Filtering the Fear of Insulin Resistance in Menopause with Val Schonberg, RD

Have you been successfully convinced that with your welcome letter to midlife, you’ve also developed insulin resistance? It’s not much different from believing that every pregnant woman will also develop gestational diabetes. Is it possible? Sure. Does it happen to everyone? Definitely not. 

In this episode, I’ve invited Registered Dietitian, Val Schonberg back on the show to help challenge some of the most common assumptions about insulin resistance for women in menopause. We dive into addressing how this overabundance of information rarely comes with a disclaimer that the connection between low estrogen and insulin resistance is not a direct one.  

What you really need to know is that the media (including diet and wellness culture influencers) want you to believe that the dreaded “menobelly” will disappear with a few quick fixes that aren’t rooted in sound scientific evidence. Your body composition may change significantly in menopause, but it doesn’t automatically mean you’ve developed insulin resistance. In most cases, it means you’re human. Join us as we cheer the cause of normalizing different body shapes and building boring balanced plates! 

In this episode, you’ll learn: 

• Low estrogen levels in conditions like hypothalamic amenorrhea don't always lead to insulin resistance
• Why it’s so common to experience body composition changes during menopause
• Why relationships and connections have a more significant impact on longevity and overall health than trying to change your body size
• Why you don’t need to take carbs or fruit off the menu
• Why you can’t treat insulin resistance just by looking at a body type

To learn more about Val Schonberg and her work, visit her website at www.enlightenUnutrition.com and follow her on Instagram at @V.SchonbergRD or on Facebook @ EnlightenU Nutrition

TRANSCRIPT

Jenn Salib Huber 0:00
Hi, and welcome to the Midlife Feast, the podcast for women who are hungry for more in this season of life. I'm your host, Dr. Jenn Selene Huber. I'm an intuitive eating dietitian and naturopathic doctor, and I help women manage menopause with old dieting and food rolls. Come to my table. Listen and learn from me. Trusted guest experts in women's health and interviews with women just like you. Each episode brings to the table juicy conversations designed to help you feast on midlife. And if you're looking for more information about menopause, nutrition and intuitive eating, check out the midlife feast community my monthly membership that combines my no-nonsense approach that you all love to nutrition with community so that you can learn from me and others who can relate to the cheers and challenges of midlife.

Jenn Salib Huber 1:09
Hi, everyone. Welcome to this week's episode of the midlife feast. This episode is kind of kicking off season four. And we are talking about a topic that is always a hot topic, whether it is online or in person or in things that you're reading. And that is the topic of insulin resistance and menopause. So unless you've been living under a rock, you probably have seen posts about women needing to be careful or cautious or watch out for insulin resistance as they go through menopause. Maybe you've seen you know, things about men, no belly, which is you know, my favorite term, obviously, being sarcastic.

But you know, what we want to really understand is, what is insulin resistance? How much does it actually matter? Is menopause the cause? And more importantly, what can we do about it? So I'm kind of starting this episode this season. Because all month long in September in the middle of fees community, we're talking about insulin resistance. So there's an entire module that does a really big deep dive into it, including what you can and can't do. There's lots of support through other modules around gentle nutrition and intuitive eating. And we're having some really great conversations.

So if insulin resistance is near and dear to your heart and is at the top of your to do list, listen to this episode, and then come find us in the midlife peace community. So big thanks to Val Schoenberg, who is one of my fellow non diet dietitians who is also a Nam certified menopause practitioner. She's an intuitive eating and an eating disorder specialist as well as a sports medicine dietitian. So she is absolutely qualified to be having this conversation about the evidence for and against, which is the interesting part. Insulin resistance in midlife and menopause. So listen.

Jenn Salib Huber 2:53
Hi, Val. Welcome back to the podcast.

Val Schonberg 2:55
Yeah, so great to be back with you.

Jenn Salib Huber 2:57
So the first time you were on, we were talking about the you know, very real relationship between eating disorders and midlife and why we need to be aware of that. And now I'm bringing you on for another somewhat controversial hot topic, which is insulin resistance in menopause. And this I can already predict I'm gonna I'm gonna make a prediction right now that this will be in the top five for the year because it is such a hot topic that I get asked about at least weekly, if not sometimes, you know, a couple of days in a row.

