Getting thyroid support, beyond medication, for the follow through for taking the medication, and doing the things that can be overwhelming when you’re first diagnosed isn’t easy. Who, after all, gets it?

Someone who’s been there and done that does.

Danna Bowman and Ginny Mahar are two thyroid patient advocates who teamed up to create a diet and lifestyle support platform for thyroid patients. They are the creators of the revolutionary wellness game, THYROID30, and hosts of Thyroid Refresh TV, a podcast featuring the world’s leading experts on thyroid-specific diet and lifestyle.

They are thyroid support for women who need a place all things thyroid. Exercise, nutrition, meds, daily habits… all around thyroid.

The site is really like thyroid-central. A resource for experts, information, education, motivation … all things thyroid. It’s truly a thyroid refresh.

Questions we answered in this episode:

  • What’s your “WHY”?
  • How did the two of you end up together?
  • What is so different about the thyroid support you offer?
  • How are you making it fun- describe the gamification?
  • What is someone saying or thinking before they join the program?
  • What mistakes are newly diagnosed thyroid patients making?
  • And why are those mistakes so common?

Are you looking for thyroid support?

So many of our Flipping 50 listeners mention thyroid issues and are just realizing the impact of food and small lifestyle habit changes. If you’re navigating this all on your own with a little overwhelm, there’s help. And it’s in the form of a game that makes it easier to adapt while surrounded by people going through exactly the same thing.

The Cliff Notes on Thyroid30 from my guests:

“THYROID30is a gamified, 30-day online wellness adventure designed to help thyroid patients reach their healing goals. Our web app is a revolutionary tool that empowers patients to make successful and sustainable diet and lifestyle changes. Our players come back season after season because THYROID30 makes the healing fun.”

Learn more about the program:

Sign up now for the upcoming Fall Wellness AdventureGame play starts September 22, 2019. Seeing this later? You can check out the next one and get some other juicy help like the Grocery Guide.

Resources mentioned on this episode:

Thyroid Thrivers’ Grocery Guide

When it comes to a thyroid-friendly diet, there sure are a lot of things you’re not supposed to eat. That’s no fun! Thyroid Fresh likes to focus on the positives, like all the wonderful and healthy foods you can eat– foods that nourish and help you feel your best.

Get Social with Thyroid Refresh at:

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20 Reasons Strength Training Should Be Mandatory

Strength training is the fountain of youth. You may love your yoga, Zumba, running or _______, and that’s awesome! Stronger muscles will keep you doing it for longer. Here are just 20 (not all all-inclusive, but a good reason to re-examine how you spend your exercise time.

1) Prevent Muscle Losses

Muscle mass peaks at age 25. The loss of muscle for adults who aren’t resistance training is between 8 and 10% every decade. At that rate, living longer will result in sarcopenia (significant muscle and strength losses) in latter decades. Muscle mass can however be developed at any age even in the 9thand 10thdecade of life. Prevention of falls and illness due to frailty is available with resistance training.

2) Prevent Bone Losses

Bone mass peaks close to age 30. At that time there’s minimal opportunity to enhance bone density. Loss of bone without resistance training occur at a rate of anywhere from .5 to 3-to-5%/year depending on a woman’s phase of life.

Nearly all older women living beyond 80 will experience osteoporosis making them susceptible to fracture related to falls. Small-framed women or those with a high number of risk factors will have osteoporosis earlier in life.

Resistance training is the only exercise with results preventing natural bone losses or reversing losses even in menopausal or post menopausal women.

3) Increase Strength, Endurance, and Stamina

Your DNA influences the way you age, but not nearly as much as the lifestyle habits you have. Six months of strength training slows down or reverses aging and the expression of 179 genes associated with aging.

4) Support Natural Hormone Balance

In a recent Flipping 50 Master Class I shared the influence of exercise on optimal hormone balance. Listen to this Flipping 50 podcast to get a summary.

5) Boost Growth Hormone

Human Growth Hormone (GH) influences metabolism, body composition and aerobic exercise capacity throughout life. GH production declines naturally with age. Resistance training and intense interval training can boost GH significantly.

6) Boost Testosterone

Testosterone is supportive of libido and of self-confidence. As sex hormone levels decline for women in perimenopause testosterone levels often dip. Intense resistance and interval training are the best ways to naturally boost testosterone levels while endurance exercise reduces testosterone.

