#264 – How aging and menopause drive muscle loss and fat gain | Dr. Robert Lustig & Ben Grynol

Both aging and menopause affect metabolism. Unless people build and preserve muscle mass, aging drives muscle loss and fat gain. While these changes affect everyone, the menopause transition can also worsen metabolic health. Dr. Robert Lustig and Ben Grynol discuss aging’s effects on body composition, how menopause exacerbates these and other effects, and what you can do to protect your health.

3:05 — Aging and muscle loss

From stress to environmental toxins, our bodies face an onslaught as we age. At the same time, we lose muscle mass.

As people age, the vicissitudes of life tend to catch up with you: the cortisol bumps from all the chronic stress that we’re all under, the ultra-processed food that we’re all exposed to, the air pollution, the obesogens in our environment, the vinyl flooring, in the cosmetics. I mean, basically we are under constant onslaught by various chemicals that interfere with our ability to burn and grow. As that happens, we’re going to lose that growth signal. And so muscle starts to decline as you get older.

4:30 — Aging and fat gain

Muscle helps uptake glucose from the bloodstream. When we lose muscle with age, we begin to store more glucose as fat.

If you lose that muscle, where does the glucose go? It stays in your bloodstream, and now your insulin has to clear it into fat. So that’s going to put an increased strain on your beta cells because they’re going to have to make more insulin to generate an increased storage place in your fat. Excess glucose wasn’t excess before, but it is now. So you tend to lose muscle and gain fat.

5:06 — Why insulin resistance can increase as we age

Growth hormone declines as we age, making building muscle mass more difficult. A loss of muscle and an increase in fat leads to less insulin sensitivity.

In addition, as you get older, growth hormone decreases. So growth hormone is one of the things that helps you build muscle. It’s one of the things that makes you grow. It’s growth hormone. Well, growth hormone has a lifecycle, and it peaks at around 17 to 25 and then starts to go down. As you lose sex hormones as you get older, your growth hormone goes even lower. And so that stimulus to make muscle is now resolving, and takes its place is fat. So basically, you’ve got less opportunity to be able to burn the energy and more laying down of fat. This of course, creates even more insulin resistance. That puts a greater strain on those beta cells, which are also losing capacity because of all those chronic exposures. And so they cannot keep up with the increased need for clearance peripherally. And so eventually you’ll get to the point where you just don’t have enough insulin for the way your body has changed.

8:13 — Loss of estrogen drives menopause symptoms

Estrogen decreases over the menopause transition. This loss of estrogen drives hot flashes and other classic menopause symptoms.

One of the biggest issues facing women today is what to do about menopause. Menopause is part of life. Menopause is the natural evolution of ovaries. Some people earlier, some people later, but eventually ovaries burn out. And when they burn out, the estrogen that they made basically goes down to zero. And that has all sorts of ramifications for metabolism throughout the body, especially in the brain. The drop in estrogen changes the sympathetic nervous system to generate heat. And so you get these hot flashes. And they feel awful because the sympathetic nervous system, which was under suppression by estrogen, is now basically released from it. And so you get all sorts of unpleasant and unwanted side effects from the drop in estrogen.

9:28 — Menopause can also impact cholesterol

Cholesterol changes in menopause can increase your risk for cardiovascular events.

One of the other problems is that women premenopausal have low serum LDL and triglycerides. But after menopause, their LDL and triglycerides rise, and no one’s sure why that is, but that puts women at increased risk for cardiovascular events later on in life. They are protected from heart attacks prior to menopause, but they catch up after menopause. So controlling that LDL and triglyceride rise that occurs after menopause is a high priority.

10:11 — Lifestyle changes can help lessen the impact of menopause on metabolism

Menopause impacts metabolism through multiple mechanisms. However, changes to diet and activity levels can help.

Estrogen is also responsible for growth hormone release. And so when estrogen declines, growth hormone goes down. And so women lose muscle the same as men. And when muscle is lost, it is often replaced as fat. So all of these phenomena are conspiring to basically destroy women’s healthy metabolism as they pass through menopause. The good news is that most of them are remediable with both changes in diet and improved exercise.

[00:00:00] Rob Lustig: You tend to lose muscle, gain fat as you get older. In addition, as you get older, growth hormone decreases. So growth hormone is one of the things that helps you build muscle. It’s one of the things that makes you grow. It’s growth hormone. Well, growth hormone Has a life cycle and it peaks at around 17 to 25 and then starts to go down as you get older.

[00:00:34] Rob Lustig: As you lose sex hormones, as you get older, your growth hormone goes even lower. And so that stimulus to make muscle is now resolving and what takes its place is fat. So basically you’ve got less opportunity to be able to burn the energy. And more laying down of fat.

[00:01:04] I’m Ben Grynol, part of the early startup team here at Levels. We’re building tech that helps people to understand their metabolic health. And along the way, we have conversations with thought leaders about research backed information. So you can take your health into your own hands. This is a whole new level.

[00:01:33] So in February of 2024, Dr. Robert Lustig and I found ourselves sitting across from each other in Los Angeles. We’d planned to sit down and have a little chat about metabolic health and some of the implications around lifestyle, sleep, exercise, all these pillars of metabolic health. When we ended up sitting for six hours, we had a really deep conversation and we covered a number of topics.

[00:02:01] The idea was that we were filming some videos, some short form videos, which would be helpful for Levels members and anyone interested in metabolic health generally, to get more insight into some snippets, some takeaways of what they could think about certain categories of metabolic health. Well, we decided to cut these into a podcast as well.

