ATHE_Transcript_Ep 561_Dr. Mary Claire Haver
JJ Virgin: [00:00:00] I am JJ Virgin, PhD Dropout. Sorry, mom, turn four time New York Times bestselling author. Yes, I'm a certified nutrition specialist, fitness Hall of Famer, and I speak at health conferences and trainings around the globe. But I'm driven by my insatiable curiosity and love of science to keep asking questions, digging for answers, and sharing the information I uncover with as many people as I can, and that's why I created the Well Beyond 40 podcast. To synthesize and simplify the science of health into actionable strategies to help you thrive.
In each episode we'll talk about what's working in the world of wellness, from personalized nutrition and healing your metabolism to healthy aging and prescriptive fitness. Join me on the journey to better health.
So you can love how you look and feel right now and have the energy to play full out at 100.
You are going to want to [00:01:00] listen to this interview probably five times. Holy smokes. It's so good. I am so excited about this guest today. I can't believe I didn't know her before. I think that maybe she's my soul sister. This is going to give you so much great information if you're perimenopausal, postmenopausal on what you can do.
If you're gaining weight, lose that weight, optimize your health feel better. And we're gonna go into hormones like should you do hormone replacement therapy? What should you consider? What are the latest on research with it? Can you start, if you didn't start right when you went through menopause so much.
Great information. Plus we are going to dig into the Galveston diet. Over a hundred thousand people have gone through it, so there's a reason. Let me tell you a little bit about Dr. Mary Claire Haver. She's a board certified OBGYN who's devoted her adult life to women's health. She began to go through menopause and she got midlife weight gain and nothing was working, and so she dug [00:02:00] into the science, figured it out, and created the Galveston diet.
Which is now an online program and a book that you can grab. It's the first and only nutrition program in the world created by an ob gyn, designed for women in menopause. And besides that is also a culinary medicine expert. So she's just got everything that she needs to really nail this, and that's why she's getting such great results.
In 2021, she opened Mary Claire Wellness and it is based on her work with the Galveston diet so that people can come in and get the help that they need. She lives with her two daughters. One of her daughters is studying nutrition too. How cool. And she's the author of the Galveston diet and she's created an inflammation quiz that you are all gonna get for free.
Plus I'll put all of our social channels and her book there too. And you can go to jjvirgin.com/GalvestonDiet to get it. Now you might be wondering, how do I spell Galveston? Here you go. G A L V E S T O N. Diet [00:03:00] Galveston. Diet. Jjvirgin.com/GalvestonDiet. And I will be right back with my new pal, Mary Claire.
I am excited to dive into everything menopause and weight gain, Dr. Mary Claire Haver, I'm super excited you're here with us. Thanks for having me. And I know we're gonna dig into the Galveston diet too, so we got a lot to talk about here. I forget what I was reading. And they said, you know, going into menopause doesn't affect your weight at all.
And I go, clearly this was written by a guy or someone in their twenties or thirties. Cuz having weathered that storm, I know that to not be the case. So how did you decide to really tackle. A very difficult subject, menopausal waking.
Dr. Mary Claire Haver: You know, I wish I had some altruistic reason. It was literally the most selfish reason in the world because it happened to me and I beat my head against the wall.
I was obsessively working [00:04:00] out. I was calorie restricting to probably dangerous levels, and it wasn't sticking. It wasn't working. And so, Finally being a scientist, having a come to Jesus with my husband about my attitude and getting up in the middle of the night to weigh myself after I'd have to pee cuz menopause.
Yeah. And he's like, what you're doing is not working? What do you tell the kids? What do you tell me? You know, you're a scientist. Figure this out. So that kind of led to my all right, if the old calories and calories out really isn't working that well, why? You know? I know I'm menopausal. That's what's changed.
And then it just led me down the rabbit hole of learning about menopause and inflammation and nutrition and visceral fat and insulin and leptin and ghrelin and cortisol and all the hormones, all the fun stuff. It's so fun. So why all the things that work for us in our twenties and thirties stop working in our forties and fifties?
You know, that we just have to change the game. So
JJ Virgin: I was in graduate school and doctoral school, and I was working my way through by seeing clients and personal training and nutrition, and they were all [00:05:00] in their forties and fifties. So this was back in the 1980s. I'm so lucky because what I was being taught in graduate school and you know what I was being taught, which is.
