117: Navigating menopause and bone health with Buff Bones' Rebekah Rotstein (Part 1)

In this episode, host and Hotflash inc founder Ann Marie McQueen interviews Rebecca Rotstein.

Rebekah is the founder of Buff Bones, a medically endorsed exercise method for bone and joint health with on-demand classes and trained instructors in more than 30 countries. Rebekah is a former ballet dancer who has trained athletes and deeply studied the body, including cadaver dissections, along with coursework and fascia research, somatic studies, and visceral manipulation. 

She serves on bone health working groups in the US, contributing to their recommendations. She's a Pilates teacher, advocate and well-known speaker.

Part 1 of this conversation delves into into the intricacies of bone and joint health, sharing evidence-based studies that emphasize the need for high-intensity exercise to increase bone density after menopause. They discuss societal misconceptions, the importance of understanding one's body type, the critical roles of muscle tension and gravity in bone health, and the impacts of early life habits on long-term bone health.

Next week in Part 2: What you do to keep your bones, muscles, tendons and fascia strong. 

NB: These episodes were recorded in late 2023. 

02:52 The Importance of bone health
04:00 Research and misconceptions in bone health
05:49 Backlash and misunderstandings
10:46 Rebekah's personal journey with osteoporosis
19:03 The interconnectedness of bones and muscles
33:14 Preventing bone problems from early life

Join the Hotflash Inc perimenoposse:

Web: hotflashinc.com
TikTok: @hotflashinc
Instagram: @hotflashinc
X: @hotflashinc

Episode website: Hotflashinc

See hotflashinc.com/privacy-policy for privacy information

Transcript

Rebekah: 0:00

at the same time, it's almost like Feeling well, if you don't do heavy lifting, then you're not doing enough. You're not enough of a woman. You're not strong.

0:10

I'm Anne Marie McQueen, journalist and proud 50 ish woman, and we are here looking for the true truth in perimenopause, menopause, midlife, and beyond. Opening our minds to other possibilities is not always easy. Hot flash ink. You're all woman to me. All right, Anne Marie. Anyone who listens to the hot flashing podcast will know I've had a hard time finding help with my perimenopause and menopause symptoms, whether it was trouble sleeping or extreme anxiety or vagina stuff. I've encountered roadblock after roadblock in doctors who didn't know anything about taking care of women like me. It made everything harder than it had to be. That's why I'm so happy that there are companies like MidiHealth stepping into the gap and sponsoring podcasts like this one. Their supportive, comprehensive, and holistic approach to the menopause transition will provide you with what we all need most, a personalized care plan. Their virtual care clinic is easy to use and covered by most insurance plans. You can chat with your specialists during an appointment or message 24 seven. You don't have to deal with this alone. Any longer book your visit today at join midi. com. That's J O I N M I D I. com.

Ann Marie: 1:29

Hi there. My guest today is Rebecca Rothstein, the founder of Buff Bones, a medically endorsed exercise method for bone and joint health with on demand classes and trained instructors in more than 30 countries. Rebecca is a former ballet dancer. She has trained athletes and deeply studied the body, including cadaver dissections, along with coursework and fascia research, somatic studies, and visceral manipulation. She serves on the bone health working group for the society for women's health and research and contributed to their 2021 recommendations published in the journal for women's health. She's a Pilates teacher advocate and well known speaker and what propelled her on this path delving into our musculature and bone structure. Well, that is just part of what we are going to talk about today that Carol. Um, we connected on. I guess social media is where I noticed you. Uh, Rebecca Rothstein. It's nice, nice to meet you buff Bones is the organization, but Got Buff Bones is the Instagram account.

Rebekah: 2:30

Correct.

Ann Marie: 2:31

I have to, we're going to get into everything, but I have to just say that you put an Instagram post that dropped, stopped me, stopped me scrolling. Okay, first of all, you're, you're a Pilates. wizard. Like you're, I've seen your website. You do beautiful movement. So I thought, well, she's going to recommend Pilates till the end of the earth. And then I see, don't look to Pilates or yoga to increase your bone density. And I was like, what? This is according to recent research with points to intensity. As a key factor in the ability of exercise to increase bone density after menopause, high and even moderate intensity exercise loads and impact are essential for improving and not just maintaining bone mass at this point of life. And then there's lots of other, um, there's other slides and there's some good information. You were a researcher, you were a researcher. So you did, you don't, you guys don't, On buff bones, you don't just put up any old thing. So first of all, what led to this post and then how, what was the reaction?

