Why Movement Matters In Midlife

What if movement in midlife is less about performance – and more about protecting the life you want to live?

In this episode of The Choice Space Podcast, Dr Lee David speaks with Dr Juliet McGrattan – former GP, runner, coach and author of The Runner’s Guide to Menopause – about why movement becomes especially important during midlife and menopause, and how to approach it in a way that feels realistic and supportive.

For many women, movement suddenly feels harder. Energy, motivation, recovery, aches and pains, changing bodies and busy lives can all affect how exercise feels. Others may feel unsure where to begin, particularly if movement has never felt enjoyable or part of their identity.

Lee and Juliet explore the many ways movement can support health and wellbeing during midlife – from improving mood, managing stress and supporting social connection, to reducing future risk of conditions such as heart disease, type 2 diabetes and frailty. They discuss why strength, mobility and balance become increasingly important during menopause, and how small, sustainable changes can make a meaningful difference over time.

The conversation also reflects on the pressures women often place on themselves around exercise. They discuss moving away from comparison, body shame and perfectionism, and instead finding ways of moving that feel flexible, enjoyable and personally meaningful – whether that means running, walking, strength work or simply starting where you are.

This is a thoughtful conversation about meeting your body where it is, valuing movement for what it gives back, and building habits that support the life you want to keep living.

Key moments
00:00 Why movement feels harder
04:16 Barriers to exercise in midlife
05:29 Why movement matters for health
09:14 Running as a gift to yourself
11:23 Making running feel enjoyable
13:07 Walking as a starting point
14:12 Listening to your body
16:59 What rest days really mean
19:12 Choice Pause – meeting your body where it is
21:05 Celebrating small wins
22:39 Staying motivated to move
29:14 Strength, mobility and ageing well
35:17 A small first step into movement

About the guest
Dr Juliet McGrattan is a former GP, award-winning author, international speaker and coach who helps women improve their health and wellbeing through movement. Once an inactive mum and GP, Juliet’s own journey into running led her to become a marathon runner and passionate advocate for women’s health through exercise.

She now combines medical knowledge with a practical, accessible approach to movement, helping women feel stronger, healthier and more confident in active lives. Juliet is the resident health expert for 261 Fearless and Women’s Running magazine, co-founder of the UK charity 261 Club UK.

SShe is the author of several books including: Sorted: The Active Woman's Guide to Health (2017), and The Runner’s Guide to Menopause: Your essential toolkit for strong, happy and healthy training was published in March 2026. 

You can connect with Juliet via her website, Instagram, Facebook or LinkedIn

About the host

Dr Lee David is a GP, CBT therapist and author specialising in mental health and wellbeing. Lee has written many books on CBT, mindfulness and teen wellbeing, and speaks regularly at conferences and in the media. Away from work she enjoys running, hiking, singing in a choir and spending time outdoors with her family. You can find Lee through her website and on Instagram, TikTok (@dr.lee.david), Facebook and LinkedIn.  You can find more about her books, wellbeing courses and therapy here:  https://linktr.ee/dr.lee.david 

Transcript

SPEAKER_01 0:00

There are many people who have a great relationship with it, and midlife doesn't seem to cause any issues with movement. But I think there are a large number of women, particularly when they hit perimenopause, where running in particular or any types of movement just become a lot harder and a lot more difficult for a variety of reasons. And then there are those women who maybe haven't already been active throughout their lives or not for many years, and they're curious and starting to become more aware of their health benefits of exercise and feeling like I want to make some changes and I want to start being active.

Dr Lee David 0:46

Welcome to the Choice Space Podcast. I'm Dr. Lee David, GP, CBT therapist, and author. In midlife, many women start to think differently about physical activity. Some are trying to hold on to previous routines. Some may notice movement feels harder than before, and others are wondering where to begin. It's not always clear how menopause may affect energy, recovery, strength, or motivation, or what kinds of movement are most helpful during this stage of life. Today's conversation will explore how our relationship with movement may change during the midlife and how to approach it in a way that feels realistic and supportive. I'm delighted to be joined today by Dr. Juliet McGrattan, former GP, runner, and author of the new book, The Runner's Guide to Menopause. Juliet, welcome. Could you start by telling us a little bit about yourself and what drew you into this area of work?

