38. What Every Woman Should Know About Perimenopause With Dietitian Angelique Clark

Why does your body feel so different in your 40s and why is no one really talking about it? 

In this episode of It Takes Heart, we sit down with Angelique Clark, an accredited practising Dietitian and exercise physiologist, to unpack the often-misunderstood stage of perimenopause. Ange explains why so many women feel like something has shifted long before menopause officially arrives and why those symptoms are often dismissed. She also shares why perimenopause isn’t just a phase to survive, but a powerful prevention window for long-term health, with implications for cardiovascular risk, insulin resistance, bone density and muscle loss.

Together, we explore the practical foundations that actually make a difference: strength training, realistic protein targets, and why fibre and gut health become even more important during perimenopause.

This episode is for anyone curious about what’s changing in midlife, wanting practical guidance from a trusted dietician, or looking for clear, evidence-based insight into navigating perimenopause with confidence.

Ange's organisation of choice is the Monash Women's Research Centre, who undertake research and provide education about common health issues that affect women throughout adult life, the impact of menopause and the role of sex hormones (oestrogen and testosterone) on health and wellbeing. Their aim is to enable women to experience the best possible quality of life through research, critical evaluation of available information and professional and community education

If you’d like to dive deeper, you can connect with Ange on Instagram, explore her perimenopause playbook, and try her choc nut protein bar recipe. Or catch us cooking with Ange in the kitchen here!

It Takes Heart is hosted by cmr’s Samantha Miklos and Kate Coomber and recorded at cmr’s head office in Brisbane.

We Care; Music by Waveney Yasso

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Transcript

Introduction

Sam Miklos 0:00

Hi, I'm Sam. And I'm Kate. This episode is for every woman in her 40s who's ever looked in the mirror and thought, what on earth is happening to my body? I haven't done anything differently.

Angelique Clark 0:10

I just don't feel like myself. And now I've got this tire around tire around my midsection and I don't know where it's come from. And so essentially perimenopause is a term that really precedes menopause.

Kate Coomber 0:22

And if you've loved this episode, be sure to jump over to It Takes Heart on Instagram as we're jumping in the kitchen with Ange to show you how to make some really healthy snacks for the busy healthcare worker.

Sam Miklos 0:37

So today's guest, Angelique Clark, is an accredited practicing dietitian, exercise physiologist, and creator of the Perry Lean Method. In her own words, she's a busy active mum in her peri-era. Oh, amen to that. Who is looking to gain more enjoyment from the second half of her life, as are we. Ange is helping women understand that their 40s aren't the beginning of the end and they might just be our most powerful health decade yet. Welcome, Ange, to It Takes Heart. Thank you so much for having me. I think you've uh you've got our attention.

Kate Coomber 1:11

100%. I want this to be the most powerful decade. I know. Look, I have to be honest, I don't know that I'm feeling that all of the time, but very interested to see how we're gonna do that today. And I guess the reason we wanted to sit with you, I'm really excited to have you here, is our healthcare community. We've got um a huge proportion of female healthcare professionals out in Australia working all over the place, particularly in this age bracket. Um focused on caring for other people. And today we just want to talk about how do we get to care for them and how can they care for themselves and put themselves first and get through this best decade.

Dietitian Versus Nutritionist

Sam Miklos 1:46

Yeah, the impact that would have on the healthcare community if we were all feeling good. Before we get to that, you are our first dietitian that we have had on the podcast, which we're super excited about, and I think that's awesome. Yeah, like let's let's first explain uh what is a dietitian and what do they do? What is the difference between a dietitian and a nutritionalist? Are you both? And yeah, well, how did you get to be one? Because I I I just realized when we were talking before I wanted to do dietetics, but uh you had to be good at science. And I was terrible at it. I did a lot of science. There was a lot of science, and I was not I had a tutor just to get a C in chemistry. So I was told probably not your thing. And here we are today. So what is a dietitian?

Angelique Clark 2:32

Um it's an accredited title to start with, so it is a licensed term, and you do have to sit through obviously rigorous examination, you have to have a university degree in order to qualify to become a dietitian. A dietitian is automatically a nutritionist, but unfortunately, a nutritionist is not a dietitian. And the hard part about recognizing the difference, particularly in the outer world, is that nutritionist isn't LL licensed title like a dietitian is. So anyone can pretty much call themselves a nutritionist, even though you do to become a nutritionist. Yeah, so the first three years of a four-year undergraduate degree in dietetics is basically your nutrition part. So you could actually do the first three years and come out and become an accredited nutritionist or a clinical nutritionist. And they have amazing training because we all train together. The last year is what really differentiates the dietitian from the nutritionist in the sense that we do uh experience practicum. So six months of actually going out into the workforce and doing volunteer work in multiple different areas. So that's also another aspect of dietetics, you don't know where you're going to end up. And then on top of that, we do another six months in a major. So I chose a public health major, but you could also do research focused as well. So you can go in multiple different areas, and I think it's really up to your personality and what area you feel most comfortable in because a lot of people just think a dietitian ends up in a hospital doing clinical care and administering medical nutrition therapy. And I guess that's one of the also the differences between just a nutritionist is that they're more generalized, so they can give really good advice, but it's more so general. Whereas a dietitian, we're really talking about medical nutrition therapy, so we are prescribing as opposed to just being a bit more of a generalist. So I wanted to have that accreditation and that title. It's a licensed body, so we also need to continue our professional development every single year to uphold that accreditation. And it is nationally recognized as well, particularly in Australia, as an APD or an accredited practicing dietitian. But just depends on where you kind of want to end up. I didn't really end up in the traditional sense.

Kate Coomber 4:31

And where yeah, where did you think you were going to end up? Because I imagine leaving university with your degree, you didn't think, you know what, women who were suffering perimenopause symptoms, that is going to be my niche. That's probably you know, basically our mums or whatever at the time. I'm sure that's maybe not what you were thinking.

Angelique Clark 4:49

Not at all. I didn't even know and understand what the term perimenopause meant until probably about six years ago. Yes. Well we'll definitely get to that because we've talked about that too. So I have to say, probably what got my interest in dietetics was I was uh an endurance runner in high school, and I also played basketball, so I was an active female. Um, and so what we were doing was carb loading essentially before long distance races, so four kilometre races, and we were fed deep-fried lasagna. Now that didn't sit particularly too well with me.

Sam Miklos 5:20

I didn't think anything worked deep fried lasagna and then a run.

Angelique Clark 5:23

But then you think about carb loading and the essence of what that was, and I and then the other thing was we were strength training in the gym, but we weren't given any direction, guidance, we were just going, oh, go and lift weights, and we're like, why? What does this actually do to my basketball performance? So all of these factors I had so many questions about. And we had a dietitian that came into the school, I was utterly disappointed with what she had to say. She showed plastinated food models, and I thought this was the most boring chick ever. Never really thought about dietetics as being something I loved, but I was really interested and I was really good at PE. So I loved that. I love movement, I loved practicing stuff and figuring it out in my own body. And so at first I did want to go into dietetics because I thought that's interesting about fuelling my performance and how I can become a better runner if I eat well. My dad was an elite-level cyclist, my mum owned a health food shop. I had a background of growing up with a lot of interesting, different advice compared to the general population. So that always was a little bit of a, I guess, a trigger for me to go, well, you know, why is it that this is better? And also to compare against my lunchbox to other kids' lunchboxes. I've got a European background, so that was very different. Um so yeah, it was it was very interesting growing up, but I think that's what sort of started my interest in it and then led me into uh dietetics I didn't get into because again, it's a very hell heavily based science degree, so I didn't have the OP it was back then. It was quite a high OP from memory. Yes. So I got an OP5, you needed a three, and it's only because of the popularity of the course. So there's a lot of female-dominated, um, it's a female-dominated industry, women are very interested about food and nutrition. I think that's probably driven by the thinness aspect of it and trying to control body composition. Um, but I got into dietetics at the back end of actually studying human movement study first. So I first became an exercise physiologist, and then I fell in love with movement, and then I thought, oh my gosh, how can I support this with food? And I still wanted to do dietetics, so I ended up doing a master's in nutrition dietetics after that undergraduate degree.