Rebekah: 3:31

So first of all, um, I research things. I am not a scientist researcher though. I want to clear that up. And yes, my original background, well, my original background was dance and Pilates. But what we do with, with buff bones is bringing in a whole bunch of different modalities. And so we don't advocate just one thing. And so the reason that we put forth this post was actually was, was twofold. First of all, to share the recent research with everybody, we did a A pretty big lit review recently looking over the last three years of 10 different meta analyses and systematic reviews, which for those who are not aware is pretty much the highest level of evidence that you can get because it's aggregating and looking at many different studies and then synthesizing that and breaking it down into those that are fitting into the criteria that you are trying to investigate and then showing this is what such and such says. So we were looking at all these different studies, uh, related to bone density increases in post menopausal women. And interestingly, some included osteoporosis and some didn't include osteoporosis. So we couldn't, we really didn't see much of anything that was solely just that. And that also does make a difference. because the research has shown that women with osteopenia and osteoporosis can actually have better increases from the exercise. But that, that's, uh, starts to go off into a whole other tangent. So the reason, first of all, was to share some of this that we did that is part of what we provide for our instructor members of continuing education, just to update everybody. The second is also to clarify. A lot of misconceptions and misstatements that are out there. There's a lot of times that claims can be made and sometimes it's innocuous. It's not meant to be harmful, but sometimes you really do have to stand by what you're actually claiming. So we wanted to clarify, here's what the research is actually showing.

Ann Marie: 5:45

Okay. And, and then what happened?

Rebekah: 5:48

Interestingly, we got a lot of backlash, which, you know, we've had backlash from two different sides because we kind of go middle of the road in everything we are not extreme of one side. And when it comes to even medication, sometimes bone medication is appropriate. Sometimes it's not. We don't think it should be the very first line of defense before looking at underlying causes. So same thing with exercise. We don't advocate for one thing. So we've had backlash from people previously who say, well, you know, you're not pushing heavy lifting enough. And then we, or that you're not pushing it or miss misstating what we're actually claiming, which is. Sure, the heavy lifting can be very useful, but we also acknowledge not everybody's going to do it. So let's do what you can do on this side here. We were getting backlash from the Pilates from some in the Pilates yoga community. We're saying you're claiming that Pilates and yoga are not helping and that's not true. And actually, if you read what we wrote, we're not saying that at all. We're trying to show this is what the body of evidence says about bone density increases and that yoga and Pilates are unlikely to be able to provide that, but don't throw them out. Don't throw out the baby with the bath water. There's so many benefits that yoga and Pilates offer, but we have to see the bigger picture of bone health. Bone density is one part. And it is important part, but it actually only accounts for about 60 to 70 percent of bone strength. And then there's other elements of bone protection, like balance, and then there's body and your coordination and there's body conditioning elements as well to make sure that you're resilient and that you have a injury free body, especially when it comes to tendons and midlife and issues like that. One is it's, it's, it's a lot more complex than I think people often realize.

Ann Marie: 7:45

Yeah, people seem to talk about our bones like they exist alone. Well, people talk about the whole body that way. And it's funny because everything is synergistic. Um, but I find in this space and you must really notice it, that there's just a lot of people producing content that don't do it very carefully. So there's just a lot of repetition. And I noticed that in journalism, um, health and wellness reporting and journalism, I mean, reporting people who are doing it officially, just repeating. What other people have said, and then it becomes these massive illusory truths where, uh, it's just been repeated so often no one would even think to question it. So, uh, you must find this in this space.

Rebekah: 8:29

Yeah. And it's partly, you know, what I'm referring to here. Also, I think when you come to a topic that is related to science or health, you have to be careful about claims you make or statements you make, because we do need to know what is backed either by evidence and also, as you've mentioned, There is validity to, uh, clinical experience as well, but we have to be careful about what we say, because especially if you're in the space of a public sphere, people are looking to you, perhaps, as truth, and maybe that's also a problem. Like, there shouldn't be one person that is your guru for everything. You should be getting your sources from multiple areas, or you should, I should say, you should get your information from multiple sources.