SPEAKER_01 1:45

Hiri, yes, thank you so much for inviting me on. Yes, so I'm a former GP. During my time as a GP, I had this personal journey of fitness and realised the amazing power of exercise for both sort of physical and mental health. And once I'd kind of experienced that, I couldn't let it lie. I had to learn more and more about it and share more and more of it with my patients. And I developed this real love of helping people to get healthier through moving their bodies. And eventually it led my career off in a different direction. And I stopped working clinically as a GP. And I now work as a writer, as a coach, and I work with a global running organisation. And it's all about educating people, particularly women, on the benefits of moving their body and how to do that, particularly in running.

Dr Lee David 2:41

It sounds amazing, and I'm really excited to have this conversation because personally I really relate to everything you're saying there. And I think for me, movement and running itself is my most effective way of managing stress and pressure and keeping my mental health in a positive balance. I think there are some traps we sometimes can fall into where it becomes a pressure that maybe moves away from that. Let's start with the people you're working with as a coach and in your book. What relationship do women in my midlife tend to have with movement or with running in particular?

SPEAKER_01 3:18

I think it can be very mixed. There are many people who have a great relationship with it and midlife doesn't seem to cause any issues with movement. But I think there are a large number of women, particularly when they hit perimenopause, where running in particular or any types of movement just become a lot harder and a lot more difficult for a variety of reasons. And then there are those women who maybe haven't already been active throughout their lives, or not for many years perhaps, and they're curious and they're starting to become more aware of their health benefits of exercise, or they see exercise as something which is very competitive and that doesn't feel part of their identity or isn't something that they're really sort of seeking for. So I think there's a whole mixed bag, and in midlife it almost comes to a head of is this something that's going to be part of my life going forwards? How can I introduce it and how can I find a way to make it work for me?

Dr Lee David 4:16

So it sounds like there may be some women who would approach midlife quite active, but maybe then the menopause starts to make exercise more difficult and it may increase pain or it may lead to vasovagal symptoms like hot flushes that can be triggered by heat, for example. And so suddenly it's no longer something that's as accessible or as easy to do as before. And then there may be other women who are thinking, well, I I've never loved exercise, but I'm hearing so much about the benefits of exercise, but I don't know how to do that, and I've never really done that, and I don't really have a positive relationship with it. I've got these memories of it being awful, and I feel really embarrassed. And so there's a lot of barriers, aren't there?

SPEAKER_01 4:57

There are huge numbers of barriers, and many of them are women specific and affect women in different ways to how they affect men. And it's hard at any point to start making the habit of exercise. It's always difficult. You know, it involves creating a new behaviour, overcoming barriers. But when you get to midlife and you hit perimenopause and menopause and even post-menopause, there just seem to be even more barriers. So I think this is why it's such an important time to be getting some information out there about what the barriers are and how women can begin to overcome them.

Dr Lee David 5:28

It is a crucial time of life for exercise, and there are some huge benefits, aren't there, around exercise in general and specifically around running. Can you share some of those?

SPEAKER_01 5:39

Yeah, absolutely. You mentioned yourself that you like running for your mental health. And menopause is often a time when mental health symptoms appear for the first time or reappear if you've had them before. So increased levels of anxiety, increased levels of stress, increased levels of depression, and being physically active, running in particular is such an amazing way to maintain and improve your mental health, but whether you're running on your own, whether you're running with other people. I'm also going to say definitely benefits social health. And social health is just as important as physical and mental health. And my experience of menopause and other women in menopause is that they often become a little less sociable because of the maybe the way they're feeling. Maybe they're getting lots of hot flushes, maybe they're just not feeling so motivated or driven. And you can sometimes become more isolated without really meaning to. And exercise can be a really great way to put you in touch with other people. So I lead women only run groups, and the conversations that are had in those run groups about midlife, about menopause symptoms, about sore breasts, about leaky bladders, etc., are such an ideal opportunity to talk to other women, find out that you're not alone, and also just give you a relaxed environment to maybe not even talk about menopause, but talk about everything else but that. And then, of course, physical health benefits, because most of the conditions that we're talking about in terms of physical health, like heart disease, type 2 diabetes, cancer, dementia, all increase as you get older. And we know and there's such amazingly strong evidence that physical activity can help to reduce your risk of all those conditions. It's not a quick fix, it's not an easy fix, but it is such a powerful one. So I think trying to make exercise as accessible to everybody as possible is just crucial.