7) Increase Metabolism

Loss of muscle mass and a correlating increase in body fat reduces metabolism. Strength training correctly will result in both fat losses and metabolically active lean muscle increases that positively effect metabolism both at rest and after exercise as you age.

“You are probably too old NOT to strength train.”

8) Boost Libido

Forty to sixty percent of women in perimenopause suffer from low libido. An informal survey at reveals an even greater percent of women in perimenopause, menopause, and post menopause report low libido. Libido can wane from multiple reasons including lack of body confidence, dropping testosterone levels, and low energy. Exercise, specifically strength training counters each of those factors.

9) Improve Sleep

It takes 10 minutes of exercise to positively improve self-ratings of sleep by 33%. That’s with no imposition of intensity or measurement of parameters. And long term regular strength training brings about improvements in sleep.

10) Improve Body Composition

Resistance training positively influences body composition by both increasing lean muscle tissue and supporting fat burning. Resistance training burns fat during acute bouts of exercise but has a greater impact on the post-exercise energy and thus fat-burning than aerobic activity does.

11) Blood Sugar Stabilization Prevents or Reverses Insulin Resistance

Compared with aerobic exercise, positive influence on blood sugar and insulin resistance occur more predictably with strength training.

12) Decreased Risk of Falls

Falls are associated with loss of muscle, frailty, and weakness. Muscle strength from resistance training prevents those falls from occurring (and reduces damaging fractures if they do occur).

13) Better Reaction skills

Age-related muscle losses are fiber specific. Fast Twitch (FT) muscle fibers are lost twice as fast as you age. FT fibers are responsible for both metabolism and reaction skills. Your ability to right yourself if you trip to avoid falls, or react quickly to changing terrain or body positions is related to the amount of FT fiber you have.

14) Decrease Anxiety

The prevalence of anxiety in older adult women is growing. Resistance training is directly correlated with reducing the severity of anxiety and used in the treatment of anxiety.

15) Reduced Depression

The incidence of depression is significantly higher in older women than men. Resistance training has proven to be instrumental in improving mild to moderate depression. Studies show the positive impact of exercise is comparable or better than medications or cognitive therapies, and compared to medications exercise offers no negative side affects.

16) Improved Cognitive Function

Brain function including memory, executive function, problem solving, and brain plasticity all benefit from resistance training. Benefits are experienced after acute (after a single bout of exercise) and long term exercise.

17) Increased Energy

Energy is generated in the mitochondria, once believed to naturally decline with age and accepted as a fact of life. In the last 8-10 years research has shown that mitochondrial function can be improved and declines reversed so older adults have the same relative mitochondria function as young adults after regular strength training.

18) Enhanced Muscle Protein Synthesis

The ability to use dietary protein for the benefit of muscle tissue repair and growth declines with age. Resistance training has proven to overcome that effect of aging and following acute bouts of resistance training and long term resistance training muscle protein synthesis is improved significantly. That has a positive effect on maintaining lean (metabolically active) muscle tissue and strength.

19) Decrease Stress

The damaging effects of stress are related to over 80 diseases. By increasing resilience to stress the physiological and psychological responses to stress both are lower. Blood pressure, anxiousness, adrenal responses, and ability to focus or remember improve in fit individuals compared to sedentary.

20) Improve Posture

The effects of a life “out front” causes rounded shoulders, rounded upper back, and forward head hang, all worsened by cell phone use and “tech neck” today. Correct selection and performance of strength training exercises can help correct these postures and the ensuing depressive states that accompany them.

…and one final “bonus” based on the summation of all the above (though this is by no means an all-inclusive buffet of strength training benefits)

21) Truly LIVE longer

“Stronger longer” is a Flipping 50-ism. The goal of longevity is nothing without an increasing long healthspan.Muscular strength is the foundation for all things physical, mental, and emotional related to aging.

If you received a prescription medication from a doctor, it will inevitably have negative side effects, as every medication does.

If you however, perform strength training, whether at a gym alone, with a personal trainer, or at home alone, there are virtually no negative and dozens (partial list above) of positive benefits.

Want support? Starting, learning proper technique, and combining hormone balancing with joint care and your health history requires strength training programming fit for midlife woman. I’ve got you covered. Check out STRONGER I. 