Ann Marie: 9:22

That is so important. I have, I mean, I have interviewed a hundred people on this podcast and the gaps in knowledge. From the doctors and scientists I've interviewed it shocks me, but it shouldn't shock me because you're just one human, like it's just impossible for you to know everything and, you know, I've been talking to doctors where I've thought, she doesn't know this, and I know this, and she doesn't know this, how is that possible, freaks me out, and I'm like, well, of course, like, of course, we all are. Have these things. So how many, we're getting way off track here, but that's a very interesting thing because many people are getting a lot of information on this from social media. So would you say follow like just sort of an array just to sort of get a flavor?

Rebekah: 10:03

No. And I think we have to be, and I do this as well with the people that I follow with the quote experts I follow, you know, I want to know, well, what is their background? What is their bias? Right. So I think those are two things that are really, really valuable. Because everybody's going to have a bias, no matter what. You can't help it. And that's okay. But let's acknowledge that so that we understand, Oh, this is where this person's coming from. This is where this person's coming from. And I'm going to aggregate all of that to make a really informed decision. And the more we do that it's, what is that? It's the basis of critical thinking, right? And that's what often gets lost. I think in this, in this realm.

Ann Marie: 10:44

Very cool. Okay. So let's go back. Uh, you, you were diagnosed with osteoporosis at the age of 28. So did this start everything going and tell me what, what that is, what led to that experience and what that experience was like?

Rebekah: 10:59

It did. So I already at that time was I was a teacher trainer for Pilates teacher. So basically helping certify and train people to become Pilates teachers and part of the curriculum that I taught at the at the institution that I was at was related to injuries and conditions. And a large part of that was because of my sports medicine background from years earlier. So really gosh, uh, almost 30 years ago. Now I started working in a sports medicine facility, um, as an, a student athletic trainer, basically at my college. And this was after I had quit dancing. And so I had a rehab background essentially from this. And I decided to get my density tested just as a I was already teaching some of the very basic curriculum on osteoporosis and what to do, like five minutes worth. This is what you do. This is what you don't do. And when I got my baseline, just for later in life, I was very surprised to be told, Hey, you have osteoporosis right now. And, uh, the good news is you can just go on medication and you'll be fine. And I said, Whoa, whoa, whoa, whoa. Hold on one second. I, I'm not willing to just. Go on to medication without figuring out why I have this. This is a shock. So I, uh, did a lot of grieving initially. I was very upset and disturbed and I met with an endocrinologist who gave me a lot of insight and ran a number of tests. And that's really what I advocate for people to first identify any underlying causes, because sometimes it can actually be a blessing. Maybe you have a diagnosis that is informing you that you have hyperparathyroidism, and that is basically destroying, um, bone much more than you would want. And that you need to address that underlying cause. So anyway, um, it just took me on this whole other path where I then, uh, was researching as much as I could and speaking to as many professionals as I could and that eventually led me over the course of the next year to develop just a workshop, a small workshop on osteoporosis to share with others the information that I had learned. And then over the course of the next couple years after that, I did a big lit review, which was really the genesis of the big research. And that was for Hatherley Medical Education. They were, at the time, moving beyond physician and nurse CEUs, continuing education, to provide for exercise professionals. So they had me write a big paper, basically, from a lit review on all the research. And that's where I started really learning and identifying what, what everything was, uh, being spoken about and what had been researched and really what hadn't been researched. So seeing the changes over just about 20 years is pretty eye opening.

Ann Marie: 14:03

Okay, so why do you think that you developed osteoporosis at such a young age?

Rebekah: 14:08

So first of all, when I was a ballet dancer, I stopped menstruating and not spoken about enough, and I would like to hear more discussion of that. Um, and the ballet world has changed a lot in the last third and for the better. And so, you know, even a colleague of mine and friend of mine is a nutritionist and works with the School of American Ballet. She's on staff, helping them understand nutrition, make better nutrition choices. And this is wonderful. But none of this was available back then. So like many people, I stopped menstruating. In my instance, it was not an eating disorder. But for many people, it is an eating disorder, and there's something that we now know is, uh, is called REDS, or Relative Energy Deficit, uh, or Deficiency, in sport. And so, it's this triad, essentially, where you're not getting enough calories to meet the energy expenditure. Happens with, uh, sometimes with distance runners as well, and you stop menstruating, and it puts you at risk for osteoporosis. So nobody talked about that back then. And that's part of it. I essentially never built up my peak bone mass because I didn't have enough estrogen in my system. And I started menstruating late, like many dancers. And then I, what, probably two years only of teenage years did I menstruate. So about 90, around 90 percent of your bone density in those teenage years. And I wasn't doing that. So that's part of it. And that's why it was also really useful for me to get all the blood and urine work and, and with this endocrinologist, because we were able to identify that bone loss was not my problem. And if I had gone on the medications that were the predominant ones back then, the bisphosphonates, antiresorptives, those stopped the bone breakdown. So basically we would have been treating. A mechanism in my body that was not actually occurring.

