Log between-meal indulgences

You may be reaching for more snacky foods and beverages than you realize.

These foods don’t need to be 100 percent off-limits; you just want to be intentional about your consumption and portion sizes.

For a couple of weeks, keep track of alcohol, sweets, and treats that you eat between intentional meals and snacks.

Review your notes at the end of each day to see if these more impulsive or less mindful eating episodes align with your memory of what and how much you consumed.

Experiment #4: Move after meals

Increased inflammation coupled with decreased muscle mass, among other factors, leads many people to become more insulin-resistant with age.¹⁸ Cells don’t respond as readily to the hormone, which means more glucose stays in the bloodstream rather than entering cells that can use it for energy.

Through a complex set of mechanisms, this can drive up hunger and overall appetite.

Consuming protein- and fiber-rich meals will help, as we mentioned earlier.

So will movement. Walking for as little as two minutes after meals can help your body process the carbohydrates you consumed, improving blood sugar levels, finds research.^{19 20}

In addition, by removing yourself from your kitchen, you create a habit that helps to psychologically shift you away from “eating” and over to “the kitchen is closed.”

Experiments for more energy

To address midlife brain fog and fatigue, you’ll want to do all you can to encourage good sleep. In addition, see if the below suggestions make a difference.

Experiment #1: Prioritize strength training over intense cardio

This was a hard lesson for me because I love intense cardio.

However, now in my 50s, if I try to fit in two weekly strength training sessions and two weekly spin sessions, I feel drugged—as if someone spiked my coffee with tranquilizers.

When my Precision Nutrition health coach suggested I dial back on the cardio for a couple of weeks, I won’t lie. I thought about firing her.

But then I took her advice and rediscovered what it felt like to be alert.

Don’t get me wrong: I still do cardio. But I’m smart about it. I now know that I can’t do everything, at peak intensity, and expect to feel rested and alert daily. There’s a balance.

Strength training is increasingly important at midlife to protect bone strength and maintain muscle mass. Aim for at least two weekly sessions. Then, fit in cardio around those sessions.

If you feel worn out, experiment with doing low- or moderate-intensity cardio (like brisk walking, slow cycling, or swimming) over higher-intensity cardio (like an hour-long spin class).

Or, if you love higher intensities, keep doing them, but shorten your duration.

Or, just save those vigorous sessions for when you got great sleep the night before.

Experiment #2: Try active recovery

Active recovery can help increase blood circulation and the removal of waste products that may have built up in your muscles during intense exercise sessions.²¹

This can include light activities such as walking, swimming, yoga, or stretching. You can also try massage, foam rolling, or a long, hot bath.

Experiment #3: Consider creatine

Lots of folks think of creatine monohydrate as something people take to get jacked.

However, more and more evidence points to creatine’s benefits for people in midlife and beyond.

The supplement may be especially helpful for muscle recovery.

In research that pooled the data from 23 studies, study participants who took creatine experienced fewer indicators of muscle damage 48 to 90 hours after intense training than participants who didn’t supplement.²²

The supplement may also help you to think clearly, especially after a bad night of sleep, finds other research.²³

Finally, by promoting cellular energy throughout the body (including the brain), creatine may help to blunt fatigue and boost mood.^{24 25}

A daily dose of three to five grams works for most people.

The winning midlife mindset

There’s one final experiment that I want to tell you about.

It has to do with embracing a mindset of acceptance.

Think back to other difficult phases of your life. For me, parenting an infant with colic comes to mind. Gosh, I was so tired back then that I likely would have forked over my entire 401k in exchange for one solid night of sleep.

However, I knew that the stage was temporary. That knowledge helped to keep me going.

Midlife can be similar.

You likely won’t weigh at 55 what you did at 25. That’s okay. However, the night sweats, brain fog, and fatigue are all fleeting. You will eventually establish a new normal.

In the meantime, see if you can accept that your body may look and feel different now. Shift your focus away from trying to look and feel like your younger self and toward consistently embracing new behaviors that will help you age with strength, vitality, and contentment.

After all, you have much more control over your behavior than the number on the scale.

References

Click here to view the information sources referenced in this article.

If you’re a coach, or you want to be…

You can help people build sustainable nutrition and lifestyle habits that will significantly improve their physical and mental health—while you make a great living doing what you love. We'll show you how.

If you’d like to learn more, consider the PN Level 1 Nutrition Coaching Certification. (You can enroll now at a big discount.)

The post Weight gain and menopause: It’s not in your head (but it might not be caused by what you think) appeared first on Precision Nutrition.

A few years back, PN co-founder John Berardi, PhD, posted a shirtless photo of himself on his 47th birthday.

He called it his “anti-regress pic” and thanked 30 years of squats, deadlifts, presses, and chin-ups—among other exercises—for his chiseled six-pack, pumped chest, and bulging biceps.

The question many commenters posed:

“Are you on testosterone?”

Dr. Berardi explained in a follow-up post that while he wasn’t against testosterone replacement therapy (TRT) for people who needed it, he himself was not on this therapy, and his testosterone levels were boringly “normal.” He also offered some thought-provoking ideas about testosterone and aging.Dr. Berardi’s take is the opposite of what you generally hear, especially these days when…

• The mainstream opinion seems to be that declining testosterone is a harbinger of aging, frailty, and impotence—not to mention a threat to masculinity.
• Increasing numbers of middle-aged men are ditching traditional medical checkups for men’s-focused telehealth clinics that specialize in testosterone enhancement.¹
• Reddit communities have popped up solely to obsess over neuroscientist Andrew Huberman’s supplement recommendations for optimizing testosterone.
• Media outlets pump out story after story about “testosterone boosting” foods to eat and “testosterone lowering” foods to avoid.

Whether you’re a coach who fields the “How do I optimize testosterone?” question from clients—or just a regular dude hoping to age well—it’s easy to feel overwhelmed and confused by the conflicting information.

Are declining testosterone levels normal?

Do testosterone-boosting supplement regimens actually work?

Who benefits from testosterone therapy—and who doesn’t?

In this story, we’ll explore those questions and more.

What is testosterone?

Secreted by the testes, testosterone is the sex hormone responsible for male sexual characteristics such as big muscles, deep voices, and hairy chests. It’s a chemical messenger that plays a key role in various processes throughout the body, including sperm production and bone density.

(In women, who also need testosterone to keep various processes humming, testosterone is secreted by the ovaries and adrenal glands. Their bodies just make much less of it; about 10 to 20 times less than men.)

Possibly because of its relationship with muscle growth and sex drive, a lot of cisgender men think of testosterone in binary terms, with lower testosterone being bad and higher testosterone being good.

However, it’s more accurate to think of the relationship between testosterone and health as a continuum that goes from too low (problematic) to too high (also problematic), with the healthy range falling between the two extremes, says Denise Asafu-Adjei, MD, MPH, urologist, men’s health expert, and assistant professor of urology at Loyola University Chicago-Stritch School of Medicine.

As the chart below shows, the dangers of extremely low testosterone are similar to the risks of extremely high amounts (typically only achievable with the use of anabolic steroids).

Low testosterone vs. lower testosterone

Testosterone levels naturally ebb with age, with most men losing about 1 to 2 percent annually starting around age 40. By age 75, most men have 30 percent less of the hormone than they did at age 25.²

(Fun fact: Between ages 25 and 80, men can expect their testicles to shrink 15 percent.³)

However, age-related drops in testosterone are not the same thing as “low testosterone.”

Hypogonadism is the medical term for low testosterone levels, and it affects about 35 percent of men older than 45 and 30 to 50 percent of men who have obesity or type 2 diabetes, according to the Endocrine Society, one of the professional public health organizations that sets hypogonadism treatment guidelines.

Not only can overly low testosterone make you feel fatigued and do a serious number on your sex drive, but it can also harm your bone and cardiovascular health, says Dr. Asafu-Adjei.

“You need testosterone for good bone strength,” says Dr. Asafu-Adjei. “As you get older, you’re already dealing with weaker bones, so having lowered testosterone isn’t going to help.”

Alternatively, bringing levels up to normal seems to offer cardiovascular benefits, she says. (The big caveat here is up to normal—not far above it.)

The importance of referring out

What if you or your client have most of the hallmark symptoms of hypogonadism but still have blood levels of testosterone in the normal range?

“Many men over 30 who feel down or low energy will now automatically blame their testosterone,” says Dr. Asafu-Adjei. “Their symptoms might be related to testosterone, but they also could be related to not sleeping, stress, or some other factor.”

That’s why seeing a healthcare professional specializing in men’s health and testosterone management is so important.

