TODAY'S AJENDA ISSUE #51

Welcome to TODAY'S AJENDA!

Hey there! It’s been a very busy week! Ajenda started in Austin, Texas, where I spoke on three panels at the SXSW Conference. We then bopped over to Orlando, Florida, where I delivered the keynote at the Women’s Dermatology Society conference to over 700 dermatologists.

Along the way, I met some incredible people (thanks for saying hi!), including current participants in the 8-Week Wellness Experiment—who are loving it—and those who signed up for the next one! 

Want to join the next cohort? Get on the waitlist HERE! 

Quick note: Last week, a technical error in our newsletter sent inquiries about the 8-Week Wellness Experiment to the wrong email. If you have any questions, please reach out to [email protected]

Glitches are rare, but they do happen. We appreciate your understanding and will not let this happen again. 

Now, onto today’s Ajenda!

TODAY’S DOSE OF HONESTY

What Does ‘Boosting Your Metabolism’ Actually Mean?

“Boost your metabolism.” We see these magic words plastered across supplement bottles and green juices all the time. But what does boosting your metabolism actually mean? 

Understanding what drives your metabolism is important because once you know the factors at play, you can fine-tune them to support weight loss or weight gain, whatever your goals might be!

Here’s the mini-med school on metabolic rate: 

Metabolism 101

Metabolism is basically how much fuel our body’s engine burns each day to keep running. Every action—breathing, moving, even digesting food—uses energy. But not all activities burn the same amount. Our body’s total daily caloric expenditure (TDEE) comes from several metabolic processes. 

Here’s where our daily calories go: 

  1. 60-70% goes to basal metabolic rate (BMR). These are the body’s vital functions, including breathing, circulation, temperature regulation, and cell growth. Think of this as the energy ‘just to keep the lights on.’ BMR is strongly influenced by height, weight, muscle mass, and gender. 

  2. 5-15% goes to the thermic effect of food (TEF). This is the energy required to digest, absorb, and process our food and extract nutrients from what we eat. Protein requires the most calories to process, which is why eating a high protein diet can help with weight loss. For example, if you eat 100 calories of protein, about 20 calories are burned just during digestion—so it’s a net gain of 80!

  3. 10-30% goes to non-exercise activity thermogenesis (NEAT). This includes movements such as standing, fidgeting, casual movements, and household activities. While it varies from person to person, NEAT is a major way to increase calories burned without hitting the gym (although you still need to work out!).

  4. 0-30% goes to exercise activity thermogenesis (EAT). These are the calories expended during intentional physical activity or exercise. For most people, this number hovers around 10%, which is why you may have heard the phrase, “You can’t exercise your way to weight loss.” While that’s not entirely true, the idea comes from the fact that exercise typically represents a small portion of your daily energy expenditure compared to other processes. 

Our Daily Caloric Expenditure, Visualized

Table

Component

Percentage of Daily Caloric Expenditure (TDEE)

Basal Metabolic Rate (BMR)

~60–70%

Thermic Effect of Food (TEF)

~5–15%

Non-Exercise Activity Thermogenesis (NEAT)

10–30%

Exercise Activity Thermogenesis (EAT)

0–30% (varies widely based on activity)

How to Boost Your Metabolism

And now for the best part: How to boost your metabolism! 

For the sake of brevity, I won’t go into the why and how of these interventions. But for more information, I’d recommend you check out Dr. Andy Galpin’s Perform Podcast—specifically, this episode on boosting your metabolism and burning fat. 

No time to listen? Here are simple ways to increase metabolism: 

  • Sleep 7-9 hours every night. 

  • Have a small amount of caffeine

  • Eat protein (but don’t overeat just to get more). 

  • Take fish oil. Aim for 3 grams a day of EPA + DHA. 

  • Cardio > Weights. Both are great, but cardio is better.

  • Build more muscle mass. More muscle = higher energy burn. 

  • Use a standing desk. It burns an extra 100-200 calories a day. 

  • Drink more water. Experts recommend about 11.5 cups a day.

SYMPTOM SOLUTIONS

The Case For Eating Green Bananas (Yes, Really!)

Recently, my daughter and I traveled to Switzerland to visit a world-renowned health center. During our time there, I met with a nutritionist who taught me something I had never heard or read before:

Green bananas have unique nutritional benefits that ripe bananas don’t. 

“Wait, what?” Yes! It turns out that as much as we love our classic yellow bananas (and those super-sweet, soft brown spots), green bananas offer a suite of health benefits. 

Here’s why you should grab green bananas on your next grocery run: 

  1. High in Resistant Starch 

Green bananas are rich in resistant starch, a type of carbohydrate that resists digestion in the small intestine (and acts similarly to dietary fiber). 