16:15

Did you know I also have a substack? That's just a fancy way of saying I have a newsletter, but listen, it's not like every other newsletter. I am the only journalist in the world who's made menopause my beat. And each week I share research, news, products, tips, and tricks from the world of menopause and midlife. Sometimes I even write an essay. Hot Flash Ink on Substack is where I pull together everything that's here and in the Menosphere. And I break it down just for you. So that we can try and make sense of it all and figure out what to do together. In real time, join more than 5, 000 women, practitioners, CEOs, and more, and become a subscriber today. You can get my podcast as well as special video and audio drops you can't get anywhere else. Sign up today at hotflashinc. substack.

Ann Marie: 17:09

Wow, good for you for asking questions. Were you sort of a anti medicine person? Or were you more just a querying person?

Rebekah: 17:15

Like, I want to figure out what's going on, rather than just, yeah. I want to know what's happening. Yeah. You know, and there is something known as idiopathic osteoporosis. Which means for unknown reason. And that's, that's possible. But that wasn't, that wasn't the situation for me. And then the other thing that was pointed out for me was And this was the endocrinologist who I give a lot of kudos to telling me this back in, uh, what was this, 2004 saying, Hey, you're really, really small boned and so you are going to be predisposed to low bone mass, no matter what, it doesn't necessarily mean your bones are weaker, but the mass is less. And that was also really eye opening and very helpful for me to identify and recognize. Um, and it's not to say that that gives you a free pass, you know, forget about, don't worry about your bones, but it is part of the big picture. And so I think when you're asking, you know, are you anti medicine? No, I'm not anti medicine. Um, for myself, I didn't want to take it because it wasn't indicated at that point in life. Um, and still at this point in my life, it would, I would not want to be taking it, you know, maybe my, and my mom, uh, takes one of the medications, uh, but she started taking it once she was 75. So I think there's a time and a place for it and everybody's individual. That's the other thing, but also it's about the big picture, whether it's exercise, whether it's your bone health, whether it's anything. I think we tend to get really reductive, and so we need to see the whole picture in order to make our informed decisions.

Ann Marie: 19:03

Okay, and you're not going to be able to explain all of that today, but could you just give me a picture of how this is working together? The bones and the muscles. And the tendons and all of the things that are working for us and against us as we head into perimenopause and menopause,

Rebekah: 19:23

you know, I think you might have be the first person to actually ask that after many, many interviews. And I'm thrilled you did I love so our bones are dependent on 2 major elements, compression and tension. And so compression comes from gravity and we know this also because astronauts. in outer space are notorious for losing bone density, and there's plenty of research to show this. So they have to address that once they come back to Earth because of the absence of gravity. The secondary element is from tension, from pulling forces, and that comes from muscle contraction. But, unlike what many people erroneously think, muscles don't attach to bone like Velcro. Actually, the way anatomy works is that the muscle becomes The tendon and the tendon then becomes this outer layer of the bone known as the periosteum, which then comes into the bone. It's like one. It's like, um, what's that, balayage, right? Isn't that what they call it?

Ann Marie: 20:33

Blonde and then it goes into the nice dark. Yeah. Yeah. Yeah. Okay Well, you know this when you have a piece of meat with a bone in it I mean, this is exactly what you you're you're you're pulling it and it's attached and you have to cut it That's it becomes and it becomes it becomes that's how it all works together. Okay