Such a physician can screen you or your client for dozens of other problems (like stress and poor sleep) and conditions (like diabetes, obesity, or sleep apnea) that either mimic the symptoms of hypogonadism or interfere with the production or signaling of testosterone.

In other words, supplemental testosterone is the answer for some men with symptoms of hypogonadism, but not all of them. An extensive workup is required.

“There are overlapping symptoms with low testosterone as well as a lot of nuances around hormone treatment,” says Dr. Asafu-Adjei.

“For example, outside of your total testosterone, we also look at your testosterone-to-estrogen ratio and other related hormones. That’s why it’s so important to go to someone who knows what they’re doing. They’ll take a deeper dive to figure out the root of the problem.”

So, if you specialize in coaching middle-aged and older men, get a urologist or endocrinologist in your referral network.

7 evidence-based ways to optimize testosterone… naturally

On the Internet, if you look for ways to boost testosterone through lifestyle, you’ll quickly become inundated with supplement recommendations and lists of T-boosting and T-harming foods.

However, research-supported ways to optimize testosterone generally center on the fundamental dietary and lifestyle measures you’ve long heard are good for you.

They include the following:

Testosterone optimizer #1: Make sure you’re eating enough.

Your body prioritizes thinking (your brain) and movement (your muscles) above sex (your reproductive organs).

Think about it this way: If there was a famine, the last thing you’d need is another mouth to feed.

So, when you chronically burn more calories than you consume, hormone levels generally drop. (This is true in both men and women.)

“A lot of men in their 20s and 30s come to me about their low testosterone levels and their low testosterone symptoms,” says Dr. Berardi. “These are mostly guys who prioritize exercise. They work out a lot and watch what they eat. In other words, they are men experiencing mid- to long-term negative energy balance.”

Dr. Berardi’s advice is often not what men expect.

If their eating and exercise routines suggest they’re in a chronic negative energy situation, he simply recommends they eat an extra healthy snack or two a day.

“In situations like this, adding a couple hundred extra calories of high-quality protein and carbohydrate often fixes everything,” he says.

Those added calories could come from a couple scoops of whey protein mixed in milk with a nut butter and banana sandwich on the side, he says.

Another favorite snack of Dr. Berardi’s: A bowl of steel-cut oats with protein powder, cacao powder, dates, raw nuts, and nut butter.

Keep in mind: Eating too much (and gaining fat) can also affect testosterone, as we’ll cover soon. Use our FREE nutrition calculator to ensure you’re consuming the right amount of calories and nutrients to support hormone production.

Testosterone optimizer #2: Prioritize sleep.

Testosterone production has its own circadian rhythm: It’s higher in the morning and lower at the end of the day.

As you sleep, levels rise again, peaking during your first segment of rapid eye movement. This may explain why various sleep disorders—including sleep apnea—are associated with testosterone deficiency.⁷

A handful of small studies have looked at what happens to hormone levels when men skimp on sleep.⁸ In one of these studies, participants slept just five hours a night for eight days, resulting in a 10 to 15 percent drop in daytime testosterone levels. ⁹

The right amount of sleep varies from one person to another. However, if you routinely get fewer than seven hours and wake feeling exhausted, it’s a good bet you’re not getting enough. If you wake unrefreshed or struggle to sleep soundly, our 14-day sleep plan can help.

Testosterone optimizer #3: Maintain healthy body fat levels.

Body fat secretes aromatase, an enzyme that can convert some testosterone into estrogen.

According to some research, men categorized as overweight or obese tend to have slightly higher levels of estrogen, as well as the stress hormone cortisol. ^{10 11}

More research is needed to know whether these slightly higher estrogen levels are enough to contribute to hypogonadism.

In the meantime, however, a healthy body composition is vital for overall good health and may also help to optimize testosterone.

Keep in mind, as we said above, that too little body fat can also negatively affect testosterone levels. To ensure your body fat levels are in the optimal zone, use our FREE body fat calculator.

Testosterone optimizer #4: Get moving.

Regular exercise is associated with elevations in testosterone. It can also help you sleep more restfully and keep body fat in check.

Resistance training offers more of a testosterone boost than endurance exercise. (Two to three sessions a week is a great benchmark.)

However, endurance exercise can also help, providing you exercise at the right intensity, finds research. (That’s 30 minutes of rigorous activity, four to five times a week.¹²)

Overtraining without enough recovery can lead to the opposite effect though, potentially causing gains to plateau and suppressing testosterone.¹³

(See our FREE exercise library for 400+ expert how-to videos and a 14-day at-home workout program.)

Testosterone optimizer #5: Consume a well-rounded, healthy diet.

In addition to helping you avoid nutrient deficiencies that can drive down testosterone levels, a healthy diet protects your blood vessels.

That’s crucial for getting erections.

A study of 21,469 men found that those who consumed foods consistent with the Mediterranean diet had a lower risk of developing erectile dysfunction over ten years compared to men who didn’t follow the diet.¹⁴

“Mediterranean diets are also known to promote heart health,” says Dr. Asafu-Adjei.

The Mediterranean diet emphasizes fruit, vegetables, whole grains, nuts and legumes, and healthy fats from foods like olive oil, eggs, and fatty fish. It de-emphasizes red and processed meat, sugar-sweetened beverages, and sodium.

However, eating patterns that center on minimally processed whole foods likely offer the same benefits.

Many fruits, veggies, and other minimally processed whole foods are rich sources of flavonoids, a plant chemical that helps to improve blood flow and testosterone production.

(This visual eating guide can help you choose the best foods for your body.)

Testosterone optimizer #6: Avoid chronic emotional stress.

When you’re under stress, your body produces cortisol and other hormones that prepare you to fight, flee, or freeze. As these stress hormones flood your body, they suppress the production of reproductive hormones like testosterone.¹⁵

This high-cortisol, low-testosterone phenomenon is a likely consequence of millions of years of evolution.

Early humans who were more interested in mating than fleeing from sharp-clawed wild animals didn’t usually live long enough to pass their genes to the next generation.

However, not all short-term stressors dampen testosterone. Some can raise it temporarily, including exam stress or exercise.¹⁶

So, aim for the stress sweet spot where you feel energized and engaged with life but not so busy and harried that you have no time to relax, sleep, or enjoy life.

(Learn more: How to tell the difference between good stress and bad stress.)

Testosterone optimizer #7: Prevent zinc deficiency.

As a certified health coach, it’s out of your scope of practice to recommend supplements to treat a condition like hypogonadism.

In addition, the boost someone might get from a supplement pales in comparison to the six pieces of advice above, or to testosterone therapy.

With that important caveat out of the way…

There is a correlation between low zinc intake and low testosterone levels.^{17 18}

However, to benefit from supplementation, someone must truly be deficient in the mineral. Simply topping off someone’s already adequate zinc stores likely won’t lead to a testosterone boost, and may even cause harm.

Checking for and treating a mineral deficiency requires the expertise of someone trained in medical nutrition therapy. If you lack this training, encourage clients with low testosterone to talk to their healthcare professionals about whether a zinc supplement might help.

Use the Deep Health lens

Let’s circle back to Dr. Berardi’s hypothesis, first mentioned at the beginning of this story:

Some evolutionary biologists have indeed theorized that men evolved to have higher testosterone levels when they’re younger (to encourage mating) and lower levels when they’re older (to encourage parenting).¹⁹

However, this is more of a theory than a certainty.

What we can say with certainty is this: There’s no one-size-fits-all protocol for healthy testosterone levels.

When testosterone drops after middle age, some men feel lousy.

Even when they do everything right in the lifestyle department—exercising, eating a healthy diet, sleeping enough, and so on—they’re unable to raise testosterone into the normal range. For these men, a healthcare professional, thorough evaluation, and, if warranted, testosterone therapy can be life-changing.

At the same time, plenty of other men continue to thrive well into (and past!) middle age.

Sure, they may be unable to pack on muscle like they used to. But, if they’re paying attention, suggests Dr. Berardi, they might notice other pluses. Maybe they’re more patient, nurturing, and empathetic, for example.

“Don’t get me wrong. I’d be very unhappy with an inappropriate or clinically significant lowering of my hormone levels,” says Dr. Berardi. “However, if I can stay in the normal range and symptom-free with good lifestyle practices, I don’t think I have too much to worry about.”

Dr. Berardi recently turned 50.

“I’m at this stage where I see an interesting fork in the road,” he said.

“Will I gracefully accept aging and see this as a new season—or will I fight against it? I could color my hair, do hair transplants, top up my T levels, and get Botox injections. Or I could accept that there will be some eventual decline and ask, ‘What am I getting in return?’”