And I think it's because there's so much confusion about what it is. Why does it matter? Is menopause the cause, you know, do we need to go down this, you know, rabbit hole of treating it because simply we're in menopause or you know, there's just so much misinformation. So I'm really, really excited to have you bring your expertise to the table. So why don't you just tell our listeners a little bit about you and your background before we start diving into it?

Val Schonberg: Experience and Expertise in Treating Women in Menopause

Val Schonberg 4:02
Sure. Well, I live in Atlanta, Georgia, and I have a private practice here in Atlanta, where I specialize in midlife health, most notably with met women in menopause. I've been practicing in the menopause space since about 2013, so almost a decade now. And I became certified as a menopause practitioner in 2015. So I've been really aware of this landscape for a long time. My clinical nutrition background, my registered dietitian, and I'm board certified as a specialist in sports dietetics. But my clinical work has always been in eating disorders until I started my private practice in 2013. And the menopause space.

What became really a reason that I'm interested in it just like sports is I find that these are two areas of individuals that are very vulnerable to disordered eating. Because of some of the messaging, and you know whether you're an athlete, and you're vulnerable to an eating disorder that might look a little bit different than a midlife woman who is vulnerable to disordered eating, and some of it is wrapped up in personality traits, like perfectionism, and, you know, wanting to do things perfect, correct and right.

Defining Insulin Resistance

Val Schonberg 6:02
And I think it really transitions us into this particular topic, which is, why would insulin resistance be one of your top five? Why are we so fixated on topics like this? Which is interesting science, potentially. But it's, it gets really, there's so many generalizations that turn into generic advice. That is like, well, everyone has this problem, and you need to solve it. And if you even drill down further, it's why is it such a big deal? It's because women are really worried about their weight. And then that really starts peeling, you know, the layers of the onion to what is that really about?

Jenn Salib Huber 6:37
Yes, and so I'm just going to throw out a few things that I noted online over the past week in relation to insulin resistance getting ready for this. So I saw at least three posts that were talking about mental belly being caused by insulin resistance. I saw I think it was two posts saying foods that women should not eat in menopause because of insulin resistance, and can you guess it was carbs and fruit. And the other one was talking about how all women develop insulin resistance because of menopause.

And that you really need to like put the push on to make sure that, you know, you're, you're doing all of these hit style workouts, and you're not eating too many carbs and intermittent fasting, that's what it was, was that, you know, learning intermittent fasting before you hit menopause will help you to avoid insulin resistance, that was the other post.

So I don't know if we can cover all of those in 30. But what, before we get started, let's actually have a little bit of a regroup around, what are we even talking about with insulin resistance. So as I teach people that insulin resistance is two conversations, there is the one that happens online, which is, as you pointed out all about weight, typically avoiding weight gain or resulting in weight loss. And it's very much targeted the mental belly without abdominal kind of pattern of the redistribution of assets that most women go through. And then there's the actual health evidence based conversations around blood sugar management, and insulin resistance being a part of displacing dysglycemia.

And you know, pre diabetes and diabetes, that are very real things that have health risks and consequences. But if you haven't had a conversation with a health care professional, you may not know that those are actually two very different conversations. And one is based in evidence and one is not today, right? So the way that I describe insulin resistance, and I'd love to hear your take on it is that if we think about ourselves as being like an engine, right, and it takes in the fuel, the insulin takes the fuel from our food, the glucose, the amino acids, brings them into the cell.

So it helps to open the doors to make sure that things can get in, so that the engine can produce the energy store the energy that our body needs. Insulin resistance is when there's a problem with that door, it's not opening efficiently, reliably, things are building up waiting to get in. And so the engine can't work. So the problem, it's more of an engine problem, it's not so much of a fuel problem. And that's why the conversations around carbohydrates aren't particularly helpful. And so insulin resistance is complicated, because it can happen peripherally.