Sam Miklos 7:25

And where at like just a high level, like where are the sort of places a dietitian can work? Like I can imagine obviously you've got your hospital, private practice. Is there other like amazing spaces?

How Ange Found Her Path

Angelique Clark 7:37

Oh, I don't know about amazing. There are a couple of other boring spaces I never wanted to end up in. Firstly, so you hit the nail that hospital placement is pretty much you know the only thing that they direct you pathway-wise into. Um and then the next is private practice, which is I did that for many years and I'm still continuing to do it, but in a smaller capacity, because it's a real burnout uh area. Uh so second to that, you can work in community placement, you can work in aged care and food service. For me, I ended up only having that one goal of working in sports, nutrition and dietetics. And that to me was really fascinating. So elite sport and supporting people that were active already. Um, and I guess then you can go into media and recipe development and also food science in this in the aspect of maybe developing certain products and and going through industry in that pathway as well.

Kate Coomber 8:25

Yeah. So if you think about the high performance athlete and sports route that you wanted to take, is that really competitive? Is that like a super competitive job that a lot of people want?

Angelique Clark 8:36

Absolutely. And I remember distinctly my one of my lecturers saying, you know, you need a plan B because good luck. Um but I didn't have a plan B. And I just because I came through with an exercise background, I did my master's, we had about three hours of sports nutrition training in my degree for dietetics, which tells you a lot about where they think you're gonna end up. Um but I just didn't, I I surrounded myself with the people that I aspired to be like. So obviously got a few mentors, just volunteered loads and loads of my time to support them. And by the time I became a sports dietitian, so that's an extra further accreditation on top of being a dietitian. I'd already had my exercise physiology degree, then had my master's, and then we do another year of training and then sit and exam to become qualified as a sports dietitian. So at one point I had three or I held three accreditations or professionally recognized, was paying more in memberships than I was in actual earning money. But when we look at elite sport, most of those people also have either a very high athletic background, so they might have been an elite athlete themselves, got their foot in that way, or they've got another PhD on top of that. So that's what it's probably what it takes now to get into the sport space. Um, and unfortunately, what I discovered is that it's actually quite limiting when you're there as well. It's not what you think it is. How so it's very competitive, clearly, obviously in elite sport. Um, but a lot of that, there isn't a lot of, I guess, um with a dietitian and their role, they're often discredited, I think, for the role that they do play. I think more so they seek, particularly with teams and sports, it depends on how the funding is allocated, who's coaching at that point in time really dictates the support team and whether they go and hire a dietitian because they value the work that they do and the impact that they can make on their athletes. Often it was the responsibility of the strength conditioning coach by default. And so you find that you're ending up with someone with an excise physiology degree, which I had, I knew nothing about nutrition. We don't learn about that, but because you're in that space, they expect you to not get paid and then to be able to deliver that type of service as well.

Kate Coomber 10:42

And I imagine that's evolving over the years because as you said earlier, like nutrition wasn't a huge focus. It was really like you need to work out, we need to do the strength and conditioning, but not really understanding what fuels your body or how what the um knock on effect to that can be. Is it is it getting better? Are there more opportunities? Is there you know a little bit of it?

Angelique Clark 11:01

Yes, and it's been led by women and the pathway that they've set through blood, sweat, and tears to be able to advocate for their own positions.

unknown 11:07

Yeah, okay.

Angelique Clark 11:09

Yeah, it is, it really is, and they need to approach it like a corporate, they needed to show I have friends that have absolutely shown the difference with how much better the players are performing. So if we're just talking about performance as being the end outcome and how nutrition supports that, they'd have to prove their position in order to get paid at the same level as the coaches.

Sam Miklos 11:29

Wow.

Kate Coomber 11:30

And is it is there is there sort of a I don't know, like an ugly side to being a dietitian too in terms of people who might be doing it with the wrong reasons or there's so much information isn't there around what is good nutrition and what is it that sort of negative outcomes too?

Angelique Clark 11:50

I think definitely something that I didn't consider was I thought I was going into dietetics wanting to fuel performance. So I always looked at food as being nourishing and so powerful. But but when I got there, it was a lot about dieting and weight management and being thin.

Kate Coomber 12:06

And if you think about you're doing it with performance athletes, but then does this exist, this role sort of exist in you know the fashion and modeling world or other places where maybe it has, I guess that's where I'm going, like a different impact?

The Truth About Elite Sport Work

Angelique Clark 12:18

Yeah, absolutely. I think we've looked at uh food as a something to manipulate as opposed to it being nourishment and being able to perform a high performing, whether it that be lifestyle or on the sporting field at the same time. We know that one in four athletes, so particularly the people that are doing high-level activity, are more vulnerable to disordered eating or eating disorders. So that to me was a real shock and an eye-opener where I thought I was entering a space where great, I didn't have to talk about diets, I didn't have to do weight loss, and it was the opposite. And so I had to find a way to really give women the value of understanding how they can fuel their bodies better in order to perform on so many different levels, and that was really tricky.

Sam Miklos 12:57

So you created the Perilan method. I suppose before we understand a bit about that, let's talk about what perimenopause is. Because I feel like um I don't I feel like it's a really new term, and maybe and it's coming up everywhere, like everywhere. You wouldn't ever hear of it. Maybe it's just menopause. Maybe it's our feedback where we're at. But you'd hear about just menopause, and now it's all about perimenopause. Like, what is it? Why why are they different? When does it happen? What are the symptoms?

Kate Coomber 13:27

When did the term really come about?

Angelique Clark 13:30

Has it always been there and we're just old and we're there, and now our phones are telling us what we're doing to know about it, and now we're I think there's a lot of visibility and the algorithms are really loving it. Yeah, yeah, yeah. There's a lot to be monetized about menopause. Um and I think that's kind of where we're sitting at at the moment, which is sad. But um how I sort of got into or landed into that coming from sports was really interesting. Fair to there. Yes. It's a really interesting transition. Um but it was because I've been a practicing dietitian now since 2009, so it's been many, many years that I've been doing that. Before that, I was a personal trainer, exercise physiologist. And so I saw a lot of um older age populations in musculoskeletal rehab, and I was training anyone from seven-year-olds to seven-year-olds, and I was like, okay, well, there's obviously exercises for everyone. So too can nutrition and diet. But what has happened over the time is active women were in my clinic and they were getting older, as was I. And so I'm seeing them across their careers and their lifespans, and then they're becoming masters athletes, and they're going, Ange, something is different. My body's changing and it's not responding as it used to. There was nothing out there to suggest otherwise, oh, you're cheating on your diet, or you're not doing, you're not training hard enough. And unfortunately, that's the message in the fitness and the diet culture is that you just need to train more and eat less.

Speaker 3 14:39

Eat less, yeah.