Why does this matter? Well, resistant starches have big health benefits: 

  • Supports Digestive Health: They act as a prebiotic, feeding beneficial gut bacteria and promoting the production of short-chain fatty acids like butyrate, which supports colon health.  

  • Helps Regulate Blood Sugar: By slowing digestion, resistant starch helps moderate blood sugar levels, reducing post-meal blood sugar spikes. 

  1. Rich in Pectin

Green bananas are bursting with pectin, a kind of dietary fiber that enhances feelings of fullness. What that means? It can potentially help with appetite control and weight management. And similar to resistant starch, pectin may help stabilize blood sugar levels after meals. 

  1. Lower Glycemic Index

“Lower glycemic what?” Simply put, the glycemic index (GI) measures how quickly a food raises blood sugar levels. Green bananas have a low GI of around 30, making them a healthy choice for those monitoring their blood sugar. Meanwhile, ripe bananas have a GI of approximately 60. 

  1. Nutrient Content 

Green or yellow, every banana comes loaded with nutrients: 

  • Potassium: Supports heart and muscle function 

  • Vitamin C: Enhances immune function and skin health 

  • Vitamin B6: Aids in metabolism and brain development

One Last Thing…

Green bananas come with a few things to keep in mind. 

First, because green bananas are high in resistant starch, some people might experience bloating and gas, especially if their gut isn’t used to it. And if you have a latex allergy? Be cautious—green bananas contain proteins similar to those in latex. 

Bottom line: Green bananas can enhance digestive health, help regulate blood sugar, and boost nutrient intake. But as with any food, listen to your body, consider your tolerance, and focus on a balanced approach.

COMMUNITY

“I Have Dense Breasts. Is HRT Risky?”

Great question! This applies to more women than you might think—about 40-50% of women in the U.S. aged 40-74 have dense breasts. But why does that matter? 

According to Fornili et al. (2021) in the journal Breast Cancer Research

Mammographic density, that is the dense area of the breast consisting of epithelial and stromal tissue that appears light on a mammogram—as opposed to fat tissue that appears dark (non-dense area, NDA)—is one of the strongest risk factors for breast cancer (BC) in both pre- and postmenopausal women.’   

In other words, dense breast tissue appears white on a mammogram, just like a tumor. That makes detecting cancer like looking for a snowball during a snowstorm. And if we can’t detect it, we can’t treat it. 

But does having dense breasts increase the risk of breast cancer for women on replacement hormone therapy (HRT)? As you might expect, the answer depends on who you ask and what data you cite.

What The Science Says

It’s a mixed bag. Numerous peer-reviewed medical journals in the field of oncology state that yes, HRT does increase the risk of breast cancer in women with dense breasts. 

One of the more recent papers to support this is the E3N cohort study published in Breast Cancer Research (2021). This study tracked postmenopausal women in France for 11 years and found:

“Mammographic density levels were higher in current Menopausal Hormone Therapy (MHT or HRT) users vs never users, already within the first year of use, whereas levels in women who stopped therapy more than 8 years earlier were similar to levels of never users. Mammographic density mediated up to 50% of the effect of MHT on breast cancer risk.”*

*Paraphrased for clarity.

In plain English: The women’s breasts on HRT appeared denser on mammograms compared to women who never used these hormones. Because this denser tissue is partially responsible for higher cancer risk, the study concluded that HRT should be prescribed with caution, “especially in women with high mammographic density.”  

Should I Not Take HRT as Someone With Dense Breasts?

No. (I have dense breasts, and I personally take HRT.) But what it does mean is that the decision isn’t as simple as evaluating just one body part or one health outcome. 

Menopause care is holistic. If you have menopause symptoms, I recommend you go to a physician who is well-versed in all of the latest medical literature—not just on breast cancer, but on the whole woman—head to toe. 

It’s also important to remember that for every study showing a negative association, there are plenty that don’t (or even show a positive effect!).    

My recommendation for women with dense breasts stays the same: Screen with BOTH a 3D mammogram and a breast ultrasound (as long as insurance will cover both). 

Since dense tissue can make it harder for mammograms to spot tumors (remember, snowball in a snowstorm!) using both imaging methods improves detection. Ask your doctor if you can get both imaging tests as well as if you have dense breasts.  

Thank you for reading! While you’re here, we’d love to ask you something:

How do you feel about the length of the Ajenda newsletter?

Login or Subscribe to participate in polls.

ABOUT DR. JEN

In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” Dr. Jennifer Ashton—”Dr. Jen”—has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time. And she has gone through menopause…

Forwarded this email? Click here to subscribe.

Missed the last issue? Read it here.

Want a copy of Dr. Jen’s best-selling book? Get it here!

*Note: This newsletter includes affiliate links. Sponsors may earn a commission if you purchase.