Rebekah: 20:52

And it's it's beautiful when you see this in a cadaver and you can you can get a glimpse of that. You're right Um when you're looking at um, at meat. So the point is essentially in the reductive view or example, the muscle is pulling against all these structures, which pulls against the end product, the bone. And so that pulling force stimulates basically osteogenesis. So bone, bone creation, um, and yet the process at which this happens and metabolic rate at which this happens changes throughout our life. So we're building more bone than we're breaking down, kind of like an exfoliation process. Like you get rid of the old bone cells in your facial to make way for the new bone cells. And that happens at different rates. So you're forming more bone than you're breaking down when you're a kid. But then around our 30s, that levels off. We actually start losing more bone than we're creating at that point. But then at menopause, because of the loss of estrogen, which is a bone protector, we have a rapid acceleration of bone breakdown, or bone loss, essentially, cumulative loss. So, it's important though, at any stage in life, it doesn't matter when, that we are using our muscles. Because that muscular pull in conjunction with gravity, tension and compression forces together, is what's going to be stimulative to the bone. And that's how we maintain the bone mass we have, and also we can, through exercise, increase the bone density. Even after menopause. Okay, I'm gonna get to that. But that is why you can lift weights and you can do high intensity and you can walk and you can do Pilates and yoga and it will be, it'll be all good because it's all working the different parts. Yes. And now the good is a qualitative term that I want to just clarify. Okay. That I think has a lot of people in uproar is that they're missing the aspect of which point on the spokes of our wheel of bone health. Are we talking about something's good for walking is not going to be beneficial for your bone density, but it's great for other things. And it's also helpful in terms of an aspect of maintaining your bone mass. Perhaps it's definitely not enough though. So don't just think that bone for bone density walking is going to be your answer, but should you walk? Absolutely. Because it's a functional thing that we do every day. It stimulates all sorts of other systems in your body. Hopefully you're getting fresh air. And there's all sorts of benefits to that. Um, but. Now, which aspect of bone health are we talking about? So, when we're talking about bone density, the moderate to heavier loads and higher intensity is going to be more beneficial for your bone density if you are looking to increase it. Now, that said, you may be able to actually just maintain the bone density that you have in the moderate or even low intensities. It's really complicated. And this is why the nuance is totally lost in the social media format, unless we go into the weeds is that going back to what I was saying before, if we know that at midlife and later, we're losing more bone typically, https: otter. ai Would that possibly indicate that you are improving your bone density because you're countering the loss? Does that make sense? I can't tell you definitively whether that can be stated or not, but that is a proposition that has been made or a hypothesis that has been made, which is why we are very, very specific and clear with our wording. Like in that post, we did not say improve bone density. We said yoga and Pilates. are unlikely to increase your bone density. There's so many nuances it can get really complicated.

Ann Marie: 25:29

Yeah, and there's a lot of fear mongering. Like when, when you're just opening social media, there's a lot of people doing really well now talking about hip fractures and you're going to be dead in a year when you have a hip fracture and making it seem like basically I'm going to fall off my chair right now and crumble into a million pieces. And I find that really, upsetting because you see these older people who weren't. Lifting at Barry's on the weekend and right, so it can't be. There's just one way to it. And I love that you said that because it's kind of like, what do you want to do and is maintaining it for some people might be okay. Like, maybe that is just good enough.

Rebekah: 26:13

Yeah. And you know, Part of a huge part of the problem. And this was, I mean, I experienced it firsthand when I was first diagnosed, you know, I was basically led to believe that I could fracture at any moment, which was completely untrue. And I encounter this all the time, uh, with, with consults with people where they're coming to me and I say, well, what's the difference between how you feel today. and the state of your bones today versus last week before you got this DEXA score and your bone density and your diagnosis. And literally there's not going to be that much of a difference in one week that is going to make you crumble now whereas you were fine before. So I think the fear mongering is, a very valid point or combating the fear mongering. And, but I think, and also I don't want to say, but, and also I think the reason that there's so much advocacy for the, for instance, the heavy lifting now is that we do have more research than we had previously. Interestingly, as I was saying, I've been looking through this huge body of evidence, um, for many years, but also more recently in depth to see what the latest is at the end of 2023. And, you know, there's been plenty of evidence showing, uh, showing moderate intensity improvements and increase even in bone density for a while. But what we're seeing is there's a growing body of evidence To support higher intensity now, here's what I think. And I'd be curious of your take on this. I think that many have jumped on the bandwagon and not in a bad way, just like are part of, of this movement for high intensity exercise, because I think from a feminist perspective, it feels very empowering to say. Hey, you know what? You're not weak. You don't have to just lift five pound weights. And I still hear physicians telling patients and clients, don't lift more than 10 pounds. You could hurt yourself, which is completely counter to the evidence, which is what medicine is supposed to be based on. Right. So I understand that. And you know, I'm a product of a women's college. I am about as feminist as it can get. So I get that. But and that also, I think can take, um, have a little bit of backlash too, because there are a lot of people who want to feel strong, but also recognize that for certain comorbidities. It's not within their wheelhouse to do this heavy lifting, or it might not even be accessible because it does require supervision, which means you have to be able to afford that trainer as well as that gym membership. So I want to just create space for everybody. If you can do the heavy lifting, great, but it's not where you're going to start. You need to have a solid foundation and you're risking injuries if you don't have that solid foundation. I like your take because I

