70 % of who we are today is due to lifestyle.
It's only 30 % it's actually controlled by genetics
so we cannot blame our genes. Why should women
want to be more metabolically healthy? The other
thing we talk about is belly fat or in other
words visceral fat and it's the hormone or it's
the product that's released by the muscle that
helps in breaking down the fat. What does 30
grams of protein look like on a plate? It's being
conscious about what you cook and every time
you eat, just think about it. You know, is this
really 25 grams of protein? Is this ultra processed
food? Is my carbs at 80 % and my protein is 20
%? Protein loads the gun. Resistance training
pulls the trigger. Right. So if you really want
muscles to develop, it's not enough to just eat
these enriched foods or these protein rich foods.
It's that you must also do the exercise. As humans,
everybody blames age for everything, including
putting on weight, feeling weaker, difficulty
sleeping. It's all about asking yourself, why?
What can I do? Which muscle strength? Which part
of my body do I need to strengthen? And yeah,
I think, you know, we shouldn't be blaming age
for all this. The 40s Formula. The 40s Formula.
The 40s Formula. Hosted by Jasmine Dillon, integrated
health strategist specializing in gut health,
hormones, and midlife well -being. And Amanda
Lim, director of Lift Clinic and a leading expert
in female strength and metabolism. Named one
of CNA's top podcasts and winner of the 2025
Asia Podcast Awards in the Best Health and Wellness
Podcast category. The 40s Formula is your no
-fluff, Science Meets Real Life Guide to Thriving
in Your 40s. No one really prepares women for
what happens to their muscles, metabolism and
energy in their 40s. We hear a lot about hormones
and hot flashes, but not about the quiet changes
happening underneath. Changes that affect how
strong we feel, how well we recover and how we
age. That's why today's episode is such an important
one. We're joined by Associate Professor Reshma
Merchant, one of Singapore's leading voices in
healthy ageing. Her work looks at exactly what
happens to strength, protein needs and functional
health as we get older and why midlife is a decade
where these shifts really start to show up. If
you're a woman juggling career, kids, stress
and the realities of perimenopause, then this
episode will give you real clarity. How much
protein do you actually need? Is walking enough?
What are the earliest signs of muscle loss? And
what can you do right now in your 40s to stay
strong and independent for the long term? It's
a conversation every midlife woman needs to hear,
especially if you want to feel capable, confident,
and in control of your health again. Before we
get started, a quick reminder. If you're enjoying
these conversations, make sure you like, share,
and subscribe wherever you get your podcasts.
And send this episode to a friend in her 40s
who's always tired or struggling with energy.
This one might be exactly what she needs. Hi,
Reshma. Thank you so much for joining us today.
Thank you for having me around. Oh, we are so
excited. So Amanda has been super excited about
today's episode. Wanted to have you on here because
we really want to speak about the work that you've
been doing. And I think before we get into that,
can you tell us why you think protein is such
an important conversation for us to be having
as women now in our 40s? Well, I think we should
be speaking about protein much earlier than 40s,
but definitely 40s not too late. And I think
40s is the age that if we don't do anything,
we're going to pay the price for it later. You
realize late 40s, early 50s is just kind of downhill
decline. And really protein is something we know.
We speak about it every day, but we actually...
do not realize how much protein we're actually
consuming unless you really objectively think
about it. It's a low -hanging fruit, and literally
having the right amount of protein with the right
type of movement, and I mean exercise, you can
really preserve your muscle, which is not just
about mobility, which is also about your health
as a whole, your metabolic health. And this is
the thing, I think people think about protein
and think, okay, maybe it's a weight loss tool
or give me bigger muscles. But you're actually
saying that it will change your metabolic health.
In what way? Like, why should women want to be
more metabolically healthy? Absolutely. So with
muscle, actually muscle is about 40 % of our
body weight, body mass. And what we now know
that it is an endocrine organ, and by that I
mean it produces a lot of hormones, which stimulates
the brain, that makes your brain cells proliferate
and grow, good for your liver health. So we now
know that if you look after your muscle, you
have lower prevalence of fatty liver, which a
lot of women are worried about. The other thing
we talk about is belly fat, or in other words,
visceral fat. It's the hormone or it's the product
that's released by the muscle that helps in breaking
down the fat. And I feel like every woman should,
not even women, I feel like everyone can. Women
and men, both should be concerned, right? So
again, we're very focused with exercise about
muscle, but we forget about what actually muscle
does. So what I heard there was also that it's
not brain or brawns. Basically, if you got the
brawns. Your brawn feeds your brain. Exactly.