You've got to create a calorie deficit one way or the other. Eat less, exercise more. And man, it didn't work. It didn't work, right? And so that led me on this crazy path of going, all right, well if your body isn't a bank account, what the heck is going on? And that was like, your body's not a bank account, it's chemistry lab.
And it's so great because we are digging so much more into it. As I first started looking at it, it was very simplistic. We're like, it's insulin or cortisol. Now we know it's a couple more things, so let's dig in because there's so many things that come up as women are going into menopause. It's like, should they fast?
Should they calorie restrict? Should they keto? Should they like, what the heck should they do? Let's talk first about what is going on as someone is heading into perimenopause here or they are in perimenopause, like what things are [00:06:00] happening that are causing this weight gain?
Dr. Mary Claire Haver: In our twenties and thirties for most of that time, we are, most of us, of course, not all are enjoying normal, regular menstrual cycles, and we've learned to adapt to these monthly changes.
Right at the beginning of perimenopause, the amount of estrogen and sometimes progesterone that we create each month begins to shift in a downward fashion. It's not a steady state decline. It's often like a rollercoaster bouncing up and down on this downward trend. So you end up like this and this process can last seven to 10 years.
And the declining estrogen levels are doing several things to our body. There's hardly an organ system in our bodies that doesn't have estrogen receptors that's being affected. Now, from a weight standpoint, what we know is that from a physiologic basis, we start seeing a shift of where fat is deposited.
Where it used to be for most women about the hips and thighs, all of a sudden we're seeing abdominal fat gain or intra abdominal fat gain where we've never had it before, despite not [00:07:00] changing one thing in our nutrition or exercise habits.
JJ Virgin: Yep. I remember my mom going through this and she called it shifting sands, and all I could think of is I am not having my sand shift like that is not happening.
Where literally I was like, it looked like her butt had gone where her gut was like, I was like, what happened here, mom, you know, I've been reading a lot in preparation for my next book on protein and menopause and things that start to shift in anabolic resistance and the fact that as we start to head into this, We increase our anabolic resistance, especially if we haven't been exercising, so our protein needs go up and that actually drives our hunger.
Dr. Mary Claire Haver: That's a huge part of what's happening on a menopausal basis, is there's chronologic aging, which is what's happening to all of us, regardless of our reproductive status, regardless of, you know, if you're a man or a woman. And then there's also endocrine aging. What's happening to our ovaries and endocrine function and what we go through is very different than what men go through.
They may have a slight decline in [00:08:00] testosterone, but we drop to less than 1% of functional estrogen levels. What you're referring to this anabolic resistance in medicine, you know, on my end we call it sarcopenia, the loss of muscle mass with age. And so yes, women who have at least 1.5 grams per kilogram of lean body weight have less visceral fat, less muscle loss, and stronger bones, versus women who don't
JJ Virgin: say that number again.
Cause I want people to really get this.
Dr. Mary Claire Haver: So it's 1.5 grams for every kilogram of lean body mass. And there's several online calculators you can find to help you figure out from metrics to pounds, but for most women, it's around seventy-five to a hundred grams of protein per day,
JJ Virgin: and I've heard that the average woman is getting somewhere in the neighborhood of 45 to 60 grams,
Dr. Mary Claire Haver: and she's stacking it at her evening meal. Yes. So you're having toast for breakfast or carb oatmealy kind of thing, and then lunch you might have a little bit of protein with your salad or whatever, and then you're kind of saving [00:09:00] your protein load at night. The other thing to remember is that we really can't process more than about 30 grams as women.
Of protein in a sitting. So one of the things I learned from studying the elderly was we've gotta stretch that protein out throughout the day. Every meal and snack should have a nice source of protein in it as well.
JJ Virgin: So I've been really looking into that 30 gram thing to go, okay, how much of that is urban legend, because you would look at and go, well, wouldn't that depend?
Like I'm six feet tall and literally 14% body fat at 59, like I've got. A lot of muscle on me, clearly how much I can utilize, you know, and so some of it would be, cause I look at protein and go, well do we want it for function or fuel? We want it for function, so how much could we really utilize? It's gotta differ.
But what's interesting here, and this is where maybe you can clear this up cuz, and or maybe we'll both just go, gosh, head scratcher is, some of the research I've been reading is you need more protein. [00:10:00] If you are sedentary to overcome, you know, it would seem the opposite. Seem like if you're really working hard, et cetera, you need protein, more protein.