Ann Marie: 29:14

was thinking the other day, this whole thing is starting to just remind me of what it's always been like. I mean, I've been reading women's magazines since I was in my twenties and I would gobble them up, not knowing it was just another person, my age writing, It's a bit of you're never going to do it. You're never quite going to be good enough. And that's you keep a person in a state where they're not quite good enough. And then they'll just keep trying and listening and buying. And, you know, it's sort of like the old advertising thing, right? Like, it's, it's again, back to a little bit of fear. And I feel when I look at social media, like I'm not doing enough,

Rebekah: 29:50

you know, yeah, that's it. And so it's, it's not that there's a problem with heavy lifting great do it, but it often excludes people who are a intimidated. And maybe with that the answer is okay, so let's help them understand how they can do that or b to recognize though that You are enough already So you want to know everything that you can do for your bones great because that's what i'm here to tell you all I want you to have the choice. I want you to have the agency and I want you to feel safe and comfortable and satisfied with yourself though, as well with those choices that you are, you are making.

Ann Marie: 30:32

And you're right. It's not, I, it excludes a whole bunch of people, right. That just can't get to a gym. Gyms are expensive. If you're, they don't have a barbell and all these like things. Right. And it is intimidating because I just started a couple of weeks ago back cause I had an injury it was really hard to go because I, I only did classes like F45 and whatever, and I'm up there in the gym and I was just laughing on the weekend, I'm like, okay, you're getting it, you're getting it, but it is very, very intimidating. So I like that you bring those things up because not everyone has all those resources, not our, some people just hate it, they just don't want to do it, right?

Rebekah: 31:05

All right, so this has a lot to do with body type. My body type is very loose. My joints are very hypermobile. I have connective tissue issues. My body loves to stretch and just move freely. It hates effort and exertion. But because of that, the lifting is actually really good for it. So I do it because it's good for my joints, because of these connective tissue things. And it's also, of course, good for my bones. Don't enjoy it, though. And, so I'm not telling you to do something you hate. But I'm just acknowledging, like, I'm one of those people, I don't actually like it. But I do it. But the interesting thing, though, is I have found a direct relationship between people who love lifting weights and those who are more prone to easy access of the fast twitch fibers. There's a colleague of mine who's a leader in the fascia world. He's the leader of the fascia research, the connective tissue of the body. Um, who references the temple dancer body and the Viking, the Viking is somebody like my husband, who's a lifelong power lifter, super bound. He loves lifting. He just feels great, but he's also very tight. And so it works well with his body type stretching, not really his thing. I am the temple dancer. Like again, I can just move freely, fluidly, but. Also, when I try to do the weightlifting, I actually can produce muscle, which some people with my condition don't, but it's just, it's not, it's not something I just am inclined to doing. And so I think that we should also recognize that likely a lot of people who love the heavy lifting are probably more inclined to doing that. And that's okay, but acknowledging that maybe we have different types and different preferences. And also, maybe we should be doing things that

Ann Marie: 33:14

What are some things do you think that could be contributing to our bone problems? That we have done earlier in our lives that people aren't thinking about? That they're still doing? We know smoking. Um, yeah. Right, like that's Yes, but what are some things that you find that people aren't aware of?