It can happen in the cells, it can also be happening with the pancreas, which is the organ that produces it. And so depending on your individual risk factors, health history, medication history, pregnancy history, you know, all of these things can contribute to your own personal risk factors that may or may not be influenced even by food at all, really. So that's kind of how I describe it. In a nutshell. That's my little elevator speech on insulin resistance. So what what would you add or change about that?

The Relationship Between Estrogen and Insulin Sensitivity

Val Schonberg 9:24
Well, I love that I think that's such a great way to explain it. And to also say that insulin is a is a very normal hormone, and useful and important hormone in our body. And that glucose is essential to life. So you know, if you can make it as simple as that, and then to say, if something's not working correctly, it's very complex. And what happens in the hormone space is something that is very complex, which is endocrinology in general, gets really be simplified.

So that it can be clickbait or, you know, a simple one liner or to sell a supplement or to whatever, or to sell a diet or whatever that might be. But I think we need to remember that, you know, the way I always think about menopause anyways, that it's this natural biological event, and to assume that all the all women are going to develop insulin resistance story. It's just not true. And that is like saying that all women who get pregnant are going to develop gestational diabetes.

So we know gestational diabetes can happen. And it happens across all body sizes. And a lot of it might be genetically driven, or it's, you know, just idiopathic, we don't know why some women might develop some a gestational diabetes situation. But we don't get so afraid of pregnancy, because there's a risk that you might have gestational diabetes.

And a think that might be a more helpful way to think about menopause, whether it's related to cholesterol or cardiovascular health risk, frankly, even bone health, I mean, I'm a huge, you know, conversationalist around bone health, but a lot of bone health is really genetically driven to.

And so there's certainly things we need to do nutritionally to support our bones. But we we make it all about nutrition and nutrition science is just a little bit more, not as reliable as people would think. So I appreciate your explanation. And I think the big takeaway for your listeners would be it's really complex. And if it's something you're worried about, it's something for you to really talk about, with your health professional, to make sure that you're being screened for it or assessed for any factors related to insulin resistance, because no matter what's happening in your belly, that may or may not mean that you have insulin resistance.

Jenn Salib Huber 11:57
Exactly. I love that. That's a great. That's a great point to make. So let's talk about what is the relationship, though, between estrogen and insulin sensitivity or insulin resistance, because there is a relationship, but it's not. It's not the slam dunk, that, you know, certainly kind of online influencers or online, even, you know, sometimes health professionals would, would lead us to believe. So what is the relationship?

Val Schonberg 12:25
Yeah, I think this is, you know, an interesting one, that when I started in the menopause space, it was probably related to this, right, because I had women between the ages of 40 and 60, who were coming to me for the disorder, their disordered eating, and they were experiencing this shift in body weight to their belly, which was very, you know, distressing. And I just wanted to come up with a solution, right? Like, as health providers, we just want people to feel better, we want to be able to fix the problem. And so I remember thinking, Well, why does that happen?

And then I always describe that this journey becomes like pulling a string on a sweater. So when you think about, well, why are we shifting to potentially storing weight in our abdomen, and I don't like these labels of men, no belly, and apron, or whatever they call all this stuff is just like, it's so frustrating. But nevertheless, I did discover and read a lot of science and research around that estrogen, which is a dominant hormone produced by the ovaries, that as you get into potentially more early, post menopause, right?

So so many women who are thinking they have insulin resistance is in perimenopause, when actually, estrogen can be quite high. So if you really think about the role of estrogen that yes, when that would be depleted, it makes sense, because there's estrogen receptors all over the body. And as we don't have that protected impact of estradiol, specifically, which helps the cells, you know, like the engine take in and use that glucose for energy, it gets a little sluggish, and it's potentially not working as well. So then that can set up an environment where you would suspect or predict that insulin resistance would exist.

The reality is that a lot of that research comes from animal models, when you really look at well, where did we get this information from is looking at mouse models. And then when they tried to apply it to, you know, humans, the human science isn't as predictable. It's not as consistent. And so there is this, like, Okay, we would anticipate that as a woman doesn't have as much estrogen on board. Well, then, if you gained body weight, you gained belly fat, you have visceral fat than we should see insulin resistance, and there are a number of studies that show that's not necessarily the case. So then why is that then what is going on?