Now, some of the research, I'm trying to think of where I just found this data was saying, you need more protein as a sedentary person. It was a researcher out of Canada, and I'm like, why would that be? Is it the anabolic resistance? We're trying to push the threshold. I think the, the answer to all of this is what we do know is 30 grams seems to be a really good threshold base.
Wouldn't you agree
Dr. Mary Claire Haver: for most, and like you said, you know, in my clinic I have an InBody scanner, so I'm able to get people realistic. You know, estimations of their muscle mass, and we have discussions around that and protein needs when I'm calculating their macros. But I can't do that for the rest of the world.
We have to just let them approximate, you know, when we're doing visceral fat,
JJ Virgin: let's talk what visceral fat is. Let's define it. It is so clear that we have to use scales as biometric tools to learn what your weight's made up of [00:11:00] and to really understand not just your body fat. But where that fat is, I mean, we've gotta know how much muscle you have and where your fat is.
Those are the key metrics. So I'd love you to dig into both of those.
Dr. Mary Claire Haver: So subcutaneous fat is the fat we've all known our whole lives. It's in our breasts, it's in our hips. It gives us cellulite, it gives us curves. If you have large amounts, could put wear and tear in your joints, but in and of itself, it's really not metabolically active or that dangerous.
Visceral fat is the fat that gets deposited in and amongst our abdominal organs. It can wrap around the heart as pericardial fat. You'll see it in fatty liver disease. You'll see big, thick momentums, which are usually thin and, and you know, we all have some fat there and you'll see it wrap around the bowel as well.
And that type of fat is very, very different. It's metabolically active. It creates cytokines, it creates its own inflammatory organ. It becomes an endocrine organ pumping out, you know, inflammatory markers, raising levels of inflammation, which then makes you more insulin [00:12:00] resistant and drives more fat. I mean, you get in this terrible negative feedback cycle, and part of what's driving this for us as women is declining estrogen levels and menopause hormone replacement therapy can actually attenuate this now.
Elevated levels of visceral fat are a stronger marker for chronic disease risk than your weight or your B M I. So I think we need a big push from a medical standpoint in getting these types of scales in people's hands in offices, so that as we're counseling our patients, I'm sure as tall as you are and as much muscle as you have, you probably tip the scales towards A B M I.
That doesn't reflect your health status at all.
JJ Virgin: Actually, I just had a Dexa done. I did a DEXA in my late thirties and I just did another one, and I did an in body like two years ago. And I'm always 13 to 14%. I always tell people I'm a weirdo. I'm one of those real mesomorphic people. I always [00:13:00] have been. So I have much lower body fat than normal.
If I, my body fat's higher, I actually don't feel good. It's just when we were in grad school, normal body fat ranges. Were 18 to 22% for women up to 25%. Now it's changed. I love how the norms have gotten bigger. That doesn't mean healthy's gotten like higher body fat, but I think what we need to discern now is.
If you were storing a lot of fat on your hips and thighs, you might not like it, but it's not gonna kill you. It really isn't the body fat. It's where that body fat is way back When. I was using skin fold calabers, tape measure and a scale. Cause we didn't have anything else and we had underwater weighing. I remember having this woman who by skin fold calibers, was very lean, but you know, her waist measurement, her waist to hip ratio, she was like greater than one.
She was literally what I would call potato on stilts. She had so much, if we could have done a DEXA or an InBody on her, then we'd have found so much visceral fat. But we had no way to look. You just knew. That's where I think at the very [00:14:00] least, cuz I've been looking at how do you take this to the masses and make it actionable.
I mean, at the very least now, a waist to height, you know, and a waist to hip can be super helpful. Least you can see.
Dr. Mary Claire Haver: We teach our students, you know, a waist hip ratio as a better measurement tool for your progress in the program. You know, is really tracking that instead of just, you know, this obsession with the scale that we all have, that this is a better indicator of what's going on internally and what's going on inside of you.
Cuz not everyone has access to a DEXA or embody or any of the scanners, but I would love to see that happen. And then we teach the principles. Okay, so what are some nutritional principles that we know in women in midlife and menopause? Postmenopause help to drive the visceral fat levels down and they're very simple.
One is making sure you're getting a minimum of 25 grams of fiber per day in your diet, and most women are only getting half of that amount. I know.