What Perimenopause Actually Means

Angelique Clark 14:40

Yeah. And that wasn't at all the case because I understood these women. I sat there, I listened to them over, you know, X amount of years in dietetic clinical practice. I've been able to listen to a lot of women's stories, and that's so powerful because they were coming in being completely dismissed by their GPs about saying something's wrong. So when I looked into it, I was like, there has to be something going on. What don't I know here or what aren't I seeing? And I was about 36, I think, at the time. And of course I'm selfish going, well, yeah, if this is happening now and these ladies are in their mid-40s, that's not too far away from where I am. How about my passion's always been prevention, right? Before treating. So, how about I look into this because I'm a little bit selfish and yeah, I want to know what's coming, and what if I end up like that? Because I'm doing the same exercise and nutrition principles and I'm telling them, why is this not happening and why is it changing now? Lo and behold, I kind of went to my mentors, looked back into the research as we do as dietitians, we look for that clinical evidence of based practice, and there was nothing or not quite a lot there. And then it what it unveiled was that there actually wasn't a lot at all about females in the exercise, sport, and nutrition space that I really just didn't even question. I was like, oh, you know those nutrition sports and nutrition guidelines that we've got that we say for everyone, a lot of it's based on male collegiate athletes who are the subjects for these tests. So then our principles are actually in sports nutrition are derived from predominantly male athletes. Because guess what? The female athlete is actually really hard to study because she has a menstrual cycle. So we can't have a baseline. We don't know how to understand how to study her. So we just might not study as many women as we possibly could. So that was my first red flag. I was like, oh my God, I cannot even believe I didn't ask this question. I didn't realise where that information was coming from. So there's a big gap in the literature, which I think is now starting to become a little bit more relevant, particularly in women's health. Then there's the issue of now the aging female. So there's even less data with that. There is still some great physiology data that we can pull from and extract from, and that's what I've done with the Periline method, is I've used a couple of those principles from what I know about sports nutrition, and particularly I ended up in physique-based sports. So this was about manipulating body composition. It was about holding on to as much muscle as possible and losing as much body fat for these athletes that were competing. Now, fun fact, a lot of those principles when I applied them across to perimenopause worked really, really well. So I have to thank my clients firstly in private practice because they were my guinea pigs. Because I'm here going, I don't actually have any evidence, so I just need to do n equals one, which is you're the subject. If you're willing to go with me on this, let's apply some of the principles I know from body composition, because you're putting on fat around your midsection, and I don't know why. Um, let's just treat you like a bodybuilder, even though you might not be that as an athlete. But let's just see if these principles apply, and sure enough, we started to get great results. And then as my, I guess my literacy improved when it came to perimenopause and what the hell that was, uh then I started to look and seek for advice outside of probably Australia. I know Dr. Louise Newsom was the one in terms of the medical space that was speaking a lot about menopause and the symptomology of that. But firstly, most women kind of recognise their body composition changes and they go, I haven't done anything differently, I just don't feel like myself, and now I've got this tire around tire around my midsection and I don't know where it's come from. And so essentially perimenopause is a term that really precedes menopause. And if we think about menopause as being one moment in time, that's a diagnosis that is made retrospectively. So you have to be at the 12-month anniversary of your last menstrual period. So your ovaries are retiring. Yeah. Fun fact, that's what they do. It's like adolescence in reverse. And by the time we get to that stage, the average age in Western cultures for women is around about 51. Now, perimenopause, if it precedes menopause, is the time, for my, from my opinion, is the most beautiful, pristine preventative window we have to stop a lot of things that are coming up in terms of disease risk factors that we see in menopause. So to be really blunt, I don't really care about menopause because that is something that if we are privileged enough, we are all going to go through as women. But if we can capture you in that decade, perimenopause could last anywhere between four to ten years preceding menopause. And if we don't know when we're going to go through that individually, we have to start thinking about this in our mid to late 30s or early 40s. And then we've got this beautiful window of opportunity where a lot of the things that we see start to unravel from a body composition perspective based on our hormonal undulation on its decline, we can actually reverse a lot of these things that are risk factors that are killing women, the big ones, cardiovascular disease, Alzheimer's, quality of life affecting that, and musculoskeletal problems such as osteoporosis.

Kate Coomber 19:16

So what are the um what are the signs then that you might be in perimenopause? And maybe particularly if you're those women who aren't doing their the heavy training or you know, I guess if you were if you were performing as an athlete or training a lot and you had a very particular routine, you notice it, but maybe women who aren't on that journey. So how do we get it? Just, yeah, what are they seeing?

Angelique Clark 19:39

I like to call you guys everyday athletes. Everyday everyday athletes.

Sam Miklos 19:42

I like being called an everyday athlete, but I am gonna grab that and go with it.

Angelique Clark 19:47

I love this term because as I said, most people that I talk to, and you know, obviously your listeners, the majority of them really do care about health. They have a health as a value, right? And so um when we look at health, it's not just the absence of disease, it's really looking at how best I can optimise how I'm functioning in order to pull more into helping somebody else improve their health. So if I think about it like that, every one of us has an athlete inside of us, and you don't get to treat yourself any differently. And I think that's the first thing is to prioritize your own health in order to become the athlete. But instead of we're talking, you know, we're not talking a performance stage on going to the Olympics, we're talking about your performance as your life.

Speaker 3 20:24

Just getting to the office.

Angelique Clark 20:25

That's part of the school trouble. Exactly. So if you look at your life like that, we all can benefit from this. In actual fact, I love working with everyday women because of that reason. I think athletes want to thank you last. I think the pleasure that I get out of working with women generally in day-to-day life, just average people like you and me, that's definitely me now as well. Um, it's it's so much more rewarding because we can see that change and that effect and the appreciation of just understanding that they are empowered and they can take control over their health markers. So the biggest thing I think for most women is they probably wait until their menstrual cycle is irregular. So that might mean or look like something like their cycles, their menstrual cycle might be getting a little bit shorter or longer, possibly they might get some heavier bleeding. There's vasomotor symptoms that are really generally pushed out there as being like menopause related, like night sweats, hot flushes, but that's actually not what women report most commonly as a sign of or a symptom of suggesting perhaps they're in perimenopause. So there is the age-related thing first and foremost. So if you're around about 40, you could definitely be in this era of between 40 to 50. Second to that is that there is no diagnostic test from a hormonal perspective to test for that, unfortunately. So we have this undulation of our hormones on their decline into menopause. We know that they are going to flatline at some point after we hit menopause. But prior to that, this is where perimenopause is so valid, is because the symptoms might actually often be erratic based on whether or not their hormones are going up and down, or they're probably just dissimilar to what they would have normally experienced in a normal menstrual system. That they might have had prior to hitting 40 years old. So it doesn't don't wait until you see those symptoms because then you're probably going, yeah, you're probably in there.

Signs, Stress And Feeling Dismissed

Kate Coomber 22:09

But then what do women do though? Because I think, you know, certainly women that I speak to and the things they might notice first are things like irritability and brain for like unable to cope, like we always have. And everybody seeks out a doctor because you want to be proactive and you're like, what's going on? Yeah. But a lot of the time it's like, well, you've got to keep it as you're busy. That's just what life is. And that's how it's dismissed. Yeah. But how does that shift? And is that shifting or is that a huge problem? And where do women go?

Angelique Clark 22:42

Yeah. So um I think the other big one, exactly what like what you said, the anxiety and the not being able to cope as much with the load that they're generally putting on their place.

Kate Coomber 22:52

Like the athletes, nothing had changed. So they feel different. We could be doing the same thing we always did, but it feels hard.

Angelique Clark 22:58

And the physical effect, and I often say you might not necessarily notice a change in the scales, but your the proportion of where your body fat distribution is changing. So it's gravitating upwards, it's going more around your midsection, so your genes aren't fitting as well on that waistline. So that's a really important telltale sign because this physiologically, when we're just looking at the musculoskeletal system and how our body is comprised. So if we look at fat mass, lean mass and body water or fluid and bone, so those things are really important. They're having a change just from an age-related perspective. So irrespective of any symptomology, we are going to start aging and we are going to enter a phase called sarcopenia, which happens around about mid-30, and it will continue to deteriorate your muscle as we start to age. I know that sounds a little bit scary. It's really scary. I thought we would just say that we're okay.