And we can just say at this time, we don't really know for sure And it's okay to not know everything for sure that's what happens in science. But I do think that I read it over and over and over again, this well, because we don't have estrogen that we're going to have insulin resistance. And if that were true that anyone who gained belly fat or weight should have insulin resistance, I would think, or maybe I'm too technical in my brain.

Jenn Salib Huber  15:27  

Well, and there's also some interesting evidence around people who have developed or who have hypothalamic amenorrhea, which is a condition of very low estrogen, where they are not having a period this can This is a common side effect of eating disorders. But it can also happen for other reasons, extreme stress, there are lots of reasons why someone might have this, but fundamentally, it is a low estrogen state.

Val Schonberg  15:53  

Right, right.

Jenn Salib Huber  15:54  

And what don't we see?

Exploring the Complexities of Insulin Resistance

Val Schonberg  15:57  

Well, it's I'm so glad you brought that in. Because again, remember, when I started down this journey of Why are women gaining weight, I just want to know the mechanism, please explain it to me, like what is happening. And then when I would read some of these reasons where, where someone might say, well, it's insulin resistance, which is causing inflammation, which leads to this weight gain. And I'm like, but that doesn't make sense, because I work with a lot of individuals with anorexia nervosa. And I do see athletes with pretty much bottomed out estrogen and progesterone.

And if you look at that science, in those particular conditions, insulin is actually really low. And the insulin resistance when measured is actually non existent or not, doesn't exist, actually. And that the cells are more sensitive, which kind of makes sense, because it's a protective mechanism, where the body does sense starvation, and is doing everything it can to take in the energy to keep the engine going, because our body is really, really remarkable at keeping us alive. So that is where I circled back to, well, then it can't just be estrogen, because then any situation, which you know, would cause low estrogen, we should predict that that would be the the outcome, and in terms of our insulin response by the body.

And that is not always the case. So it brings us back to Okay, that's there's more to the story probably. And the other. The other part of that, too, is, let's say in the case of someone who is a postmenopausal woman who is potentially seeing higher triglycerides, maybe increases in lipids, maybe even a one C, which might be something to track or measure glucose, where we are seeing some disturbances in that, you know, that individual may or may not necessarily have gained weight, potentially. But what might be going on as sarcopenia. sarcopenia is the natural loss of lean tissue as we age. And that is where the muscle is really the engine, right?

Like, that's one of the main things. So if, if our engine does doesn't need as much energy, then that could be potentially a mechanism for why we might see an insulin resistant, you know, scenario, which is why if you look at the, you know, the high intensity interval training, you know, this is what everyone needs to do now. And it's like, okay, well, again, all of this has like a little bit of truth. Yes, that would make sense. If we did high intensity interval training, lift, heavier weight, do resistance exercise that will keep that muscle stronger, so that it can do that glucose uptake. Absolutely. That can make a difference. However, if you look at studies of masters, competitive female athletes, and you look at studies where they've done this, and I can send it if you want to link it in your notes, that show, you know, no matter how active and strong these women are, they still are having a higher number higher amount of visceral body fat.

So it goes back to Okay, well, we don't really know what that's about. Even though their vo two Max remains strong. They still maintain their lean tissue. There's still some deposition of body fat. And so again, I would circle us back to why does anyone really care about insulin resistance or the fear of insulin resistance? I do think there's a subliminal message of women just want to not have their body change that's really uncomfortable, and they want to fix the problem. And people, you know, sell these messages. We'll just do this diet, do this weight training, do this exercise intervention, and then you'll be okay. And when women do that, and then they're still seeing the outcomes that they are they felt you even more frustrated. So I'm very passionate about like, yeah, that's an important intervention is exercise. Absolutely. For your overall health and well being. But we have to be careful about kind of some of the, the marketing pitches that gets rounded there.