References

Click here to view the information sources referenced in this article.

If you’re a coach, or you want to be…

You can help people build sustainable nutrition and lifestyle habits that will significantly improve their physical and mental health—while you make a great living doing what you love. We'll show you how.

If you’d like to learn more, consider the PN Level 1 Nutrition Coaching Certification. (You can enroll now at a big discount.)

The post The REAL way to optimize testosterone appeared first on Precision Nutrition.

As a health coach, you can become an expert in multiple areas: nutrition, behavior change psychology, fitness and athletic performance, stress management and recovery, and more.

However, no matter how many certifications you earn, you’ll invariably encounter clients with progress-blocking problems you don’t have the skills, training, expertise, or legal right to solve.

Here’s the thing…

You may not be an expert at fixing marriages, treating GERD, or counseling someone with an eating disorder, but someone else is.

Here’s where a healthy referral network comes in.

By connecting your client with such a person, you get to stay within your scope of practice, give welcome business to respected colleagues, and help your client solve their problem.

(Total. Supercoach. Move.)

All of our certification programs include sections devoted to teaching coaches how to build robust referral networks of professionals skilled at solving common client problems.

In this article, we’ll discuss how to do that—by exploring the top mistakes we see coaches make. Avoid them, and you’ll be able to refer out with confidence.

First, what’s a referral network?

A referral network is a list of supplementary professionals, businesses, and resources that benefit clients.

Your network might include local or virtual:

• Medical doctors, psychologists, registered dietitians, and other professionals with the training and credentials to help clients with problems outside of your scope of practice. (For an in-depth refresher, see our Scope of Practice worksheet.)
• Fellow health coaches and personal trainers with deep knowledge in an area outside your experience. (For example, maybe a client is interested in learning yoga, but you haven’t the faintest idea of how to salute the sun.)
• Workshops, fitness groups, webinars, food services, and other resources that support clients during their behavior change journey.

To confidently refer clients to skilled practitioners with excellent reputations, you’ll want to do some legwork. That brings us to the top mistakes to avoid.

Mistake #1: You build your network before launching your business.

For recently certified health coaches, the task “create a referral network” can double as a procrastination tool, says PN’s Director of Community Engagement Kate Solovieva.

Rather than take on clients, these coaches search for an increasing number of professionals, valiantly trying to be prepared for every potential referral situation. Yet, as much as they continue to work on it, their list is never “complete.”

That’s because…

“We can’t be prepared for everything,” says Solovieva.

The solution

Take on clients as soon as you’re certified.

Yes! That might sound scary, but the best way to figure out your “gaps” is to begin your practice, and see where your clients actually need help beyond what you can offer.

Add folks to your referral network over time as you:

• Connect with professionals on LinkedIn and other virtual networking sites
• Lean into peer networks (such as the Precision Nutrition Facebook communities)
• Mingle with members of your local Chamber of Commerce
• Chat with family, friends, and clients about professionals and resources they love
• Attend health conventions and other local events where a variety of health professionals tend to congregate
• Search for (and try out!) providers based on your own health needs

Mistake #2: You assume your referral list will cover all client needs.

As we mentioned above, you’ll never be able to anticipate every referral or client question ahead of time—and that’s okay.

This is especially true if you coach virtually with clients worldwide.

(You might know three fantastic massage therapists where you live in Toronto, Canada, but that knowledge won’t help if your client is based in Wellington, New Zealand.)

Similarly, some professionals or resources might work for some clients, but not others.

(You might, for example, know of several meal delivery options, yet none are suitable for that plant-based client who’s on a strict gluten-free diet.)

The solution

Learn how to help clients find the professionals and resources they need.

You might:

• Ask clients to describe their preferences. (Do they prefer working with a specific gender? Do they want to meet in person or online? Do they like the eagerness and creativity of a newer professional, or the “I’ve seen it all” sageness of a more seasoned pro?)
• Devote a coaching session to searching online for potential professionals and services together.
• Encourage clients to contact three practitioners, ask questions, and use what they learn to pick a winner.

Mistake #3: You let social awkwardness derail networking opportunities.

Reaching out to a stranger requires some bravery. You have to put yourself out there, explain who you are and what your motives are, and risk being ignored or turned down.

This is where many coaches get stuck, says Toni Bauer, PN’s Director of Coaching and Education Operations.

As a result, many coaches may put off the conversation.

The solution

Turn networking into a challenge. Coach Solovieva calls it “Operation 100.”

• Set a goal to contact 100 professionals over 12 months.
• Work toward your goal every week for about 20 minutes.
• Follow up with each non-responder once or twice.
• Instead of expecting a “yes” from every person you approach, understand that only about 10 percent of people will get back to you.

To ease yourself into the challenge, draft your elevator pitch, suggests Bauer.

Don’t overthink this. Your pitch doesn’t have to be a multi-page persuasive essay. Nor does it have to contain magical talking points. Just be yourself.

Mistake #4: You use dated persuasion tactics.

If you use LinkedIn, then you’ve likely been on the receiving end of old-school cold sales tactics. We’re talking direct messages from strangers who clearly haven’t read anything on your profile and know nothing about you.

These spammy messages are as welcome as a stranger who sidles up to you at a bar and says, “So, wanna come back to my place?”

We’re not here to discourage you from using cold outreach. It has a place. However, to increase your response rate, we’d like to introduce you to a rarely used technique.

The solution

Get to know people before making an online ask, suggests Coach Solovieva.

Follow them, read their content, download and consume their free resources, comment on their posts, congratulate them on career wins, and become a part of their online life.

Do that, and people will remember you. More of them will respond to your messages, too. Plus, the intel you gather by forming a relationship will help you avoid…

Mistake #5: You don’t personally vet referrals.

How do you ensure you refer clients to compassionate professionals who truly know what they’re doing?

It involves more than checking someone’s website or social media profile.

If you only look at someone’s website or social media posts, “You’re just vetting their confidence and copywriting skills,” says Solovieva. “If we’re fortunate, confidence and copywriting go hand in hand with ability, but not always.”

The solution

Try out their services. Take someone’s yoga or Zumba class. Book a massage. Ask a medical professional to look at your creaky knee.

That way, you can see the professional in action.

If you’re thinking, ‘I don’t need some of the services my clients need!’ you’ve got a couple of options:

• Offer to pay a professional to meet with you for 30 to 60 minutes so you can ask some questions, get a sense of their treatment philosophy, and chat about referring clients to them.
• Interact with people in local social networking communities like NextDoor.com. Ask group members if they’ve seen a practitioner and, if so, whether they’d recommend the person.

Mistake #6: You sell clients too hard on your referrals.

When you recommend a professional you’ve personally vetted, it’s natural to want your client to take action.

However, despite your hard work, some clients just won’t make an appointment with the professional in question—and that’s okay.

“Let your clients be adults,” says Coach Bauer.

Clients have their reasons. Maybe their insurance won’t cover the service in question. Or, maybe they decided to see someone else.

“It’s not your responsibility for the relationships to be perfect or to flourish,“ says Bauer.

A cycle of support

Some coaches fear referrals because they see them as “giving business away.”

In reality, however, when you refer clients to solid pros, your clients simply feel like you have their back. (Which means they’ll be more likely to refer friends and family to you.)

Plus, when you send business towards another respected colleague, it also puts you on their radar for a cross-referral.

It’s good for your clients, good for business, and good for your community of health pros at large.

If you’re a coach, or you want to be…

You can help people build sustainable nutrition and lifestyle habits that will significantly improve their physical and mental health—while you make a great living doing what you love. We'll show you how.

If you’d like to learn more, consider the PN Level 1 Nutrition Coaching Certification. (You can enroll now at a big discount.)

The post How to build a referral network with confidence appeared first on Precision Nutrition.

If you don’t lose weight, people will criticize you for being “lazy,” “unhealthy,” or “lacking willpower.”

But if you take medication to help you, you’ll be criticized for “cheating” or “taking the easy way out,” even if you’ve tried for decades to manage your weight through diet, exercise, and lifestyle changes (sometimes extreme ones).

In this article, we’ll be talking about a highly contentious group of medicines—GLP-1 receptor agonist drugs such as semaglutide (Ozempic, Wegovy, Rybelsus) or tirzepatide (Mounjaro, Zepbound).

And people have lots of opinions about them.

But the opinion that matters most? Yours.

At PN, we’re medication agnostic.

We’re not here to judge whether a person should or should not take medication for weight loss. Ultimately, that’s a choice left up to you, with the guidance of your primary care physician.

Either way, we’re here to support our clients and elevate their results.