And when you say hormonally active tissue, can
we break this down a bit more? I think, you know,
something that we use that we say in our practice
with our patients and clients is that, you know,
women with higher skeletal muscle tend to experience
lower vasomotor symptoms through menopause, for
example. Okay. So that's that. Would that be
an example of the way that muscle affects endocrine?
production or are there other ways that we should
be aware of? I mean, muscle, as I said, affects
every organ in the body, which, as I said, it
releases a product called brain -derived neurotrophic
factor. I know it sounds a mouthful, but essentially
it just grows that part of the brain that kind
of shrinks in Alzheimer's dementia. So basically,
as I said, it helps your pancreas. It also stimulates
glucose uptake in the muscle. And if you don't
have enough muscle and then you get resistance
to insulin, again, you're going to put on more
weight. And we also know that your menopause
symptoms, hot flushes, I mean, muscle is definitely
one of it. But again, it's just the movement,
adequate sleep. Everything is connected in our
body. I actually was having a conversation with
a client yesterday and to try and encourage her
to go into the gym and do strength training.
I was like, the more muscle you've got, the more
carbs you can eat. Facts, real facts, okay? Everybody
hear that, right? It is a true thing. And when
it comes to the insulin resistance piece, I think
for a lot of women here in Singapore, and you
can correct me if I'm incorrect, I think their
first taste of the relationship of muscle or
lack thereof. And insulin resistance and that
being a problem is gestational diabetes in pregnancy.
I feel like that's the first little signal. Absolutely.
I mean, as I said, I mean, we have to focus on
prevention across the life cycle. And we also
know that. Charity starts at home. So whatever
you do at home is going to impact your whole
family, your children, and if you have grandchildren,
that too. So again, it's really important at
any stage in life to start looking at exercise,
at protein. And there was a recent study that
was released from the UK, from Oxford. And they
found that the BMI at the age of 10 years old
was predictive of early mortality as well. Wow.
Can you dive into that a bit deeper, meaning
high, low? Or high BMI at the age of 10 years
old. So again, for women in 40s, they may have
teenage children at home. And it's, again, so
important to just have a healthy lifestyle as
a household. Because what we eat is what our
children are going to learn from us. And if we
go and do our exercises, it doesn't have to be
gym. It could be done at home. It could be done
while you're waiting for your kettle to boil.
It could be done while you're brushing your teeth.
It could be simple squats. So again, it's our
children will also learn from us. What are two
things that parents could do now, today, to model
better muscular health for their kids? I mean,
again, it's all about lifestyle. So firstly,
I need to emphasize that 70 % of who we are today
is due to lifestyle. It's only 30 % it's actually
controlled by genetics. So we cannot blame our
genes. And if I say lifestyle, again, it's basically
what you cook at home, you know, and try to discourage
ultra processed food because we know so much
about ultra processed food being harmful. If
you eat just to make sure your proteins are there.
And when we're cooking or when we're eating on
the table, I mean, what I used to do with the
kids is, oh, you know, you've eaten one egg.
This is only six grams, you know. So I think
it's educating on the go. It's really important.
I love it. Make an egg competition. All right.
Who can eat the most eggs at this table? Timer
starts now. At least that's my house. In addition
to that, besides exercise and nutrition, again,
as family, you need to emphasize sleep. I mean,
it's really important, half nine, 10 o 'clock,
all the lights off, everybody's in bed, no phone,
no social media, because sleep is another thing
that we often forget and there are no supplements
for sleep. There are not. There are not. Not
really for exercise either. So two things you
got to handle. And that's the thing, I guess,
as humans, you know, did we not need sleep? We
would have stopped sleeping. millennia ago you
know so it's definitely part of the recovery
process now muscle decline starts to happen at
the age of around 30 why is it so important then
that we focus on preserving our muscle mass what
are the risk factors especially when we reach
kind of late 30s early 40s if we're not going
to put effort in it we're going to end up losing
a lot of muscle And that's when, that's a time
in our life, that's a decade in our life where
the hormone changes happens. The fat gets diverted
to different areas. And people who don't put
in an effort, you realize by late 40s, you have
fats in your love handle, in your belly. And
it's ever so important, that particular decade,
if you take care of it. Hopefully, as you rightly
said earlier, you know, I mean, during your menopause,
you may not experience a lot of symptoms. At
60, you can look as though you're 40 years old.
Can we talk about how no one prepares you for
how your skin changes in your 40s? Honestly,
one day it's fine. The next it's dull, dry and
showing every single emotion you've ever felt.
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which seems like a very rare little treat. And
yes, we earn commission when you use our code.
So don't forget to support the show by using
code TFF. And again, as all the chronic disease,
we also know from the studies that we've done
that the incidence of high cholesterol or hyperlipidemia
goes up significantly between 50 to 60 year olds.
