TODAY'S AJENDA ISSUE #49

Welcome to TODAY'S AJENDA!

Hi there! I’m stunned—over 4,000 of you have already joined our 8 Week Wellness Experiment. As we approach our Monday, March 3rd kickoff date (Note: The sales window closes on March 2nd at midnight), I’ve been thinking:  

4,000 people don’t jump into a 8 Week Wellness Experiment on a whim. They join because something isn’t working anymore. Because committing finally felt doable. Because “someday” became “today.” 

That’s what this experiment is all about.  

Here’s a sneak peek into Week One: We’re starting with a nutrition reset to trigger autophagy—your body’s natural process of cellular maintenance and repair. You’ll get everything you need—affordable grocery lists, meal plans, and easy recipes—right in your inbox! 

Personally? During these modified fasting periods, my favorite (and oh so easy) way to stay committed is sipping teas. And if you guys know me, you know my favorite brand is Pique.* Shoutout to them for being my secret weapon! 

With just days until we begin the journey together, now’s the perfect time to join us! Ready? Join us here before the doors close! 

TODAY’S DOSE OF HONESTY

Protein Is Having Its Moment. But What Are Its Myths…And Truths?

Protein is having a moment. While there are two other macronutrients (fat and carbohydrates), you’ll find an abundance of information—and let’s be honest, noise—about protein.

It can quickly get overwhelming: What’s the truth…and what should you take with a fat grain of salt? 

Don’t get me wrong: I’m very PRO protein! But like anything in science and health, the devil is in the details, and it’s important to consider factors such as timing, amount, age, and type. 

Let’s get you up to speed. Here are seven things you probably didn’t know about protein: 

  1. Only about 11% of the protein we consume goes to building muscle. Our guts and livers break down the rest to make neurotransmitters. 

  2. Not all protein is created equal. Lower-quality proteins, (not saying this in a judgy way!) such as soy or wheat proteins don’t stimulate muscle protein synthesis to the same extent as whey protein does. 

  3. Age matters. Older adults need more protein to stimulate muscle growth.

  4. Timing also seems to matter. Research shows that consuming protein roughly every 3-5 hours during awake hours may maximize muscle protein synthesis. 

  5. Protein greatly impacts postmenopausal women. Data suggests that postmenopausal women who consume higher protein diets have ‘significant and meaningful’ differences in their physical performance versus women who consume less protein per day. (But that depends on the amount…more on that in a second!)

  6. Muscle protein synthesis goes up during menopause. The bad news? So does muscle breakdown. This is why women in menopause need more protein to build muscle mass and maintain the muscle they already have.

  7. A high-protein diet isn’t necessarily harmful. Research shows that eating a high protein diet (defined as more than 2.2 grams/kg body weight per day) isn’t linked with adverse effects on kidney function or bone density in healthy women. However, more research is needed for post-menopausal women specifically.

“Jen, what if I’m vegetarian or vegan?” Don’t worry—you can still consume enough protein (including the nine essential amino acids). The only caveat is it’s slightly more difficult since you’ll likely have to eat a larger volume of food to hit that quota. For this reason, whey protein is queen for its completeness and easy digestibility. 

Let’s revisit timing for a second. While data seems to suggest that protein is ideally spread throughout the day (every 3–5 hours), other studies add that women benefit from consuming protein within 30-45 minutes of resistance training or a strenuous workout. 

Bottom line (especially if you’re new to the protein party)? Focus on meeting the daily protein target amount. What that amount is for you depends on your weight. Here’s how to find that target: 

  • The Equation: Take your weight in pounds. Divide that by 2.2. Then, multiply by 1.8 - 2.0. (In my case, I aim for 90 grams a day!). 

It’ll likely be a triple-digit number—so plan ahead, read those labels, and focus on getting about 20-30 grams of protein in every meal or snack. 

As you can see, there’s a lot that goes into incorporating protein in your day-to-day life. If you’re looking for protein-rich meal ideas, the best workouts for building muscle, accountability, and community you’ll find it all in my 8 Week Wellness Experiment! We’d love to have you. 

