Barbie Boules on Women’s Midlife Brain Health: Key Risk Factors to Tackle
In collaboration with Barbie Boules, R.D.
Women are living longer than ever, with a life expectancy that surpasses men’s. However, this longer life also comes with a higher risk for Alzheimer’s disease—2 out of 3 Alzheimer’s patients are women.1 There is a time when a woman’s brain becomes more vulnerable to damage, this is during the menopause transition. Alzheimer's can start developing 10 to 20 years before symptoms appear in women, often during this midlife phase.2
For World Alzheimer’s Month, we’ve joined forces with Barbie Boules, a registered dietitian and women’s health expert specializing in cognitive and cardiometabolic wellness during the menopause transition. She focuses on practical nutrition and lifestyle strategies to help prevent Alzheimer’s and support long-term brain health. Barbie will be sharing exclusive insights on how women in midlife can address four key risk factors highlighted in the 2024 Lancet Commission report to help reduce their risk of Alzheimer’s.
Barbie's passion for helping women manage their lifestyle and diet to achieve healthy aging through a holistic approach that's evidence-based, led her to discover RELEVATE. RELEVATE, a brain health supplement with 17 key nutrients from the Mediterranean and MIND diets that help in keeping the brain sharp and strong now, and for the future. Use code BARBIE20 to get $20 OFF your first order, and when you subscribe, enjoy 15% OFF all future orders. Learn more and order RELEVATE by visiting here.
Prioritizing Metabolic Health: A Must for Midlife Women
"Midlife for women – specifically the menopause transition – is a time of significant physical change on a metabolic level. Our bodies’ management of cholesterol levels, blood sugar balance, and fat storage start to shift in an undesirable way. The good news is that we can absolutely effectively fight back with nutrition and lifestyle, and pharmacotherapy if necessary." -Barbie Boules
Midlife Diabetes
One key metabolic change during the menopause transition is the rise in insulin resistance. This condition occurs when the body becomes less responsive to insulin, a hormone crucial for regulating blood sugar levels. As insulin resistance increases, blood sugar levels can rise, which, if not managed, can lead to type 2 diabetes over time.3
"The number one dietary strategy for improving insulin sensitivity, is to not overdo calories in general. Insulin resistance can be transient and affected by things like a poor night’s sleep or overeating at a single meal (think Thanksgiving), or chronic, as a result of excess visceral and ectopic fat storage. So, losing some of that visceral and ectopic fat via a calorie deficit is number one. That said, there is some evidence your body composition can shift favorably even without weight loss by keeping saturated fat, alcohol, and refined grains and added sugars to a minimum, getting more fiber, better sleep, and daily exercise." -Barbie Boules
Midlife Obesity
Weight fluctuations are a common occurrence during midlife, with weight gain being particularly prevalent in women during menopause. This weight gain often accumulates around the abdominal region, leading to an increase in visceral fat. Unlike subcutaneous fat, which is located just under the skin, visceral fat is stored deeper within the abdomen, surrounding vital organs.
Visceral fat is not merely a fat storage site; it functions as an active endocrine organ. It releases inflammatory chemicals known as cytokines, as well as other substances that can contribute to higher blood pressure and other health issues.4
"When it comes to exercise, just start. Know that there’s value in simply walking; and 15 minutes is great if it’s 15 minutes you weren’t doing before. Make a daily, non-negotiable appointment with yourself for a set amount of time – perhaps a minimum of 15 minutes and do what you have the energy for. On high-energy days, go all in with some high-intensity or strength training, for lower energy days, perhaps gentle yoga or a walk – the point is to keep the appointment and protect it as valuable time to do something positive for yourself. If you’re just getting started with switching up your approach to food, try adding more greens and color, or trading 3 high-saturated fat and high-calorie meals a week with something more nutrient-dense for fewer calories, and trading high-sugar beverages for water or zero calorie drinks can be very impactful." -Barbie Boules
Midlife Hypertension
During menopause, women often experience a rise in blood pressure, primarily due to hormonal changes and aging. As estrogen levels decline, blood vessels become stiffer, and the body's ability to regulate blood pressure diminishes. This hormonal shift also increases the production of substances that constrict blood vessels, further raising blood pressure. These factors combined can lead to an increased risk of hypertension in menopausal women.5
Midlife LDL Cholesterol
During midlife, women often face an increased risk of elevated LDL cholesterol levels. LDL cholesterol, often referred to as "bad" cholesterol, can build up in the arteries and lead to blockages. This risk is heightened during menopause due to hormonal changes affecting cholesterol levels, like dropping estrogen levels.6
This ties into two other risk factors smoking and physical inactivity. Elevated LDL cholesterol levels can be influenced by smoking and physical activity. Smoking, through its nicotine content, significantly raises LDL cholesterol and total cholesterol levels. Conversely, women who engage in regular exercise can lower their LDL cholesterol levels more effectively than those who do not.7
Barbie's dedication to empowering women to reduce their Alzheimer’s risk inspired her to discover RELEVATE, a brain health supplement with 17 key nutrients from the Mediterranean and MIND diets that help in keeping the brain sharp and strong for now, and the future. Use code BARBIE20 to get $20 OFF your first order, and when you subscribe, enjoy 15% OFF all future orders. Learn more and order RELEVATE by visiting here.