And that's scary, isn't it? Yeah. And if only
if we knew about it in the 40s and if we could
prevent that, you know, that would be fantastic.
Well, and you said putting in effort, right?
And I would say the two of us are definitely
on this train where it's like it is now time
to take. Action toward your health. You can no
longer ride the coattails of youth. That has
gone beyond. Now it is time to take action. But
are there efforts that are more bang for your
buck than others? Are there ways that we can
invest in our movement and nutrition that will
pay off better than other forms? Definitely there
are. And I have to say the 40s is one of the
most difficult times in life. You're juggling
with aging parents, with teenage children, with
your career because you may be holding some leadership
positions. And really having to find time to
do resistance exercise, it's ever so important.
I mean, some people think it's about going to
the gym. It's you can do it. even at home. So
you need at least twice a week of resistance
exercise. We need to watch what we eat and need
to consciously make an effort that you take at
least about 30 grams of protein each meal during
the day and not skip any of the meals just because
you're rushing with your day -to -day task. What
does 30 grams of protein look like on a plate?
That's a very good question. And you'll be amazed
how many people don't really know how much protein
they're eating. So essentially, if you're talking
about lunch or dinner, we're talking about a
palm size of meat, be it chicken, fish. And if
I need to kind of drill it down a little bit
for breakfast, for example, one egg, as I mentioned,
is six grams. Perhaps a slice of cheese is six
grams. A glass of milk is about six grams. And
essentially, if you want to have a proper kind
of 25 to 30 grams breakfast, you could consider
having a Greek yogurt with chia seeds, fruits,
and nuts. These are kind of simple on the go.
A person like me who likes to eat oats, sometimes
I do supplement with a scoop of whey protein
in it together with nuts and fruits as well.
I had this morning. Real talk. This is exactly
what I had this morning. Yeah, I call it Proatmeal
QTM. Yeah, it works. Yes. And if you want a variety,
you could have eggs on some days and supplement
with... cheese or something like that. So again,
it's being conscious about what you cook and
every time you eat, just think about it. You
know, is this really 25 grams of protein? Is
this ultra processed food? Is my carbs at 80
% and my protein is 20 %? Can I throw a challenge
though? So say I'm at the kopitiam and my usual
breakfast is two eggs, kaya toast, kopisi. Like
how am I adjusting? my norms to get a higher
protein meal if I'm out and about? Difficult
question. I think we've all kind of eaten our
kaya toast and had our two eggs and there's definitely
nowhere I would say probably 15, 16 grams probably
at most. That's a beautiful estimate. High end
estimate, assuming your bread is packed with
fortified protein. Exactly. That's most, but
it's really important. I mean, really, if you
cannot grab something else, I mean, I do sometimes
do take some protein drink in between mid mornings
just to get us going. But the one thing is really
important to bear in mind is not just about protein.
It is again, because if you're going to take
your protein and you're not going to put in your
exercise there, that protein may turn into fat,
right? Yeah. So again, and it's also advisable
for people who do do exercise or resistance training.
I'll go to the gym in the morning sometimes to
maybe try to take protein within two hours of
your exercise because that's where your peak
muscle protein synthesis happens as well. So
you did a study back in 2023. It was the leucine
enriched protein plus exercise study. Now we
want to hear all about this, but before we sort
of dig into what happened and what your findings
were, can you just explain what leucine is? Because
I feel like some people might hear this term,
but not necessarily understand what it means.
Other people sort of use protein as a generic
term and say, oh, I get my collagen. Yeah, exactly.
You know, so if you could just explain to us
what is leucine? Yeah, I mean, protein, as you
said, is just a buzzword, right? A bit like exercise
is another buzzword. I mean, protein, you have
different types of protein. You have animal protein,
you have plant proteins. And leucine is one of
the amino acids. It's one of the building blocks
within the protein. Most proteins, or rather
I would say most animal proteins and some plant
proteins do have embed leucine in it already.
And you really need to think about your quality
of your protein. So we all know, for example,
whey protein, you know, has got leucine in it.
You probably don't need additional leucine. But
again, if you are taking some different types
of protein or different types of plant protein,
you need to consciously be aware about which
are the ones that contain leucine because it
does accelerate your muscle protein synthesis.
I mean, there's some plant proteins that do have
leucine as well. What are some of those? Soy
protein. tofu, tempeh, pea protein, you can consider.
So again, it's just being conscious about protein
as a whole. And so what did you find in that
study? Yeah, so really interesting. I mean, this
is a study that one of our co -authors was somebody
from Health Promotion Board and another co -author
from Thomaset Polytechnic, who also looks at
nutrition. And we actually focus on people in
their declining trajectory, still independent,
but we call pre -frailty. What age range is that?