Dr Lee David 7:30

I completely agree. And I think there's hardly anything that wouldn't be benefited by moving our bodies and increasing exercise. It's one of those things that really is a panacea. It really does help on so many different levels. And if we had a medication that had the same level of benefit as doing exercise, it would be such a popular drug to be prescribing. I was just going to pick up on a couple of things that you said there. I think the social benefits are really important to emphasize because there's very good evidence about our happiness and well-being, how that's really linked to our social connections hugely. And I think exercise alongside people who feel supportive, I certainly see it as a great way to regulate distressing emotions. We obviously have the happy hormones, but we also manage some of the stresses and the strains. And there's something going on in the background in our brain where our stresses are being packaged away in the brain, and they feel just a little bit more sorted at the end of a run than they were at the beginning. And I think in the menopausal period, in the perimenopause, women are often in the sandwich generation where they've got a lot of pressures. They might have older parents, they might have children of different ages or who are leaving home. And they may also have very responsible jobs and other life pressures as well. And so there's a whole lot of stuff to have to try and deal with. And there is a risk that maybe exercise becomes just another thing to add to the to-do list. It becomes this other stress. Oh, I'm not doing it well enough. And I really think it's trying to see it as a gift to ourselves, that it's time for me to connect with people, to give myself time to wind down, to do something that is really good for me, and a way of investing in my well-being because I value that. And I just wonder if if that kind of reframe feels helpful.

SPEAKER_01 9:14

I think when it comes to running, you might get people who would say running is is not a gift because it's actually quite hard to do because it can feel really unpleasant. As someone said to me the other day, you never really see a smiling runner. You know, whenever you pass them, they're always looking like they're in pain. So I think when it comes to running, it's a really important to know that actually there are so many different ways to run, and you don't have to run fast. You can run really, really slowly so that you're comfortable that you can chat, and that makes running so much more of a pleasant experience. I think that especially if people doing it for the first time, that you know you put your trainers on and you think you have to have a good speed to be a runner. So I think there definitely needs to be a bit of a reframe when it comes to running for many people to see it as a gift, but it's the benefits that you get afterwards that make it worthwhile putting yourself through any sort of discomfort that you might experience when you first start running. It's very easy for exercise to become a pressure, especially if you start putting too much pressure on yourself in terms of the distances or the paces or wanting to enter events and things like that. And I think, you know, running does not have to be like that. It can literally be 20 minutes at a snail's pace, outside, in nature, feeling good. And I think that's often where we we lose people when they try it for the first time and it feels horrible. Um and you need to do it more often and much more slowly to really fall in love with it.

Dr Lee David 10:41

Do you think people do struggle with pacing at the beginning and not realizing how slowly it is actually possible to run? I run in a very social way, and our motto is if we can't chat as we're going, then we're going too fast. And I know that that wouldn't work for everybody because some people really enjoy setting goals and aiming for speed. But for people perhaps who are less confident around running or perhaps not in the phase of life where they need a lot of goals. You know, sometimes we want to push ourselves, but sometimes we just want to ease off and let ourselves off the hook a little bit with that pressure and and make something more enjoyable to do. What are the ways to make running something that is something that makes me feel good? Yes, afterwards, but actually even a little bit while I'm doing it.

