Dr Sheela Nambiar is an ob-gyn who has specialised in lifestyle medicine, and is also a certified fitness trainer. In a live session on Instagram as part of the #LockdownWithWeekend series, she tells us how to be the best version of ourselves when we hit middle age
Hormonal imbalances, stress, weight gain — life after 40 and beyond can be hard if we look at it through the single lens of responsibility and age. But it can also be liberating, with life experiences, some hard won battles, and a feeling of freedom from the need to conform. Here, Dr Sheela Nambiar, obstetrician-gynaecologist, lifestyle medicine physician, and NAFC-certified fitness trainer, tells us how we can be the best versions of ourselves at 40, 50, 60, and beyond.
A question on everyone’s mind that we don’t fess up to openly: Will we ever have the body we had at 20?
Physiologically, your body has changed so much and you really can’t re-engineer your cells to go back to 20. You can still be in great shape and look fabulous, and there’s a lot you’ve gained over the years — you wouldn’t want to lose all that. You are wiser now and you know better than to over-train, for instance. You have a better understanding of diet, of other things that compromise wellness – sleep, relationships – which we didn’t take quite so seriously back then.
How different is the ageing process for men and women?
Men have a higher percentage of muscle on average, so they burn more calories even at rest. But having said that, if a man eats badly, he’s going to gain weight too. There is something called andropause, which is the male version of menopause – that’s when the testosterone takes a dive and men start losing hair and gaining belly fat. Both men and women need to put in the effort to stay fit and healthy.
What should women expect from perimenopause?
The word menopause just means ceasing of the period — when your period has stopped for a year — and it is usually around the same time that your mother attained menopause. Perimenopause can be anywhere from two to five years. Some symptoms you need to look out for are a delayed period, skipping three or four months, or irregular spotting in between or a long time of no bleeding and then a heavy bleed. The other symptoms are mood swings, bloating, memory issues, hot flushes… They may or may not come, and not all women have all of these. There is some research to say that people who lead healthier lives, eat better, exercise regularly, have less symptoms of menopause.
With age, certain foods that our body was fine with earlier leave us feeling uncomfortable. How do we figure out which ones work and which don’t?
You’ll have to do a form of an elimination diet, which means that if you think that milk doesn’t agree with you (there’s bloating or discomfort) you need to remove that completely from your diet. Many Indians are lactose intolerant, and it gets more prominent as we age. If you really want to eat the food or need to, for some reason, reintroduce it in small quantities to see if the symptoms recur. Also, avoid eliminating a whole group. If channa doesn’t agree with you, you may be able to consume another form of bean.
How do I maintain a sustainable diet through life?
There are many diets, often with conflicting information, but there are some commonalities: a high-fibre diet is beneficial, which means all kinds of vegetables and fruits, beans, nuts, seeds, some whole grains and millets. The two things you really need to eliminate are added sugar and processed food. The human body does not require sugar — even honey or jaggery that produce an insulin response. If you’re not eating sugar, don’t tell yourself you’re on a ‘diet’; you are normal. If you’re eating sugar, that’s the abnormality. You have to consider it a treat: once a week or month.
Dr Sheela Nambiar
Is intermittent fasting recommended?
It is — start with a 12-hour fast. You can have water, black coffee or green tea which do not stimulate insulin. What you’re trying to do is to keep the insulin levels very low. You can gradually increase it to 14 and then do 16 hours once a week or so. It’s also important what you eat during your feeding window – if you eat all through or eat junk food, it would defeat the purpose. If you have diabetes and are on medication, check with your doctor.
How do we build an exercise programme that will last?
Once you hit 40, your focus should shift from doing a lot of cardio to doing more strength. There are several reasons for this: as Indians, we have very little muscle mass. This is detrimental, because it leads to a higher fat percentage in the body, fat around the belly and metabolic syndromes. In order to get a more metabolically active body, which burns calories even at rest, you need to build more muscle, and cardio won’t do that. Don’t be afraid to lift heavy. Once you start to build muscle, your body will change, because muscle produces what is called the after-burn, which means you are burning more calories six to eight hours after, which is what sustains weight loss.
Gyms and weights can scare the beginner and trainers are often ill-qualified. What can we do at home?
You can start with own body weight exercises, like lunges, squats, push-ups, planks, but eventually you will need something more. If you’re not at your ideal weight, you may find it difficult to do these, so you could use free weights and online programmes to help you through: ACE Fitness or IDEA Fit, for instance. They teach you exercises from scratch, and once you learn these, you can build your own routine. As you grow into exercise, try and include compound exercises that use more than one body part, such as a deadlift or a clean and press, or lunges with shoulder press. The main thing is to enjoy the journey, so you appreciate your body and the fact that we can move.
What is the secret to close relationships?
The most successful relationships are the ones where there is some amount of effort put in from both sides, where we set aside time to listen. There has to also be an element of mutual respect for it to grow, and authenticity. Good quality social connectedness improves health. Perceived social isolation (PSI), which springs from lack of connection, can lead to dementia, Alzheimer’s disease and bad behavioural habits (like overeating).
How important is Nature?
Very important. There’s research that even having plants inside your house helps with well-being. If you really can’t get out to a park or even the beach, then nurturing plants on a terrace garden really works wonders.
With high levels of anxiety during the lockdown, how do we focus?
Focus on what you have control over: protecting yourself and building your immunity. So social distancing, sanitisation, eating well, taking zinc and vitamin C, exercising regularly, making sure your prexisting diabetes or hypertension are under control… This is a great time to go off sugar and processed foods, because we know that people who are obese have a greater propensity to develop severe symptoms of COVID-19.