Female Muscle – Misconceptions of Training and Nutrition

In the many years working as a fitness professional and health educator, I’ve encountered a wide array of myths and misconceptions about exercise and nutrition. Some of those seem to be more prevalent among women. Because these misconceptions can be the reason why you’re not achieving your fitness goals, I’m addressing some of the most common ones in this article.

More Cardio = More Fat Loss

Sadly, too many women still rely exclusively on long, boring, mindless cardio sessions to achieve their weight loss goals. Cardio is great for your heart and should most definitely be part of your regular exercise routine BUT:

  • More is not always better. Too much cardio without resistance training can actually cause you to lose calorie-burning muscle mass, which will decrease your overall metabolic rate and bring your weight loss efforts to a screeching halt.
  • 30 minutes of resistance training causes metabolic rate to increase by 150 calories over the 12 hours post-exercise. But that’s not all…the real benefit comes from the added muscles that resistance training builds. For every pound of muscle you add, you can burn 30-50 calories more per day.
    • Recommendation: Include resistance training to your workout routine and vary your cardio workouts by mixing days of longer low-intensity bouts (45-60 min) with shorter high-intensity interval bouts (20-30 min).

Fear of “getting to big” 

  • Women don’t want to be muscular; they want to be “toned” – hmmm? Sorry, but to be “toned” means to have muscle definition, which you really can’t achieve without being muscular.- Women fear too much muscle and think that weight lifting regularly, will make them look like men.
    • Reality check: Muscle does not grow overnight and if you’ve ever talked to anyone extremely muscular they’ll tell you just how hard it is. It takes a lot of dedication, time, training, and nutritional work to achieve a physique like that. There is no risk for the average fitness enthusiast to wake up one day and look like a professional bodybuilder. It’s really pretty simple: You work out until you like how you look and then you change your routine to maintain that muscle. Trust me, you’re safe from Hulkoniasm!

The importance of resistance training:Woman Exercise With Kettle Bell - Crossfit Workout

Besides making you look good, muscle has countless benefits you don’t readily see such as increased metabolism and strength, reduced risk of osteoporosis, as well as increased cognitive function. It also plays a crucial factor in slowing down sarcopenia, which is the age-related loss of muscle mass, strength and function. Sarcopenia happens to all of us but we can significantly slow it down by including regular resistance training (at least 2 x week) into our routine.

Less Calories = More Weight Loss

Breakfast With Coffee, Orange Juice, Croissant, Egg, Vegetables

  • Cutting calories will make you lose weight BUT cutting too many calories will backfire
  • You’re body needs a certain amount of calories to function correctly. You may have heard of BMR but aren’t quite sure why it’s so important. BMR is the basal metabolic rate and is the absolute minimum amount of calories your body needs to perform all of the basic bodily functions such as breathing.
  • If you drop below your BMR, your body’s only concern is to survive. It is not concerned with building muscle and speeding up your metabolism.
  • Solution: Find out what your caloric need is and never drop below that number. This number depends on many factors and if you want an exact number you should contact a fitness professional. But as a rule of thumb, the American College of Sports Medicine (ACSM) recommends that women do not drop their caloric intake below 1200 calories. If you compare that to the calories in the average juice diet, you know you’re in trouble.

I Don’t Need More Protein

  • The average woman eats insufficient amounts of dietary protein.
  • Protein is one of the major building blocks in muscle growth and also important in the proper functioning of your body (major structural component of our muscles, nervous system, brain, blood, skin and hair and is used by the body as a transport mechanism for vitamins, minerals, oxygen and fats).
  • Simple equation: If you don’t eat enough protein, don’t expect maximum results from your fitness and weight loss efforts.

Recommendation from the American Dietetic Association and ACSM:

  • General population 0.4 grams per pound of body weight
  • Endurance Athlete 0.5-0.6 grams per pound of body weight
  • Strength Training Athlete 0.6-0.9 grams per pound of body weight

This list of misconceptions is a very short list as I’ve only listed a few of the ones I hear the most. There are many more and if you have any questions about other myths, feel free to contact me.

Stay happy and healthy

 – Dr. Maria


Waters, D.L., R.N. Baumgartner & P.J. Garry. 2000. “Sarcopenia: Current Perspectives.” The Journal of Nutrition, Health & Aging 4(3):133-139.

Nagamatsu LS, Handy TC, Hsu C, Voss M, Liu-Ambrose T. Resistance Training Promotes Cognitive and Functional Brain Plasticity in Seniors With Probable Mild Cognitive Impairment. Arch Intern Med. 2012;172(8):666-668. doi:10.1001/archinternmed.2012.379.

American College of Sports Medicine @ www.acsm.org


Physical Activity and Menopause

Diverse Hands Holding The Word Exercise 

Menopause is bad.

