By Dr. Alyssa Dweck, practicing gynecologist and ChromaDex spokesperson.

Women who come into my office often ask me the same thing: How do some women age so gracefully? I tell them it is in part genetically determined, but that they can take a proactive role to optimize the process. The reality for most women is that well before the first menopausal symptom is experienced, a series of hormonal changes is already well underway. 

What’s happening during menopause?

Menopause signals the end of the natural reproductive potential and declining hormone levels for women. You see, women are born with a full complement of eggs which are stored in and released by the ovaries on a monthly basis, in most cases. Typically, a well-orchestrated sequence of estrogen, progesterone, and testosterone (aka sex hormones) production occurs each month with ovulation. Over our lifespan, our ovaries age as we age. In other words, we do not produce more eggs over time. In fact, as ovaries age, ovulation becomes less frequent and eventually ceases. As such, these sex hormone levels start to fluctuate and eventually decline significantly. This can last for upwards of 10 years prior to the last menstrual cycle.  

It may come as a surprise that our brain, muscle, and fat cells all have hormone receptors, thus, these changes occur on a cellular level. In addition to the well-known vasomotor complaints associated with this transition, aka hot flashes and night sweats, other common but less-publicized symptoms are numerous. These include sleeplessness, fatigue, less energy, memory loss, poor concentration, weight gain, mood volatility, joint pains, imbalance, and yes, even a lower libido.  

“While it is never too late, the sooner healthy lifestyle habits are initiated, the less dramatic and more positive this transition can be.”— Dr. Alyssa Dweck

Although the transition to menopause can take upwards of 10 years for some, the average age of menopause is 51. Menopause is defined as a full year without a period. While it is never too late, the sooner healthy lifestyle habits are initiated, the less dramatic and more positive this transition can be. 

Here are some helpful pearls to ease the menopausal transition and maximize energy at the same time.

You age how you eat.

The Mediterranean diet emphasizes eating primarily plant-based foods including fruits and vegetables, whole grains, legumes, and nuts—all of which are helpful for controlling weight and preventing hot flashes. More importantly, this diet, rich in natural antioxidants, is encouraged for prevention of major chronic diseases such as heart disease and cancer, including breast cancer in women. The Mediterranean diet suggests limiting salt intake and replacing it with herbs and spices for flavor, which may reduce hypertension (high blood pressure), an independent risk factor for heart disease. 

The low glycemic index in a plant- and lean protein-based diet promotes stable insulin and glucose levels and helps to reduce hot flashes, often associated with a high sugar intake. Sugar highs and subsequent lows or “sugar crashes” are avoided on this diet. Healthy fats such as olive oil and canola oil, instead of butter, help promote a normal lipid profile including elevated HDL (good cholesterol) and lower LDL (bad cholesterol). The Mediterranean diet is also rich in complex carbohydrates, but devoid of simple ones, promoting satiety.

Caffeine, commonly found in coffee, black tea, and chocolate, should be consumed in moderation or avoided altogether, as excessive caffeine intake triggers hot flashes. Not only can caffeine prompt hot flashes, but it can also zap energy upon its withdrawal, contributing to the overall energy loss women feel during this transition.

Exercise does more than keep you fit.

During menopause, lean body mass or muscle is naturally lost. In part, this is due to diminished ovarian production of testosterone. Testosterone naturally declines with age; the most rapid loss occurs during the perimenopausal transition. This leads to a lower metabolism, diminished lean body mass (muscle), and difficulty with weight control. Remember, muscle cells have testosterone receptors (a site on the surface of a cell that binds to and responds to testosterone). Less circulating testosterone means lowered lean body mass. This alteration occurs on a cellular level. 

"Exercise, including cardio (running, elliptical, biking, swimming, walking) and weight training, are essential to build and maintain muscle mass and a strong metabolism, particularly with lower circulating testosterone levels."— Dr. Alyssa Dweck

Stress a little over your stress levels.

Chronic stress spurs the hot flashes and night sweats of menopause, leads to weight gain around the middle, visceral (around internal organs) fat accumulation, and is generally unhealthy. This in part occurs since chronic stress leads to increased cortisol production by the adrenal glands (small glands that sit on top of the kidneys). This starts a cascade of events including increased insulin levels, plummeting glucose levels, increased dietary intake of carbohydrates, and eventual deposition of adipose tissue (fat), particularly around the waistline, aka the dreaded “muffin top” so many menopausal women struggle with. Remember, less stress means less cortisol secretion.