Whether you take medication or not, a coach can help you optimize nutrition and satiety with the right foods, find exercises that work with your changing body, and help you navigate the emotional ups and downs that come when you attempt to tackle a big, meaningful, long-term goal.

However, we also understand that if you’re debating the pros and cons of beginning (or continuing) medication, you might have mixed feelings.

If you’re not sure if these new medicines are right for you, we have your back. In the following article, we’ll give you the honest, science-backed information you need to make a confident decision.

You’ll learn…

• Why it’s so hard to lose (and keep off) fat
• Why taking medication isn’t “cheating,” nor is it the “easy way out”
• How GLP-1 drugs work, and the health benefits they can have (aside from weight loss)
• How to determine if you’re at a “healthy weight” (it’s not just about BMI)
• What actions you can take to minimize side effects and maximize long-term health, if you do decide to take these medications

Let’s begin.

First, why is it so hard to lose fat?

Fat loss is hard. Period.

But for some people, it’s harder still—because of environmental, genetic, physiological, social, cultural, and/or behavioral factors that work against them.

Here are a few of the contributing factors that can make fat loss so challenging.

We live in an environment that encourages a caloric surplus.

Imagine life 150 years ago, before cars and public transit were invented. To get from point A to point B, you had to walk, pedal a bicycle, or ride a horse.

Food was often in short supply, too. You had to expend calories to get it, and meals would just satisfy you (but not leave you “full”).

Today, however…

“We live in an obesogenic environment that’s filled with cheap, highly-palatable, energy-dense foods [that make overeating calories easy, often unconsciously],” says Karl Nadolsky, MD, an endocrinologist and weight loss specialist at Holland Hospital and co-host of the Docs Who Lift podcast.

“We also have countless conveniences that reduce our physical activity.”

Of course, even in such an environment, we have people in lean bodies, just as we have people who struggle to stop the scale from continuously creeping up.

Why?

Genetically, some people are more predisposed to obesity.

Some genes can lead to severe obesity at a very early age. However, those are pretty rare.

Much more common is polygenic obesity—when two or more genes work together to predispose you to weight gain, especially when you’re exposed to the obesogenic environment mentioned earlier.

People who inherit one or more of these so-called obesity genes tend to have particularly persistent “I’m hungry” and “I’m not full yet” signals, says Dr. Nadolsky.

Obesity genes also seem to cause some people to experience what’s colloquially known as “food noise.”

They feel obsessed with food, continually thinking, “What am I going to eat next? When is my next meal? Can I eat now?”

Physiologically, bodies tend to resist fat loss.

If you gain a lot of fat, the hormones in your gut, fat cells, and brain can change how you experience hunger and fullness.

“It’s like a thermostat in a house, but now it’s broken,” says Dr. Nadolsky. “So when people cut calories and weight goes down, these physiologic factors work against them.”

After losing weight, your gut may continually send out the “I’m hungry” signal, even if you’ve recently eaten, and even if you have more than enough body fat to serve as a calorie reserve. It also might take more food for you to feel full than, say, someone else who’s never been at a higher weight.

Being in a larger body often means being the recipient of fat stigma and discriminatory treatment.

Until you’ve lived in a larger body, it’s hard to believe how different the world might treat you.

Our clients have told us stories about being bullied at the gym, openly judged or lectured at the grocery store, and otherwise being subjected to innumerable comments and assumptions about their body shape, health, and even worth.

Even in medical settings, people with obesity are more likely to receive poor treatment.^{1, 2} Healthcare providers may overlook or downplay symptoms, attributing health concerns solely to weight. This can lead to delayed- or missed diagnoses or just plain old inadequate care.

All of this combined can add up to an incredibly pervasive and ongoing source of stress.

This stress—in addition to being socially isolating and psychologically damaging—can further contribute to increased appetite and pleasure from high-calorie foods, decreased activity, and poorer sleep quality.³

Which is why…

Taking medication isn’t an “easy way out.”

In 2013, the American Medical Association categorized obesity as a disease.

And yet, many people still don’t treat it as such, and rather consider obesity as a willpower problem, and the consequence of simply eating too much and moving too little. (The remedy: “Just try harder.”)

In reality, people with obesity have as much willpower as anyone else.

However, for them, fat loss is harder—for all the reasons mentioned above, and more.

So, just like chemotherapy or insulin isn’t “the easy way out” of cancer or type 1 diabetes, medication isn’t “the easy way out” of obesity.

Rather, medication is a tool, ideally used alongside healthy lifestyle behaviors, that can help offset some of the genetic and physiological variances that people with obesity may have, and have little individual control over otherwise.

What you need to know about GLP-1 drugs

In 2017, semaglutide (a synthentic GLP-1 agonist) was approved in the US as an antidiabetic and anti-obesity medication.

With the emergence of this class of drugs, science offered people with obesity a relatively safe and accessible way to lose weight long-term, so long as they continued the medication.

How Ozempic and other obesity medicines work

Current weight loss medications work primarily by mimicking the function of glucagon-like peptide 1 (GLP-1), a hormone that performs several functions:

• In the pancreas, it triggers insulin secretion, which helps regulate blood sugar (and also helps you feel full).
• In the gut, it slows gastric emptying, affecting your sensation of fullness.
• In the brain, it reduces cravings (the desire for specific foods) and food noise (intrusive thoughts about food).

In people with obesity, the body quickly breaks down endogenous (natural) GLP-1, making it less effective. As a result, it takes longer to feel full, meals offer less staying power, and food noise becomes a near-constant companion, says Dr. Nadolsky.

Semaglutide and similar medicines flood the body with synthetically made GLP-1 that lasts much longer than the GLP-1 the body produces. This long-lasting effect helps increase feelings of fullness, reduce between-meal hunger, and muffle cravings and food noise.

Interestingly, by calming down the brain’s reward center (the part of the brain that drives cravings and even addictions), these medicines may also help people reduce addictive behaviors like compulsive drinking and gambling, says Dr. Nadolsky.

Note: Newer weight loss medicines, for example tirzepatide, mimic not only GLP-1, but also another hormone called gastric inhibitory polypeptide (GIP). Like GLP-1, GIP also stimulates post-meal insulin secretion and reduces appetite, partly by decreasing gastrointestinal activity. Other drugs soon to come on the market, like retatrutide, mimic a third hormone, glucagon.

How effective are GLP-1 drugs?

Researchers measure a weight loss medicine’s success based on the percentage of people who reach key weight loss milestones of 5, 10, 15, or 20 percent of their weight.

These medicines are still evolving, but so far, they have shown to be quite effective:

About 86 percent of people who take GLP-1 drugs like Ozempic, Rybelsus, and Wegovy lose at least five percent of their body weight, with about a third of them losing more than 20 percent of their body weight.^{4, 5}

And newer generation versions of these medications—such as tirzepatide, and the not-yet-FDA-approved retatrutide—are only getting better, with up to 57 percent of people losing more than 20 percent of their body weight.^{6, 7}

How do weight loss medications compare to lifestyle interventions?

In the past, weight loss interventions have focused on lifestyle modifications like calorie or macronutrient manipulation, exercise, and sometimes counseling.

Rather than pitting lifestyle changes against weight loss medicines or surgery, it’s more helpful to think of them all as compatible players.

With lifestyle modifications and coaching, the average person can expect to lose about five to 13 percent of their body weight.

When you add FDA-approved versions of GLP-1 and other weight-loss drugs to lifestyle and coaching, average weight loss jumps up another ten percent or more. ^{8, 9, 10, 11}

Fat loss often comes with powerful health benefits

For years, the medical community has told folks that losing 5 to 10 percent of their body weight was good enough.

Partly, this message was designed to right-set people’s expectations, as few lose much more than that (and keep it off) with lifestyle changes alone.

In addition, this modest weight loss also leads to measurable health improvements. Lose 5 to 10 percent of your total weight, and you’ll start to see blood sugar, cholesterol, and pressure drop.¹²

However, losing 15 to 20 percent of your weight, as people tend to do when they combine lifestyle changes with second-generation GLP-1s, and you do much more than improve your health. You can go into remission for several health problems, including:

• High blood pressure
• Diabetes
• Fatty liver disease
• Sleep apnea

That means, by taking a GLP-1 medicine, you might be able eventually to stop taking several other drugs, says Dr. Nadolsky.

Experts suspect GLP-1s may improve health even when no weight loss occurs.

“The medicines seem to offer additive benefits beyond just weight reduction,” says Dr. Nadolsky.

