We recently opened the doors of The Longevity Practice for our first community event of the year. It was an evening filled with honest conversation, expert insights, and a deep dive into female health, specifically focusing on perimenopause and weight management.

Hosted by our founder, Dr. Maya Fehling, alongside Anne, founder of the female health data startup HER-MED (hermaid), the event explored how we can increase our healthspan—keeping us healthy and independent for as long as possible.

If you missed it, here are the key takeaways from the night.

The "5 Horsemen" of Mortality

In longevity medicine, we typically look at the four main causes of death: cardiovascular disease, cancer, neurodegenerative disease, and metabolic disease.

However, Dr. Maya introduces a critical Fifth Horseman: Bone Health which refers to fractures due to Osteoporosis. Often ignored, fractures in later life can lead to a loss of independence, disability and death within months. The good news? Osteoporosis is something we can actively prevent through specific lifestyle interventions as well as hormonal balance.

The Perimenopause Shift: Why We Gain Weight

A major topic of the evening was the frustration many women face: gaining weight in midlife despite not changing their diet or exercise habits. Dr. Maya Fehling explained the physiological reasons behind this:

  1. Insulin Sensitivity: As estrogen drops, our cells become less sensitive to insulin. This keeps blood sugar higher and signals the body to store fat rather than burn it.
  1. Visceral Fat: This fat doesn't just sit on the hips; it moves to the belly (visceral fat), where it is metabolically active and increases the risk of cardiovascular disease and inflammation.
  1. Muscle Loss: From age 40, we lose about 8% of our muscle mass per decade. Since muscle consumes energy, losing it slows down our metabolism.
  1. The Sleep-Stress Cycle: Hormonal shifts affect sleep, increasing the hunger hormone (ghrelin) and cortisol, leading to emotional eating.

The 3 Golden Rules for Management

We discussed actionable strategies to combat these changes. Here is what you need to know:

1. Protein is Queen: To maintain muscle, the recommendation is high: aim for 2 grams of protein per kilogram of body weight (or at least 1.6g).

  • Tip: Eat the protein portion of your meal first. It increases satiety, making it harder to overeat carbs or fats subsequently.
  • Tip: Women should avoid training fasted; try a small protein shake before working out to support muscle synthesis.

2. Lift Heavy and Jump: Yoga and cardio aren't enough. We need resistance training (heavy weights) to build muscle and plyometrics (jump training) to stress the bones and prevent osteoporosis.

3. Measure What Matters: Forget BMI. A simple and better metric for metabolic health is the Waist-to-Height Ratio, which should ideally be below 0.5.

The Nuance of GLP-1 Agonists

The discussion touched on the rise of weight-loss drugs like Ozempic and Mounjaro. While effective for heart health and insulin resistance, they carry a risk: up to one-third of the weight lost is lean muscle mass. Dr. Maya’s approach involves "microdosing", starting low and going up slowly, with a strict "contract": clients must engage in resistance training and hit their protein targets to ensure they lose fat, not muscle.

Join Us Next Time

We ended the night with a Q&A on Hormone Replacement Therapy (HRT), discussing how estrogen and progesterone can support muscle building and energy. This will be the dedicated topic of our next event in three weeks.

If you are interested in a personalized roadmap for your health, learn more about our 360 Longevity Check, a comprehensive 3-hour assessment covering everything from VO2max and grip strength to advanced blood panels.

See you at the next event!

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Disclaimer: This information is for educational purposes only and is not intended to diagnose, treat, or prevent any medical condition. Consult with a doctor before making any changes especially if you have existing health conditions or concerns.