Are You at Risk for Osteosarcopenia? How to Know

What a mouthful, osteosarcopenia. This condition that refers to bone and muscle losses is relatively new. There is a lack of consensus among researchers on what to call it (sarco-osteopenia, sarco-osteoporosis, osteosarcopenia). No matter what they name it, for you and I this is a topic we need to unpack.

Before we dive into this week’s episode … a shout out to listener mlg114 who left this comment in iTunes:

“You and Figs might have saved my marriage. My husband and I have been in the “me exercise you not” pattern for a few years! We’ve been hurting each other unintentionally on this very subject! Result has been severe resentment though we’re about to celebrate 25 years married! You have spread your mission of kindness to us successfully! Thank you with all my heart for this valuable, intelligent podcast!”

So thank you to mlg114 this made my day and I shared it with Figs, too.I’d love it if you’d leave a rating in iTunes too. I have been reading these regularly and want to start sharing them with you. I’ll link to iTunes in today’s show notes at and to the episode about how to encourage healthy habits without nagging.

So let’s get into it. I’ve got a lot to cover here. You’ll notice this episode is potentially longer than most. It’s a big topic. There’s a lot of controversy at first glance and that’s resulting in a lot of confusion. I want to clear it all up for you.

Osteosarcopenia is the new term given to the combination of osteopenia/osteoporosis and sarcopenia.

I’ve got to cover some vocabulary first.

Osteoporosis is the low bone mineral density (BMD) that is statistically 2.5 standard deviations from the ideal of a young woman. Meaning, it’s significantly lower than ideal bone density.

Osteopenia is the space between that ideal bone mineral density and 2.5 standard deviations from ideal. You’re not good any longer, you’re not quite bad enough to diagnose as having osteoporosis. But it’s not going in the right direction.

Sarcopenia is pronounced muscle and strength loss. It can be in spite of normal weight or obesity – that when coupled is termed “sarcobesity.” It’s characterized by low grip strength, a poor chair stand test (say you can’t do more than 5 rises from a chair in 15 seconds), low muscle measured by a DXA scan, and low performance of a battery of tests like an up and go test and a timed 400 meter walk,to name a couple.

The combination of both low bone density and low muscle mass is what I’m referring to today as osteosarcopenia.

This Episode

Non-pharmacological strategies to help prevent, reverse, or treat (by way of exercise and lifestyle habits) to improve both conditions independently and the combined condition osteosarcopenia are the topic for this episode.

Spoiler alert. This episode is aptly sponsored by STRONGER I, my 12-week strength training program designed for women in perimenopause, menopause, and beyond. It’s based 100% on research featuring women in that group. Such a small percent of programs are made for women, based on research featuring women, that most everything you’ve learned about exercise may be a lie. If it wasn’t about who you were or are at the time you did it, then it wasn’t considering the unique hormones, metabolism, body composition or unique socialization that you as a woman have.

I don’t think for a minute any 60-year-old overweight man would have begun an exercise program based on what worked for 22-year-old female collegiate athletes. Do you? And yet, the equivalent is essentially what’s been going on for decades in fitness for women.

STRONGER I opens four times a year. As I record this my team just let me know it’s open! That means there’s a juicy early bird rate right now. You can learn more about it at [I’ll share that link in the show notes] If you’re listening to this later – which I know happens – and you’re curious you can get on a notification list to learn when it does open again and have first chance to save a spot if you decide you want it. 

Stopping Bone Losses

Let me start with osteoporosis. For women in post menopause concern about bone density usually heightens. For good reason, once we lose the protective factor that estrogen offers, we lose bone faster – in fact it really accelerates right after menopause.

Currently losses of .6%, 1.1% and 2.1% per year for the 60-69, 70-79 and over 80 age groups is the level of average bone loss.

In the first 4-5 years post menopause loss is accelerated to 1.5% per year for spine and 1.1-1.4% for hip.

I want to stop the red flags and alarms going off in your head right now. I want to remind you: that these statistics are looking at a lot of women who Do Not exercise. They may smoke, drink more than a glass of wine a day, eat poorly and never lift weights. This is like “normal range” in labs. It’s COMMON, it may not be you. And no matter what, bone losses are preventable, and to some extent reversible, or there are ways to prevent falls and fractures so bone losses are not devastating.