Research indicates that GLP-1s may reduce the risk of major cardiovascular events (heart attacks and strokes) in people with diabetes or heart disease.^{13, 14, 15} In people with diabetes, they seem to improve kidney function, too.¹⁶

The theory is that organs throughout the body have GLP-1 receptors on their cells. When the GLP-1s attach to these receptors in the kidneys and heart, they seem to protect these organs from damage.

For this reason, in 2023, the American Heart Association listed GLP-1 receptor agonists as one of the year’s top advances in cardiovascular disease.

7 strategies to make weight loss medicines more effective—and improve long-term health

Here’s what we believe:

Weight loss medicines don’t render lifestyle changes obsolete; they make them more critical.

When GLP-1 medicines muffle food noise and hunger, many find it easier to prioritize lean protein, fruits and veggies, whole grains, and other minimally processed foods. Similarly, as the scale goes down, people often feel better, so they’re more likely to embrace weight lifting and other forms of exercise.

Indeed, according to a 2024 consumer trends survey, 41 percent of GLP-1 medicine users reported that their exercise frequency increased since going on the medication. The majority of them also reported an improvement in diet quality, choosing to eat more protein, as well as fruits and vegetables.¹⁷

This is great news, because it further reinforces the idea that medication isn’t simply “the easy way out.”

(Of course, sometimes drugs are used as “the easy way out”; After going on medication, people can continue to eat poor quality food—just less of it. This increases the risk of losing critical muscle and bone, and losing less—or even no—body fat.)

When used correctly, weight loss medication is a tool that, as mentioned above, can make healthy lifestyle changes easier to accomplish, making both the drugs and the lifestyle changes more effective, and enhancing both short- and long-term success.

If you do decide to take weight loss drugs, use these strategies to get the most out of them—and preserve your long-term health.

Strategy #1: Find ways to eat nutritiously despite side effects.

The slowed stomach emptying caused by GLP-1 drugs can trigger nausea and constipation.

Fortunately, for most people, these GI woes tend to resolve within several weeks.

However, if you’re experiencing a lot of nausea, you’re not likely going to welcome salads into your life with open arms. (Think of how you feel when you have the stomach flu. A bowl of roughage doesn’t seem like it’ll “go down easy.”)

So, try to find more palatable ways to consume nutritious foods. (For example, fruits and vegetables in the form of a smoothie or pureed soup might be easier.)

Dr. Nadolsky also suggests people avoid the following common offenders:

• Big portions of any kind
• Greasy, fatty foods
• Highly processed foods
• Any strong food smells that trigger your gag reflex
• Sugar alcohols (like xylitol, erythritol, maltitol, and sorbitol, often found in diet sodas, chewing gum, and low-sugar protein bars), which can trigger diarrhea in some

Strategy #2: Prioritize strength training.

When people take GLP-1 weight loss medicines, about 30 to 40 percent of the weight they lose can come from lean mass.^{18, 19, 20}

Put another way: For every 10 pounds someone loses, about six to seven come from fat and three to four from muscle, bone, and other non-fat tissues.

However, there’s two important caveats to this statistic:

1. People with severe obesity generally have more muscle and bone mass than others. (Carrying around an extra 100+ pounds of body weight means muscles have to adapt by getting bigger and stronger.)

2. Muscle and bone loss aren’t inevitable. (As Dr. Nadolsky puts it, “Muscle loss isn’t a reason to avoid treating obesity [with medication]. It’s a reason to do more exercise.”)

To preserve muscle and bone mass, aim for at least two full-body resistance training sessions a week.

In addition, move around as much as you can. Walking and other forms of physical activity are vital for keeping metabolism healthy—and can help to move food through the gut to ease digestion.^{21, 22}

(Need inspiration for strength training? Check out our free exercise video library.)

Strategy #3: Lean into lean protein.

In addition to strength training, adequate protein consumption is vital for helping to protect muscle mass.

You can use our free macros calculator to determine the right amount of protein for you. (Spoiler: Most people will need 1 to 2 palm-sized protein portions per meal, or about 0.5 to 1 gram of protein per pound of body weight per day.)

Strategy #4: Fill your plate with fruit and veggies.

Besides being good for your overall health, whole, fresh, and frozen produce fuels you with critical nutrients that can help drive down levels of inflammation.

In addition to raising your risk for disease, chronic inflammation can block protein synthesis, making it harder to maintain muscle mass.

(Didn’t know managing inflammation matters when it comes to preserving muscle? Find out more muscle-supporting strategies here: How to build muscle strength, size, and power)

Strategy #5: Choose high-fiber carbs over low-fiber carbs.

Beans, lentils, whole grains, and starchy tubers like potatoes and sweet potatoes do a better job of helping you feel full and managing blood sugar than lower-fiber, more highly processed options.

(Read more about the drawbacks—and occasional benefits—of processed foods here: Minimally processed vs. highly processed foods)

Strategy #6: Choose healthy fats.

Healthy fats can help you feel full between meals and protect your overall health.

Gravitate toward fats from whole foods like avocado, seeds, nuts, and olive oil, as well as fatty fish (which is a protein too!)—using them to replace less healthy fats from highly-processed foods (like chips or donuts).

(Not sure which fats are healthy? Use our 3-step guide for choosing the best foods for your body)

Strategy #7: Consider coaching.

It may go without saying, but the above suggestions are just the start.

(There’s also: quality sleep, social support, stress management, and more.)

While many people choose to tackle these strategies on their own, many others find that the support, guidance, and creative problem-solving that a good coach can provide makes the whole process a lot easier—not to mention more enjoyable and more likely to stick.

And that’s the real gift of coaching: A coach doesn’t just help you figure out what to eat and how to move; They help you remove barriers, build skills, and create systems and routines so that habits become so natural and automatic that it’s hard to imagine not doing them.

Then, if you do want to stop taking medication, your ingrained lifestyle habits (that coaching reinforced, and medication perhaps made easier to adopt) will make it more likely that you maintain your results.

References

Click here to view the information sources referenced in this article.

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The post Considering (or currently taking) weight loss drugs? Here’s what you need to know appeared first on Precision Nutrition.

As a physician and obesity medicine specialist, Dr. Fitch knew the lifestyle levers to pull—and she had the financial means to yank them hard.

After giving birth, she lifted weights with a trainer twice a week. She sweated through one Peloton workout after another and tracked her food intake on MyFitnessPal.

Nevertheless, for the next decade, Dr. Fitch lost (and regained) the same five to ten pounds. Her blood pressure crept upward. Then came a sleep apnea diagnosis.

As her 50th birthday neared, Dr. Fitch decided to take the advice she gave her patients. She went on medication. (And, she lost 30 pounds.)

In the years since, Dr. Fitch has occasionally stopped her meds. For a few months, she maintains her results.

Eventually, however, the scale climbs back. For now, she’s decided that she’ll be on medication long-term.

If you’re a coach, how does this story land with you?

Does it…

… Make you feel disappointed? Does this seem like a story of someone “giving up” or “not trying hard enough”?

… Inspire you with a sense of awe? That modern medicine has figured out how to treat yet another chronic disease?

… Bring up questions? Like wondering about the effects of being on medication—potentially long-term? (Or if weight loss is even that relevant—so long as a person is eating healthy and exercising regularly?)

Dr. Fitch is now president of the Obesity Medicine Association and chief medical officer of Known Well, a primary care and obesity medicine practice in Needham, Massachusetts. Regardless of how you feel about her story, it illustrates what can initially seem like an inconvenient truth for those of us in the health coaching industry:

Behavior change on its own isn’t always enough.

For many people with obesity, semaglutide (Ozempic, Wegovy, Rebelsus), tirzepatide (Mounjaro, Zepbound), and other glucagon-like peptide-1 receptor agonists (GLP-1 RAs) serve as valuable tools that make significant and lasting weight loss possible.

But for health coaches, these drugs can seem like an existential threat.

You might wonder:

‘Who needs a nutrition coach or a personal trainer when people can get faster, easier, and more dramatic results with drugs?’

However…

People need health coaches now more than ever.

In this story, we’ll explain why—and show you how to turn “the golden age of obesity medicine” into a massive career opportunity.

With fat loss, there’s no such thing as an “easy way out.”

To manage diabetes or treat cancer, most people consider it normal and natural to combine lifestyle behaviors with prescription medicine.

No one would tell someone with cancer, “You’re on chemo? Way to take the easy way out!”

However, that’s what many people with obesity hear when they mention medication or surgery.

For decades, much of society hasn’t viewed obesity as the disease that it is.

Instead, people have seen it as a willpower problem.

The remedy: “Just try harder.”

However, rather than motivating people to succeed, this “remedy” often encourages them to give up. (More importantly, the willpower theory isn’t based on science.)