That was 60 years old and above for people with
pre -frailty. And, you know, it may just mean
I feel a bit tired. I feel I'm slowing down a
little bit. And who are taking less than one
gram per kilogram per body weight. So if somebody's
60. And they're taking anything less than 60
grams a day, which still comes to 20 grams each
meal, which I'm sure a lot of people will qualify
for that. And we gave them additional about 17
grams of protein. So just a top up of 17 grams.
It was just a top up. And what form was that?
Interestingly, we worked with different F &B
companies locally. Well, you know, even soy milk
and granola bars with soy milk, chicken porridge.
So these are the ones with the local F &B companies
that she provided to the participants. Wow, okay.
And they actually beefed their protein up on
average to about 1 .3 grams per kilogram per
day just by supplementing the 17 gram. And interestingly,
for those who took the protein, and did exercise.
And the exercise, there was a resistant component,
but it was kind of, we call it multi -domain.
There's some cognitive exercise. There was resistant
component, balance component. And at three months,
for people who had the protein and exercise,
improved in all their physical function measures.
Walking speed, sit to stand, balance, falls.
And also inflammation. So we did check some blood
tests to see whether it affected inflammation
in your body. As we know, when we reach 40 years
old, the inflammation in our body just goes higher
and higher and higher. And that's where the fat
gets deposited. But for people who only consume
the protein without exercise, we did notice the
inflammation level did go down. However, the
muscle mass did not really reach any significant
level. So it really shows that it's the resistance
exercise that stretches the muscle, that releases
all the goodies from the muscle that actually
helps you in different parts of your body. So
basically, the protein is good, but in order
for it to work, you need the combination of the
two. The strength training or the exercise must
be combined with protein, but in this case, leucine.
In this case, it was leucine and protein. Okay.
So leucine, you actually need less than three
grams of leucine. Okay. Is that overall or per
meal? It's about per meal. Okay. Yeah. So we
supplemented with leucine and protein. Okay.
Because some of the protein diet or the protein
food that they received was mainly plant protein,
soy and granola. But yeah, so it was protein
plus the leucine. Yeah. So anything between two
to three grams per meal is actually sufficient.
The way we explain it to clients, I think you've
probably used this metaphor as well, is that
protein loads the gun, resistance training pulls
the trigger, right? So if you really want muscles
to develop, it's not enough to just eat these
enriched foods or these protein rich foods. It's
that you must also do the exercise. Now I'm interested
in this experiment. What was the resistance exercise
program? that they were on? It's a very valid
question. And again, this was done at the community
setting. This was done in community centers,
in the white deck. And it was just resistant
bands, really. Perfect. We used to, you know,
we used to tie the resistant band on the pillars
and then they used to sit there and pull on the
resistant bands. It could just be sit to stand,
try to stand up from your chair without holding
the handles. You could do balance exercise. You
could just walk in a tandem gait. If you're worried
about falling, you can have a stack of chairs,
I mean, a line of chairs there. It could be as
simple as that. Really simple stuff, though.
Things that your elderly parents could absolutely
do at home. Absolutely. Because I guess this
is, it's like for untrained individuals, that
is loading their muscles in a way in which they
would never have done. Now, obviously someone
like Amanda could definitely. Yeah. I wouldn't
be getting jacked from like hundreds of sit to
stand. Okay. But, but again, my, my elderly in
-laws would like, that's something that would
work for them. I need to know about this term
pre -frailty. So thinking about what, what my
husband and I do at our preventive health clinic
is we're, you know, we're focusing on before
the disease. So pre -diabetes, early signs of
insulin resistance. So pre -frailty, is this
an ALMI cutoff? Is there a diagnostic for pre
-frailty? So there are many, many diagnostic
criteria, many terms that we could use to classify
ourselves as pre -frailty. So your ALMI, which
is essentially muscle mass, it's mainly, I would
say, for early sarcopenia or possible sarcopenia.
Because sarcopenia essentially means low muscle
strength through hand grip strength and low muscle
mass. Low muscle mass alone may not necessarily
classify you as being sarcopenic. It has to be
low function. It has to be low function. Pre
-frail, I mean, we use simple skills like a frail
scale, but some of the indication is you feel
extraordinarily tired. If you go up the stairs,
you have to hold the handrails. So this is a
self -guided questionnaire. You could do self
-guided questionnaire. The frail scale, by the
way. Yeah, I love it. I love it. If you Google
a frail scale, essentially fatigue, difficulty
walking one bus stop, difficulty. climbing one
slide of stairs. If you have five or more chronic
illness or you have lost... Five or more chronic
illnesses? You pre -failed. Okay. You definitely
had a frailty. Yes. Or you have lost weight,
basically significant weight loss. And I guess
with that sort of weight loss, you're talking
more about... muscle mass loss or is it just
overall body weight? Weight loss, it's another
story altogether. I think we all want to lose
weight, but I think the most important thing
to remember is we have to make extra effort not
to lose your muscles. There you go. Preach, Reshma.