SPEAKER_01 11:23

Yeah, I mean I think that's the most amazing thing about running is that it can be whatever you need it to be. If you need a challenge, if you need a goal, you can you can set that and you can get the benefits from running that way. If you don't want that and you just want time outside, then it can be that too. And I think it's it's thinking about what you need on that particular day at that particular moment. And I think in menopause particularly, you never really know how you're going to feel day to day. So it's ideal to have something which is flexible, where you can push yourself a little bit on the days when you feel good, or you can just take it right back on the days that you don't. And I think if you're new to running and you're wanting to sort of get into the habit of it, then running with other people is a great way to do it, but you need to find the right group. You need to find maybe it's just a friend or two friends that you run with, or maybe it is a very beginner-based running group, or maybe you do it solo and you use something like the NHS Couch to 5K app, which is excellent because it does help you to do it in a very, very gradual way. And I think that's the key. It's starting very slowly and building up slowly to allow your body to adjust to it, to adapt to it, to get stronger, for you to get fitter, and to not be afraid to take a break, not be afraid to walk. You don't have to run the whole thing. You can run, walk, run, walk just according to what feels good. And giving it a try and seeing what does feel right for you. We need to really open our minds to what being a runner means. If you're putting one foot in front of the other, you know, you're a runner and um and a lot of it's in our head. But we can often feel pressure and feel judgment if we're trying something new or going out on a day when we yeah just don't really feel like it and we want to go really slowly.

Dr Lee David 13:07

And just thinking though about walking, do you think that is a way in that can support people if they're lacking confidence to say, I'm going to go running, but to to start walking and maybe walking a bit more briskly for periods or then gentle jog here and there, we can just bridge from something that feels a bit more accessible to then move towards running.

SPEAKER_01 13:28

Oh, absolutely. And walking is really underrated as an exercise. Just walking whenever you can for as much as you can and increasing your pace to brisk walking, and tell yourself you're going to go out for a brisk walk. And then maybe you'll just like go, I'm just gonna I'm just gonna jog for 10 steps and then I'm gonna go back to walking. And runners too can benefit from going on on walks. Even if you are running regularly, it's remembering that just doing a short run during the day is not enough to counteract or to fill up your activity for the whole day. You you need to be active on and off throughout the day, and walking is a really great way to do that because there are health benefits from moving frequently through the day, and there are health risks from being sedentary. Yeah, all runners could do with probably walking a bit more as well.

Dr Lee David 14:12

What are your thoughts about listening to our bodies? Because I think in the perimenopause, then as you mentioned earlier, there can be that fluctuation in our bodies, and we may be more prone to aches and pains. I know certainly I'm I and so it can be frustrating because you think I was just getting good and I was just getting up to that distance, and and what do I do now? And I'm just wondering how you feel it's helpful to respond to changing bodies.

SPEAKER_01 14:39

Yeah, it's a tricky one because it's a balance between working out, is the exercise gonna do me good and maybe reduce the aches and pains I've got, or is it going to make them worse? And sometimes it takes a bit of effort to do exercise. So I sometimes have to say, Am I just making an excuse because I don't really want to go? Or is there genuinely a need for me to rest and recover? And it can take a lot of trial and error, and it can take you getting it wrong a few times, and sometimes you don't really know until you try. For example, you're exactly right in menopause, the day to day you never quite know how you're going to feel. And there are some women who say, Do you know what? If I listened to my body, I would never do any exercise because it's always feeling as stiff as a board and really achy and uncomfortable. But they go out and they start with a gentle walk and then maybe they do a little bit of jogging and then they feel better for it. So I think sometimes it is tricky, if in doubt, just go for a little bit of a walk and see how you feel. Because we know that being active really will bring you lots of benefits. And when it comes to muscle aches and pains, you've heard the phrase probably motion is lotion, but being sedentary and doing nothing is generally far worse than just moving gently. The other thing that I would say is that sometimes you need a bit more recovery than you've had before. So if you're comparing what you used to do in the past to how you feel now, it might be that you need to bring things down a notch. It might be that you used to be active for five days of the week and actually it's taking you longer to recover, particularly if you're going for a long run or something, and you might need an extra day. And it's often kind of feeling your way along, thinking, hmm, I'm not sure. It what do I actually really need? And sometimes you don't know till you try for the majority of sort of recreational runners, especially if you're new to it, you need at least one, if not two, maybe three days a week when you're not running. And I think when it comes to menopause, actually some women find that is the key, that they need to maybe change what they have been doing, sometimes even cut back a run a week and switch it out for something different, preferably some strength work. So I tend to try and look at what you've done over the course of a week or a month rather than specifically thinking, gotta do this today, gotta do this tomorrow, gotta do and and if you can be regularly active over the course of the week and or over the course of a month, then that is much better.