Rebekah: 33:35

restricipted eating. And I know in the menopause space, this comes up a lot because many women of our generation and older, um, were used to dieting and being, you know, we're used to Cosmopolitan magazine, I think it was Cosmo, I don't want to malign them if I'm incorrect, but you know, the, the, Comparing two women and basically pitting them against how they looked with one another or fat shaming, you know, in pictures of celebrities. Everybody has cellulite, but you know, you were, we were made to believe that this is horrible. So basically a lot of our Gen X experience, um, and then, you know, you may put some of that to the side when you have a family or you go through other points in life. And then at menopause, you know, a lot of this stuff resurfaces. So, um, I think, first of all, the resurfacing of that, but also the habits that we may have had when we were younger probably did not help us in any way. And so, in other words, if we're kind of thinking about future generations, that's absolutely one area we can target. And then another thing comes to activity. So I don't think we, the Nexers, have this experience, um, because we didn't have anything to do. But the young ones now who can't imagine, you know, what would that be like to play jacks? What's that? You know, now, you know, you don't have to move your body at all. You can just sit there and watch your TikTok all day long. So I think that's a major consideration that we have to, we have to think about. So there's a, there's a program called Best Bones Forever that, I used to be part of when it was part of, um, I was working with the, uh, U. S. Department of Health and Human Services, uh, Office of Women's Health. They created this program called Best Bones Forever, which was enlightening young girls between, I believe it was ages 9 and 12. I think I have to double check that but around that age, basically preteen, on matters of bone health so that we could start targeting them to thinking in different ways before a lot of disordered eating and other problematic factors of teenage years came into play. It shut down at one point, but then American bone health. took over it. And now American Bone Health, which is a bone health society in the United States, has been, folded into the umbrella of the Bone Health, and Osteoporosis Foundation. Full disclosure, these are all organizations that I work with as an ambassador. but again, because again, this is all advocacy work. So there is, um, there is a program in the United States that I hope we will be able to push forward again that will address this and has addressed this because what you're bringing up is really prevention. It's pivotal because how can we make sure that others can overcome some of the downfalls that we've had.

Ann Marie: 36:46

I mean, so many people are chronically vitamin D deficient. So if that, if you had been that for a long, long time, that would also be like, I think there's just like with dementia. Um, there's just so many factors that go into dementia. I feel like if you really burrowed into it, there's probably prescription medication, probably. Other controversial things, but the vitamin D, I

Rebekah: 37:08

didn't think of that one and that's actually a perfect one to mention. So one of my, one of my problems was a vitamin D deficiency that is super commonly known now, but back in 2004, nobody was talking about this. And so I, that I literally remineralized my bones. Through increased vitamin D and I'm not even talking the levels at which you're seeing today. I think I was taking like 800 IU, which is like nothing and not alone. Um, but yeah, I would say that's actually, I'm so glad you mentioned that. I didn't think of that because that's a, that's a key one is monitoring vitamin D levels from a young age. Yeah. Because we're now finding so many people are vitamin D deficient. And I think also looking at gut health, still the mainstream, bone health community in the medical world does still separate. and distinguishes between different disciplines of medicine. And I think that's going, you're going to see changes in that. I mean, we're starting to see it a little bit, but I think that's going to be a big change over the next 50 years and acknowledging the role that gut health plays in bone health. So I think One of the things that we could do also is acknowledging for anybody who's had, whether it's IBS, or just, maybe you're not even diagnosed with IBS, but just some digestion challenges to recognize these. The role that plays multisystemically on everything else, including your skeletal system. And so to work on that or to look into that, because that could play a role in your absorption capacity and it could harm your bones in the long run.

38:59

Hot Flash Inc. was created and is hosted by Anne Marie McQueen, produced and edited by Sonia Mack. The information contained in this podcast is intended for informational purposes only and is not intended for the purpose of diagnosing, treating, curing, or preventing any disease. Before using any products referenced on the podcast, consult with your healthcare provider, read all labels, and heed all directions and cautions that accompany the products. Information podcast should not be used in place of a consultation or advice from a healthcare provider. If you suspect you have a medical problem, i. e. menopause or anything else, or any healthcare questions, please promptly see your healthcare provider. This podcast, including Anne Marie McQueen and any producers or editors, disclaim any responsibility from any possible adverse effects from the use of any information contained herein. Opinions of guests on this podcast are their own and the podcast does not endorse or accept responsibility for statements made by guests. This podcast does not make any representations or warranties about a guest's qualifications or credibility. This podcast may contain paid endorsements and advertisements for products or services. Individuals on this podcast may have direct or indirect financial interest in products or services referred to herein. This podcast is owned by Hot Flash Inc Media.