Yes. While you're trying, because I've seen so
many people who try to skip meals, who try to
eat small portions, thinking they're going to
lose weight, they end up losing muscle. Yes.
And with Asian particularly, there's this high
prevalence of skinny fat syndrome. They may be
skinny, but they have high percentage of body
fat. Can you talk about the sarcopenic obese?
Because I think that's kind of, that would be
the term -ish for skinny fat, but almost like
low muscle fat. So again, sarcopenic obese. So
sarcopenic is muscle loss and obese is obese.
We actually have another study that we've done
locally amongst the population Bukit Panjang,
about 1 ,000 or older people above 60 -year -old.
But essentially what it really means is BMI is
not real marker for obesity. BMI is a composite
of fat mass and fat -free mass, which is muscle
again, right? And what predicted a bad outcome
in somebody was their waist circumference. BMI
and high waist circumference. And people with
even normal BMI and high waist circumference
did equally bad in their function, their cognition,
their quality of life. So then BMI wasn't actually
predictive of poor function. No, it didn't. So
people with high BMI with a normal waist size.
waist circumference they actually did much better
especially men what would you consider as uh
i guess um a normal i mean i don't have normal
yeah like what what would the cutoff be for a
waist circumference let's say for a woman for
women um it's about 30 inches so if you're wearing
pants that uh much larger than that and for men
i would go for 40 40 feels quite generous. That's
pretty generous. I was just going to say, I was
like, wow, that is generous. Yeah. And interestingly,
again, I had another patient who told me one
of the ways to know whether you've got a big
waist circumference is to, if you eat and the
food drops on your tummy, and that's a sign you
have a higher waist. Oh, so that's, you know
what? Well, I don't know. It happened to me this
morning. I was kind of trying to lean over, having
my cottage cheese on my toast as I bit into it,
the kind of cottage cheese drop. So I'm going
to take that as in, I don't think it was my big
tummy, but more what I was eating. I remember
a girlfriend who was well endowed telling me
that that was a constant battle for her is food.
And I was like, yeah, it doesn't really happen
for me. It just kind of slides right down. Not
a lot going on here. You also did another study,
which was whey protein and vitamin D. Now, can
you tell us a little bit about that study? Now,
what was that study about and what were your
findings? Yeah, so this was actually the PRO
-WIDE study that was actually done in Europe,
if I'm not mistaken. That was an RCT, RCT one?
Yeah, it was an RCT, yes. But what they did,
okay, that was a really different population
category. So those people were really sarcopenic.
They really had low... functional kind of strength
and much lower muscle mass. And they then categorized
to one group that got the whey protein and vitamin
D, and the other group did nothing. And, I mean,
again, it showed that those taking protein and
vitamin D had much lower inflammation at three
months. But in terms of functional measures,
Because there's no exercise in there. There was
only protein, right? I mean, there was a very
marginal improvement in sit to stand by about
one over seconds. And very, very, very marginal
improvement in muscle mass. But that was about
it. So while the study did show it was positive,
yes, it was good. But if you really look... deep
down to the numbers, without exercise, you're
not going to get much out of it. It could have
been better. It could have been much better,
yes. I'll give you a case study. Lives in my
house, my mother -in -law. So my husband and
I took her in -body recently, and we've been
tracking her SMI and ALMI, you know, same. And
unfortunately, it has declined from 5 .7, already
not superb, to 5 .6. And so we're inching toward
that sarcopenic threshold. And so, which I recently
found out, by the way, from Dr. Mia. has actually
gone up to 5 .5. Is that true for the Asian working
sarcopenia group? I mean, they have a different
cutoff, but it's about the same as before, though.
We haven't really changed very much, unless if
you're younger. Oh, okay. I guess that must be
what she's talking about. We've got different
age, yes. But yeah, so it's been declining. We've
been concerned. And of course, first line of
defense. they're willing to take supplements,
right? So she was willing to kind of hear our
spiel about the protein and hear our spiel about
the vitamin D. So we did that for a bit, but
it didn't really make a huge difference. And
so finally we were able to actually get both
my mother and father -in -law into the gym, working
with a personal trainer that is experienced in
working with elderly and helping. And what's
interesting is exactly what you said. And now
we haven't, that intervention has just begun.