Sam Miklos 23:49

We're already on the downward spiral. Yeah, but we can't. You said we can do this. What can we do?

Angelique Clark 23:56

So sarcopenia, age-related loss of muscle, happens after the age of 35. We need to be starting to wake up and do something now. And I unfortunately I do somewhat agree in the sense of um are we putting up with too much? And is it also a stress response and a responsibility for us to actually go, you know what, we need to take some of these things off our plate and we can't keep doing all of that stuff for everybody else? Because amongst the meantime, we've probably lost our own ability to train to exercise. And this is what I see a lot, and we see also see it represented in the literature, is that women are eating less, actually. They notice that their physical body's changing with or without symptoms. So they start to knee-ject reaction, what the fitness and diet industry has told me, I'll just take more food out, but they're actually not exercising because they are so busy doing things for everybody else. You think about your life, your job, your sedentary, you're not doing that much. Um, and we don't have the time to be able to invest in formal activity. So that's starting to drop. We're too tired, sleep's affected, and then anxiety is waking us up at three o'clock in the morning with a to-do list that's you know longer than my arm. So there are a few things that definitely uh aren't helping in relation if you can't sleep well based on maybe some hormonal flux, and we start to see a little bit more anovulatory cycles, so that's where um we're not we our eggs might not be releasing as quickly as what they would have every month, and therefore our progesterone doesn't rise as it normally would, and that's the anxiety and mood stuff that we think is attributed to feeling a little bit like rage. Um I can't cope.

Kate Coomber 25:31

I mean, not me, not me, Sam, obviously. I think my family will say that I'm very tolerant and fun all of the time right now.

Angelique Clark 25:40

Yeah, and in some respects that's awesome. But if you don't feel like yourself, maybe are you doing too much as yes, the first thing to ask yourself. Second to that is going, okay, well, what can I do to remove some time to give myself back more time so I can invest in those health behaviours?

Kate Coomber 25:53

But I don't think that's the need the reaction is like, what's wrong with me though? I think women in particular will go, well, it's my fault, something's wrong. I need to I need to just be better. Yeah.

Sam Miklos 26:03

But also I think if you think about our healthcare community, like to what you were just saying there, Andrew, they're always looking after everybody else. So what are a few like, you know, practical tips, I guess, around even nutrition to fuel and nourish your body? Because yes, the the quick thing, and even if you think about our healthcare workers, they they're on shift work, they're out in remote communities. It just feels like, and probably the one time we really need to lean into nourishing and looking after ourselves is the very time that we just don't feel hardest.

Angelique Clark 26:32

Yep. Yep, and I want to acknowledge that firstly, because we don't have the same 24 hours as our 25-year-old self or other people in general. So clearly want to recognise that, and that's the biggest part of my job is I know we talked a lot about it is a science, but it's so behavioural. So there's a lot of the counselling and the lifestyle management that I just feel like most dietitians, until they live it, they don't really understand how to help somebody that has aging parents on one side and children on the other. And the person that's left in the middle is really hard to find time to care for. So that is absolutely it. So the best thing I can say, and I will tell you the tips that we can absolutely do to reverse a lot of that and help our longevity and our aging and our health span. But firstly, we need to be efficient about it, and that is one of my biggest key factors when I'm looking at the Perilid method is going, how can I do the least amount possible that's going to have the biggest impact for what it is that I need to stop that's gonna help me to have the lowest risk of disease for those big players that we talked about. So let's talk about that.

Kate Coomber 27:32

That feels great. The lowest possible. Like, you know, that is that is what people need.

The Big Rocks That Matter

Angelique Clark 27:37

Absolutely. And we know that that decline in estrogen, we understand it's cardioprotective, it also has an influence on our anabolic ability, so being able to put on and lay down more muscle and bone. So when that gets removed or reduces as we start to hit menopause, that's when all those disease risk factors go up. And if you haven't noticed it by now, I think it's starting to happen earlier. I know my friends, we're in our 40s. My friends have cancer diagnoses. Like what? Like, where did that come from? Like, I don't understand why that's happening, right? I thought that was an old person's disease. And we always think it, you know, set 60s or 70s, right? Menopause itself is just purely, if you we look at the research, that is a risk factor for so many things, particularly heart disease. And so for women, there are some things that I think let's look at the things that we can control and the things we can't. We're all going to go through menopause. Yes, there are some ways from a perspective of being able to talk to your GP about perhaps maybe some hormone therapy that might help if you are particularly one of the 30 people that suffer from severe symptoms that are really life debilitating. But most of us are in the middle and we're just trying to deal with stuff going on day to day. So these are my big rocks, the things that I really want women to understand and know.

Sam Miklos 28:46

I hope we're recording.

Angelique Clark 28:48

So, firstly, we need to put some mechanical load on our body because muscle loves tension. If the saying goes, if you don't use it, you lose it, and that's pretty true. Our body's pretty amazing, but it will start to break down our muscle and our bone to supply us with other things if we're not actually doing something to attenuate or hold on to that muscle. We are human beings, we love to move and exercise, we've got a skeletal system that loves that. So if we can do resistance training as a priority, I think that most women are probably a little bit shy of that. They've generally grown up in the cardio bunny era. So true. Aerobics hostile anyway. Yep. So often we were portrayed the image that cardio is going to help us to stay thin, and thin is an ideal, and if I'm worthy, I must be thin to be able to do that, and it's somewhere along that line, that body image dysmorphia just happened. But it wasn't without being in a culture and society that just portrayed that all the time. I'm really fortunate I didn't grow up in the era of social media and when we're constantly bombarded with that as well. But it's still an underlying message, I think, that thinness is an ideal, and we have to acknowledge the elephant in the room based on that. So, firstly, yes, we need to resistance train. Minimum twice a week, ideally three times a week. And I'm talking about what's efficient here. Yeah.

Kate Coomber 29:58

And when you say that, like how much are people needing to do? It's a really good point. Is it like a 30 minutes, three times a week? Is that 10 minutes a day? No. But also, yeah, if we think about our community who are here, there and everywhere, not always having access to a gym, like what are some really quick wins that people can do there?

Angelique Clark 30:13

Well, firstly recognise that probably about 70% of women aren't actually exercising the amount that's required for just general health and well-being. So that statistic alone, I don't even care what you do, please exercise. I don't mind where or how you do it. If it's accessible, please do it. The amount by the Australian College of Sports Medicine would suggest 150 minutes of moderate to vigorous exercise per week, but you can split that up. So if that's five by 30 minutes, um, I actually think ideally when we're hitting this sort of midlife phase, I would love people to think about an hour each day to move. Now that doesn't have to be the same thing, but at least it's an hour for your own time, whether that's a yoga class or whether that's a resistance or weight training session, whether that's a walk, whether that's an interval run. It doesn't really matter at at this point in time just to be able to move. And then we can go into this the layers of why it's probably like I said about the efficiency. So if we don't have that much time to devote 30 to 60 minutes every single day to exercise, then what becomes more important is the intensity of that. So we can actually do really great things the more intense we go, given that we need to consider injury management. So what we looked at with studies is that we understand that aging does have an influence on what we call muscle protein synthesis. So our ability to lay down and hold on to skeletal muscle, which is a metabolic sink, it actually helps keep us really, really well in terms of not only functioning, being able to move in older life, but it is actually really cardiometabolically protective. Helps our brain as well, not to age. So if we can do those things and exercise our muscles, then the intensity we're looking at, we still respond. So this is great. We know that at any age, you can actually improve. So there's never too late. But what we found is that if we look at studies with adults that are young versus old, so I'm talking like a 20-year-old versus a 70-year-old, they are exercising at the same capacity as those the younger individuals, but the the effect is flatter. So they just don't get the same muscle protein synthesis just purely from an age perspective. Now, needless to say, the intensity of the exercise actually helps. So it's around about 60 to 75% of what we term our one repetition max, which is if we think about lifting a weight, you could only do that once. It's so heavy you need to put it down. So I know we don't want to train to that level, but if you think about six or seven out of ten in terms of intensity or like on a rating of perceived exertion, that's where I kind of want to be sitting at before I put that dumbbell down. So six to ten reps? Not necessarily reps, it's the intensity of those reps. So the repetitions will change depending on how heavy you're lifting. So if you're just new or just starting out, you're not all that confident in a gym, you can pick up a weight and go, gosh, yes, that's really heavy. And I'll get you to do as many reps as you can until you feel like you're around about a six or seven. Or we talk about it as three reps in reserve. So I I say to you, okay, if you can do this, keep going until you stop and say, I can only do maybe one to three more reps and I'm done.