So if your thoughts are spiraling downward, stop.

Stopping Muscle Losses

Truthfully, stopping muscle loss is easier or at least has less specific “rules.” To provide adequate stimulus to muscle for lean muscle maintenance or increases, you must reach fatigue. That can be done with heavy load and few repetitions or with a lighter load and more repetitions.

Fatigue, or temporary fatigue, is simply getting to the last repetition that you can do with good form or complete. Within minutes, or actually seconds, you recover and are able to do more if you had to. But without that actual muscle fatigue stimulus of overload for women in perimenopause and beyondcountless studies are coming back saying the positive influences on muscle, strength, fat burning, and metabolism is minimal.

I Exercise, Is that Enough?

At this point I hope you understand there’s some criteria you have to meet for either bone and or muscle benefit. The effect of exercise on bone loss is controversial. At best, however, every professional not quoting research and testing effects of bone density tends to have anopinion, based on general research collectively done for populations, young and old, men and women. If you are in our Flipping 50 tribe, what I’m about to share is specifically filtered for YOU.

All too often a woman may be told to “exercise” or to “walk” by her physician. She may be told to lift weights but that it doesn’t have to be heavy. I provide research here to explain why that information is or is not on target depending on who you are, what your activity history is.

There is a continuum of exercise with minimal and with optimal benefits. There’s a continuum of sedentary and deconditioned women on one end and athletic women on the other end. Consideration of both continuums has to be examined to arrive at the best option for you.

Exercise for Osteosarcopenia

For osteopenia and osteoporosis aerobic and low impact exercise fails to benefit Bone Mineral Density(BMD) in most studies. In a few studies walking limits progressive bone loss. Note that is limits losses, not stopsbone losses or increases bone density.

Typical aerobic activity like elliptical trainers, bicycles, rowing machines have little to no positive influence on bone density. There’s a complete lack of heel strike or what’s referred to as Minimal Effective Stress (M.E.S.).  Though there may be some resistance benefit at higher settings as opposed to use of speed for intensity.

Swimming potentially has a negative effect. It completely removes the effect of gravity.

With co-existing factors many women have in addition to osteoporosis or sarcopenia, like arthritis, prior joint issues, or lack of cartilage, many older adults naturally (and should) choose water exercise. Choice of swimming for cardio exercise increases the need for resistance training. Surf and turf is a must.

M.E.S. is not even met in repetitive low impact exercise like walking or jogging beyond a certain point of adaptation. Once you’re ambulatory and moving around your body has gained all the benefits it’s going to from that position and stress. More steps do not equate to more stress that the bone will positively respond to.

Jumping rope or other plyometric exercise is most associated with building bone density though it may not be wise in many cases where there is already a low BMD.

Strength is the clear winner for bother bone density and for muscle maintenance.

If You’re Out of Shape vs. Fit

For untrained individuals aerobic activity that is weight bearing in nature, like walking or Zumba, may increase BMD while in already trained individuals who have already attained a baseline of osteogenic activity (bone reformation to avoid getting too technical) these activities neither stimulate more bone density or prevent further losses.

In other words, once you’ve achieved a minimal level of bone density from an activity, you don’t get more bone benefit from the same level of stimulation. More steps, more miles, more minutes don’t equate to more benefit.

Summarizing A Few Exercise Considerations:


The load above gravity is less effective in osteoporosis prevention.


In some cases subjects whose primary mode of exercise is swimming show a 10% greater occurrence of low bone mineral density than those who do land based exercise. Other studies show some minimal support for bone mineral density from swimming and water exercise. This goes back to… are you a beginner who’s been doing very little? Or already active?


This activity misses the heel strike though there is some muscular force that can increase BMD in those with LBM mass upon initial use. This aerobic activity may be safe for those with high risk of fracture, provided they have good balance (required not necessarily gained from the activity). Can you do more? Can you walk? Can you dance or box with more ground mechanical forces?

Rebounding may make sense. For someone who can’t do higher impact exercise, but higher impact will provide greater benefits for those who are able.

Do you remember Lance Armstrong? It’s rare for a young male, let alone an elite athlete to be diagnosed with osteoporosis. At one point one of the fittest men on earth, from hundreds of hours cycling in an unloaded environment (even with the resistance of uphill climbs) was diagnosed with low bone mineral density. This was before the interference of chemotherapy.