In reality, people with obesity likely have as much willpower as anyone else.

However, for them, fat loss is harder—because of genetics and physiology, along with social, cultural, behavioral, and/or environmental factors that work against them.

Why is it so difficult to lose fat?

Imagine life 150 years ago, before the invention of the automobile. To get from point A to point B, you had to walk, pedal a bicycle, or ride a horse.

Food was often in short supply, too. You had to expend calories to get it, and meals would just satisfy you (but not leave you feeling “full”).

Today, however…

“We live in an obesogenic environment that’s filled with cheap, highly-palatable, energy-dense foods [that make overeating calories easy, often unconsciously], and countless conveniences that reduce our physical activity,”
says Karl Nadolsky, MD, an endocrinologist and weight loss specialist at Holland Hospital and co-host of the Docs Who Lift podcast.

You might wonder: Why do some people gain fat in an obesity-promoting environment while others don’t?

The answer comes down to, in large part, genetics and physiology.

(Obesity is complex and multifactorial. As we noted above, there are other influential factors, but your genes and physiology are mostly out of your control, and so medication might be the best tool to modify their impact.)

Genetically, some people are more predisposed to obesity.

Some genes can lead to severe obesity at a very early age. However, those are pretty rare.

Much more common is polygenic obesity—when two or more genes work together to predispose you to weight gain, especially when you’re exposed to the obesogenic environment mentioned earlier.

People who inherit one or more of these so-called obesity genes tend to have particularly persistent “I’m hungry” and “I’m not full yet” signals, says Dr. Nadolsky.

Obesity genes also seem to cause some people to experience what’s colloquially known as “food noise.”

They feel obsessed with food, continually thinking, “What am I going to eat next? When is my next meal? Can I eat now?”

Physiologically, bodies tend to resist fat loss.

If you gain a lot of fat, the hormones in your gut, fat cells, and brain can change how you experience hunger and fullness.

“It’s like a thermostat in a house, but now it’s broken,” says Dr. Nadolsky. “So when people cut calories and weight goes down, these physiologic factors work against them.”

After losing weight, your gut may continually send out the “I’m hungry” signal, even if you’ve recently eaten, and even if you have more than enough body fat to serve as a calorie reserve. It also might take more food for you to feel full than, say, someone else who’s never been at a higher weight.

Enter: GLP-1 drugs

In 2017, semaglutide—a synthetic analog of the metabolic hormone glucagon-like peptide 1—was approved in the US as an antidiabetic and anti-obesity medication.

With the emergence of this class of drugs, science offered people with obesity a relatively safe and accessible way to lose weight long-term, so long as they continued the medication.

How Ozempic and other obesity medicines work

Current weight loss medications work primarily by mimicking the function of glucagon-like peptide 1 (GLP-1), which is a hormone that performs several functions:

• In the pancreas, it triggers insulin secretion, which helps regulate blood sugar.
• In the gut, it slows gastric emptying, affecting your sensation of fullness.
• In the brain, it reduces cravings (the desire for specific foods) and food noise (intrusive thoughts about food).

In people with obesity, the body quickly breaks down endogenous (natural) GLP-1, making it less effective. As a result, it takes longer to feel full, meals offer less staying power, and food noise becomes a near-constant companion, says Dr. Nadolsky.

Semaglutide (Ozempic, Wegovy, Rybelsus) and medicines like it flood the body with synthetically made GLP-1 that lasts much longer than the GLP-1 the body produces. This long-lasting effect helps increase feelings of fullness, reduce between-meal hunger, and muffle cravings and food noise.

Interestingly, by calming down the brain’s reward center, these medicines may also help people reduce addictive behaviors like problem drinking and compulsive gambling, says Dr. Nadolsky.

The growing effectiveness of weight loss drugs (especially in combination with lifestyle modifications)

Researchers measure a weight-loss medicine’s success based on the percentage of people who reach key weight loss milestones.

For example, most people start to see health benefits after losing five percent of their weight—and remission from disease after losing around 20 percent.

As the chart below shows, weight loss medicines have become increasingly effective at helping people to reach both milestones.

How do weight loss medications compare to traditional interventions?

In the past, weight loss interventions have focused on lifestyle modifications like calorie or macronutrient manipulation, exercise, and sometimes counseling.

Rather than pitting lifestyle changes against weight loss medicines or surgery, it’s more helpful to think of them all as tools.

As the graph below shows, the more weight loss tools someone uses—including coaching—the more significant the results.^{13 14 15 16}

Fat loss often comes with powerful health benefits

For years, the medical community has told folks that losing 5 to 10 percent of their body weight was good enough.

Partly, this message was designed to right-set people’s expectations, as few lose much more than that (and keep it off) with lifestyle changes alone.

In addition, this modest weight loss also leads to measurable health improvements. Lose 5 to 10 percent of your total weight, and you’ll start to see blood sugar, cholesterol, and pressure drop.¹⁷

However, losing 15 to 20 percent of your weight, as people tend to do when they combine lifestyle changes with second-generation GLP-1s, and you do much more than improve your health. You can go into remission for several health problems, including:

• High blood pressure
• Diabetes
• Fatty liver disease
• Sleep apnea

That means, by taking a GLP-1 medicine, you might be able eventually to stop taking several other drugs, says Dr. Nadolsky.

Experts suspect GLP-1s may improve health even when no weight loss occurs.

“The medicines seem to offer additive benefits beyond just weight reduction,” says Dr. Nadolsky.

Research indicates that GLP-1s may reduce the risk of major cardiovascular events (heart attacks and strokes) in people with diabetes or heart disease.^{18 19 20} In people with diabetes, they seem to improve kidney function, too.²¹

The theory is that organs throughout the body have GLP-1 receptors on their cells. When the GLP-1s attach to these receptors in the kidneys and heart, they seem to protect these organs from damage.

For this reason, in 2023, the American Heart Association listed GLP-1 receptor agonists as one of the year’s top advances in cardiovascular disease.

Ozempic side effects

You’ve likely heard that slowed gastric emptying from GLP-1s can lead to nausea, constipation, and other GI woes.

That’s all true.

However, for most, these side effects are manageable, especially with the help of a few key strategies (which we’ll cover later).

For now, however, we’d like to hash out a particular downside you’ve likely heard about from the media—because it offers a huge opportunity for health coaches.

When people take GLP-1 weight loss medicines, about 30 to 40 percent of the weight they lose can come from lean mass.^{22 23 24}

Put another way: For every 10 pounds someone loses, about six to seven come from fat and three to four from muscle, bone, and other non-fat tissues.

This statistic has been broadcast among many media outlets in recent weeks as a dire warning against taking Ozempic, Wegovy, or Zepbound.

Such stories often fail to mention two important caveats:

Caveat #1: People with severe obesity generally have more muscle and bone mass than others.

To understand why, imagine you were forced to wear a 100- or 200-pound body suit every day for a year. Everyday activities—getting in and out of chairs, walking to and from the mailbox, climbing steps into a building—would feel like a resistance workout.

That’s likely partly why bariatric surgery patients experience a nine-year extension on their life expectancy, despite 30 percent of their weight loss coming from lean mass. They have more muscle than average to begin with, and therefore can safely lose some.^{25 26}

For people with severe obesity, the health boost from body fat loss offsets the health risk of muscle and bone loss, says Dr. Fitch.

That said, there’s a caveat to the caveat: People who are only 30 pounds or so overweight may not be starting out with muscle and bone mass to spare. Especially if they’re older, they may begin their weight loss journey already under-muscled, with relatively low bone density. In those people, another drop in lean mass and bone density can add up to big health problems.

However…

Caveat #2: Muscle and bone loss aren’t inevitable.

As Dr. Nadolsky puts it, “Muscle loss isn’t a reason to avoid treating obesity [with medication]. It’s a reason to do more exercise.”

This is where coaches can shine.

By showing clients how to adopt muscle-building behaviors like strength training, combined with adequate protein consumption, you can help people offset the worst of the side effects when taking these medicines.

The yo-yo problem

GLP-1s are expensive, costing roughly $1000 USD a month. As a result, many insurers either refuse to cover them or limit their coverage to a year or two.

Once the money runs out, people tend to go off the meds—and the hunger and cravings return.

If they’ve done little to change their foundational eating habits, this puts them at a significant disadvantage. If they’re not eating slowly and mindfully and improving satiety with veggies and lean protein, the return of hunger and food noise can be overpowering.

That’s likely why, in one study, participants who stopped taking semaglutide regained, on average, two-thirds of the weight they’d lost.²⁷

Again, here’s another opportunity for coaches…

Use weight loss medicine as a key that unlocks lifestyle changes.

