Menopause Part 3: Body Composition, Bone, Brain, & the Fitness Changes (The Data vs the Influencers)

Most women in 2026 are told menopause affects everything, the weight, the belly fat, the bones, the heart, the brain, and that the fix is hormones, supplements, and a proprietary protocol. The data tell a different story. Menopause does some of it, but not all of it.

In this episode, Dr. Jordan Feigenbaum and Dr. Austin Baraki, with OB-GYN Dr. Loraine Baraki at the clinical handoffs, put real numbers on what menopause actually changes, e.g. body composition, the cardiometabolic shift around the final menstrual period, bone, cognition and sleep — and on the single biggest modifiable lever against what actually kills postmenopausal women.

This is Episode 3 of Barbell Medicine's four-part menopause series.

Timestamps:

01:23 Intro
02:45 Body composition & the SWAN study
04:16 How much weight gain is really menopause?
06:55 The answer: about 1.5 kg 08:14 Subcutaneous vs visceral fat
11:08 Why waist beats weight (and body-fat %)
17:21 Does menopause crash your metabolism? 19:02 Clinic: MHT for body composition
23:51 Dr. Loraine Baraki — MHT, weight & testosterone
27:29 The cardiometabolic shift: cholesterol at the FMP
30:18 Insulin resistance & metabolic syndrome
33:12 Blood pressure & 10-year heart risk
34:54 Clinic: the "estrogen crisis" lipid panic
39:13 Bone: the advice vs the data 40:34 Why DXA misses most fractures
41:24 LIFTMOR: lifting heavy with low bone density
44:47 The LIFTMOR results
46:53 Lifting vs Pilates, and falls
52:17 Clinic: "Should I be deadlifting?"
56:14 Cognition & brain fog
57:50 Why brain fog is mostly a sleep problem
59:17 Clinic: brain fog, night sweats, broken sleep
1:03:06 Depression & dementia in midlife
1:05:43 Does hormone therapy protect the brain?
1:08:53 Clinic: "Am I getting early dementia?"
1:13:19 Dr. Loraine Baraki — the timing hypothesis & the brain
1:16:15 What actually kills postmenopausal women
1:17:31 Fitness: the biggest mortality lever
1:20:21 Strength, power & grip
1:25:15 Clinic: where to start when you're overwhelmed
1:30:41 The detraining problem
1:32:38 Trained vs untrained: what's recoverable
1:34:53 The actual plan
1:39:48 Takeaways

Resources:

Subscribe to BBM Plus for the full unabridged Direct Line: https://barbellmedicine.supercast.com/

Barbell Medicine coaching and templates: https://www.barbellmedicine.com/

Signal book pre-order: https://www.barbellmedicine.com/shop/learning/signal/

Body composition & metabolism

Greendale et al., SWAN body composition, JCI Insight 2019: https://doi.org/10.1172/jci.insight.124865

Lovejoy et al., visceral fat across the transition, Int J Obes 2008: https://doi.org/10.1038/ijo.2008.25

Pontzer et al., daily energy expenditure across life, Science 2021: https://doi.org/10.1126/science.abe5017

Karppinen et al., metabolism in midlife women, Eur J Prev Cardiol 2023: https://doi.org/10.1093/eurjpc/zwad177

Cardiometabolic

Matthews et al., lipid changes & the menopause transition, JACC 2009: https://doi.org/10.1016/j.jacc.2009.10.009

Janssen et al., menopause & metabolic syndrome (SWAN), Arch Intern Med 2008: https://doi.org/10.1001/archinte.168.14.1568

El Khoudary et al., AHA Scientific Statement on midlife women, Circulation 2020: https://doi.org/10.1161/CIR.0000000000000912

Bone

Greendale et al., SWAN bone loss across the FMP, JBMR 2012: https://doi.org/10.1002/jbmr.534

Siris et al., undiagnosed low BMD & fractures (NORA), JAMA 2001: https://doi.org/10.1001/jama.286.22.2815

Watson et al., LIFTMOR, JBMR 2018: https://doi.org/10.1002/jbmr.3284

Kemmler et al., EFOPS 16-year, Menopause 2017: https://doi.org/10.1097/GME.0000000000000720

Kistler-Fischbacher et al., MEDEX-OP, JBMR 2021: https://doi.org/10.1002/jbmr.4334

Sherrington et al., exercise for preventing falls, Cochrane 2019: https://doi.org/10.1002/14651858.CD012424.pub2

ACSM Position Stand: Osteoporosis and Exercise, Med Sci Sports Exerc 1995;27(4):i–vii (no DOI)

Cognition & mood

Greendale et al., SWAN cognition, Neurology 2009: https://doi.org/10.1212/WNL.0b013e3181a71193

Kravitz et al., sleep in midlife women, Obstet Gynecol Clin North Am 2018: https://doi.org/10.1016/j.ogc.2018.07.008

Cohen et al., Harvard Study of Moods and Cycles, Arch Gen Psychiatry 2006: https://doi.org/10.1001/archpsyc.63.4.385

Bromberger & Kravitz, mood and menopause (SWAN), Obstet Gynecol Clin North Am 2011: https://doi.org/10.1016/j.ogc.2011.05.011

Livingston et al., Lancet Commission on dementia 2024: https://doi.org/10.1016/S0140-6736(24)01296-0