So literally they went for their first session
two weeks ago, but I would venture to guess.
that seeing that intervention play out over 12
weeks is going to produce better results than
the nutritional intervention alone based on your
work. Absolutely. I mean, even just one month
with the gym, perhaps, and the nutritional supplements,
I'm sure, you know, they will start to feel much
better. But in terms of all the other measures,
you need to wait for three months at least. And
I think the other thing that we forget is after
three months, a lot of people drop it. Yes. Yes,
I'm better. I don't need it anymore. They see
the change. They're like, well, that's enough.
I fixed it. Yeah, but that's not the way. It's
just the continuation is the persistence. You
could do something else, but it needs to continue.
Yeah, and the sad truth is the effort level actually
kind of keeps going up, right? It's like you
still need to progress. The newbie gains only
last so long. Yeah. And, you know, I feel like
even women that we see, you know, they're on
this like weight loss journey, but they don't
really think about the long term. They just think
about, right, when I get to this weight or this
body composition, which actually is never really
the body composition, it's always the weight,
you know, then I'll be fine. But it's kind of
like, well, you kind of need to progress and
continue because otherwise you'll fall back into
bad habits and then be... probably worse off
before you started as well. I would argue that
a weight loss journey that involves disproportionate
muscle loss is going to leave you worse off.
Absolutely. Yeah, I agree. And people forget
about it. You mentioned before that sort of 30
grams per meal is like the ideal amount. Now,
if we were to break that down as a per gram for
body weight, what do you recommend then as a
sort of a daily total based off of your body
weight? I would say probably 1 .2 grams. per
kilogram of body weight. So again, you just need
to calculate if you're 40 kilograms or you're
50 kilograms, you can just break it, you know,
you can just calculate. For some, it could be
20, between 20 to 30, depending on your weight.
And that's a minimum, right? Oh, that's the minimum.
Absolutely. That's the minimum. I mean, I have
to say that the recommended daily allowance,
people will kind of argue and say it's 0 .8 grams
per kilogram per body weight. However, if you
go to the Health Promotion Board website, they've
now amended that to 1 .2. If I'm not mistaken,
I think it's in about 50 or 55. I'm not quite
sure, but they've amended that. But really for
women, it's a different ballgame altogether because
it's just the hormonal changes that are happening.
And if we don't intervene then, you're going
to pay the price for it. So what do you think
is the ideal then? So if 1 .2 is the bare minimum,
what do you think women should be aiming for?
Well, think 1 .2 to 1 .3 or 1 .2 to 1 .4. I think
you don't want to take too much as well. I mean,
there's studies to show. I mean, I recently reviewed
a study, you know, somebody and they were taking
protein 1 .8 gram and that was definitely harmful.
So you don't want it to go the other extreme.
Yeah, harmful in what way? I mean, with very
high protein. Depending again, what's your underlying
condition is, obviously you want to make sure
you have no kidney disease. I mean, I can't exactly
remember, but obviously mortality is the other
part that you need to worry about. But again,
maintaining a balance of 1 .2, I would say to
1 .5. Obviously, if you're doing a lot of weightlifting,
you can take more. That's perfectly fine. And
I'll argue if you're building a baby, you might
need some more. Yes, yes. Again, if you're ill,
if you're hospitalized, you're doing weightlifting,
I mean, you know, much higher than 1 .5, I mean,
over 1 .5, 1 .6 is okay. But on a daily basis,
I would say 1 .2 to 1 .5 will be the right amount.
So based off of your sort of activity levels
and your personal needs, you should adjust your
protein intake. depending on what you're doing.
Absolutely. Because as I said, if you're going
to take a lot of protein and you're not going
to exercise, that is going to turn into fat.
Yeah. Yeah. That needs to be heard as well. Right.
Protein isn't magic in that sense. It's not above,
you know, it's a provision of calories just like
anything else. Right. So if we were to sort of
look at sort of early indications then of, of
pre -frailty, what would you say women in their
forties should be mindful of? You know, the very
common symptoms, including now we've got an ongoing
study in the community, is fatigue. You'll be
amazed, but one third of them say they feel tired
most of the time. And obviously the tiredness
also comes with sleep. And we know with sleep,
it affects your, basically your body hormones,
affects your, what we call the cortisol in your
body. When that goes up, the fat level goes up.
So fatigue is definitely one of the ones that
you need to be wary about. Other things, as I
said, if you sit on a low sofa and you have a
problem getting up, then you need to worry about
it. If you go up the stairs and you're worried
that your balance is affected, you need to worry
about it. Okay, so balance, getting on and off
a chair without assistance or having trouble
getting on and off a chair, unexplained fatigue
potentially. But I think exactly what you said,
this is confounded. with other lifestyle elements,
right? If, for example, I'm undernourished, I
may have low energy. If I'm terribly, if I'm
sleeping terribly, short sleep, interrupted sleep,
I might be, you know, so is it worth it in your
opinion to kind of look at these lifestyle elements
one by one? And then kind of at what point do
you get down to the fact that, hey, you just
don't have a lot of muscle? I would think it's
good to be conscious. I mean, I'm usually because
the fact that I know the facts now and I'm almost
mid 50s now. So I'm usually very, very conscious.