Exercise is good. 

More exercise is the solution!

Is that it?

It’s not quite that simple, although most things you will read will tell you that any form of physical activity is helpful. There is a lot of truth to it. Physical activity at any age is beneficial and for women during mid-life exercising carries additional substantial health benefits. The menopausal transition is associated with many health risk factors such as increased risk for cardiovascular disease, osteoporosis, decreased bone mineral density, metabolic syndrome, and musculoskeletal symptoms. Exercise prescriptions for those health risks are the same as for non-menopausal women.

However, according to my research, not all forms of physical activity are of equal benefit in helping with menopause symptoms. In fact, some forms of exercise can exacerbate certain types of symptoms such as hot flashes and insomnia.

I believe that it is important to pick the type of exercise depending on your symptoms rather than just exercise to exercise.

So how do you know which exercise is best for you? You start by reading this blog 🙂 To help you find your way through the labyrinth of research that is out there, I’ve consolidated the findings of the last 20 years of research on this topic so you don’t have to.

First I want to highlight the overall benefits of exercising regardless of symptoms:


  • Benefits brain function and functional capacity
  • Increases beta endorphins
  • Quality of Life
  • Strength and balance
  • Increased Bone Mineral Density
  • Increase in quality and length of sleep
  • Maintenance of healthy BMI
  • Self-perceived physical condition
  • Sport competence
  • Body image & physical self-worth


  • Vasomotor Symptoms
  • Somatic & psychological symptoms
  • Depression (1 exercise session/week = 22% reduction)
  • Osteoporosis
  • Body Mass Index
  • Musculoskeletal symptoms
  • Cardiovascular Disease (50% reduction)
  • Overall mortality (20% reduction)

Exercise has many benefits but can also be stressful on the body

Too much exercise and/or intensity can:

    • Decrease sleep quality and length, which in turn is correlated with adverse physiological and psychological outcomes
    • Increase circulating cortisol levels, which can lead to increased abdominal fat (read last week’s post for more info on this)
    • Have negative effects on thermoregulation as it causes substantial increases in metabolic heat production and core temperature (during exercise, metabolic heat production can increase by ten to twenty-fold and recent studies suggest that hot flashes are triggered by small elevations in core body temperature)
  • Moderate intensity appears to have the most benefits
    • Highest menopause-specific quality of life
    • Lowest number of symptoms
    • Increased sleep, energy, confidence, mood

The following exercise guidelines are specific to helping you with menopause symptoms as well as increased quality of life throughout the menopausal transition. These recommendations do not apply to overall physical health.

Type of Exercise 

Female running athlete. Woman trail runner sprinting for successEndurance/aerobic training best for increased sleep

Woman Exercise With Kettle Bell - Crossfit WorkoutStrength training for body image, strength, body aches

young yoga female doing yogatic exericiseYoga for vasomotor (VMS) symptoms and overall menopause-specific quality of life (Hatha yoga for cognitive function (memory, concentration)

walking womanWalking at ~3-3.5 mph for anxiety and depression

Duration & Intensity

  • Moderate Intensity (60-70% Target HR)
  • Min. 3 x week (more days = decreased severity of symptoms)
  • Programs lasting at least 12 weeks

Special Considerations

  • Keep body core temperature at comfort level to avoid increases in VMS
  • Focus on activities that are enjoyable to you. Forcing yourself through workout regimens that you dislike can have negative effects on quality of life. I hear too many people say: “I think I should run more” and my question to them is “Why? Do you like running?”. “No, but it’s good for you”. Really? Is it? I don’t believe in doing things just because someone said they’re good, especially in regards to exercise. If you don’t like it, you won’t stick to it. It’s as simple as that. And when it comes to working out, consistency is the key. So find activities that you truly enjoy. Not only will you continue doing them and reap the physical and mental benefits but doing things you love will help you reduce stress and keep off that unwanted meno-pod (if you don’t know what a meno-pod is, you have to read last week’s post).

Have a comment or question? Leave me a note on the blog or tweet me @doctorluque

Stay happy and healthy

– Dr. Maria

All information is based on peer-reviewed research. I usually add a reference list of all the articles I read to put together an article but this one would be way too long. If you’re interested in finding out more about specific research articles used for this blog, contact me.

Menopause Treatments

The “M”-Word – Let’s Talk Menopause

Most Common Treatments

Crazy Chemist Woman With Chemical Glassware Flask Isolated

During the last installment of this series, I introduced you into the basics of what menopause is. But I know that what you want is solutions. How can I make these hotflashes stop? Is there something I can take to help with the insomnia? Help me with these mood swings before I kill someone!