There’s got to be a mechanical stress that is more than usual your stimulation. Once achieved more of the same mechanical stress does not improve bone. A long distance runner for instance, cannot outrun the need for strength training. In fact, because most endurance athletes tend to be lean or smaller in frame, they are likely candidates for low bone density. They’re even more at risk if they have a diet low in absorbable calcium, protein, and otherwise high in nutrient density and also don’t lift weights.

Walking and Running Examples

If you walk 3 miles three times a week and then become a runner you may experience a slight bump in bone density. You leave the ground with running and there’s a greater force to the bones. After that initial change, your bone density won’t further increase.

Running 3 miles 3 days a week then increasing to 3 miles 6 days a week would not make you less likely to lose bone mass. In fact, if you did become leaner, you may accelerate your likelihood of low bone mass. Regular endurance exercise (without strength training) can over time accelerate muscle breakdown called catabolism. The combined loss of muscle and bone loss make a runner just as likely for osteosarcopenia as anyone.

Don’t Throw Out Your Cardio Completely

However controversial, there is some proof that aerobic activity can begin a process of stimulating some enzyme activity within the bone that then makes resistance training more effective. For that to happen the exercise can occur concurrently on same days or on alternate days.

Resistance Exercise for Osteopsarcopenia

The research on aerobic exercise is a little controversial at least before you look at the populations studied. There is no controversy about resistance training’s effects on bone mineral density. There is some confusion however about what qualifies as adequate bone mineral density and I’ll get to that next. Almost all studies point to resistance training – provided it is done with adequate intensity– as providing a protective factor for bone.

What qualifies as resistance training?

There’s a continuum here too.

Yoga trainings for registered instructors list bone density as a benefit. I came unglued the day my instructor told the class that in my own 200-hour Yoga Instructor Training. There is evidence yoga helps, again on a continuum.

For someone who has been previously sedentary and deconditioned, there will be bone density benefits from yoga. From couch to mat, I can’t argue that. But we’ve got to keep very clear on the fact that this doesn’t eliminate the need for a progressive resistance training plan. For someone who has been lifting weights regularly or even doing higher impact aerobic activity, there will not be “more” bone benefits from yoga, even “power” yoga.

Resistance exercise for sedentary, weak, or most frail individuals might include water exercise (with adequate intensity), bicycling (again- in high gear simulating uphill climbs) though the benefits will be site specific. That is, if you’re pedaling a bike you’re going to gain the most bone density and muscle benefits in the upper leg and hip. With swimming your gains will be in the arms, upper back, and shoulders, somewhat dependent on your stroke.

Starting and Progressing

You can experience initial bone density benefits from yoga, bands and tubing, pilates reformers, and work your way into free weights and, ultimately, if you have known low bone density, use machine weights. Machine weights make lifting as heavily as you can, safe. I’m a firm believer that every retirement center, assisted living community should provide at the least a leg press, a chest press, and a seat row machine to help load the hip, spine and wrist.

The recommendations for resistance training for bone density specifically include:

Not every resistance protocol that supports muscle – (which can prevent sarcopenia) – will help bones and prevent or treat osteoporosis. For muscle-specific benefits you need to reach fatigue and it can be done with lighter weights for more repetitions. That, similar to reasons more running doesn’t result in more bone density, will not be enough stimulus for the bone.

Nutrition for Osteosarcopenia

Low protein is directly correlated with both bone loss and muscle atrophy.

High protein is associated with less muscle loss at a given age and better lower limb performance.

Protein supplementation over 3-24 months corrected sarcopenia. The intervention provided 6-30 gram servings/day combined with resistance training.

Where older adults need to lose weight, resistance training plus protein intake prevent muscle loss related to calorie restriction.

Bone density is also associated with higher protein intake. Further, hip fractures decreased by 16% in subjects who had high protein intake compared to those with low protein intake.

Lifestyle Choices

Decreasing alcohol intake and managing daily supplements like Calcium(when dietary calcium intake or absorption is less than optimal), Vitamin D, and magnesium may also support bone health. Overall nutrition adequacy is more important than it’s ever been considered before.

In an upcoming podcast I’ll discuss the role of stress and happiness, as they’re associated with bone density.

It’s simple. Strength training is key to aging well, independently, and to metabolism.