So if I feel tired that particular few weeks
and it's always a question is why? Is it because
I'm not sleeping enough? Is it because my diet
has been bad? And, you know, is it because I'm
just too stressed because I have a deadline to
get to? So it's always kind of think. And again,
you need to also think if I'm fatigued and I've
ruled out and ticked all these boxes, do I have
a medical reason to be fatigued, right? So we've
seen a few people with undiagnosed diabetes who
start to feel fatigued. fatigue um and um like
thyroid problem underactive thyroid will make
you fatigue as well i guess iron issues would
be a big one as well especially in the 40s because
uh you know if you're approaching well in the
perimenopause time you know you get heavy bleedings
and things like that so you do have to worry
about your hemoglobin as well yeah so so it's
all about thinking that and again say if you
have difficulty trying to stand up from a low
seat or a sofa The question is, is it something,
do I have a back pain? Do I have a back trouble?
Or do I need to build up on my core muscles even
more? So it's always, I think it's very important
to ask yourself why and then you kind of dig
down, kind of dig deeper about what can I do
about it. So we're going to move on to our favourite
segment, and that is Fuel Your 40s, which is
sponsored by The Meat Club. And The Meat Club
can offer $20 off your first order with code
TFF20. And they have a question for you, Reshma.
And that question is, if you had to design a
simple high -protein meal for a woman who is
busy in midlife, what would that be? It depends
what meal is it. If you're talking about breakfast,
it could be as simple as Greek yogurt, chia seed,
fruits and nuts. If you're on the run, you can
get the protein bowl with quinoa in it with,
well, you can have egg, you can have chicken,
you know, supplemented with greens. But each
time you eat, you just need to think about what
am I eating and how much protein it is. And again,
if you, for your lunch and dinner, make sure
you have at least a palm -sized chicken, fish,
meat in it. Yeah, I love that. That's so easy,
right? If you're wondering what is enough. And
I think it's a really helpful kind of visual
aid as well for folks that are used to eating,
let's say, a soup that has these little shards
of chicken in it, right? Does that add up to
a palm? Let's be honest, it does not. So it's
a helpful metric. Yeah, and I think a lot of
people, they think that they're eating enough.
Yeah, because protein is there. Yeah. It had
chicken. But did it have enough chicken? You
know, it had fish, but was it a fishbowl? You
know, like what's the quality of this protein?
A lot of my patients, when they get a palm -sized,
they actually share it with two people. That's
another thing to remember. That is, you have
never seen me sharing a palm -sized protein,
I promise you that. We're usually doubling up.
Yes, it's double, everyone, all hands on deck.
And what's your favorite protein then? What do
you enjoy eating? For breakfast, usually either
it's Greek yogurt, as I said, or oats with fruits
and nuts and supplement with a scoop of whey
protein. I mean, lunch and dinner, make sure
there is a palm size of either fish or chicken
breast. I mean, meat, not very much, but I try
to make a point. I mean, on other days, as I
said, when you live in a household with three
generations, you also have to be mindful. And
I mean, even things like chickpeas, right? Sometimes
in the evening, if you think there's not enough
protein on the table, you can just make a chickpea
salad with cheese and chickpeas and some tomatoes.
So there's a lot of things you can do to supplement
the protein in your household, even if you're
staying as a family. And I think that's a big
thing, isn't it? Because people say, oh, I don't
like meat. Or I can't eat that much in one sitting.
Okay, we'll break it up into different sources
of protein, you know? We also want to play this
little game that we do, and that's called Hot
or Hype. I'm going to throw out some trending
words, topics, phrases, and I'd like you to tell
us whether you think it's hot or if you think
it's hype, and then you can add in an explanation
afterwards. But collagen for muscle. It's actually
mainly for skin. Collagen is not for muscle.
Say hype. Hype. Hype. What about protein bars?
How to hype? Protein bars, I would say hot only
if you choose the right protein bar with less
sugar. Because I guess it could be a candy bar.
Yeah, exactly right. Yeah. What about plant -based
diets for muscle? How to hype? Well, it's hard.
Plant -based, you have to eat the right plant
-based diet and you need to make sure you get
enough of it. Yeah, I think you're right. I think
it's not impossible, but it will take more planning
and intention. So if planning and intention are
not what you have time for right now, it might
not be the best path forward. What about strength
training once a week? Ideally, it should be twice
a week, but once a week is better than nothing.