Dr Lee David 16:58

We'll definitely think about other activities that support running. Let's just think a little bit more about what a rest day is. So if I'm having a rest day, what what would you be recommending that I do on that rest day? Are we talking about sitting on the sofa? Are we talking about going for a bit of a walk? So what I heard was one to three days a week of rest. And what does rest look like?

SPEAKER_01 17:22

It varies according to your fitness levels. So if you are used to high intensity exercise and you tend to recover more quickly the fitter that you get as well. So generally for a rest day doesn't mean doing nothing because we know that being completely sedentary is not good for us. So you can use active recovery where again you can go for a walk, you can do, you can do light walking. But I I think having sort of some run-free days is good. Whether you do something more intense, look like cross-training on those days, I I think you do still definitely need one one to three days when you're you're not doing high intensity exercise. I try and be evidence-based when I can, but this is from sort of the experience of working with lots of people and seeing that in order to be consistent and to have long-term habits, do need to have plenty of recovery.

Dr Lee David 18:12

Yeah, that's really interesting. And and it fits with having a balance then of movement as a pattern over a week or month rather than I've got this goal that I have to get done today. And maybe then there's a bit more space if we're feeling a bit, you know, we've got a bug, we catch something off one of the kids, or we tweak our calf muscle, and it's like, mm, it doesn't feel quite as good as it would normally do, and then we have to turn it down a bit. It doesn't feel quite so bad, maybe if we're thinking about the whole month's worth of activity rather than just today.

SPEAKER_01 18:40

Yeah, absolutely. And I think that helps to reduce the pressure. That helps to stop it feeling so overwhelming that it's on the to-do list and I absolutely have to do it. Like even looking at your nutrition and things, it's looking at what you've had over the course of a week rather than looking on an individual day basis can make it feel much more achievable and much more realistic. And I think it's so easy in fitness to have unrealistic goals. And if you can look at the longer-term progress and the longer-term habits, that's so much, so much more beneficial.

Dr Lee David 19:12

This is the choice pause, a short tool you'll hear in every episode, drawn from my books and therapy practice. Each time it offers a different way to pause, notice, and choose your next step. Today is a pause for meeting your body where it is. Take a slow breath in and a longer breath out. Let your shoulders soften a little. Allow your body to settle where you are. But at times your body may not feel or move the way you want it to. Movement may take effort or come with discomfort. You might notice when you're deciding to do some activity or when you're thinking about what feels possible today, there may be a sense of frustration, sadness, or self-blame. And when this happens, it's easy to push through and ignore your body or to give up on movement altogether. See if you can pause here. Notice your feet on the ground, gently shift your weight and notice your body is here. Let your attention move outwards to what you can see or hear around you. You might gently say to yourself, This is how my body is today. I can meet it with a little kindness, I can work with what I need right now. And from here, ask yourself what could be a helpful next step. It might be going for a shorter run than you planned, or slowing the pace. It might be going for a walk instead. Or simply moving for a few minutes and just noticing how this feels. And choose your next step from here. Do you think it's important for people to pause and actually just appreciate and maybe congratulate ourselves for the small wins? Because certainly some people I've worked with are quite critical, and so they might achieve something, they go out for a run, but then somehow it never quite feels like as much as they would have liked to do, it was quite as far as they could have gone, or perhaps they did a fast one last week and then this week it wasn't quite as fast, so it feels like, oh, I've I've now I'm on the downhill again. And I just wonder if there's something about trying to celebrate in small ways what we are doing.