Strength training targets bone density and lean muscleboth in a way that aerobic activity does not. That’s not to discount aerobic exercise. It’s important, though in much smaller doses than you’ve ever believed before.

The Bottomline on Osteosarcopenia

“Those with osteosarcopenia have worse prognosis than adults with either osteopenia or sarcopenia alone. Therapeutic strategies that have a dual effect on bone and muscle are critical in the management of osteosarcopenia.”Those therapeutic strategies include:

I leave you with this last comment. If you’re not strength training now, start. If you influence and love young women encourage them to get into strength training early in life to prevent bone losses that begin at age 30 otherwise.

If you influence pre-teens or teens encourage participation in sports with higher impact like basketball, soccer, gymnastics, and martial arts. Swimming and biking are wonderful activities but have little influence on bone mineral deposits. Balance them with other activities.


If you want support with the right kind of exercise, the progression and the tips for safe and effective exercise, I’d love to see you in STRONGER I. Click here right now while registration is open. If you’re listening later, click to check whether I’m about to launch a new 12-week series or to get notified when I do.


You Still Got It, Girl! The After 50 Fitness Formula for Women

Hot, Not Bothered:99 Daily Flips for Slimmer, Trimmer, Fitter Faster So that You Can Master Metabolism Before, During, and (Long) After Menopause

Please leave a rating in iTunes! It really helps! 

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  3. Click ratings and reviews
  4. Leave your 5 star rating (seriously I’d love it, but your authentic comments are what I need to grow and give you more of what you want and less of what you can leave!)
  5. Know how much I appreciate you doing this!

What do you think of when I say blood flow restriction exercise?

Without checking Google, most of our Flipping 50 tribe would think this sounded like something terrible. It sounds like something that happens in a lab and not on purpose in a workout session. If you think it sounds like there’s risk involved and it might be bad for blood pressure or increase heart stress, you’re not alone.

But if you Googled (odd how that is now a verb to anyone else?) it you’d find that there’s emerging science around Blood Flow Restriction (BFR) training. And some of it has promise for older adults, and you. In fact, it’s quite exciting.

What Is It?

Originally developed in 1966 by Yoshiaki Sato in Japan where it was known as “kaatsu training,” meaning “training with added pressure.” It’s performed all over the world. So why haven’t you heard of it before? A quick look on Amazon for BFR bands shows images of (big) body builders, 98% of which are male. It doesn’t look like something you or I would naturally gravitate toward. It certainly hasn’t made it to Prevention or Reader’s Digest… yet.

But it might. Very soon.

Essentially, BFR training involves preventing blood flow to working muscles (or those at rest I’ll discuss later). That tricks the body into thinking it’s doing hard work to increase Human Growth Hormone (or GH), which burns fat and builds muscle.

If you don’t like hard work, won’t or can’t do hard work… blood flow restriction exercise may be your next best friend.

It Helps Muscle, Does It Help Bones?

Though some studies have suggested yes, for you and I, no, or very minimally. Only with instances of growth hormone deficiency in young male adults, or with unexplainable osteoporosis in male subjects was there any positive effect on bone density. There’s no evidence of bone support for women with age-related bone density declines. So, heavy weights when possible are still the answer.

Yet, there is some correlation with reduced fracture risk from increased GH. That may be due to increased muscle strength lending to better strength, reaction skills, and balance.

Are There Risk factors?

A review of literature for a position statement with older adults with frailty, Coronary Artery Disease (CAD), and prior existing Venus Thrombeoembolism, conclude there is no additional risk, “though further studies are encouraged,” Always your selection of appropriateness should be made on an individual basis together with your physician and a medical exercise specialist. Blood pressure response can be higher if cuffs are not removed during the recovery interval periods. 

Blood Flow Restriction Exercise Research

In one research study, adults in a large review of literature were between 57 and early 70s. BFR was effective in developing muscle in low load (walking) compared to walking without BFR.

Positive results are reported in both muscular strength and muscle mass from use of BFR exercise.

It’s important to note that most research confirms the BFR results are similar but still lower than that from High Load (HL) strength training. That is, if you can safely, and are motivated to lift heavy weights, it will still provide the most benefit. If however, travel, special conditions, or you’re unwilling BFR opens up alternatives. 

More Study Results

Optimal strength response was found in subjects (without physical limitations) from Heavy Load strength training combined with low load walking with (BFR) restriction.