JJ Virgin: Let's talk fiber so we can hear it again. Let's talk fiber. Let's unpack fiber, [00:15:00] then we'll talk protein. I love all these. We're going through all of them, but fiber, let's hear it again because gosh, it feels like if fiber was a drug, it would be like the most prescribed drug for weight loss.
And help right there with sleep.
Dr. Mary Claire Haver: If no, no one ever takes anything away from me other than this one fact, ladies minimum. 25 grams of fiber per day. And most of that should come from food. If you need to supplement to make up the gap, do it. But ultimately the fiber source should come from food because foods rich in fiber have a lot of other wonderful things about them.
You know, avocados have fat keep you full longer, packed with nutrients, fruit, vegetables, legumes, you know, all those things that keep you healthy from a nutritional standpoint. Men, it's 38. They need more than us cuz you know, men. But for a woman, minimum 25 grams per day. And, in order to get that, you're probably gonna need to track what you're eating, you know, until you get used to it.
And then you know how much of whatever you need to eat per day to hit, hit those goals.
JJ Virgin: Well, and I think it's tracking for a short period of time, like tracking forever, forget it. No one's [00:16:00] gonna do that, but boy, just tracking and then spot checking once every once in a while. Here's what I give an example of, we did a really funny YouTube on this once on wine.
You're at home drinking wine and your glass gets bigger and bigger and bigger and bigger and bigger and bigger. I actually got a glass for one of my girlfriends that could hold the whole bottle as a joke, you know? And you go out to a restaurant and they give you your like four ounce wine glass, and you're like, what's this?
You know? And so it's the same with, we tend to under eat on the protein side, but on the vegetables. We really need to measure all of this. We need to measure our protein to get really clear that we're getting enough. We need to measure our vegetables to make sure we're getting in those servings, so I love that tracking.
Amen. Let's go on to the next one. You were mentioning
Dr. Mary Claire Haver: protein. Protein, so making sure you're getting not only adequate amounts, that 1.5 gram per kilogram of lean body mass, minimum per day. So 75 to a hundred ish, depending on height, weight, muscles.
JJ Virgin: And that was ideal body mass, right? Ideal body mass. Yeah.
[00:17:00] How are you helping someone determine what that ideal body weight
Dr. Mary Claire Haver: should be? You know, most women know the weight at which they were happy. I'm like, what did you wait at 25? When you felt good, when you get out and run a mile or climb some stairs or whatever number that is, because you have to assume their muscle mass was pretty good at that age, and so let's just use that number so you know, what's your goal?
Weight within reasonable. Then we do the calculations, take the pounds to kilograms, and then I walk them through that. Then we look at the numbers that way.
JJ Virgin: That makes a ton of sense. Okay, so protein and you, how are you having people then eat it, and what are some of your favorite sources?
Dr. Mary Claire Haver: We are not restrictive.
So I am an omnivore, I eat anything, but we of course have people on our program who are vegan, vegetarian, whatever. And it's a little more of a challenge cuz they have to really fight to get their protein levels in. So for me, one of my favorite ways to break a fast is they call it the Mary Claire Smoothie.
My students do, I did not name it after myself. Plain Greek yogurt, [00:18:00] 5%, nothing added. And then we add lots of stuff to it. So I add hemp, chia, flax. Fresh fruit, usually berries and some kind of a nut. I mix my nuts up every day so that I get the different nutrients and that combination just packs a punch.
You know, you got your fiber, you've got your protein, you have your omegas, you have anthocyanins through the berries, you know, and, and it's delicious. I mean, for me, I love it.
JJ Virgin: I call it the protein, fat, fiber trifecta.
Dr. Mary Claire Haver: You know, when you're at a restaurant, I'm like, look, ask 'em for double veggies and get some lean, grilled, you know, meat that's gonna rock your world.
And I tend to order things at restaurants, but we don't cook a lot at home, so I'll eat more shrimp or fish where at home we'll do more chicken or beef, Turkey. So those are some of my favorite ways to make sure I'm getting protein in. So
JJ Virgin: there's one, there's two. What are some of the other ones?
Dr. Mary Claire Haver: Snacks?
Nuts. I just made a big pot of lentils last night when I meal prepped. That's another great source of fiber and protein. And so we talk a lot about, you know, [00:19:00] meal prepping, having things on hand, pre getting your lunches done, throw it in the bag and go so that you're prepared, especially if you don't have time.
JJ Virgin: Right. That is a huge one. All right. Any other tips? I have a definite inflammation question to ask.