Weight loss medicines don’t render behavior-based strategies obsolete; they make them more critical.

When GLP-1 medicines muffle food noise and hunger, your client will find it easier to prioritize protein, fruits and veggies, legumes, and other minimally processed whole foods. Similarly, as the scale goes down, clients feel better, so they’re more likely to embrace weight lifting and do other forms of exercise.

According to a 2024 consumer trends survey, 41 percent of GLP-1 medicine users reported that their exercise frequency increased since going on the medication. The majority of them also reported an improvement in diet quality, choosing to eat more protein, as well as fruits and vegetables.²⁸

This is great news, because, as mentioned above, lifestyle changes are critical to preserving lean mass and preventing regain, should clients choose to discontinue medication.

When working with clients on GLP-1s, keep the following challenges in mind.

Coaching strategy #1: Find ways to eat nutritiously despite side effects.

The slowed stomach emptying caused by GLP-1 drugs can trigger nausea and constipation.

Fortunately, for most people, these GI woes tend to resolve within several weeks.

However, if you’re working with a client who’s experiencing a lot of nausea, they won’t likely welcome salads into their lives with open arms. (Think of how you feel when you have the stomach flu. A bowl of roughage doesn’t seem like it’ll “go down easy.”)

Instead, help clients find more palatable ways to consume nutritious foods. (For example, fruits and vegetables in the form of a smoothie or pureed soup might be easier.)

Dr. Nadolsky also suggests people avoid the following common offenders:

• Big portions of any kind
• Greasy, fatty foods
• Highly processed foods
• Any strong food smells that trigger a client’s gag reflex
• Sugar alcohols (like xylitol, erythritol, maltitol, and sorbitol, often found in diet sodas, chewing gum, and low-sugar protein bars), which can trigger diarrhea in some

Coaching strategy #2: Prioritize strength training.

To preserve muscle mass, aim for at least two full-body resistance training sessions a week.

In addition, move around as much as you can. Walking and other forms of physical activity are vital for keeping the weight off—and can help to move food through the gut to ease digestion.^{29 30}

(Need inspiration for strength training? Check out our free exercise video library.)

Coaching strategy #3: Lean into lean protein.

In addition to strength training, protein is vital for helping to protect muscle mass.

You can use our free macros calculator to determine the right amount of protein for you or your client. (Spoiler: Most people will need 1 to 2 palm-sized protein portions per meal, or about 0.5 to 1 gram of protein per pound of bodyweight per day.)

Coaching strategy #4: Fill your plate with fruit and veggies.

Besides being good for your overall health, whole, fresh, and frozen produce fuels you with critical nutrients that can help drive down levels of inflammation.

In addition to raising your risk for disease, chronic inflammation can block protein synthesis, making it harder to maintain muscle mass.

(Didn’t know managing inflammation matters when it comes to preserving muscle? Find out more muscle-supporting strategies here: How to build muscle strength, size, and power)

Coaching strategy #5: Choose high-fiber carbs over low-fiber carbs.

Beans, lentils, whole grains, and starchy tubers like potatoes and sweet potatoes are more likely to help clients feel full and manage blood sugar than lower-fiber, more highly processed options.

(Read more about the drawbacks—and occasional benefits—of processed foods here: Minimally processed vs. highly processed foods.)

Coaching strategy #6: Choose healthy fats.

Healthy fats can help you feel full between meals and protect your overall health. Gravitate toward fats from whole foods like avocado, fatty fish (which is also a protein!), seeds, nuts, and olive oil—using them to replace less healthy fats from highly processed foods.

(Not sure which fats are healthy? Use our 3-step guide for choosing the best foods for your body.)

Coaching strategy #7: Build resilient habits.

It may go without saying, but the above suggestions are just the start.

(There’s also: quality sleep, social support, stress management, and more.)

Most importantly, clients need your help to make all of the above easier and more automatic.

And that’s the real gift of coaching: You’re not merely helping clients figure out what to eat and how to move; You’re showing them how to remove barriers and create systems and routines so their road to health is a little smoother.

That way, if they do need to stop taking medication, their ingrained lifestyle habits (that the medicine made easier for them to adopt) will make it more likely that they maintain their results.

References

Click here to view the information sources referenced in this article.

If you’re a coach, or you want to be…

You can help people build sustainable nutrition and lifestyle habits that will significantly improve their physical and mental health—while you make a great living doing what you love. We'll show you how.

If you’d like to learn more, consider the PN Level 1 Nutrition Coaching Certification. (You can enroll now at a big discount.)

The post Ozempic for weight loss: What coaches (and clients) need to know about GLP-1 drugs appeared first on Precision Nutrition.

It was February in Toronto, Canada, during the lockdowns of the pandemic, and Greg Wells, PhD, was so very tired.

“I was struggling with fatigue, general mental health, and feeling a bit down,” he says.

A former elite swimmer, Dr. Wells had long used chilly baths and sweaty saunas as recovery tools. He was also familiar with the teachings of Wim Hof, the bearded Dutch athlete who’d earned fame for swimming in icy waters.

So when Dr. Wells noticed thin sheets of ice floating on Lake Ontario, mere steps from his home, he thought, “Why not?”

He called an old swimming friend to serve as his lifeguard, changed into his swim trunks, trudged through the snow, and waded in.

Pins and needles attacked every nerve ending.

He focused on his breathing as he tried to become one with the wickedly painful moment. A minute later, he was drying off and on his way home.

Greg Wells, PhD, soaking in a partially frozen Lake Ontario. Photo credit: Judith Wells.

Later, after changing into warm clothes and relaxing with a hot beverage, Dr. Wells noticed something.

“I felt exhilarated—and much happier,” he says. “That was the moment that sparked my passionate engagement with these practices.”

Popularized by Wim Hof (widely known as “the Iceman”), cold plunge groups have popped up all over the world—and now boast hundreds, even thousands, of members.

Yet, the practice is nothing new, dating back thousands of years to ancient Roman frigidoriums.

Similarly, heat therapy—in the form of saunas, sweat lodges, and hot tubs—has been with us, in one form or another, for just as long.

In the following article, we’ll explore:

• What are the actual, scientifically-vetted health benefits of these sweat- and shiver-producing practices?
• What’s the best temperature and duration?
• Is heat better than cold? Are saunas better than hot tubs?
• Could your ordinary everyday shower or bathtub offer benefits?
• Perhaps most importantly: Are hot and cold plunges something you should be doing—or encouraging your clients to do?

We sort the hype from the science—and share accessible protocols that nearly anyone can try.

The healing power of microstressors

There’s a principle in biology known as hormesis, which is a fancy word that describes how our bodies respond to stress.

Small doses of stress—termed microstressors—engage the immune system, which sends out cells to repair the damage and leave you stronger than before.

(Big doses of unrelenting stress, on the other hand, can lead to the opposite, overwhelming the immune system and wearing you down.)

“A little is good. A lot is not. This idea applies to many aspects of our lives,” says Dr. Wells, whose book Power House explores the upside of microstressors like hot and cold exposure.

The health benefits of extreme heat and cold exposure

For thousands of years, humans roamed the Earth without modern inventions like air conditioning or heating to keep them comfortable. People who adapted to changing temperatures tended to survive and pass on their genes to the next generation.

Today, those genes trigger protective molecules, called temperature shock proteins, to rise when we’re under certain types of stress.

Heat shock proteins are released when exposed to extreme heat, as their name implies, but also to things like exercise, says Paige C. Geiger, PhD, a professor of cell biology and physiology at the University of Kansas.

Cold shock proteins are released when exposed to extreme cold, such as a plunge in an ice bath or frigid natural body of water, or a cold shower. They can also be triggered when you spend time outdoors in below freezing temperatures.

How heat shock proteins and cold shock proteins work

Temperature shock proteins are busy little buggers, performing many vital bodily functions. Among their many roles, they…

Stop other proteins from sticking or clumping together. Protein clumping (also called misfolding) is one of the drivers behind many age-related diseases ranging from Alzheimer’s to diabetes.¹

Act as molecular chaperones, escorting healthy proteins to their cellular destinations and disposing of damaged mitochondria and other molecules that would otherwise create cellular havoc.²

Help mitochondria work more effectively. “We’ve shown that they can activate mitochondria function,” Dr. Geiger says. That’s important because your mitochondria help generate power. When they’re healthy, overall metabolism is too.

Can extreme temperatures extend your life?

Heat shock proteins first captured Dr. Geiger’s attention when she was a graduate student and signed up to participate in a fellow grad student’s study. For several hours a day, Dr. Geiger wore a specialized rubberized suit that circulated hot water.