SPEAKER_01 21:39

Absolutely. The celebration of goals is it's so important. And I think it's so easy to focus on the negatives, isn't it? It's like if you've been in an exam or an interview, you come out and you remember all the questions that you didn't answer well and you forget all the ones that you did. So if you are somebody that needs that sort of encouragement and tends to look on the negative, then even writing down the positives. The things that went well during that day or during that exercise and focusing on those. And I think it's important to remember too that fitness doesn't improve in a linear fashion. It doesn't just improve, improve, improve, improve. It can be demoralizing if you go out and expect to be better every time. And I think that's a trap that new runners often fall into. They just think every week, every day, every time I go out and do a run, I need to go a bit further or I need to go a bit faster. And that's not going to happen, especially when you're not an elite athlete and you have other stresses in daily life that use your energy, physical energy, use your mental energy, and those all impact on how well you can perform in running.

Dr Lee David 22:40

Thinking about motivation, if you think about people perhaps that you've coached or or worked with, we've talked about some of the benefits and we we can list all these health benefits, but what do you think it is that helps people to find that relationship where they do want to keep running?

SPEAKER_01 22:56

I would say in midlife, I definitely find that women who are in perimenopause who come for me for advice are wanting to improve their health and they've got to a point in life where they can see the future and they want to have a better future and remain independent and able to look after themselves and those people around them. That certainly is one for me. I'm very highly motivated by the fact I want to be active and independent for many, many years. Often it's knowing how good you're going to feel afterwards and how proud you'll be of yourself and how it will influence the rest of the day to make you feel more positive. And then also finding other things such as communities, knowing that somebody else is expecting to meet you there, having some sort of accountability and working towards a goal that's really, really important to you, having a goal that that's really personal. It's all about the why, isn't it? I mean, lots of behavior change is about finding the the why and what it really means to you. So using all of those sort of motivational tricks. But I think the people that are doing it really long term regularly are generally doing it because it's become a habit. And they don't have to find those little grains of motivation to get them out the door. They do it because that's what they do on a Friday or that's what they do on a Monday. And that only comes through doing things repeatedly and building up that habit, and it becomes more of a sort of a discipline than waiting for motivation to strike, which to be quite honest, doesn't happen very much. You know, if I relied on my pure motivation to go running, I I don't think I would be out there very much. But knowing that on a Friday it's a running club, on a Saturday I'll do this, on a Tuesday I run with this friend, it becomes a habit.

Dr Lee David 24:33

Yes, so it's it sounds like it's about finding a routine that's really workable in whatever pattern of life you're in and where would running work best. And I think running is a very efficient time user for exercise because you can be out of the door and back home and in the shower in a much quicker time sometimes than going to the gym. Maybe you've got to drive to the gym and then go in and log in, and it all takes a lot longer. So but it does take that extra bit of motivation, as you say, and and I really like the idea of creating a routine that just works. That yes, on a Friday I go in the morning, I will get up at this time and I'll meet my friend, and we'll just do half an hour and we'll chat all the way. And I also really like the idea about tapping into what your own personal motivation is. So, what would be the one or two most important reasons for you to think about changing your relationship, increasing physical activity, maybe moving more, maybe thinking about running. And I I'm like you, I'm very motivated by the idea of being active when I'm older and able to stay physically well for as long as possible and be independent. And I I kind of imagine that a run now could be a walk when I'm in my 80s or 90s.

SPEAKER_01 25:48

I have this sort of picture of 80-year-old Juliet. She's got her pom-poms and she's she's my best cheerleader. So if I'm ever lacking motivation, I just sort of have a a quick chat with her, and she pushes me out of the door so well because she's like, come on, just go and do a little bit. I'm really proud of you. Look at me now. I I'm living this great life because you did these things at that point in time. And so that that motivates me. Everyone's got to find the thing that drives them on.

Dr Lee David 26:15

I love the idea of eight-year-old Juliet, and I think if you asked her, what do you care about in life, what would you like life to have looked like up until this point, then she would have a very different perspective. That that older version of ourselves will have that really long-term wise view about what really matters. So it becomes then very much about our values and who we want to be, rather than based on, well, this is a target I need to live up to, this is another stress. It it makes it feel much more personally meaningful, I think.

SPEAKER_01 26:42

Definitely. And I think sometimes physical activity and and running can get very caught up in body image and you know, you do it because you want to lose weight, or you do it because you want to look a specific way. I think we need to really disassociate those two things because exercise is so much more than that. It is so much more about how you feel rather than how you look, and also, as you say, set you know, setting you up for a healthy future, and it's very much not about earning your food. And I, you know, I I feel really passionately that we shouldn't be saying, oh well, I've done that, so now I deserve to have this piece of cake. And that is a really quick way to develop an unhealthy relationship with exercise and with running, is to focus it around how many calories that you're burning. I I feel really quite strongly about that.