Dr. Mary Claire Haver: For visceral fat, limiting the added sugars. And this is something that, you know, they're, oh, well, I'm not gonna have fruit. I'm like, no, no, no. Added sugars are the sugars added in cooking and processing. And this is something that the American Heart Association and the World Health Organization are really honing in for so much so that the FDA is now requiring added sugars to be on the packaging.
So it's the last thing under carbohydrates. They both agree for women somewhere limiting your added sugars to 20 to 25 grams per day. So women who are able to do that through their nutritional choices have much less visceral fat than women who don't.
JJ Virgin: I had to interview him twice because my work obsession is, do you know Dr. Rick Johnson? Nature wants us to, oh my gosh, [00:20:00] he wrote the book. Nature Wants us to Be Fat. But when I was writing the Sugar Impact Diet, where I really looked at, you know, the rule of fructose, both insulin and glucose, what was raising insulin, glucose, I think you've gotta look at both of them and then fructose against nutrients and fiber, the good of carbohydrates and the bad of carbohydrates.
And you know, he was talking about how just the change from cane sugar to high fructose corn syrup, what it has done to NAFLD and visceral adipose tissue. So I just don't see a place for added sugars. And one of the things that's really frustrating is when they sneak it in and lie to you by putting in apple juice concentrate, right?
Dr. Mary Claire Haver: So we are big in the program about read those labels. Here are some of the hidden words to look for. But now that the FDA is requiring added sugars to be on the label, it's a lot. Yes. Amen. When you look at a tablespoon of sugar or you know, the equivalent of berries, the berries. Have fiber [00:21:00] built in, it's gonna slow that absorption.
Mm-hmm. Outta fruit. The minerals and nutrients are gonna just make you so much healthier and keep you full longer and there's no comparison of the two.
JJ Virgin: Yeah. You cannot compare an apple and apple juice. Right. And apple juice concentrate, you're looking at a piece of fruit and a soda. Exactly. And if it's dried fruit is candy, like, let's call it what it really is.
Now let's talk inflammation. I know you're gonna give everyone your inflammation quiz, and we're gonna put that at jjvirgin.com/GalvestonDiet. You've been talking through the Galveston diet. This is what we are actually talking about. This is the program that you put together when you started struggling, did all the research, and then now you've taken how many people through this.
Dr. Mary Claire Haver: We have about a hundred thousand through our different levels of
JJ Virgin: program. That's just crazy amazing. And your book out now, so that's very exciting. If you're listening to this podcast, it's not quite out yet. You can pre-order it, but most likely it is out, and you'll wanna go get this at [00:22:00] jjvirgin.com/GalvestonDiet
that's where you'll get the inflammation quiz. Let's talk inflammation, why it's problematic in your favorite anti-inflammatory foods.
Dr. Mary Claire Haver: So when I went down the rabbit hole of research to help me figure out why calories in calories out wasn't serving me or my patients or my friend, my girlfriends, who were all roughly the same age, one of the recurring things that was coming up was, you know, inflammation through nutrition.
How to lower inflammation through nutrition. Can it make chronic inflammation worse? And so when I looked at, you know, what are we doing to treat chronic inflammation? Every single thing was nutrition. There wasn't a drug or a, you know, medication to take. It was just eat more of this and less of that.
This will start fixing itself. We kind of knew that it was like porn, you know, when you see it, what is healthy? But no one actually sat us down to teach us what healthy eating was about. Now I went back to school to learn that in 2018 and 2019 I became culinary medicine [00:23:00] certified. But I saw that.
JJ Virgin: So cool.
I only know two other doctors, Uma Naidoo, who's heading up the Harvard School, she does psychiatry and food is medicine. And then Steven Masley, two doctors. There's three of you. We need a lot more. So cool.
Dr. Mary Claire Haver: Thanks. Everything about the way I practice medicine. Wow, how so? Nurse practitioners, physicians, nps, PAs, and pharmacists and registered dieticians can all get certified in this.
It taught me one, the basic, the basics of nutrition and then medical nutrition as well, but also like cultural differences. You know, all about obesity and all the causes. You know, like you said, it's a chemistry lab, not a bank account. And the chemistry lab is so much more complex than we ever imagined.
And you know, when you layer in, we are not little men, we react very, very differently to different environmental responses and you know, and how to use all of that to treat each patient as an individual, including socioeconomic [00:24:00] reasons that they don't have the choices that some other patient might have.