Shumaker et al., WHIMS (estrogen+progestin & dementia), JAMA 2003: https://doi.org/10.1001/jama.289.20.2651

Espeland et al., WHIMS (estrogen-alone & cognition), JAMA 2004: https://doi.org/10.1001/jama.291.24.2959

Gleason et al., KEEPS-Cog, PLoS Med 2015: https://doi.org/10.1371/journal.pmed.1001833

Henderson et al., ELITE (timing hypothesis & cognition), Neurology 2016: https://doi.org/10.1212/WNL.0000000000002980

USPSTF, hormone therapy for primary prevention, JAMA 2022: https://doi.org/10.1001/jama.2022.18625

Fitness & mortality

Mandsager et al., cardiorespiratory fitness & mortality, JAMA Netw Open 2018: https://doi.org/10.1001/jamanetworkopen.2018.3605

Kodama et al., fitness & mortality meta-analysis, JAMA 2009: https://doi.org/10.1001/jama.2009.681

Sui et al., fitness & adiposity in older adults, JAMA 2007: https://doi.org/10.1001/jama.298.21.2507

Momma et al., muscle-strengthening activity & mortality, Br J Sports Med 2022: https://doi.org/10.1136/bjsports-2021-105061

Araújo et al., muscle power vs strength & mortality (CLINIMEX), Mayo Clin Proc 2025: https://doi.org/10.1016/j.mayocp.2025.02.015

Leong et al., grip strength & mortality (PURE), Lancet 2015: https://doi.org/10.1016/S0140-6736(14)62000-6

Detraining & trained-vs-untrained

Troiano et al., accelerometer-measured activity, Med Sci Sports Exerc 2008: https://doi.org/10.1249/mss.0b013e31815a51b3

Fleg et al., aerobic-capacity decline (BLSA), Circulation 2005: https://doi.org/10.1161/CIRCULATIONAHA.105.545459

Ratley et al. aerobic-capacity changes during menopause, 2025

https://pmc.ncbi.nlm.nih.gov/articles/PMC12358808/

Janssen et al., skeletal muscle mass across adulthood, J Appl Physiol 2000: https://doi.org/10.1152/jappl.2000.89.1.81

Pollock et al., master athletes & aerobic capacity, J Appl Physiol 1987: https://doi.org/10.1152/jappl.1987.62.2.725

Latella et al., strength across ages in powerlifters, Sports Med 2024: https://doi.org/10.1007/s40279-023-01962-6

Our Sponsors:
* Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com
* Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com
* Check out Factor and use my code factormeals.com/bbm50off for a great deal: https://www.factor75.com
* Check out Quince and use my code BBM for a great deal: https://www.quince.com
* Check out Ten Thousand and use my code PODCAST15 for a great deal: https://www.tenthousand.cc

Advertising Inquiries: https://redcircle.com/brands

Tämä jakso on lisätty Podme-palveluun avoimen RSS-syötteen kautta eikä se ole Podmen omaa tuotantoa. Siksi jakso saattaa sisältää mainontaa.

Jaksot(448)

Is It Safe to Train When the Air Is Full of Wildfire Smoke?

Parts of the country now get a few weeks of wildfire smoke every year, and the obvious question is whether there is a point where the air is bad enough that the workout costs you more than it gives yo...

24 Syys 37min

Do You Need a Calorie Surplus to Build Muscle? | Dr. Eric Helms

Most lifters have been told they need to eat in a Calorie surplus to build muscle. That rule has always come with a list of exceptions: unless you're new, unless you're carrying extra body fat, unless...

17 Syys 2h 1min

Is Obesity A Muscle Problem?

Muscle is where most of the glucose goes, and muscle insulin resistance is the first thing that breaks on the road to type 2 diabetes. Both of those are true, and neither one means that building more ...

4 Syys 1h 17min

Who Needs Testosterone, and Who's Not Getting It I Signal Episode 4

Most men who start testosterone never needed it, and some who genuinely do never get treated. In the final episode of the Signal series, Dr. Jordan Feigenbaum and Dr. Austin Baraki work through who ac...

27 Elo 1h 26min

Your Fat Has a Storage Limit

In 2004 a surgeon removed about ten kilograms of fat from fifteen women and measured everything that mattered. Nothing improved. Four years later, it still hadn't.That result should have ended an argu...

20 Elo 49min

Lifting and longevity: is 1 hour a week really the limit? Plus GLP1s and mood, training with ME/CFS, and Protein vs. Calories

A popular paper claimed the longevity benefit of lifting disappears once you train more than an hour a week. It's a real paper, but the claim is a misread. This is the free cut of this month's Direct ...

12 Elo 46min

The FDA Voted for 6 Peptides. Its Own Scientists Said No

An FDA advisory committee just voted to open a legal compounding supply line for six of seven peptides, including BPC-157 and TB-500, over the objection of the FDA's own scientists, who recommended ag...

7 Elo 1h 6min

The Man Who Couldn’t Stop Gaining Weight | A Medical Mystery

A previously healthy 21-year-old shows up with seven months of headaches and 30-plus pounds of weight gain he can’t explain. He’s eating the same and training more, and the scale climbs anyway. We han...

31 Heinä 1h 10min