Dr Lee David 27:30

Yeah, I I completely agree. And it becomes about kind of shame-based activity then. I I don't want to look this way, so therefore I have to go running. And that kills all the joy if we're feeling ashamed about our body and we're feeling worried about how we look and we're judging ourselves negatively. It doesn't have that uplifting feeling because our threat system is activated because of all those negative beliefs that we're holding about ourselves that we're taking running with us. It's all about this towards step where it's I go running because I value my health, I value my social relationships with the people I've run with, I value my future version of me, and I want to look after her, and I want to make sure that she's really strong. And I might imagine, you know, grandma Lee playing with her grandkids, for example, and being fit enough to be able to do that and still be able to go to the park and be part of the family life and not that shame-based negativity, which I think it weaves its way into so many things that we do. It's so important to try and take a breath, regulate our distress, and then let go of that as a motivator.

SPEAKER_01 28:33

Yeah, absolutely. It and it's it's so ingrained and it's so entrenched in in that world. It's hard to break free from that. But I think midlife is an opportunity for us to really just take a step back and take that breath, like you say, and reassess what exercise means to us, how it can be helpful to us, what type of exercise is going to work for us, what we what we really need physically, mentally, socially. And menopause is often talked about very negatively, obviously because of the barriers and the symptoms that can occur, but it can be a gift and it can be an opportunity to just yeah, do a little MOT and have a rethink and a reassess and do things differently, which is which is wonderful.

Dr Lee David 29:13

And you mentioned there around some of the other types of activity and we we touched on that previously. Could you talk to us a little bit about patterns of movement that are most supportive in the menopausal period? And what what types of activity do you feel are most important for women in the perimenopausal period and beyond?

SPEAKER_01 29:32

So the chief medical officer's guidelines are that you should do 150 minutes a week of activity of moderate intensity when you feel a bit out of breath, and that you should do strength training on at least two occasions a week as well. But I think it's important that you're trying to aim towards reaching those. So you want the moderate intensity exercise where you feel a little bit out of breath, which could be very brisk walking, but running is great because it really hits the spot and even pushes you into the intense exercise, which you you only need half as much, 75 minutes. So you need that cardiovascular aerobic type exercise. But really importantly, you need to address your muscle mass and your muscle strength, because we know that everybody starts losing a little bit of muscle mass from mid-30s, but once you get to mid-life, that accelerates and you can lose a significant amount. And if you do nothing, then you are at very high risk of developing sarcopenia, which is low a low muscle mass, which increases your frailty level. Now, for a while everybody thought that menopause directly reduced your muscle mass, but the evidence now is more pointing to it being much more of an age-related change than necessarily a purely hormonal one. But this is such a good opportunity in life to look at increasing the strength exercises that you do or starting to do them for the very first time. And that can feel overwhelming and frightening, but you can start simply at home using a home video, doing body weight exercises, things like squats and push-ups, and then you can start to introduce using some weights. Ideally, some getting some guidance if you can from somebody who's who's a personal trainer or a gym or a class and getting some some instruction on how to use them safely so that you don't cause yourself any injuries also helps to improve bone density. It also helps to improve your metabolism, to reduce risk of heart disease. So if you do one thing, yeah, please do a little bit of running, because I love running. But really, if I'm honest, the main thing that you should be really doing with the best evidence is to do the strength exercises.

Dr Lee David 31:40

It really is amazing how clever our muscles are at don't think we think about how important it is to have muscle and how that supports not just movement, but actually every metabolic process going on in the body. It's really, I think, important for women to maybe recognise that.