Speaker 3 33:16

Yeah. Yeah.

Angelique Clark 33:17

Does that give you an indication of the intensity?

Speaker 3 33:19

Yeah.

Angelique Clark 33:20

So it doesn't matter exactly. You I think the fallacy is that people think they need to lift heavy in order to have this elicit this change. You don't necessarily need to lift heavy, you just need to lift at the intensity that would stimulate the muscle protein response. Yeah.

Sam Miklos 33:33

Okay.

Kate Coomber 33:34

So resistance.

Angelique Clark 33:35

Yep. I'll go on.

Kate Coomber 33:37

If you're not in a gym, how does someone do that if you're just so resistance can be applied by anything.

Angelique Clark 33:43

You can do body weight if you're just starting out. Uh you can do elastic bands if you can take that, pack that in your suitcase or wherever you're traveling to. Um there are some parks now that have equipment, or you could do some bench equipment outdoors as well in a park setting or arena. You can do some of these things in your hotel room, like I said, with just maybe a chair and a bench and body weight. Yeah, it's something at the very least. And we can add things like plyometrics to that to increase the intensity. So maybe you know, removing your feet from the floor, so a jump squat will add more of that, I guess, resistance and more load on the bone, which actually helps um our bone mineral density as well over time. So, yeah, multiple things we can do, but this is what ChatGPT is great for. Give it your scenario and go, I am travelling to here, I don't have this much equipment, or maybe I've got a couple of dumbbells at home and an elastic band or a booty band or something like that. Um, write me some exercises that could be resistance training.

Sam Miklos 34:35

That's a great thing. There you go. That's so true.

Strength Training Without A Gym

Angelique Clark 34:38

And information's so accessible now. It's just you've got to learn to understand what you're looking for.

Sam Miklos 34:42

Yes.

Kate Coomber 34:43

And this and that's so true because I think that what you said in Chat GPT is excellent, but then you know my feed is flooded if you look at social media with all the things I should be doing. Yeah, it's too much. And so then we just we just do nothing. Have a coffee, have a few, don't have the coffee. Fast, don't fast. Definitely. So a lot of things. So, okay, so we've got the movement. We've got the mechanical load.

Angelique Clark 35:03

Yes. So second to that, we're adding and complementary that with protein. So protein becomes a really important macronutrient. It's not the only macronutrient because I bet your feeds are full of protein pulsing and you know, prioritizing protein.

Sam Miklos 35:16

A lot of protein. But I want in powders. So are you talking protein in a powder or in actual protein?

Angelique Clark 35:22

In actual protein as a macronutrient. So if we look at like what we're trying to achieve in a plate, uh, we want to have an element of protein at every single meal. And I think most of us, unfortunately, eat a lot of protein at our dinner time, probably a little bit too much, and we're not having a lot of protein maybe in our breakfast, which is a lot of busy women. They might not even be eating breakfast, they could be just starting with coffee. And they have might have a little bit at license. And then um the bulk of their protein at dinner time. So collectively, what we've understood is because we're going into this era of anabolic resistance, so our muscles need a little bit of extra intensity, but they also need a little bit of extra protein, which are the building blocks of essential amino acids that help support that muscle protein synthesis response. So if we can complement that, add it in over the day. We're looking, if we're looking at numbers and being specific, it's about 1.2 to 1.6 grams per kilogram of body mass that we want of protein per day. But let's be real practical. If you grab your hand and look at it, that's the serving of a protein-based food that we want to add onto your plate for breakfast, lunch, and dinner at the very least. And if you're resistance training, maybe we'll add an extra one around that as well.

Sam Miklos 36:27

What are the um kind of top five protein foods that you're like breakfast, lunch, dinner, like try and just pick one or two? You know, like for someone will go, oh, like what is that?

Protein Made Practical For Busy Women

Angelique Clark 36:37

Yeah, so easy these days because obviously protein's heavily marketed on lots of different things, but it's very important to understand what the good sources of protein are versus the not so great ones and just being fed marketing. Um, so the first thing we look at is what we term a high biologically available protein, which contains all nine essential amino acids. So we can't assimilate that in our bodies, we need to get it from our food source. Now we cannot store protein either, so we actually need to be getting it from our food. And the top ones I love at the moment are the high protein, low-fat yogurts. So you'll see them advertised as Icelandic or Skia, or for instance, if I give you some brands, Farmers Union Protein, we've got Paul's Protein Plus, we've also got some generic Coles and Woolies brands that are equally an Aldi, equally just as good. They they just literally say high protein on them. Yep, yep. So it's a Greek-based yogurt, but it is low in fat, and they strain that multiple times in order to increase the content of the protein, but by default it ends up increasing our calcium, which is great for our bones, and second to that, it also contains probiotics for our gut. So all of these factors is that is a fantastic food for us to be looking for and a great option to add protein at breakfast time. There are also some high protein milks if you want to kind of look at those types of things as well. But the easiest thing that I have, because I'm busy working, mum, like every single one of you, is to have a protein powder just on the shelf. And that just is used as an ingredient in a whole food recipe. It's not something to rely on. We don't want to have protein powder chalked into our day all the time. You definitely don't need a protein powder, but it's really bloody convenient. Yeah, it's good. So there are different qualities of protein powder, and we can go into that, but ideally you probably want one that's around about 80 to 90% protein. So if you look at the per 100 gram label, the protein column, it's around 80 to 90% or 8 to 9 out of that hundred, so 80 to 90 grams out of that 100 mil or grams. Um, yeah, so they're the things that I think off the top of my head from a breakfast point of view, and then we're looking at the other animal-based proteins, which are generally higher in those amino acids. I'll always get lean sources of this, so our skinless chicken breast, um, you know, lean cuts of beef. Fish is fantastic, it's got wonderful omega-3s in there as well. So anything like our salmon, um, our tuna, tins that you can take with you, um, non-perishable, you know, whack in your bag. Um, but don't be shy of actually increasing your plant-based protein. And that is my third point, is also relating to increasing fibre in our diet, because we actually need to focus on the gut microbiome in order for us to be able to digest and absorb and utilize that protein. So when I look at plant-based proteins, things such as edamame, so when you go to the Japanese shop, there's edamame in there, you get them frozen as well, so it doesn't have to be fresh. Um, legumes, so tinned even, is even great, like chickpeas, kidney beans, lentils, um, tofu is another one that's in there, and all of these have what we call a property called phytoestrogens, which also help mimic a weak effect of estrogen in our body, which potentially might actually alleviate some of those vasomotor symptoms that we discussed, like the hot flushes and the night sweats. So, all of these factors involved is have a good combination of plant-based proteins and animal-based proteins, and the combination of those together is going to be really impactful for our gut microbiome.