SYMPTOM SOLUTIONS

The Mitochondrial Culprit Behind Your Low Energy Levels

 Pop Quiz. Fill in the blank: “Mitochondria is the _____ of the cell.” 

  1. Home 

  2. Battery 

  3. Powerhouse

If you took high school biology (and like me spent hours creating posters of the cell with different organelles!) you almost definitely remember mitochondria as the “powerhouse” of the cell. 

Back in the day, we thought mitochondria just ran the engines. But today, these tiny cellular engines are at the forefront of research and development in health and medical science—and for good reason. 

Healthy, energized mitochondria are linked with longevity and vitality, while depleted, senescent mitochondria are associated with (you guessed it!) aging and disease. And when these powerhouses falter? It can lead to a slew of symptoms:

  • Brain fog & memory issues

  • Persistent fatigue (despite rest) 

  • Slower metabolism & weight gain

  • Muscle weakness & slow recovery

  • Increased inflammation—leading to inflammaging

What triggers this mitochondrial decline? Aside from the obvious—aging—it could also be from chronic stress, poor diet, inflammation, and toxin exposure (Cell Metabolism, 2022). 

The good news: Science-backed strategies can naturally boost mitochondrial health. While supplements do exist, let’s focus on the lifestyle ways you can fuel these powerhouses (that don’t require a stroll down the supplement aisle): 

  1. Prioritize Nutrient-Dense Foods

Mitochondria convert nutrients into adenosine triphosphate (ATP)—your body’s energy currency—but not all foods fuel this process equally. Here are the key vitamins and minerals that do:  

  • Coenzyme Q10 (CoQ10) supports mitochondrial energy transfer. 

    • Best Sources: Salmon, spinach, and nuts (The Journal of Clinical Investigation, 2021).

  • Magnesium is required for ATP activation. 

    • Best Sources: Avocados, almonds, and leafy greens.

  • B Vitamins convert food into energy. 

    • Best Sources: Eggs, lentils, and fortified grains. 

  • Omega-3s support mitochondrial membranes. 

    • Best Sources: Fatty fish, flaxseeds, and walnuts.

  1.  Engage in Mitochondria-Boosting Exercise

Just as your body needs movement, your mitochondria crave physical activity to thrive. Exercise is a powerful stimulus for mitochondrial regeneration and efficiency (particularly these workouts): 

  • High-intensity interval training (HIIT) and strength training stimulate mitochondrial biogenesis—creating new mitochondria (Science Translational Medicine, 2020).

    • Think: Sprint intervals, circuit training, and progressive resistance work  

  • Zone 2 cardio (steady-state exercise at 60-70% max heart rate) improves mitochondrial efficiency and fat metabolism, as does more intense cardio.

    • Think: Brisk walking, easy cycling, or jogging—any activity where you can hold a conversation 

  1. Reduce Oxidative Stress & Inflammation

The secret mitochondrial killer? Excess oxidative stress—which heavily impairs ATP production. Fortunately, you can combat this with:

  • Antioxidant-rich foods

    • Best Sources: Blueberries, turmeric, dark chocolate. 

  • Glutathione support 

    • Best Sources: Garlic, onions, and cruciferous vegetables—all sulfur-rich foods! 

  • Polyphenols (which protect the mitochondria). 

    • Best Sources: Green tea, resveratrol from grapes, and olive oil (Nutrients, 2022).

While these foods combat oxidative stress, you can also avoid it in the first place by restricting ultra-processed foods, refined sugars, and excessive alcohol from your diet. 

Lastly, sleep. Mitochondria also need rest to recharge and do their cellular jobs well. Shoot for 7-9 hours every night (not just on weekends). And yes, I said 7-9 hours! 

After reading this, you might be thinking: “This is great, but…are you sure I can’t just replenish my mitochondria with supplements?” Well, I’ll be answering that exact question (in full scientific detail) in an upcoming issue of Ajenda. Stay tuned! 

COMMUNITY

Is It Too Late to Start HRT in My 60s?”

“I'm 65. Is it too late for me to start HRT or MHT?” 

This question landed in my Instagram DMs last week (you can send me your questions right here) and my answer is: Absolutely not! 