So I dug into the research and found lots of great information. It is important to note that thousands of studies have been published on this topic and of course I haven’t read all of them but I tried my best to consolidate the most recent results so you can make a more informed decision. This article is designed to give you unbiased and factual information obtained from peer-reviewed articles and reviews published in reputable journals. It is not meant to provide clinical advice on which treatments are better or which to choose. Talk to a menopause specialist if you have specific questions about any treatments.

Hormone Replacement Therapy Concept.

The big kahuna – the mother of all menopause treatments

To date, HRT is both the most common and most controversial form of treatment for menopausal symptoms. After the results of the Women’s Health Initiative (WHI) were published, the use of HRT dropped significantly because they showed an association of HRT use with greater breast cancer incidence and heart disease1. But there is much more to the story. The results were oversimplified and overgeneralized. Without going into too much medical detail, you should know that the study had two components: the estrogen plus progestin (E+P) trial for women with an intact uterus and the estrogen only (ET) trial for women with a history of hysterectomy. The published results that caused such a big backlash where only for the E+P trial but generalized to the entire study population. According to a recent study published in the American Journal of Public Health, “Over a 10-year span, starting in 2002, a minimum of 18,601 and as many as 91,610 postmenopausal women died prematurely because of the avoidance of estrogen therapy”2. In 2011, the post-intervention data of the ET were published indicating a reduced risk of mortality due to cardiovascular disease and invasive breast cancer.

The moral of the story: get clear and accurate information about HRT that is dependent on your own situation. One size does not fit all.

Here is HRT at a glance based on both types of HRT:


  • Relieves vasomotor symptoms (hot flashes, night sweats)
  • Relieves vaginal dryness
  • Risk of bone fracture
  • Improved Cholesterol
  • Reduces risk of colon cancer
  • Reduced risk of cardiovascular mortality (ET)
  • Reduction in mortality because of invasive breast cancer (ET)

Does not cause significant changes in:

  • Depression
  • Overall cognitive function


  • Increased risk of stroke
  • Increased risk of serious blood clots
  • Increased risk of breast cancer (E+P)
  • Unpleasant side effects such as bloating
  • Increased risk of heart disease

Note: It is very important to mention that the risks associated with HRT are heavily dependent on personal factors, family history, as well as type of HRT and time of initiation of HRT.

Alternative TherapiesBioidentical Hormone Therapy (BHT)

Bioidentical hormones explained:

  • Endocrine society defines bioidentical hormones as “compounds that have exactly the same chemical and molecular structure as hormones that are produced in the human body.”3
  • FDA approved BHT are available in pills, patches, creams, gels, and vaginal tablets.
    • These are controlled and regulated preparations that are manufactured under strict standards3
    • Various studies have documented their beneficial effects on hot flashes
  • Compounded bioidentical hormones are not FDA approved4
    • They are specifically compounded for an individual patient by a pharmacist
    • There is no scientific evidence to support the claim that they are superior to conventional HRT
    • They are not required to provide information about risks, contraindications, dosage, purity and potency
    • They carry some of the same benefits and risks as HRT


Phytoestrogens are plant-derived chemicals that exhibit weak estrogen-like effects.

Isoflavones, originated from soy, are the most common form of phytoestrogens and have received a lot of scientific attention because of the possible benefits it may have in treating menopausal symptoms as well as the concern that they might stimulate the growth of existing estrogen-sensitive breast tumors7. The majority of studies researching the association between soy consumption and breast cancer risk, have found an inverse relationship between the two. Studies show that the soy intake during early life may both reduce breast cancer risk and risk of recurrence and that a diet rich in isoflavones from soy products also reduces the risk of postmenopausal breast cancer5-6. Promising research studies also show the potential benefit of increased soy consumption on bone health especially for postmenopausal women but more research is needed.

I was not able to find any credible evidence to suggest that consumption of traditional soy products high in isoflavones has adverse effects in healthy individuals. The latter (healthy individuals) is very important. You should always consult a health professional before increasing your soy consumption considerably as it may have adverse affects depending on your particular health condition. As with everything, moderation is key. Don’t replace every protein source with soy and when consuming soy products, be sure they are quality products. Beware of many commercial soy products as they have little or no isoflavones but are high in sugars and fillers. Another factor to take into account is that a large number of soy crops in the United States are genetically modified and therefore can have significantly different effects.

Here is a list of foods that contain phytoestrogens. These items are also high in other nutrients and make a great addition to any diet.