And cultural things about things that they like to eat. How can you take that and make it healthier for them? I mean, it really was one of the best things I've ever done in medicine.
JJ Virgin: That is so cool. It kind of led you down the path of realizing, I mean, when you really think about it, what's creating inflammation in the body?
Chronic inflammation. Not like, you know, broke my leg or I pulled a muscle. Aging
Dr. Mary Claire Haver: is one thing. We are breaking down every day. Okay. We're never gonna be as healthy as we were yesterday, and that's just part of getting older and what we put in our bodies. And for women declining estrogen levels associated with menopause.
Those are the top three.
JJ Virgin: So the aging thing, you know, we can support as much as possible with exercise and stress reduction sleep. The estrogen. We can do bio identicals, which we should do a whole nother show on the food is the one here that you can make such a shift in. So you said eat this, not that.
What are the eat? This is your favorite eat. This is
Dr. Mary Claire Haver: eat this. [00:25:00] If it came from God, it's pretty much okay. Unless it's a known poison. So fruits, vegetables, legumes, nuts, seeds, you know those are your top five. And then lean meats kinda are neutral. They're not super anti-inflammatory. Now, heavily saturated fats can shift you more towards an inflammatory pathway, meats can be made, any food can be made inflammatory. So if you take a meat and you pump it full of nitrates and artificial colors,
JJ Virgin: right? If you make it baloney, you just created a problem.
Dr. Mary Claire Haver: You overly process something, you're losing any of the nutritional benefit. Added sugars, you know, things just pumped into food to make it more sellable.
Last, longer on the shelf are things that we should eat on a limited basis.
JJ Virgin: Makes a ton of sense. So we're just gonna go there cuz we need to, cause I would love to have your input because it's still, you know, I feel like this is still a controversial subject when it shouldn't be is hormone [00:26:00] replacement therapy.
Mm-hmm. So love to hear how you work with it.
Dr. Mary Claire Haver: Back in the day when I trained, right, so I was in the middle of my training residency is what we call an O B G Y N. When the Women's Health Initiative study was released and the uproar,
JJ Virgin: yeah, I was gonna say, what a firestorm.
Dr. Mary Claire Haver: And you know, we were like, after all of that fallout at the time, only if there's no option and she is gonna jump off a building without hormones, should we even offer it?
Otherwise try antidepressants. Some actually can't help with hot flashes. The other thing was we were only treating symptoms, so we're only trying to make the hot flashes go away. You know, we might try to help her bones stronger, but we have all these other medications with tons of side effects, by the way.
Mm-hmm. That can keep her bones strong. If she's not sleeping, give her a sleeping pill. If she's, you know, having vaginal estrogen is very, very safe. Does not fall into the same category that was not studied in the WHI. [00:27:00] Really, a lot of women have just suffered, A whole generation of women have suffered needlessly.
So now this bombshell study came out, and I'm embarrassed for OB gyn because it was done by the American Heart Association that went back and looked at the W H I and every other study that's been done as far as heart disease. And women's health, and this was published in Circulation Magazine at the end of 2020, right as Covid was still kind of crazy.
So it kind of took a little bit for it to to gain. But what they found was women who were starting young, so starting in late perimenopause or early menopause who were offered hormone replacement therapy and accepted it, and then they followed them for 20 years, have lower incidence of heart disease, lower incidence of cardiovascular death.
Than women who did not take h R t. Also, they have a lower all cause mortality death from any reason and a lower all cause mortality from cancer.
JJ Virgin: And that is so huge cuz heart disease that's established, but that one,
Dr. Mary Claire Haver: so right now, [00:28:00] American College of OBGYN and North American Menopausal Society are not saying, Hey, we should offer H R T for primary prevention of heart disease.
But this is a conversation I'm having with my patients of these are things to consider. You will probably live longer. We know you will suffer less. We've known that forever, you know, and we're learning about mental health, Alzheimer's and dementia, joint pain,
JJ Virgin: leading gums. It goes on and on, on and on and on.
Dr. Mary Claire Haver: We know your gut health gets worse in menopause. There's something protective about estrogen in almost every organ system of our body. If a patient after that discussion chooses not to do HRT, and it's not for everyone, there are people have individual risk factors, but I think every single woman deserves conversation around it, and then it's up to her to make that informed choice, but to be categorically denied the offer is unacceptable.