Challenging the Aesthetics vs. Health Paradigm

Jenn Salib Huber  20:16  

Oh, yeah, I mean, there's a whole industry that is literally chomping at the bit to prey on the vulnerability that women feel as they go through the stage of life. No, I mean, the data I don't think will ever point us to a single number. But I've certainly seen studies showing, you know, 7080 90% of women experience weight changes as they go through the menopause transition. And even if they're not weight changes, as in, you know, their mass on the scale has changed, there is this redistribution of assets, we go from this gynoid, this pear shaped to more of an apple shape, that is where the belly comes from, and that change is pre programmed into our DNA, you cannot spot reduce that you can't, you know, intermittent fast your way out of that.

And, you know, there likely is a biological, you know, function that that serves, like we've talked about, it produces a bit of estrogen. And you know, as you've mentioned, in this study, we see this even in these really elite athletes. So, if we can just move past the idea that there's something wrong, because our body has changed, if we can just like set that aside and believe that, okay, I'm not doing something wrong.

Because this is happening, I'm simply going through this life stage, this transition, and there may be some health changes that actually do matter and do need to be addressed and taken care of. But that doesn't mean that we need to focus on the outcome of getting rid of the mental belly as an outward or objective measure of insulin resistance, because that's, I think, what a lot of people think, is that oh, well, if I, if I have developed this belly, it's because of insulin resistance. Right? But that's not necessarily true.

Debunking Myths About Estrogen and Weight Loss

Val Schonberg  22:03  

Absolutely. Yeah. Yeah. And I think that's really important. But also, like, when a woman notices that distress, or worry, or concern, I do believe it becomes like an opportunity to wonder what's going on. Because it's, it's like, if we could accept that, look, this is what happens to the female physiology. We don't quite understand it, whether it's based on the grandmother hypothesis, or for whatever reason, we outlive our reproductive years, you know, we live beyond our ovaries. Women still leave live a really long time, and have for a long time.

So there's something potentially protective about it. We don't necessarily have data to support that one way. And it is certainly important to go look at the research. But even recently, I was looking at Harvard has this. I'm going to drop blank on the name of the study, which is this the longest longevity study, and it was started with men, right? Have you heard about this, like an 85 year study? You can't think of the name. Yeah, it's a it's like the adult anyway, we'll come back to it. But. But what's interesting about it is they did recruit and bring in women later on. And one of the things that stood out to me in this study is that for the individuals in the study, when they looked at at midlife, at like, say at age 50, their cholesterol numbers, as an example, did not predict longevity. So if you had elevated cholesterol that did not necessarily indicate whether you thrived or were healthy later on, what did matter was relationships, and connection. And so if a woman is starting to develop this insecurity related to something's wrong with my body, I need to fix it, I'm going to do whatever it takes to fix it. And I'm not going to go live my life until I get it fixed.

And then they're constantly being sold. kind of not really helpful information. I worry that we're really, you know, that's That's unfortunate, because what we probably know about longevity, whether it's from the Harvard study, or even the 90 Plus study, which is a California based study, we know that connection, relationships, all of those things actually help women and men eat better, be more physically active, be more physically healthy. So just to kind of keep that in mind is what are we really worried about? Like, is it that you want, like for me, I want to be super happy and active. So I can chase around my new little granddaughter, right like Mads Woods becomes more important. And so if, if it's an aesthetic, if it's needing to look a certain way, if it's battling with your biology, really, it's and an opportunity to pause and say,

Okay, what's really going on here? And then how can you get some support with that. And I think you have a fabulous group that women can join, to get that support to get a new way of thinking about it. Because we've just been brainwashed to believe that, my gosh, if you end up with hyperlipidemia, or insulin resistance, you're just doomed. And no, I mean, there's something you want to do your preventive healthcare, you certainly want to, you know, stay on top of that, look at your own unique medical history. And at the same time, it doesn't, it doesn't have to be the some doom and gloom message because you've gained some weight or even weight in your belly.