Stress reduction through exercise, yoga, meditation, and mindfulness exercises are vital to a healthy lifestyle. Many find these practices, even for short time spans first thing in the morning, promote energy and well-being throughout the day.

Start now to stay healthy later.

It may seem overwhelming to commit to dietary and lifestyle changes, but here are some helpful hints to ease the transition. Avoid smoking and moderate alcohol intake to minimize uncomfortable vasomotor symptoms of menopause, lessen cancer risk, and maximize cardiovascular health. Both smoking and alcohol affect blood vessel tone. Smoking constricts blood vessels which increases blood pressure and skin temperature and decreases tissue oxygenation. Conversely, alcohol dilates blood vessels on the skin surface to dissipate heat. Both have effects on the blood vessels of the brain as well.

Regular sexual activity raises endorphins (the feel-good chemicals in the brain), diminishes stress, and promotes a general sense of well-being.

Many women are also deficient in vitamin D, which is vital for bone health, and provides numerous other health benefits. Ensure adequate levels of vitamin D with a simple blood test and supplement with vitamin D3 if levels are low. 

NAD+ supports energy levels.

On a cellular level, it’s important to note that levels of a molecule known as NAD+ also decline with age. NAD+ (nicotinamide adenine dinucleotide) is critical for mitochondria function. It fuels the cell's powerhouse and enhances cellular metabolism. Supporting NAD+ through supplementation may further support energy levels before, during, and after the menopausal transition

In my busy OB/GYN practice, I try to impress upon my patients that menopause can be and should be a liberating time rather than one of fear or dread. With age comes wisdom, freedom, and confidence. So, what is the secret to a smoother transition to menopause? I try to practice what I preach: commit to healthy lifestyle habits, maximize energy, and manage stress. With these principles and a little bit of genetic good luck, women can and should take an active role to embrace the aging process with grace and ease. Make it a priority.

ALYSSA DWECK, MS, MD, FACOG is a practicing gynecologist and ChromaDex spokesperson in Westchester County, New York, and Adjunct Assistant Professor of Obstetrics and Gynecology at New York Medical College. As an author of three books, a Massachusetts General Hospital, Vincent Memorial OB/GYN Service consultant, and accomplished triathlete, Dr. Dweck offers her expertise across various platforms in an effort to destigmatize gynecologic issues and support women’s health across the country. She resides in Westchester County with her husband, their two sons, and their extraordinarily girly English bulldog.   

The current strain of the stay-at-home lifestyle has already led to poor dietary choices for many. Whether you’re finding it hard to source healthy foods or reaching for junk food to offset stress, eating poorly can impair your cells. What are the cellular effects of poor diet, and how can we best counteract the harm caused by unhealthy foods?

Poor food choices can lead to malnutrition.

We all know eating well generally leads to feeling well. But coping with additional stress during this unprecedented time makes it more tempting than ever to select foods that satisfy in the short term, and damage our health in the long term.

When we keep our diets balanced and full of whole, natural foods, we equip our cells to thrive. Our metabolism hums right along, and we give ourselves an energy source that burns evenly over time. But when we eat poorly, immunosuppression and lowered NAD+ levels follow.

A study published in Nutrition Journal demonstrated that malnutrition can cause immunosuppression.

Malnutrition happens when we don’t eat enough foods that provide the vitamins, minerals, and sustenance we need to function normally day-to-day. And when our immune function becomes suppressed, our cells become more susceptible to infection and less protected against various types of disease.

Malnutrition is generally caused by either not eating enough in general, or eating too many foods devoid of nutritional value.

Understand the consequences of overeating.

But not all of us have fallen victim to this type of nutrition deficiency during these trying times. Some overeat foods that are generally considered healthy in order to offset the stress and lack of control they’re confronted with.

Overnutrition occurs when our nutrient intake becomes oversupplied. While it might seem logical to pile on the fruits, veggies, vitamins, and supplements right now, our cells suffer when the amount of nutrients we’re ingesting exceeds the amount necessary for normal growth, development, and metabolism.

If you’re overcompensating for current health worries by overdoing it in this area, consider changing your approach. Overnutrition can cause low-grade, chronic inflammation that compromises protective immunity, and increases the risk of cardiovascular and metabolic disease.

In a study published in Frontiers in Immunology, one team of scientists found that malnutrition decreased cellular leptin levels, while overnutrition induced the opposite effect.

Leptin is a hormone our fat cells secrete in order to help regulate body weight. We count on leptin to regulate our appetite and control our energy expenditure over time.