Alfalfa Beets Carrots Apples Chickpeas Licorice
Eggplant Fennel Garlic Potatoes Soy foods (tempeh, tofu, edamame) Eggs
Dairy foods Flax seed Pomegranates Red beans Sunflower seeds Tomatoes
Cherries Celery Cinnamon Citrus fruits Black-eyed peas Broccoli
Brussel sprouts Cabbage Leeks Kale Artichoke Peppers

Botanical Alternatives

In addition to bioidentical hormones, botanical alternatives have received a lot of attention in regards to their potential benefits in helping with menopausal symptoms.

Although there is a lot of research in regards to botanical alternatives, there is not much consensus on what works. Black Cohosh seems to be the most effective but more research is needed for conclusive evidence8. Below is a list of botanical alternatives that have been mentioned in the scientific literature as possible treatments for menopausal symptoms.

Botanical Supplement Possible symptoms relief for Notes/Possible side-effects/Words of caution
Black Cohosh (Actaea racemosa or Cimicifuga racemosa) Insomnia, anxiety, hot flashes Does not act like estrogen (hormone-sensitive tissue such as uterus and breasts are not negatively affected).
Studies are still out on possible liver problems; do not take if you have known liver problems
Red clover (Trifolium pratense) hot flashes Contains phytoestrogens and might therefore negatively affect hormone-senstive tissue
Dong Quai (Angelica sinensis) heart palpitations, anxiety, night sweats, Possible effect on blood clotting; women with fibroids, blood-clotting problems or taking medications that affect clotting, should not take Don Quai
Ginseng root (Panax ginseng or Panax quinquefolius) Mood and sleep disturbances, headaches, gastrointestinal disorders Some types of ginseng may affect blood sugar. Use caution if diabetes is of concern
Agnus castus stimulates pituitary gland, general well-being
Milk Thistle mood swings, depression
St. Johns worth mood swings, depression
Kava (Piper methysticum) anxiety Potential damage to liver

Note: studies on all botanical alternatives listed in this table (besides Black Cohosh) were inconclusive or inconsistent. This table merely describes those mostly listed in scientific studies.

As mentioned before, the menopausal transition is a highly subjective and individual experience and there is not a one-size-fits-all answer. I wrote this article to give you unbiased information about treatments that may help with menopause symptoms. It is meant to be a guide and by no means do I advocate the use of any of them. Always consult your health care provider before experimenting with any of these supplements. In the next installment of this series, I will talk about the dreaded menopausal belly fat. Why does it happen? What can help?

Stay happy and healthy – Dr. Maria

Note: If you are interested in finding a health care provider that specializes in menopause, here is a great starting point – The North American Menopause Society: http://www.menopause.org/for-women/find-a-menopause-practitioner


1 Yang, X.P., & Reckelhoff, J.F. (2011). Estrogen, hormonal replacement therapy and cardiovascular disease. Current Opinion in Nephrology and Hypertension, 20(2), 133-8.

2 Sarrel, P.M., Njike, V.Y., Vinante, V., Katz, D.L. (2013). The Mortality Toll of Estrogen Avoidance: An Analysis of Excess Deaths Among Hysterectomized Women Aged 50 to 59 Years. American Journal of Public Health, 103(9), 1583 – 1588. doi:10.2105/AJPH.2013.301295

3 Files, J., Ko, M., Pruthi, S. (2011). Bioidentical Hormone Therapy. Mayo Clinic Proceedings, 86(7):673-680. Doi10.4065/mcp.2010.0714

4 Pfeifer, S., Goldber, J., Lobo, R., McClure, RD, Thomas, M., Widra, E, et. al. Compounded bioidentical hormone therapy. Fertility and Sterility, 98(2):308-12.

5Goodman MT, Shvetsov YB, Wilkens LR, Franke AA, Le Marchand L, Kakazu KK, Nomura AM, Henderson BE, Kolonel LN. (2009). Urinary phytoestrogen excretion and postmenopausal breast cancer risk: the multiethnic cohort study. Cancer Prev Res., 2(10):887-94.

6 Guha N, Kwan ML, Quesenberry CP Jr, Weltzien EK, Castillo AL, Caan BJ. (2009). Soy isoflavones and risk of cancer recurrence in a cohort of breast cancer survivors: the Life  After Cancer Epidemiology study. Breast Cancer Res Treat., 118(2):395-405

7 Song WO, Chun OK, Hwang I, Shin HS, Kim BG, Kim KS, Lee SY, Shin D, Lee SG. (2007). Soy isoflavones as safe functional ingredients. Journal of Med. Food;10(4):571-80.

8 Mohammad-Alizadeh-Charandabi, S., Shahnazi, M., Nahaee, J., & Bayatipayan, S. (2013). Efficacy of black cohosh (cimicifuga racemosa L.) in treating early symptoms of menopause: A randomized clinical trial. Chinese Medicine, 8 doi:http://dx.doi.org/10.1186/1749-8546-8-20