Embracing Mindful Self-Care and Balanced Nutrition

Jenn Salib Huber  25:44  

I love all of them. That's definitely my mantra for sure. You know, when I think about what we know about insulin resistance, and menopause, the data is pretty limited, right? I mean, you know, we don't have, you know, 20 or 30 studies that are looking at this, there's a handful, right? So we're still learning. So absolutely, in a year from now, we might be having a completely different conversation if we have new information.

But what I really want people to kind of hear from what you've said is that it is not uncommon for lots of things to change at midlife, especially around lipids and blood sugar, and loss of muscle and maybe some other changes that may result in insulin resistance, or pre diabetes, or even diabetes showing up in your life, we don't know that the loss of estrogen is the cause. Right? So it's a correlation versus causation kind of conversation. And it's really important for people not to go into menopause, with fear. And, you know, when we make decisions that are fear based, we are not making good decisions. Because fear, fear isn't comfortable, we're impulsive, we kind of go towards the shiny things, because our brain is saying, hey, yeah, do whatever is going to fix it, do whatever is going to fix it.

But if you're making those decisions based on bad messaging in bad data and bad science, because maybe somebody doesn't understand it, or they're just, you know, taking advantage of this age and stage, you're never going to arrive where you think you are, you're never going to fix the insulin resistance with quick fixes. Because if you have insulin resistance, then that is a health conversation that you need to have that can and should include nutrition and movement and all those things. But it really needs to be about what is the effect on your health and not what is happening on the outside of your body, which is again, the other conversation, that tends to happen so much.

Val Schonberg  27:40  

Yeah, and even like you just said, I mean, the fact that we, you know, can't necessarily tie it back to just estrogen. Even if you can, the other point I always make with this and research that I dug into is, well, if estrogen would fix the problem, then let's just take estrogen. Right. And there are studies that look at that, you know, that use menopause hormone therapy, to, you know, see if it can attenuate weight gain.

And at first it can like sometimes in that pre menopausal transition, but there's not a direct core, you know, it, you can't just take estrogen and fix that weight redistribution and or insulin resistance outcome. And so it brings us back to Not that you should or shouldn't take Mountain House hormone therapy that might be really appropriate based on, you know, the woman's unique needs and physiology. But it's kind of says, Well, what can we control, you could choose to take menopause hormone therapy, because that might be a protective for actually your bones for that matter. And maybe it will protect from some cardiovascular health risks if that's what the individual is concerned about.

But we still come back to the basics of Mindful self-care, we still need to fuel our body well, with good fruits and vegetables, and lean protein and all that, like sexy language need to move our body in ways that we really enjoy and that we can do forever and ever. Amen. As I always say. So those are things that we can control when your body maybe feels confusing or out of control. And I think just so that, listeners know, if estrogen were the end all be all, well, then you should be able to take estrogen, hormone therapy, we can readily get that through a patch or, you know, different combinations. And we know that that doesn't necessarily solve that concern.

Jenn Salib Huber  29:35  

Yeah, and I think that the data around body composition especially, it's pretty clear that it's it's not it's not a fix it, you know, one and done situation. You know, that really, it's not it's not the solution, the magic pill that you know, I think people would have wanted it to be. So if we come back to the Okay, insulin resistance, it's happening to some not all we don't know exactly why But people want to do something. You know, I always kind of bring it back. But I, what I usually tell people is, you know, don't cut the fuel source, don't cut the carbs don't cut the foods you enjoy.

Don't fast, don't do all the ridiculous things that the internet tells you to do, you know, build balanced plates as boring and unsexy as that is, you know, more plants more fiber, a bit more protein, but you don't this isn't, you know, it doesn't have to be a magical combination. Like it really comes down to eating regularly building balance plates, and increasing demand from your engine by moving your body in ways you enjoy more often kind of what you were just saying, right. And I think that's really where the bulk of the evidence is, unless, you know, I unless I've missed something recent. It's like I said, it's not sexy, but it can be effective, if that is an actual concern for people.