[00:02:20] So we’ve got a number of topics and we thought, why don’t we categorize them and people can pick and choose what they want to listen to. So. Lots of good information, lots of soundbites here, but we stitched them together into these different categories. So there’s some transitions, but it might be something that is of interest.

[00:02:37] So the idea is always hope it helps people to learn more, to take metabolic health into their own hands. In this episode, Rob covers aging and metabolic health. Specifically, there’s some insight around menopause and metabolic health. How does women’s metabolic health change as they go through hormonal changes at different stages in their life?

[00:03:04] Rob Lustig: As people age, the, uh, vicissitudes of life I tend to catch up with you. The cortisol bumps from all the chronic stress that we’re all under, the ultra processed food that we’re all exposed to, the air pollution, the obesogens in our environment, and the vinyl flooring, and the cosmetics. I mean, basically we are under constant onslaught by various chemicals, interfere.

[00:03:40] Rob Lustig: With our ability to burn and grow. As that happens, we’re going to lose that growth signal, and so muscle starts to decline as you get older. One way to keep that up is, of course, exercise. The natural, uh, event is for muscle mass to decrease as one gets older. Because of all of this onslaught. Well, that’s one less place for glucose to go.

[00:04:16] Rob Lustig: So when you eat a sizable portion up to sometimes 70 to 75 percent of a glucose load will end up in your muscle to power the muscles of your body. If you lose that muscle, where does the glucose go? It stays in your bloodstream. And now your insulin has to clear it into fat. So that’s going to put an increased strain on your beta cells because they’re going to have to make more insulin.

[00:04:49] Rob Lustig: to generate an increased storage place in your fat for all of that now excess glucose that wasn’t excess before, but is now. And so you tend to lose muscle, gain fat as you get older. In addition, as you get older, Growth hormone decreases. So growth hormone is one of the things that helps you build muscle.

[00:05:15] Rob Lustig: It’s one of the things that makes you grow. It’s growth hormone. Well, growth hormone has a life cycle and it peaks at around 17 to 25 and then starts to go down as you get older. As you lose sex hormones, As you get older, your growth hormone goes even lower, and so that stimulus to make muscle is now resolving and takes its place is fat.

[00:05:48] Rob Lustig: So, basically, you’ve got less opportunity to be able to burn the energy and more laying down of fat. This of course creates even more insulin resistance. That puts a greater strain on those beta cells, which are also losing capacity because of all those chronic exposures. And so they cannot keep up with the increased need for clearance peripherally.

[00:06:19] Rob Lustig: And so Eventually, you’ll get to the point where you just don’t have enough insulin for the way your body has changed.

[00:06:36] Casey Means: This is Dr. Casey means co founder of levels. If you’ve heard me talk on other podcasts before, you know that I believe that tracking your glucose and optimizing your metabolic health is really the ultimate life hack. We know that cravings, mood instability and energy levels and weight are all tied to our blood sugar levels.

[00:06:57] Casey Means: And of course all the downstream chronic diseases that are related to blood sugar are things that we can really greatly improve our chances of avoiding if we keep our blood sugar in a healthy and stable level throughout our lifetime. So I’ve been using CGM now on and off for the past four years since we started levels and I have learned so much about my diet and my health.

[00:07:19] Casey Means: I’ve learned the simple swap. that keep my blood sugar stable, like flax crackers instead of wheat based crackers. I’ve learned which fruits work best for my blood sugar. Like I do really well with pears and apples and oranges and berries, but grapes seem to spike my blood sugar off the chart. I’m also a notorious night owl and I’ve really learned with using levels.

[00:07:40] Casey Means: If I get to bed at a reasonable hour and get good quality sleep, my blood sugar levels are so much better. And that has been so motivating for me on my health. journey. It’s also been helpful for me in terms of keeping my weight at a stable level, much more effortlessly than it has been in the past. So you can sign up for levels at levels dot link slash podcast.

[00:08:03] Casey Means: Now let’s get back to this episode.

[00:08:12] Rob Lustig: One of the biggest issues facing women today is what to do about menopause. Menopause is part of life. Menopause is the natural evolution of ovaries. Some people earlier, some people later, but eventually ovaries burn out. And when they burn out, the estrogen that they made basically goes down to zero. And that has all sorts of ramifications for metabolism throughout the body, especially In the brain, the drop in estrogen changes the sympathetic nervous system to generate heat.

[00:09:01] Rob Lustig: And so you get these hot flashes and they feel awful because the sympathetic nervous system, what, which was under Suppression by estrogen is now basically released from it, and so you get all sorts of, you know, unpleasant and unwanted side effects from the drop in estrogen. One of the other problems is that women premenopausally have low serum LDL and triglycerides.

[00:09:36] Rob Lustig: But after menopause, their LDL and triglycerides rise, and no one’s sure why that is. But that puts women at increased risk for cardiovascular, uh, events later on in life. They are protected from heart attacks prior to menopause, but they catch up after menopause. So, controlling that LDL and triglyceride rise that occurs after menopause is a high priority.

[00:10:10] Rob Lustig: Estrogen is also responsible for growth hormone release. And so when estrogen declines, growth hormone goes down. And so women lose muscle the same as men. And when muscle is lost, it is often replaced as fat. So all of these phenomena are conspiring to Basically destroy women’s healthy metabolism as they pass through menopause.

[00:10:41] Rob Lustig: The good news is that most of them are remediable with both changes in diet and improved exercise.