SPEAKER_01 31:56

It it really is, and I think that's come through increased knowledge about how muscles work. And previously thinking no, they're just about looking toned or they're just about pure strength, but we know that muscles are really metabolically active and they're an organ and they talk to other parts of our body, and we know that all those diseases that we talked about before, like heart disease, dementia, types of cancer, strokes, etc. etc., are partly caused or at least sort of sped up, accelerated by this low-grade inflammation going on in the body. So anything we can do which is anti-inflammatory will really help. So it's not just about frailty and being able to stop ourselves falling and strength. It is very much about improving our general health. And I think once you realise that, that certainly for me, because runners don't generally like to do strength work, they'd rather just go for a run. But I think learning so much about muscles and understanding that is something that's made me wake up and go, yes, strength work will mean I'm gonna get less injured as a runner, but really I need muscles for for my life and my well-being and my health in the future. And that for me has been the trigger that's made me. Now I can say it confidently because I have been doing it religiously for three times a week for a year now, and I feel very proud about that. But it it really was understanding that it was now or never that I had to do something about it that that really triggered me to do it.

Dr Lee David 33:22

That's really interesting to hear that you're now bringing that into your your routine. And I I've also brought it into mine. And one of my motivators is that I I imagine that Grandma Lee trying to get off the loo, you know, doing a squat is very much that movement. And I don't want to have to have somebody to lift me off if I can do it myself. I I feel quite strongly that I'd like to be able to keep doing that myself for as long as possible. And so that's what I think about when I'm doing my squats.

SPEAKER_01 33:48

And I think also in terms of that thinking about your future self and exercises to do in midlife, it's really important to also think about two other things mobility, balance coordination, kind of linking them together really, because if you don't use those things, then you lose them. So particularly when it comes to balance, I definitely see with the older members in my running group that they s often struggle to stand on one leg to do the stretches or to do the exercise that that we're we're doing. And that very quickly, those nerve pathways between your brain and and your muscles and vice versa, and they they can wither if they're not used. So I think even as simple as brushing your teeth standing on one leg every day, you don't need to find any extra time to do that because you're doing it anyway, can just start to uh wake up those pathways and introduce you to the idea that that balance and coordination is really important. Um and mobility, you probably find that you get stiffer and less flexible as you get older. And you don't need to be able to do the splits unless you're a gymnast, but you do need to be able to type your shoelaces and reach up into the cupboard for something. Maybe as well do some separate um stretching routines, a little bit of yoga or joint mobility and to to keep things to keep things moving. Because yeah, definitely use it or lose it.

Dr Lee David 35:00

And I I guess they could also be part of an active recovery potentially if they're sort of a bit less intense.

SPEAKER_01 35:06

Yeah, perfect. Yeah, a nice bit of gentle yoga on a on a rest day. I mean, yoga can be quite challenging, but if it's more of a stretch stretch-based one, then then something like that on a on a rest day is is perfect, yeah.

Dr Lee David 35:17

Brilliant. Thank you so much. But just to finish, we always do a choice-based takeaway, which is about practical tools that people can take from the conversation and maybe make a change tomorrow. So for anyone listening, what's one small way they might improve their relationship with running or maybe just get that start or maybe lift move forward with running? What what are your tips?

SPEAKER_01 35:37

I would say if you wanted to do one thing tomorrow, I would say put your trainers on and go out of the door. Just put some really comfortable shoes on, head out the door, and don't don't measure your time, don't measure your pace, just go technology free and just move your body, you know, round the block. And when you get back from that, you'll feel so much better. And that feeling will encourage you to do it again the next day.

Dr Lee David 36:00

I really love that. And I'm gonna build on it, I think, with tracking, but instead of tracking your metrics, your speed, your time, how far you went, your pace, just track did you go out of the door? Did you go out of the door and do a little bit of movement? So for me, it's just doing it rather than how good we are at doing it.

SPEAKER_01 36:19

Absolutely, definitely, and that that helps to develop a positive relationship with it, doesn't it, rather than it feeling like a pressure.

Dr Lee David 36:25

Thanks for listening to the Choice Base podcast. I hope this conversation has offered a little room for you to pause and choose your next step. We've included links to Juliet's book and how you can connect with her in the show notes. If this episode has been helpful, please download and share with someone else who might value the conversation as well. And please do consider leaving a rating or review on whatever platform you listen on. It really does help people find our show.