TODAY’S DOSE OF HONESTY

Dr. Jen’s (delicious) breakfast Rx for weight loss.

Recently, I did something I don't usually do: I came home at the midway point in my typical 10-hour workday. As I was making my typical “breakfast” smoothie, I hit record on my phone and posted it to my Instagram page. I was FLOORED by the response: many requests for more info and details, great questions, incredible interest. So, in keeping with the promise I made when I launched AJENDA—to offer you science-backed, no BS, real-world solutions to help you achieve a healthier perimenopause/menopause/weight-management existence—here's my recipe! I love it, and I hope you do too, but feel free to modify and tweak as you wish.

Dr. Jen’s Breakfast Smoothie

Into a large blender, add:

• Ice and water. Hydration without unnecessary calories.

• Fresh or frozen banana: 1 gram of protein, 3 grams of fiber.

• 1.5 scoops fiber powder: I use Garden of Life Raw Fiber, but you can use whichever you like. 1.5 scoops provide 13 grams of dietary fiber and 12 grams of protein!  

• 2 scoops collagen peptides: Hydrolyzed bovine collagen; it’s dairy- and gluten-free. 2 scoops provide 20 grams of protein.

• 2 tablespoons prebiotic daily greens: I use Laird but there are many great brands. Laird has 5 grams of fiber and 2 grams of protein, supports a healthy gut microbiome, and is a great source of calcium (360 mg), magnesium, and functional mushrooms. (While the data is still evolving as to the potential benefits of functional mushrooms, I feel the risk is extremely low.)

Total: 30-35 grams of protein, 21 grams of fiber. 

I hit the button on my blender, then pour it into a giant pint glass—yum! This smoothie is really delicious and starts my day out right by giving my GI tract something easy to digest, something filling, and something loaded with the two elements I prioritize: protein and fiber.

The recommended daily fiber intake for women is approximately 25 grams a day, ideally from food sources. I know I don’t get anywhere near that number in a day. For protein, I shoot for 80 grams a day. (This is a weight-based calculation, and it’s NOT the same for everyone. The formula is 1.5 grams per kilogram of body weight per day. Take your weight in pounds, divide that number by 2.2, then multiply by 1.5.) This is a big number, and it’s hard to get this much protein. So, my smoothie is key to getting what I need in a day. It’s also a great addition to weight-loss or weight-maintenance eating plans.

Feel free to add berries, veggies, etc., as you wish. Try it for a month and let me know how you like it!

SYMPTOM SOLUTIONS

Can collagen supplements reverse wrinkles and hair loss?

There’s been a lot of buzz around collagen for a moment—specifically, about collagen supplementation. Before I answer the question, let me explain a few things.

Collagen is a protein, in fact the most abundant protein in the human body. It’s responsible for a mission-critical function: manufacturing the connective tissue that’s an essential element of bone, organs, skin, hair, muscles, tendons, and cartilage. When we’re young, the foods we eat provide plenty of fuel for our bodies to produce all the collagen we need. But as we age, our bodies gradually produce less of it; on top of that, collagen levels can decrease even more rapidly due to ongoing sun exposure, smoking, excess alcohol consumption, and lack of sleep and exercise—which can lead to wrinkly, saggy skin, hair loss, achy muscles, and painful joints. The body doesn’t absorb collagen proteins because they’re too large, so eating collagen-rich foods really doesn’t help. (And they are mostly very tough animal meats.) Certain foods provide your body with the raw materials to produce it—those with vitamin C, copper, zinc, and the amino acids choline and glycine—and they should be part of a healthy diet. But that won’t help to reverse aging or make you pain-free.

Enter collagen products. Skin creams and serums were the first to market, but some studies have determined that these don’t significantly penetrate the skin to reach the deeper layers where collagen works its magic. Oral collagen supplements—in pills, powders, and certain foods—contain amino acids, the building blocks of protein, and often have additional nutrients related to healthy skin and hair like vitamin C, biotin, and zinc. These supplements are generally available now as collagen peptides or hydrolyzed collagen, both broken-down forms of collagen that are more easily absorbed by the body.

And the results have been encouraging. Some randomized controlled trials have found that collagen supplements can improve skin elasticity, while other studies show that they may increase joint mobility and decrease joint pain from osteoarthritis or overexertion. Lab tests in cells (meaning not in humans) have pointed to hair health improvements—fighting damage to hair follicles and preventing hair thinning and even graying. And while mild digestive issues related to the absorption process in the gut have been reported with some collagen peptide use, side effects generally have not been serious.

But most of the research so far has been industry-subsidized. Also, because these supplements are not FDA-regulated before they go to market, there is no definitive and uniform way to substantiate dosage, purity, and efficacy claims on the label. And there have been reports of contaminated, tainted, or sham products—so buyer beware.

So, to the question: Should you buy collagen supplements to help with joint and muscle pain, skin, nails, and hair? Here’s my take: It comes down to risk vs. benefit. Overall, risks are generally low for most people. And there may be some benefits. So, I’m willing to give it a try. As I said earlier, I put 2 scoops of collagen peptides in my morning smoothie. Always make sure, though, to check in with your healthcare provider before taking any supplement.

COMMUNITY

“Why am I MAD all the time? I never used to be this impatient and irritable!”

Don’t feel like the Lone Ranger: Approximately 1 in 4 peri- and postmenopausal women will experience varying degrees of irritability, which can feel like things are just out of whack. I asked my friend and AJENDA Core Expert, psychologist Dr. Sue K. Simring, about anger during the menopausal years and what women can do to help control it.

First, there’s a BIOLOGICAL reason for the crankiness: Decreased estrogen and shifts in certain brain chemicals during and after menopause affect a woman’s ability to respond to stress without fear or panic. These same changes increase sensitivity to even minor annoyances, leading to unexpected emotional outbursts. But there ARE things you can do to deal with this anger:

Take control. If angry feelings kick in during a situation, slow down, breathe deeply, and take a break until you can talk calmly. This kind of nervous system regulation will help you deal with the activation that comes with anger.  

Learn the difference between reaction and response. Reaction is automatic and defensive. Response comes from thought. This awareness will help you focus first on your body sensations, then on your behavior.

Explore mind-body practices that can help you corral emotions. These include yoga, tai chi, muscle relaxation, and meditation.

Sigh. A big, deep breath can reset and regulate the respiratory system, and help in situations where you feel acutely angry or stressed.

Be honest with your friends and loved ones. Let them know you’re in a hormone storm that will eventually pass. Once your nervous system calms down, you’ll be better able to address important issues.

Seek support. If you feel your anger is interfering significantly with your well-being and relationships, consider getting professional help.

Take a Deep Breath with 4-7-8

The 4-7-8 technique is a form of breath regulation common in yoga, and it can work wonders to reduce the tension, anxiety, and stress that can cause blowups.

• Close your mouth and inhale quietly through your nose to a count of 4.

• Hold your breath for a count of 7.

•  Exhale completely through your mouth, making a whoosh sound to a count of 8. This is 1 breath cycle.

• Repeat for 4 full breaths and try to work your way to a series of 8 full breaths.

OUR CORE EXPERT

Sue K. Simring, Ph.D., practices individual and family psychotherapy. She has served on the faculty of NYU School of Social Work and Columbia University School of Social Work, and is the author of several books, including Making Marriage Work for Dummies and The Compatibility Quotient.

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ABOUT DR. JEN

In her roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” Dr. Jennifer Ashton—”Dr. Jen”—shares 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 written several books, including the best-selling 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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