Any movement is better than nothing. Preach.
Yeah. You know, there are days where I'm like,
I've got 20 minutes. What can I do? That's it.
Yeah. 20 minutes though is, I mean, if most people
were doing 20 minutes of strength training, even
once a week, that would be a vast improvement.
Yeah, for sure. What about whey protein? Hot
or hype? Whey protein is hot. I mean, it's well
proven, there's evidence base and it doesn't
have to be in the milk base. It also comes in
liquid base as well. Yeah. I think I've started
trying to have that. sometimes as a supplement
because you don't always fancy like that creamy.
Oh, I like never fancy that. Can I be honest?
My husband and I have to have, well, first of
all, if you've seen our protein closet, it's
ridiculous. Like you just say, yeah, yeah. I
mean, we're like the most, whatever, like caricatures
of fit people. But I will say like, we have distinct
tastes in protein. He's got a five kg bag of
milk tea. Like as I'm saying it, I can't. And
then, but I'm, and I'm clear way all day. Yeah.
I love my like mango. my like juicy fruit, you
know, my mojito. Yeah, all the funky flavors.
All the funky flavors. And what about protein
harms your kidneys, hot or hype? It's only if
you have very severe kidney disease. And there's
now guidelines that say if you're feeling weaker,
even if you have kidney disease, you can still
take. enough protein just let your doctors know
there you go it's just like when people are like
you know oh yeah people you know with blood clotting
diseases can't can't take too much vitamin k
well yeah i mean so people with blood clotting
diseases definitely need to be on alert about
a lot of things but it's like your general person
can have a cup of kale it's not gonna kill you
what is one myth about aging you wished women
would stop believing As humans, everybody blames
age for everything, including putting on weight,
feeling weaker, difficulty in sleeping, joint
pains. I think all that is preventable. It's
all about asking yourself, why, what can I do?
Which muscle strength, which part of my body
do I need to strengthen? And yeah, I think, you
know, we shouldn't be blaming age for all this.
blame your aging process. But if you did, like
you said, strengthen those particular areas,
then actually they'll be in a position where
it shouldn't hurt. Yeah. You don't feel the aging
process. Okay. I feel the aging process every
day. Every day. And my children age me so much.
I have three little ones, little ones. So I was
an old mom, right? So I still have a one -year
-old at home, like help. But so all of that being
said, you can definitely feel You can feel like
a 42 -year -old 42. You can feel like a 32 -year
-old 42. Or you can feel like a 62 -year -old
42. And you do kind of do that to yourself. I
think it's the accumulation of lifestyle choices
that amplify with aging. It's not that they suddenly
come on, you know. feel generally maybe like
a 32 year old i'm like 36 i feel like a solid
36 you know this morning my little son i was
like you know doing his top button on his shirt
and um i was like oh why are you so handsome
and he looks at me he goes mommy why are you
so old and i was like oh cheers darling thank
you thank you so much savage commentary this
is what you get when you're an older mom like
us exactly Oh, Reshma, it's been so wonderful
having you on the show. It's been amazing hearing
about the studies you've been doing and the progress
that you're making with ageing and frailty in
the community. But before we go, we do have one
final question for you. And this is a question
we ask all of our guests, and that is, what's
your 40s formula? What piece of advice or mantra
would you like to share with our audience to
help them thrive through this decade? It's important
if you have not started any strength training
to start tomorrow. Even 10 minutes a day is sufficient.
It can be as simple as when you're brushing your
teeth, you could do squats. When you're waiting
for your hot water to boil, you can do some stretches.
And when you eat, you just make sure or just
have something in your mind or you can calculate
some sum in your mind that I'm eating enough
protein. Make a conscious effort to choose your
food that has good quality protein. Protein and
strength. You heard it from the doc, okay? So
now, you know, hear it from this show as well.
Thank you for that very simple but effective
40s formula. Thank you. Thanks. No one really
prepares women for what happens to their muscle.
Oh God, I messed that up. Sorry. That is true
though. That sentence was true. Yeah. But what?
Hold on. I feel like my eyes are going funny.
Right. Let's try that again. This one I can't
increase. I know. This is as big as it gets.
Okay. Okay. When I was reading it earlier, it
came out completely fine. Right. No one really
prepares women for what happens to their muscle.
Oh, fucking hell. Sorry. See, this is why we
have editors. And this is why this is not live
per se. Her work looks at exactly what happens
to strength, protein needs and functional health
as we get older. And why midlife is a decade.
Midlife is the decade. Is the decade, right.
Then this episode will give you real clarity.
And give you real crap.