Individualized Nutrition and the Pleasure of Eating

Val Schonberg  30:52  

Right, yeah, we say this over and over and over again. And you nailed it. Like, it's just not that sexy. And I think it always gets that, that someone's really just trying to lose weight. Yeah, right. And we don't know how to do weight loss. Like that brings us into the weight loss conversation, which is, we've been studying weight loss for a gazillion years, we've been studying weight cycling forever and ever, we know that diets don't work that people gain the weight back, that they often if they gain the weight back have more metabolic health issues.

And so a lot of these studies that even associate BMI with some health outcomes, which are correlation studies, they don't control for diet, cycling, or weight cycling. So it really kind of gets back to why are people very excited about eat fruits and vegetables and lean protein and fish and nuts and seeds and enjoy some dessert, you know, as you want to. It's because really what they're getting at is they want their body to be shrunk to a size that their body probably doesn't want to be shrunk to. And so that's inherently what I see is often what's really going on. And even the balance plate recommendation, which I 100% agree with. It's always so individualized too, though. So like with carbohydrates, you know, if you don't like vegetables, like well, you're probably going to maybe eat something that you really don't like, and then you're going to feel deprived and then that backfires. I think ethnic diversity around food.

So, you know, I have, you know, when you look at like, say someone who has a Hispanic background, and they've been told over and over and over and over rice and beans are really bad, don't eat rice and beans, and let's watch of childhood food memory is and there's delicious cuisine that they grown up with, or here in the south where I think collard greens are like one of the most healthy things you can eat. And people are I can't have those, like they're cooked in a bunch of pork fat all day long. And like, yeah, because they taste horrible. If you don't, I mean, it breaks down the fibers, and it makes them delicious. I mean, that's what the, you know, generations ahead of us learned is that, you know, you get still the calcium from the collard greens, you get the healthy nutrients, you get the fiber, even if you cook it to a way that you can enjoy it and have some pleasure with food.

So my approach is always to say, well, nutrition is really nourishment plus pleasure. So if you're only doing pleasure, pleasurable eating, well, maybe we need to work on that. And if you're only focused on eating perfect, correct and right, then that might be where the issue is. And where do you find that balance of bringing it together that really works with yours, unique food preferences, your unique food background and food history, your medical concerns, health concerns, your values, the things you care about? It really is so individualized and I believe needs to be that way.

Jenn Salib Huber  34:03  

Oh, I'm sad to say I think that's a good place for us to end. For but we'll have a card three. Well, and I really, you know, I think we should do a part three really talking about, you know, the, the health as a proxy or the weight as a proxy for health conversations. So stay tuned. But what I what I really hope that listeners will have heard is that there's really only preliminary evidence like good evidence, there's lots of little studies, but like in terms of like data that we can actually sink our teeth into and believe to be mostly true. There is we don't have all the answers when it comes to insulin resistance and menopause and midlife.

What is aging. What is genetics. What is previous history. You know, people who have had gestational diabetes, for example, have an increased risk of developing dysglycemia later in life, like where does that factor into all of it right so there's so much Don't know, combined with the little bit that we do know, it's that if you have insulin resistance that is something that your doctor your healthcare team can find can look at through bloodwork, you can't tell that someone has insulin resistance simply by looking at them.

And you can't treat what you see on the outside, that even if you have insulin resistance, you're not going to be able to know whether or not what you're doing is working simply by what's happening around your belly. It's much more complicated than that. Yes, thank you so much, Val. I know that this is going to be a well loved episode. Like I said, I'm calling it a year from now I'm gonna say when I do my vacation vote next August. I'm gonna say that this is going to be in the top five.

Val Schonberg  35:44  

Oh, and who knows? Well knows much more by then. But yeah, we probably do need a part three on the weight health, because that would be the next thing to get into. Really.

Jenn Salib Huber  35:56  

Stay tuned. Yeah. Thanks so much. Well,

Val Schonberg  36:00  

thank you so much for having me.

Jenn Salib Huber  36:03  

Thanks for tuning in to this week's episode of the midlife feast. For more non diet health hormone and general midlife support. Click the link in the show notes to learn how you can work and learn from me. And if you enjoyed this episode and found it helpful, please consider leaving a review or subscribing because it helps other women just like you find us and feel supported in midlife.