While timing does matter with hormone replacement therapy (HRT)—with most consensus guidelines recommending initiation within 10 years of menopause—starting in your 60s can still offer significant benefits, especially for bone health, brain function, and quality of life. 

The key isn’t your age: It’s individualized care and assessing your personal health risks with a knowledgeable healthcare provider. 

Speaking of knowledgeable healthcare providers? I’m lucky to know an incredible one: Dr. Avrum Bluming. I first met Dr. Bluming when I was a little girl as my father and he were old medical school friends. Today, Dr. Bluming is a leading expert on HRT and co-author of Estrogen Matters

His research, along with data from The Women’s Health Initiative (WHI), suggests that estrogen therapy may be protective well into a woman’s 60s and beyond, particularly for bone density and cognitive function.

Here’s what HRT can help with: 

  • Bone Health & Osteoporosis Prevention – HRT remains one of the most effective ways to prevent fractures and osteoporosis, which accelerate after menopause (Bluming & Tavris, 2018). If you’re in your 60s and experiencing bone loss, joint pain, or fractures, estrogen therapy could be valuable. 

  • Brain Health & Alzheimer’s Risk – Estrogen has neuroprotective effects. Some studies suggest that women who use HRT may have a lower risk of Alzheimer’s disease, especially if started early post-menopause, though research is ongoing (JAMA Neurology, 2021). Even in later years, estrogen may still support cognition, memory, and mood stability.

  • Quality of Life & Symptom Relief – Still battling hot flashes, sleep disturbances, or vaginal dryness? HRT can offer substantial relief, improving daily function and overall well-being (Menopause Journal, 2022).

What About Risks?

Worried about HRT’s potential negative side effects? I totally get it. In 2002, a WHI study threw many women and their doctors on high alert with its possible correlation between hormone therapy and heart disease. 

However, researchers re-evaluated this study and found it overstated the risks for the majority of women. Current research now shows that HRT does not increase heart disease risk in healthy women and may actually reduce it if started within 10 years of menopause (Circulation, 2020). 

So what happened? The complications for women in their mid-60s and beyond are simple statistics—cardiovascular risks (e.g. heart disease, stroke, etc) naturally increase with age. 

For this reason, women who start HRT in their 60s should have a personalized approach that considers factors such as heart health, cancer history, and stroke risk. 

As I always say, ask your health provider four key questions: 

  1. What is the risk of taking HRT? 

  2. What is the risk of NOT taking HRT? 

  3. What is the benefit of taking HRT? 

  4. What is the benefit of NOT taking HRT?  

Important Note

The Menopause Society is not quite as enthusiastic about HRT as Dr. Bluming. Their official statement on their consensus report reads: 

"For women who initiate hormone therapy more than 10 years from menopause onset or who are aged older than 60 years, the benefit-risk ratio appears less favorable (than women who are in their 50s or within 10 years of menopause) because of the greater absolute risks of coronary heart disease, stroke, venous thromboembolism, and dementia. 

Longer durations of therapy should be for documented indications such as persistent VMS, (hot flashes) with shared decision-making and periodic reevaluation. For bothersome genitourinary syndrome of menopause symptoms not relieved with over-the-counter therapies in women without indications for use of systemic hormone therapy, low-dose vaginal estrogen therapy or other therapies (eg, vaginal dehydroepiandrosterone or oral ospemifene) are recommended."

I’m sharing both perspectives with you because medicine rarely offers clear-cut answers. (And if someone claims it does? They might be trying to sell you something.) As always, your decision should be informed by multiple viewpoints and tailored to your specific needs. 

One last thing: Talk to your doctor about the route of administration. Transdermal (patch) estrogen and micronized progesterone are often recommended for women starting later, as they minimize clotting risk compared to oral forms.

Bottom Line

It’s not too late to consider HRT in your 60s! But it does require a personalized discussion with your doctor and an evaluation of YOUR risks of heart disease and stroke. 

If your primary concerns are bone density, cognitive health, or symptom relief, HRT may still be a safe and effective option—especially when guided by evidence-based medicine rather than outdated fears. 

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…

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