JJ Virgin: And they need to have the real information [00:29:00] because there was a whole lot of crazy derivatives from these studies that just were fear-mongering. Especially when you see, you know, look at it and go, well, what's the number one killer of women Heart disease, right? It's heart disease, but there's so much out there of like, you'll take this and get breast cancer.
Dr. Mary Claire Haver: Let me stratify this risk for your patients. So when you're on estrogen alone, the W H I data. Then you're starting from age 50 to 59. Okay, so early young. That's young. I'm, I'm 54, so I'm 59. So if you start in that age bracket and we follow you for five years, the chance of all women with no hormones getting breast cancer is 23 out of a thousand.
Okay? If I add in estrogen only, so you've had a hysterectomy or you were born without a uterus or whatever, if I add estrogen to this, the risk is now 23 out of a thousand zero increased risk. Now the W H I only looked at synthetic progestrens. That's all that data that we have though. There's some really good data out of France I can talk about later.
So those women, that risk [00:30:00] went up to 27 out of a thousand. So four more women. Okay. And if you're one of those four, God bless you. But the risk of being obese or overweight is 44 out of a thousand. Okay. And the risk of having two glasses of wine a night every night is 28 out of a thousand. When you think about stratifying the risk, we make decisions every day to get in a car, to drive somewhere, knowing we could get in a car accident.
We do things to protect ourselves. We follow the rules. We wear a seatbelt. You know, we do what we can, but we know that could happen to us and we could die. Okay? So this is how I counsel my patients. Like if you still. Choose not to do this. I a hundred percent support you in that decision, but you understand what you might be leaving on the table as far as your long-term health
JJ Virgin: in terms of bones, heart, and brain, right?
Dr. Mary Claire Haver: When I paint the picture of menopause for my patients, I'm like, if you rock a bikini, God love you for it. But I am here to teach you how to have strong bones, strong muscles, a strong mind, and a strong [00:31:00] heart, and not be plagued by chronic disease that would potentially would've been avoidable. And H R T is one part of this.
We can't leave exercise out, nutrition out, mindfulness out, stress reduction, sleep, all of the things. Sorry, I get so passionate. It's
JJ Virgin: so good. There's one other thing that. Keeps coming up as an urban legend, and I think it's just based on how the studies have been done and not knowing is this whole idea of if you don't start H r T, you know, as you're going through perimenopause or Right, right.
As you hit menopause that you can't do it. You've heard the rumors, like you've heard this urban legend though, right? Oh no. Everything's shut down at that point. You're done. Yeah. You know, it's like, but you're replacing it anyway.
Dr. Mary Claire Haver: There is. Once certain disease states have started like heart disease and like Alzheimer's and dementia, starting estrogen, after those diseases have gotten a hook on you might be detrimental.
So these are the [00:32:00] conversations I have with my patients. Risk factors disease state, not everyone is a candidate, but if you're five, 10 years past menopause, you have no other risk factors. You are a candidate. We are no longer saying 60, 65. That's a thing of the past and North American Menopause Society and ACOG support this fully.
It's individual discussion of risk factors with your patient.
JJ Virgin: So I would love to hear one of these, and again, like we've gone all over the place with so much great information. I am super excited to share the inflammation quiz and remind everybody to get the Galveston diet. Holy smokes, we are totally aligned.
I love what you're doing. You've done so much great research. I'm so happy you're selfish. Yeah, your selfishness has been selflessness cuz you've really gotten this out there and this is what needs to happen for, you know, things to shift. I'd love you to share a success story.
Dr. Mary Claire Haver: Oh gosh. Okay. So I, I have a clinic now that I devoted specifically to menopause.
I left. Traditional [00:33:00] OBGYN in 2018 to focus on the business,
JJ Virgin: which you're a brave woman. I had a girlfriend an OBGYN who went into menopause and she's like, oh my gosh, they're so angry and mean.
Dr. Mary Claire Haver: I've just had the opposite experience and they feel like they know me because most of my patients now have seen me on social media and they come in and they just start talking cuz they feel like we're friends.
So I had a woman come in and she had already been doing the nutrition program. For like a year and she had, she probably had lost 50 pounds or something, you know, of body fat. And she was coming in to talk about hormone replacement therapy and. It was just such a beautiful, uplifting thing for her to come in.