Managing These Areas with Diet as a Cornerstone
Diet is a truly powerful and underlying part of cognitive health, as it can address and treat multiple risk factors at once. A well-balanced diet, such as the Mediterranean or MIND diets, is crucial. These diets focus on high intake of vegetables, fruits, whole grains, nuts, and olive oil, while limiting red and processed meats. It provides a high intake of fiber, vitamins, minerals, and beneficial plant compounds like flavonoids and polyphenols. Research shows that adherence to the Mediterranean diet can reduce the risk of metabolic health factors, enhance quality of life, and even extend lifespan.8 The Mediterranean diet is linked to reduced body weight and lower levels of total and visceral fat. Following this diet is also associated with lower blood pressure and LDL levels.8 The Mediterranean diet is rich in omega-3 fatty acids, which also helped to lower insulin resistance. These effects make the Mediterranean diet especially beneficial for managing diabetes.9
"Number one: more leafy greens. Number two: add colorful fruits and veggies. I like to say leafy greens every day and a rainbow throughout the week. Add two tablespoons of nuts or seeds to salads, oatmeal, yogurt, or smoothies. Try to have one plant-forward meal a day. Use olive oil as your main cooking and dressing fat." -Barbie Boules
Combining this diet with regular physical activity and quitting smoking can further enhance these effects. Research shows that a combination of not smoking, maintaining a healthy diet, and participating in regular physical activity can greatly reduce LDL cholesterol levels.7
For women in midlife, we understand this can be a challenging time, with hot flashes, sleepless nights, and life changes all adding to the stress. But here’s the good news—you don’t have to leave your brain vulnerable during this phase. By making small, intentional changes in your lifestyle and diet, you can manage these risk factors and protect your brain for the long run.
"I’m convinced that one of the biggest roadblocks to better health is being in a hurry. Take your time, experiment, find what feels so right you want to be consistent. Simple, small changes lead to meaningful and sustainable results over time." -Barbie Boules
Take Action for Your Brain's Health:
Barbie's passion for helping women manage their lifestyle and diet through an integrative approach that's evidence-based led her to discover RELEVATE. Understanding how overwhelming it can be to make a complete diet overhaul, she found RELEVATE is an ideal supplement to help fill in the gaps, while focusing on eating a brain healthy balanced diet. RELEVATE combines 17 powerful nutrients from the Mediterranean and MIND diets, offering support while you work on making healthier changes in your life. By providing these key nutrients, RELEVATE helps protect your brain, safeguarding it’s health now, and well into the future.
"I definitely champion a “food first” approach, but sometimes that’s just not realistic. I like using RELEVATE myself, and recommend it to my clients, because it’s the only supplement I’ve found that incorporates crucial brain health nutrients, in reasonable amounts, without anything that sounds sexy but is actually unnecessary. It’s nice to feel “covered” at times when getting all of these nutrients from food isn’t possible." -Barbie Boules
You can use the code: BARBIE20 to receive $20 OFF your first order, and when you subscribe, you’ll also receive 15% OFF all future orders.
References
1. Beam, C. R. et al. Differences Between Women and Men in Incidence Rates of Dementia and Alzheimer’s Disease. J Alzheimers Dis 64, 1077 (2018).
2. Schelbaum, E. et al. Association of reproductive history with brain MRI biomarkers of Dementia risk in midlife. Neurology 97, E2328–E2339 (2021).
3. Carr, M. C. The emergence of the metabolic syndrome with menopause. J Clin Endocrinol Metab 88, 2404–2411 (2003).
4. Taking Aim at Belly Fat - Harvard Health Publications - Harvard Health. https://www.health.harvard.edu/newsletter_article/taking-aim-at-belly-fat.
5. Maas, A. H. E. M. & Franke, H. R. Women’s health in menopause with a focus on hypertension. Netherlands Heart Journal 17, 68 (2009).
6. Chiu, H. Y., Chang, H. Te, Chan, P. C. & Chiu, P. Y. Cholesterol Levels, Hormone Replacement Therapy, and Incident Dementia among Older Adult Women. Nutrients 15, (2023).
7. Wang, D. et al. Healthy lifestyle during the midlife is prospectively associated with less subclinical carotid atherosclerosis: The study of women’s health across the nation. J Am Heart Assoc 7, (2018).
8. Gonçalves, C., Moreira, H. & Santos, R. Systematic review of mediterranean diet interventions in menopausal women. AIMS Public Health 11, 110 (2024).
9. Vetrani, C., Verde, L., Colao, A., Barrea, L. & Muscogiuri, G. The Mediterranean Diet: Effects on Insulin Resistance and Secretion in Individuals with Overweight or Obesity. Nutrients 2023, Vol. 15, Page 4524 15, 4524 (2023).