Kate Coomber 39:50

Okay. So we've got the resistance, we've got the protein. You need the fibre.

Angelique Clark 39:55

We need the fibre. Yep. This brings it all together. So as our hormones undulate on their decline, what we start to see is remember the whole apple shape and the pear-shape description of like fat distribution. So estrogen has an influence of where fat is distributed, and as we start to age, we start to see that midsection belly fat. That is real, it is true. We've looked at studies where women sit around, we call it visceral fat as a specific term, but women sit around 5 to 8% visceral fat. In menopause, it goes upwards of about 15%. Again, nothing different, nothing changed, it's a hormonal fluctuations, nothing wrong that you're doing, but it's redistributing where that goes. And so unfortunately, if that's around your midsection, it is closer to your organs, it has an inflammatory response, it increases our risk of lifestyle diseases, particularly cardiovascular disease. But what we see in women, which is also very silent and something you won't necessarily notice, insulin resistance. And so this is a precursor for anything that we're looking at with blood glucose management for type 2 diabetes as a precursor. So when I'm looking at things that are going to help that, we need to improve our gut microbiome. We need to improve the ability of our body to take on board a multiple diversity of different plants because what we also see that contributes to the effectiveness of the gut microbiome is that as our hormones start to drop, so too does the diversity of our gut and our gut bugs. So if you think about going into a forest, we've just chopped down a few trees as we start to hit perimenopause and menopause, and now we don't have as many players to protect us from our immunity, from our ability to take on board nutrients from our food, process, digest them, and have our body utilise them effectively well. So we start to see the flexibility in how we can process a lot of our carbohydrates and other different types of foods, and that starts to have an impact as we age. So the more fibre we have, we have around about 30% of the population at the moment currently hitting the recommended guidelines for fibre. That's actually pretty good. It has improved. But does anyone know what the recommended guidelines of fibre is? So generally it's 25 grams, but I would actually advocate, having looked at the research in the studies, that between 30 to 40 is where we start to see the lowest risk of all-cause mortality. So the lowest risk of disease happens around people that consume around about 40 grams of protein. Oh sorry, fibre, fibre, fibre.

Sam Miklos 42:10

What's fibre?

Angelique Clark 42:11

So fibre is the indigestible component of most foods. Sometimes it's soluble, insoluble, or resistant starch. So it's three different types of fibre. We love to get that in our bodies and in our system, and particularly resistant starch. It's what we call a prebiotic. So it's the food that feeds the gut microbes that sit in our gut. And if we get a lot of resistant starch in there, they go along right the way to the large colon and then they ferment and they produce these metabolites that really protect and support our health. Yes, great question. So um all our plant-based foods. So we want to aim for um five cups of salad or veg every day, two pieces of fruit as a minimum, and then we're adding things like nut seeds and legumes on top of that, but also included in that plant count is our spices and our herbs as well.

Sam Miklos 43:01

Five cups of veggies. Two pieces of fruit. Back there was always the don't have so much fruit, it's full of sugar, of course. And then you stop eating the fruit. Yeah. Five cups of the fruit.

Kate Coomber 43:11

And look on it. I dipped into your program recently, and I want now they're in my recipe wheelhouse, and I love it. Um definitely what you're talking about, the protein and the overnight o it's super easy that I can literally walk out the door with in the morning and wherever they've been all my life. Right, which I'm loving. And the meals I definitely noticed the increase in fibre. Like it was a lot of food for me, and I'm probably a person who doesn't eat as much as I should. And I actually struggled um just in the amount of food because yeah, five cups of Yeah, it seems it seems like a lot.

Angelique Clark 43:49

But that's what we need to hit around 30 grams of fibre each day. And then uh we can have, you know, there's uh some supplements that we can take on top of that that boost that up that we can't maybe find from our food system.

Kate Coomber 44:00

Do you think if you start and if it is if it is feeling too much, maybe rain it in a little bit, but then need to up the exercise and then it will balance out and it won't feel like that?

Angelique Clark 44:08

Um yes and no. I think um most women when they do come into the program is uh they're very so I take I like to take the signs and then turn it into food, right? Because we don't need to know all the numbers. It's nice that I know them and I need to know them.

Sam Miklos 44:22

You just need to tell me what you cook.

Angelique Clark 44:24

That's it. And I love doing that. And you know, making sure that that really good food doesn't have to be boring or tasteless. So aside from that, um it's a lot of volume, but it's not necessarily a lot of calories. So what we're also doing with fibre and protein in that instance is we're creating a satiating effect. And so what happens is when you're full, this is great because you often don't eat a lot of the discretionary foods that might kind of come into the way, which then if we look at the ultra-processing of foods and how we can eat a lot of calories but not get a lot of nutrition, that then becomes the catalyst for then putting on more body fat over time, which is not great for our metabolic health. So the idea behind that is that you have to start slow with fibre. Like if we're taking you from going, oh my gosh, I'm having one cup of vegetables in total and maybe a piece of fruit every second day, we have to start slow. So we would completely reverse. I'm like, right, I'm on the program, I'm doing all the excitement. Yes, and we really have to add fluid into that as well, because if we don't, just think about cement. So if we add more fibre and more roughage, um if we don't add the fluid with that, unfortunately we're going to probably feel a little bit constipated and get more gas wind and bloating as well. So it could often have the opposite effect. Now it takes around about two weeks for your gut microbiome to kind of get on board with what's happening and what you're feeding it.

Sam Miklos 45:38

And so it wouldn't be like, what?

Angelique Clark 45:40

It's a little bit of a shock.

Kate Coomber 45:42

And I and I just, you know, you kindly shared some information about it, and I just wanted to dive into it to understand it a little bit more today. So I wasn't, you know, following it to the tea or anything like that, but the recipes have stayed in my house. Like they really are, you're right, they're so delicious. Um it was just because I hadn't dived in properly, I didn't have all of this knowledge, and that would have been probably really.

Fibre, Gut Health And Visceral Fat

Sam Miklos 46:07

So I've had a hysterectomy uh in my, I think I was 40 or something. Um what is the difference gonna be for me and for other women who've had a hysterectomy early on then in this peri in our peri-era? Are we gonna have all of the same That's a great question? Did you keep your ovaries? One. Okay. The other one was just flapping in the breeze, twist it up in all sorts of things. I like it.

Angelique Clark 46:31

So that's an important piece, and the reason why I asked that is because um does your brain signalling still uh is still making messages to your ovaries? And if your ovaries are removed, then we would say, well, that's a complete hysterectomy, which means you've straight into menopause. So immediately. And often um, you know, there's other situations of that, maybe primary ovarian insufficiency, so early menopause. So there's definitely cases and scenarios where that's happening, but a lot of it is from surgical um uh procedures that women go into that early.

Sam Miklos 46:59

Can I just ask though, if they had taken both, would I have just skipped all the bits and just you would have gone straight into menopause.

Angelique Clark 47:06

So that actually, from most women report, would have been more severe in terms of symptomology. Yeah, right. So it's like saying your body's working in a symphony and it goes through this menstrual cycle, you know, estrogen goes up, progesterone comes up and down, we've got ovulation in the middle, um, testosterone's doing its thing as well. Um it's gone, here's the symphony, let's just wipe the orchestra out.

Kate Coomber 47:25

You probably should have asked that question.

Angelique Clark 47:27

I'm I'm surprised. Um I mean, I'm not surprised that it wasn't you weren't aware of that in that instance.