She's smiling and we did her body scan. I got to show her, you know, I didn't have a before cause I didn't know her before, but like, show her how low her visceral fat was and how healthy she was. And then get the blood work and show her how great her cholesterol was and her a1c. Now she did have older labs that she showed me and I could show her.
You know, this is just one [00:34:00] patient, you know, when they say you've changed my life. Living your life on social media is not easy. You have the haters, you're
JJ Virgin: just doing it for the money. I'm like, I can tell you the amount of time this takes. It's, you know,
Dr. Mary Claire Haver: and you know to know my daughter's a nutrition science major.
Oh, how cool. Who will call me out so fast. Other OBGYNs who are out there, you know, kind of policing what I'm doing. They have my back and so I'm just so grateful that these patients are coming and telling me, you know, you've changed my life. You made me believe in myself. You made me feel like I wasn't crazy.
You gave me a safe place where I could go and find a community of women who are going through the same thing I'm going through, you know, with real actionable ways to change my health for the better. And you know, stories of like looking at their parents and how they're aging and having to take care of them and how they don't wanna burden their children with chronic disease.
I can't change your genetics, but we can put some changes in a place now. That can hopefully decrease that
risk
JJ Virgin: for you in the [00:35:00] future. And I think the important thing about the whole genetic story is it's been the same for the last thousand plus years, yet our metabolic health risks have skyrocketed like in the last few decades.
So it's basically not a genetics problem, right? There you go.
Dr. Mary Claire Haver: The cost of retirement, you know, of healthcare costs and taking care of yourself when you're older and all the things that you need. I mean, it's absolutely skyrocketed when people were absolutely functional 50 years ago until they died. Yeah.
JJ Virgin: Crazy. Anyway, you're doing your part. We appreciate it. And I wanna remind everyone, go to jjvirgin.com/GalvestonDiet. Here's what you're gonna get. You'll get information on the book, which you're gonna wanna grab, and then you'll also get a link to the inflammation quiz. So, and I'll hook you up with all of Mary Claire's stuff cuz she is huge on TikTok, she's on Insta, so I'll get you all dialed in there too.
And thank you so much for coming on [00:36:00] board here. Thank you. Thank you. Take care. So how good was that? Wow. That is definitely something you're gonna wanna listen to again and again, and so many pearls in there. So much great information. A couple things I just wanna give you as takeaways here is, again, you really wanna know your body composition.
You wanna know what your weight's made up of, how much skeletal muscle you have. It's so critical. What I'm seeing a lot out there is that we're not overweight, we're under lean, we don't have enough muscle, and where your fat's located, you might think you know, but. Really you need to look at it through the eyes of a DEXA scan or an in body to really see how much fat is around the organs because that's the fats that are dangerous.
You might not like that stuff around your butt and thighs. Learn to love that. That's the safe fat and that's the fat that gives you curves. It's the stuff around your internal organs that's creating the problem. And one of the easy things you can do is do a waist to hip and a waist to height ratio. I actually did a whole [00:37:00] podcast just on this and on my DEXA scan.
Basically when you do those and you can Google this, you will be able to really track. What's going on? Cause if you lose weight, but you don't lose your waist, you're making yourself worse. Not better. That's why we have to make sure that as we're losing weight, we're holding onto our building muscle while we're dropping fat.
And generally, if you're already fit, you're gonna have to make a decision. Do I want to build muscle or do I wanna lose fat? It's very hard to do what's called recomping when you are already a worker outer. If you're not a worker outer, you can do it. Hope that made sense. I've been talking a lot about this.
Topic and about how much protein to eat. That's why I was so excited to hear someone. Going through all of this, using it in their practice, having huge results with the Galveston diet. Again, you can get that quiz jjvirgin.com/GalvestonDiet, and be sure to check out my social channels. I'm doing a lot on IG and a lot on YouTube where I'm talking about all of this.
And we of course also send out blogs and recipes, et cetera. [00:38:00] jjvirgin.com, if you haven't subscribed yet, hello, subscribetojj.com and if you found something of interest here, It would super help me out if you could leave a review cuz people check those out and make decisions to listen or not. Based on that, this is how we change the health of the world.
Thank you so much. See you next time. Be sure to join me next time for more tools, tips, and techniques you can incorporate into everyday life to ensure you look and feel great, and more importantly that you're built to last. And check me out on Instagram, Facebook, YouTube, and my website jjvirgin.com. And make sure to follow my podcast so you don't miss a single episode at subscribetojj.com.
See you next time.

Hide Transcript