“I laid in a hospital bed for three hours a day in my own pool of sweat. It was horrible, and I never forgot it,” she says.

Years later, when she launched her research lab, Dr. Geiger focused on heat shock proteins, trying to understand if manipulating them could help reduce chronic diseases like obesity, diabetes, and Alzheimer’s.

Research from her lab (a.k.a. the University of Kansas’ two hot tubs) and elsewhere shows that intermittently elevated levels of heat shock proteins may…

• Reduce insulin resistance, blood sugar, and risk for type 2 diabetes^{3, 4, 5}
• Improve cognitive function and lower risk for Alzheimer’s disease⁶
• Speed recovery after exercise-induced muscle damage⁷
• Help acclimate the body to other stressors, such as high altitude⁸
• Mimic some of the effects of exercise, thus helping to maintain muscle mass and function during prolonged bed rest⁹

That last bullet likely will make you wonder…

Can you skip the gym and lounge in a hot tub instead?

“There’s never going to be anything that provides the same benefits as exercise,” says Dr. Geiger. “However, I do think it can come close.”

Hot and cold therapy can help maintain (but not build) muscle mass, plus improve other aspects of cardiovascular and metabolic health. (We’ll discuss more in following sections.)

It can also help people become more mobile, which is especially good news for folks who can’t exercise—because of an injury, health condition, or stroke.

That’s precisely what happened when Dr. Geiger and her team asked people with fibromyalgia to sit in a 104° Fahrenheit (40° Celsius) hot tub for 45 minutes three days a week.

“They were in a lot of pain, so much so that some of them couldn’t hold down jobs,” says Dr. Geiger. “In the beginning, during the first couple of visits, some could barely get in and out of the tub. Their mobility was so limited.”

The study was cut short due to the COVID pandemic. However, the unpublished preliminary results are encouraging. After four weeks, participants were walking regularly, working in their gardens, and sleeping better.

“We don’t know exactly what was helping them,” says Dr. Geiger. “We think we lowered their inflammation a little bit. We think we definitely reduced their pain.”

Heat vs. cold immersion: Which is better?

Studies on heat immersion are more common than studies on cold immersion. So if you’re looking for a health boost, heat exposure might be the more reliable modality (for now).

But both have many potential benefits, as we explore below.

This is what happens when you’re in a sauna.

Wear a smartwatch while in a hot tub or sauna, and you’ll see your heart rate climb. Depending on the temperature and duration of your exposure, it might reach 80, 100, 120, or even 150 beats per minute—as if you were walking briskly or running.

As your heart pounds, blood pressure drops while cardiac output rises, flooding your muscles, bone marrow, and skin with blood.¹¹

(Sounds kind of like exercise, doesn’t it?)

According to research, these heat-induced changes may lead to heart and vascular benefits, lowering blood pressure, improving artery health and insulin sensitivity, and reducing the risk for sudden cardiac death, stroke, fatal heart disease, and all-cause mortality.^{12 13 14 15}

Heat immersion can also induce deep relaxation. After your warm bath or sauna, your body temperature drops as it cools down, and a sleepy sensation sets in. A review of 17 studies found that people who submerged themselves in 104° Fahrenheit (40° Celsius) water for 10 minutes an hour or two before bed fell asleep more quickly and experienced improved sleep quality.¹⁶

This is what happens when you’re in an ice bath.

During a cold plunge, your blood vessels constrict, and nerve conduction slows, relieving swelling and soreness.

There’s also a “What have I done?!” sensation, which triggers the release of alertness-producing brain chemicals like noradrenaline, cortisol, and dopamine.

Cold plunge enthusiasts say this cocktail of neurochemicals unleashes more energy and focus than a triple espresso. These brain chemicals may also help to lift depression.¹⁷

It’s counterintuitive, but repeated cold exposure can also help you instill a deep state of calm, especially if you learn to breathe through the experience, says Dr. Wells.¹⁸

Stay in chilly temps long enough, and you’ll shiver, which is your body’s attempt at producing heat.¹⁹ So, theoretically, frequent cold plunges could activate heat-generating (and metabolism-boosting) brown and beige fat to help you adapt.²⁰

However, Dr. Geiger notes this research was mostly done on rodents. “Rodents have more brown fat than humans,” she says. Of the scant studies done on humans, sample sizes were small and yielded mixed results.^{21 22 23}

(Curious about different types of fat and what they in your body? Read: What everyone needs to know about body fat.)

Finally, though the research is still in its infancy, cold exposure may stimulate the thymus gland to release white blood cells, helping you fight off colds and flu.

In one study, people who routinely did 30- to 90-second cold showers called in sick from work 29 percent less often than non-cold showerers.²⁴

So, which method is right for you?

When deciding whether to immerse yourself in a hot or cold environment, it helps to weigh several factors.

Factor #1: Your health and fitness goals

If you’re looking to decompress, improve sleep, and potentially enhance your cardiovascular health, sweating is the way to go, says Dr. Wells.

On the other hand, if you want more energy and focus, better stress tolerance, or a mood boost, plan to shiver, he says.

Factor #2: Your location

For people who live in hot climates, a cold shower can seem refreshing, whereas a hot bath may only extend the day’s misery.

Similarly, the Fins popularized the sauna for a reason. The average temperature during a long, dark Lapland winter is 8.5°F (-13°C). Frequent visits to the sauna serve as a break from the unrelenting cold.

Factor #3: What you’re willing to do

Maybe you’re drawn to hot tubs because you love how it feels when your muscles seem to “melt” and your skin beads with sweat.

On the other hand, perhaps you love that skin-prickling sensation of cold water against your skin, and the rush it gives your thrill-seeking self.

It all comes down to what you find pleasurable, refreshing, and worthwhile.

And remember: This doesn’t have to be a binary decision.

The Fins are known for doing both.

When they can’t bear more time in the sauna, they take a cold shower or a dip in a frigid body of water, like the Baltic Sea. They might cycle through several hot sweats and cold chills before showering off and calling it quits.

“Do what feels good for you. That way, you are more likely to do it,” says Dr. Wells.

About hot and cold protocols: Don’t overthink it

As with so many health practices, it’s easy to get caught up in a “what is the IDEAL way to do this?” spiral.

That spiral will likely encourage you to try to mimic a protocol from research. For example, you might look up Dr. Geiger’s studies and see her participants sat in a 104°F (40°C) hot tub for 25 minutes until their internal temperature rose by 1 degree Celsius. Then they stayed there for 20 minutes more.

“You get pretty uncomfortable,” Dr. Geiger says.

The rare person might be willing to put themselves through that experience in the name of science and for a paycheck.

But the average person?

Probably not, which begs the question…

Can milder temperatures for shorter durations also lead to health
benefits?

It’s likely, says Dr. Geiger, but more research is needed to know for sure.

Until future studies reveal the needed answer, put your money on heat and cold exposure functioning a lot like exercise: The tiniest romp with extreme temperatures likely offers more benefits than no romp at all.

Don’t get too hung up over finding the best protocol around—or even following our beginner protocols (below) “perfectly.”

Instead, consider: What are you (or your client) ready, willing, and able to do, say, three times a week?

Cold water immersion protocols for beginners

At the end of your typical hot shower, turn the knob to cold. Then stick your face in the increasingly chilly water for 30 seconds. Work up to getting your whole body under the spray. This is likely all you need to feel incredibly energized as well as to boost immunity, says Dr. Wells.

Once you get used to that and you’re ready for more, extend your cold shower time. You can also try the following:

Take a short, cold bath. This can be especially helpful if you’re looking for a mood, focus, or energy boost. Aim for several minutes in water that’s around 60 F (15 C) or colder.

Try cold water immersion. If you have an inflammatory condition like arthritis, then you might benefit from more time in colder water, says Dr. Wells. To get your bathtub water below 60°F (15°C), you’ll likely have to add some ice. Try to soak for five to 20 minutes.

Heat immersion protocols for beginners

Take a warm bath for 15 to 20 minutes an hour or two before bed.

Then, if you’re ready, willing, and able for more, you might ditch your bathtub for a more prolonged (and hotter) immersion in a hot tub, sweat tent, or sauna.

Welcome to the ultimate 5-minute action

For many clients, experimentation with hot and cold plunges can serve as a catalyst for more behavior change.

“Try to see them as ‘gateway drugs’ for health and wellness,” says Dr. Wells. “If you get into hot and cold water immersion, I guarantee you will go to the gym at some point. The more you get into it, the more you will do and the more benefit you’ll get.”

References

Click here to view the information sources referenced in this article.

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