Kate Coomber 47:33

I've been I'm sure I was.

Sam Miklos 47:35

You would have been. I had a one year out of the control at the time. But still, yeah, it was there was a conversation around like um definitely keeping one. But yeah, then now I'm just not going, yeah. So do I are these symptoms going to be the same for me?

Angelique Clark 47:47

We don't know. And you're the one that's gonna be able to tell us that, but just the awareness of that now is really important to understand. You probably likely maybe you will go through menopause earlier than the 51. Yeah, because of that reason, because now we've removed an ovary which might have been releasing eggs each month and going through that menstrual cycle, but with that kind of um, you know, being reduced, then we're likely to explore the fact that you probably will go a little bit earlier. It's not a bad thing, but I think it's more important now for us to be input inputting all these things that are preventative if you're going to be then dealing with an environment in our body that's now estrogen and progesterone is at their lowest state. So all the things we can do, like I said, that's in our control from a lifestyle management perspective, um, is everything that we want to do to the best of our ability. And second to that, then what are our other options? And we can talk to our medical professionals about that and being complementary to that as well.

Sam Miklos 48:35

Yeah. I'm just gonna say you mentioned supplements before too. Do you think that um through the right nutrition you can avoid needing supplements?

Angelique Clark 48:47

We always have I mean, I think this is a dietitian rule, food first, supplement second. Yeah. Um no matter what you do in relation to supplements, if your diet and your exercise isn't easy cutting it, uh no supplement's gonna help that. Um I know, I know, and I say that, but I have changed my opinion on this a little bit as I start to look at midlife. So we're often looking at supplements as being the one or two percenters to increase performance after everything when you work with a a somebody that's at an elite level, they're already doing a lot of things right in that instance. But this is a thing. So, yeah, so maybe it'll make a one to two percent difference on a performance scale, but that might mean you're winning a gold medal, right? So we're gonna throw everything that we can at that. Now, if we look at our lifestyles, I think if I give a general amount, let's just say 80% of your results are driven by what you eat day to day. So breakfast, lunch, and dinner, how you choose your snacks, and the consistency of your exercise. Once you've established that, then let's start to explore some other things that could actually help, I guess, fill the hole where our diet might not be up to scratch, which is just being realistic about everything. I'm busy, I don't eat five cups of salad and veg every single day. Uh so you know, and also the fear around fruit as well. Again, what I think is don't listen to all the big noises out there, just determine what's actually correct for you. Firstly, I always say you can never get fat from eating too much fruit, go and try it. So if you take on what a nutrition message, I mean, I'm happy to try anything once. Like I'm a guinea pig, I'll be, I'll be an experiment. But honestly, you'll probably find that the fibre content of something like that is far more beneficial, and you'll probably be sitting on the toilet compared to you know getting bigger from it. So again, it's the fibre, it's the water, it's the nutrients that go into fresh fruit that I am so not at all afraid of when it looks when we're looking at this from a weight management perspective. So remember the other thing to look at is going, can we remove the focus on the weight on the scale and really fulfill it back into how can I nourish myself the best? And then what will happen by default is when we get all that stuff right, our body composition changes. So we start to at least hold on to that muscle or put on more muscle, which would be great. We start to improve our ability to process and digest carbohydrates and then reduce that risk of insulin resistance. Um, and then we lose body fat. And so all of all of a sudden we're actually feeling great because we're adding more to what it is that we're performing. Our workouts feel better because we're not depleting ourselves or doing it on empty. And now we've got a woman that's entering really this empowerment phase of her midlife going, I'm actually stronger. That translates across to me having the energy to help my kids or do stuff at work. Um, I feel fantastic. Who cares what the scale says? I mean, that's a byproduct, right? But it's the body composition we need to look at. So I think we're looking at it from a different lens in the sense of it can't always be about weight loss, it has to be about how we can change our body composition and how do we feel doing it as well.

Sam Miklos 51:36

If we really lean into that, that's where it then creates our best era. It does. Because we've we've we're almost being forced to do it and rather than resisting it if we actually lean in it and have these conversations.

Kate Coomber 51:47

And I think any woman in their 40s would say, I just want to feel great. That's it. And the looking great was always maybe the focus. But when you start to not feel great, you just want to feel good. You've got older parents probably that you're caring for too, and the busiest work period of our lives for everyone. It's um yeah, it's really important. I think it's really catching people.

Sam Miklos 52:14

Is there more um research now around parameters? Like, is it um really evolved? And I guess is that uh having a positive effect on the health system? Because I imagine you know, many years back a lot of the symptoms and the brain fog and the anxiety like would have been dealt with in other ways.

Angelique Clark 52:35

Absolutely, and they were very quick to jump the gum and go, okay, is it depression? Yeah, is it anxiety? Can we medicate that?

Hysterectomy, Supplements And The Scale

Sam Miklos 52:43

Yeah, yeah. So what what is the I guess the positive or negative effect on the health system that we're seeing now from more awareness around?

Angelique Clark 52:50

Yeah, look, I mean, I didn't get a lot of training at all in my degree um going through, and obviously that's in exercise science and nutrition dietetics. Do you think that's different now for the groups going through? Do you know? To be fair, um the GPs? Well, I I think it's uh I I'm just going by what probably I've seen GPs speak about. I'm not actually too sure from a medical perspective, but I imagine that they wouldn't have got the training, particularly in menopause itself. I mean, I was taught anatomy, so it's not like we weren't aware of the reproductive system, but I was never taught about it from a physiology perspective. Um like what is my menstrual cycle and why do I feel like this at certain times? Why do I have lots of energy maybe around mid-cycle? Um, why do I feel really cranky seven days or five days before my period? Why does that alleviate when I get to my period? None of that was spoken about. So even if we weren't taught, we were taught from just a purely an anatomical and reproductive lens as opposed to a physiology lens and how this works with our body and how we can actually guide ourselves through our menstrual cycle. And I always say it's just about low mood state at the same time as well. We can add that into the piece. It's understanding our bodies radically and then learning and listening to that before you make a decision that's going to dictate your health or make a behaviour change or do an action. It's all about how you feel. And when you feel good, you make a better decision from that place, nine times out of ten, right? Than when you're feeling shitty and you're making massive decisions. You're like, well, I need to ride this out, or actually, what about I get curious and ask, how do I feel? as we just said. That's really important. And often in a medical space, a feeling isn't necessarily factual. So they're looking for facts. We can't diagnose perimenopause, it's an undulation of that.

Kate Coomber 54:27

We've got a fitness system.

Angelique Clark 54:29

Exactly. So we've got markers for menopause. That's fine. We can test FSH, we can look at anti-malarian hormone, we can actually classify you based on, like I said, the last time you had your menstrual cycle or your period. Um, but unfortunately, we're looking at symptomology, and symptomology is subjective, not objective. So very hard to determine where that sits. Um, so when we're going in, we also don't have advocacy for our own health. I think we don't have agency, so we trust people in white coats. And unfortunately that gets dismissed. But if I have to say something, I feel like women are so intuitively gut instinct, we talk about gut health, so powerful, there is a gut instinct within that. You need to start trusting and listening to yourself more. If something doesn't feel right, please look for a different answer. Um, and and continue to advocate for your own health. And the more you do that, the more language that you'll get around that to ask better questions. And so that might be okay, have I looked at my blood panel, right? Can you give me a full blood count? Often we go to the doctor because we're sick or it doesn't feel right. How about we do it just as routine after the age of 40? You know, so then we've got a reference point, we've got a baseline, and anything we can do from there, we've always got that point to compare back to. So I'm comparing back to myself rather than comparing to the population. So that would be really cool to actually do and understand and having that data on you, and then you pair that with your subjective symptomology. There's a beautiful validator tool called the MenQual questionnaire. I use that with my clients coming in. I like that validated tool to actually manage their symptoms before and after the intervention. So I'm going to tell you go and eat and exercise and do all these things. I'd like to know that those symptoms have improved. So I'm doing my rigorous testing just because that's my the way that I practice. I'm not sure that that's happening in practice, but the Australian Metapolis Society does have practice guidelines for GPs in that space. I would now have to say that it is a specialist quality that I think they need to also do in terms of the training, and I'm very aware of that when I go and recommend people to go to different doctors, or if they've been kind of dismissed and their doctor doesn't understand that. And that's okay. They might not have that skill set and training. Similar to like, I don't know what to do in a hospital dietitian role.