When our leptin levels climb too high, our body’s ability to dictate appetite based on current fat stores gets scrambled, and we end up ingesting food we don’t actually need to run efficiently.

When leptin levels drop too low, our body responds by over-stimulating our appetite in order to build more fat and the rate at which we burn calories in a resting state decreases.

Poor diet affects our NAD+ levels.

Poor diet has a profoundly negative effect on our cells whether we’re eating too much or too little. When nutritious eating habits fall by the wayside, so do our NAD+ levels.

NAD+, or nicotinamide adenine dinucleotide, is a vital coenzyme that supports cellular repair, energy, and metabolism. When we eat poorly, our NAD+ levels and the cellular processes supported by steady NAD+ production suffer.

However, NAD+  supplements can supply your cells with the necessary nutrition to support your NAD+. When environmental factors out of our control make it difficult to regularly consume healthy foods, NAD+ supporting supplements can make a difference by working symbiotically with the body to curb cellular strain.

You have control.

You have control over what you choose to consume, and it doesn’t take an extensive knowledge of nutrition or a big budget to be mindful about dietary choices. To maintain a healthy diet, do your research, shop thoughtfully, and listen to your body. Your cellular well-being depends on it.

In the midst of a global health crisis, people all over the world have been confined to their homes for prolonged periods of time. For most, this “new normal” has taken a toll in many respects. With our usual workout locations closed, our only option is to try staying active within a limited amount of space. And for those who are older, infirm, or who have health conditions that preclude outdoor exercise or vigorous physical activity in general, it’s become necessary to slow down.

While we’re all well aware that sitting around too much is bad for our health, we rarely examine the repercussions for our cells. So what are the cellular effects of this troubling lifestyle, and how can we guard against them?

The connection between sedentary living and telomeres.

Scientists have already demonstrated across various studies that regular exercise and maintenance of cardiorespiratory fitness are directly linked to better health. So it makes sense that when we can’t exercise, our cellular well-being inevitably takes a dive.

In one study published in Medicine & Science in Sports & Exercise, scientists examined the effects of a sedentary lifestyle on the preservation of telomeres, which function as the protective regions of our DNA. Found at the ends of our chromosomes, telomeres help maintain genetic stability.

As a consequence of cell division, oxidative stress, and inflammation, telomeres erode. This erosion serves as an indicator of cellular aging.

Regular physical activity is linked to reduced oxidative stress and inflammation, and several large studies have reported a beneficial connection between physical activity and telomere length. The evidence from the aforementioned study suggests that a sedentary lifestyle can contribute to telomere shortening.

Another study published by the UCSD School of Medicine found that women who sat for 10 hours a day and exercised for 40 minutes or less had shorter telomeres than women who are more active.

And yet another study from the Archives of Internal Medicine shows that men and women who are less physically active in their leisure time experience expedited erosion of leukocyte telomeres compared to those who are more active.

Move your body.

So how can we guard against the debilitating effects of prolonged sedentary time, and protect our cells from eroding too fast? The first step: get moving.

If you have the ability to exercise, go for a run, jog or walk— even if that means finding creative ways to do so at home. The rush of endorphins will help your cells thrive, and will help your mindset as well.

You can also find a bevy of resources on the internet. In response to stay-at-home orders, droves of personal trainers, gyms and fitness studios are offering a variety of exercise routines online at no cost. From national chains to independently owned facilities, offerings span a wide range.

Whether you’re a yogi, a dancer, or a fan of circuit training, the only thing you’ll need to get active is the willpower to press play. This equipment-free 10 minute workout by fitness expert and ChromaDex advisor Jen Cohen is a great place to start.

Prioritize cellular nutrition.

If you want to double down on your cellular reinforcement, you can also consider adding a supplement to your wellness regimen. Supplementing with cellular nutrients can provide additional support for your cells. NAD+  supplements work to stimulate energy on the cellular level.

While NAD+ supplements don't replace the need for exercise, they afford an added layer of resilience and support as your cells reap the benefits of healthy physical activity.

And for those struggling to get active, NAD+ supplements help support the depleted NAD+ levels sedentary life inevitably triggers.

Strike a healthy balance.

Though it’s tempting to resort to extremes during trying times, it’s more important than ever to prioritize health and stay active. The next time you’re tempted to spend the day on the couch or overdo it on the burpees, think of the cellular consequences. If you strike a healthy balance between lounge time and physical activity and lend your cells some extra support with the right nutrients, you could emerge from this period feeling better than ever.