Sam Miklos 56:30

So that's cool.

Angelique Clark 56:33

That's exactly right. Unfortunately, I think the biggest barrier to that is now the price tag that goes on top of that as a skill set and qualification. So that could also be very discouraging for most women or a a barrier to getting good healthcare advice in that space.

Speaker 3 56:48

Yeah.

Kate Coomber 56:48

Should we talk um just briefly maybe about your program? So what how could people if people are listening today and they're just like, this really speaks to me, how do I get in touch with you, or what do you offer, or is there something there that people can access?

Advocating For Care And Finding Support

Angelique Clark 57:03

I love that. Well, first, maybe Instagram is probably the best way in terms of social media. I often say if something's flooding your Instagram profile and it doesn't make you feel good, then delete them and add something else in there. I really try to, I'm not on there, I try to be on there, but be proactive and educational. So I think my Instagram's the best place to start. I give a lot of free content, a lot of practical advice. I will show you what I make for myself and my family, how it can be very integrative in terms of lifestyle. Um, so Instagram is at Angelique Clark underscore nutrition. Um, firstly, start there. You can jump on my website, which is just my name, anguletteclark.com.au, and there is a free download there that speaks to all those beautiful midlife macros and the principles that we just discussed. So if you want a point of reference and something to refer back to and all the numbers in one spot, there's a free download that you can do there. It gives you an idea of what like a day on a plate kind of will look like when we start to put those 30 grams of protein in every meal, the 30 grams of fibre in our day, what that kind of looks like in real life. So that would be the first point to start with. Um, and second to that, I've tried to make my services accessible to every woman, no matter which stage that they're at. I think that for me I love the research, but I was never inclined to be in research because I wanted to work boots on ground with people, with women and actually see change. And so my public health background became really important. I didn't think I'd ever end up doing this, but I do have a group-based program that is online and accessible, and that's called the the Peri 28 program. So that is actually a 12-month program. Um, and people often go, Oh my god, I don't have 12 months, but that's where I go in and I actually coach and be able to hold your hands through that system and that process, but it's full of recipes and education around what's happening to our bodies, why we're changing and what we can do about it. But as an entry point, I think a great place to start if you're interested is to do the per secret challenge, like you guys did, and just get you a feel for okay, what how powerful nutrition can actually be in seven days. So it is a bit of a plug-and-play system, like it's something that I go, look, just trust me on this. I am asking for your trust. Um but most women come out of that and report probably the most the thing to me that really warms my heart and the reason why I keep doing what I'm doing. And I always get emotional about it because it's more than food. Like it's really giving women that permission to go, oh my god, I can actually, I can nourish myself. And the outcome of that is me being a better person. So whatever your mission is, whatever your purpose is, every one of us has a unique role to play on this planet. Um, if you can do that better, taking care of your health and your body to be able to do that as a vehicle is my job. Like you're gonna go into the world being so much better. And honestly, the reports that I get back, it's not just I've lost centimetres off my waist or I've lost weight. That's nice. Again, I said it's a byproduct. But the real biggest point is women going, oh my gosh, I'm yelling less at my kids. Like, that is powerful. We talk about gut health and the influence of that and so many other factors in terms of symptomology when women feel like they can't get anywhere or if they're stuck or everything that they've tried hasn't worked. If you spend seven days in my orbit, um you'd be surprised about what you can achieve in that lifetime as well.

Kate Coomber 1:00:10

Oh, I love that word I want to get into. I can I can vouch for that. I I definitely had that feeling just in the little snippet that I saw. So thank you. Um CMR make a donation to a charity of every guest choice. Where are we donating for you?

Angelique Clark 1:00:27

So for me, it's all about increasing that research in the space of women's health because I think that there is a lot to be done, particularly with the midlife females. So there is they're getting there, there's more funding, but we're gonna go to Monash Women's Research Centre. It's headed by Professor Susan Davis, and she has been instrumental in actually helping support women's health and really getting the evidence that we need to make those wonderful prescriptive-based recommendations that we know and have trust and confidence over that are gonna improve women's health rather than just focus on some of the influences that tell you all this stuff and put fear into you. Unnecessary fear. Um but can I also say as well, it's not just about the funding, it's also about you as women volunteering and being participants in these studies. So there's currently a study going on at the moment that they're recruiting for. So if you are in Melbourne, um and I don't know actually, I don't know if it's Australia-wide, it could be, it could be like electronic as well. Um but yeah, they are currently running a um a study, and I might be able to put that link into the show notes as well. Because if you can volunteer and be that person that we actually need to study to help them teach us. So, yes, it's about then us being able to contribute to that as well. So if you can, um yeah, sign up and be an experiment.

Sam Miklos 1:01:45

I've never thought about that. Like, yeah, you should definitely do that. When I was in uni, I did try to sign up for a sleep study where they they were gonna give me Japanese encephalitis or something. Great amount of money. My mother said no. So she's gonna cut me off in front of it.

Angelique Clark 1:01:59

Risk factors, if anything, you're gonna get some information on your blood work and your body composition, which is really cool. So, not just your weight, but maybe they might measure your muscle, your bone, and your visceral fat as well to give us that precursor.

Kate Coomber 1:02:12

Yeah, people are very interested. Yeah.

Angelique Clark 1:02:14

That's awesome.

Sam Miklos 1:02:14

Ash, thank you so much. What a great conversation. Um I'm really excited now to be in this era that we are in that we need to embrace. But I think there's some really good practical tips that, you know, particularly I think about our healthcare community and for them going out on contract and and you know, they often report it so hard there's not enough food there, but that just a few little um tips and tricks and changes that they could make, and and even thinking about just going for a walk at the end of a shift or just those few little little switches that can just help us all to really move through this moment and and embrace it and and come out. Better people, but we're gonna sit in step into the kitchen with you now. Now I know. That's okay. Like probably the best I do is eggs in the air for us. That was my biggest challenge when I dipped into your food is oh my gosh, I need to cook again because I'm really useless. We're like a platter kind of scenario. So we are gonna stand in our kitchen and we are gonna do things apparently with you and learn how to be.

Kate Coomber 1:03:13

Yeah, and we're gonna share all of this with our healthcare community. So they've got some great easy snacks with accessible ingredients that they can take with them anyway. That has lots of protein and fibre as lots of protein and fibers.

Angelique Clark 1:03:25

So thank you.

Sam Miklos 1:03:26

Thank you so much, Ange, for all of your time this morning. It's been wonderful.

Angelique Clark 1:03:30

Oh, thank you so much. It's just been an absolute pleasure to talk about the stuff that I love. Thank you.

Speaker 3 1:03:35

Thank you. Further letters.

Kate Coomber 1:03:41

We acknowledge the traditional custodians of the land of which we meet, who for centuries have shared ancient methods of healing and cared for their communities. We pay our respects to elders past and present.