For older athletes BFR may enhance performance by allowing combination of low load training with restriction and heavy load more typically used (requiring less of heavy load yet more overall training without damage and risk of injury).

Personally, during training for Ironman, I’m usually an advocate of heavy weight training for avoiding lean muscle losses and bone density benefits. [Yes, more exercise can be a risk just as too little exercise can.] However, as training volume increases for an endurance event balancing sport-specific activity with less strength is better for reduced overall physical stress.

So I’m wearing BFR bands walking the dog before a run and then cutting the volume of training runs significantly. I’m able to optimize hormones this way instead of impose constant fatigue so common in endurance athletes.

For older adults who are unable (or unwillingly, untrusting) to do heavy load training BFR provides a viable way to increase strength and maintain lean tissue, specifically Fast Twitch (FT) muscle fiber. Adults can lose Fast Twitch fibers twice as fast as they age. FT fibers are responsible for metabolism and reaction skills – so you can catch yourself and prevent falls.

How Often Should Blood Flow Restriction Training Be Done?

It depends. Don’t you love that? (sarcasm) Yet, truly it depends on you now and why you’re implementing it. Do you need this to allow you to do something while you’re recovering from an injury? Do you need a good substitute for your regular exercise while traveling? Are you looking for a way to supplement a very active life and fitness program to boost progress without burning out or injury? Use your answer to determine how you start:

How Tight Do Blood Flow Restriction Exercise Bands Need to Be?

You’ll see in the video I discuss the 7/10 on a “tightness” scale. You’re doing this at your perception of tightness. You may need to experiment a little. I find it easiest to go to the point I couldn’t stand it and then back off slightly to get to my “7.” If you’re in our Flipping 50 tribe you’re used to rating your effort level on a 0-10 scale for various exercise so this is familiar.

Why Does It Work for Adults Over 50?

Proper use of the bands creates greater metabolic stress that brings about greater release of growth hormone and IGF-1 – key for gains of lean muscle and prevention of muscle loss.

By inducing greater muscle fatigue with lower loads there may be more Type II fiber recruitment for the relative load. (You’ve heard me talk nation-wide about Fast Twitch Muscle loss prevention.)

Enhanced muscle protein synthesis that occurs with resistance training is another huge win. Research shows clearly that resistance training offsets reduced muscle protein synthesis (ability to use protein you consume to benefit muscle) that can otherwise occur with age.

Enhanced Human Growth Hormone (GH) is an important advantage of lifting heavy weights and intense interval training as you age. Nearly comparable results are reported with BFR bands. Heavy lifting seems to still have the positive edge. This is one of your biggest hormone benefits of resistance training. Feel like you can’t get the muscle tone you once had? Decreases in GH are a part of that.

You can overcome reduced production of GH with age by resistance training at proper intensities. If until now you haven’t chosen or haven’t been able to do resistance training, you have a lighter load option.

Each of these aforementioned benefits point to reducing the signs of aging. What has been “accepted” as normal no longer has to happen. You’re in control. You can prevent and reverse aging. 

When high intensity interval training may not be appropriate (due to fatigue or cortisol levels, current injuries, or lack of access while traveling, Restricted Blood Flow exercise (low load) may be a good option to prevent muscle and strength losses.

For an idea of activities and intensity that work with BFR exercise:

Resistance Training:

Choosing the Load

Loads for resistance training in most studies feature loads of 20-30% of 1-rep max. Now, I’d never suggest you do a 1-rep maximum test. I’ve discussed that many places in books and posts. It is however the language of intensity in resistance training. If you can lift a weight only once and reach fatigue you’ve found the ultimate of “heavy.”

To give you an idea of 20-30% you’ll need an estimated one-rep max. If you can lift something 10 times to fatigue it’s about 80% of your 1-rep max. (This by the way is the best protocol for bone density).  With a little math you can determine your 1 rep max is about 12.5 lbs. So 20-30% is 2.5-3.75 lbs. I’d suggest starting with a 3-lb dumbbell.

As you perform the exercises you can experiment with what truly causes fatigue in the muscle. The biggest take-away? You’re going to use far lighter weights (or resistance) than you would without the bands.

Aerobic Training:

These types of exercises performed are performed at about 40% VOx2 max which is about the equivalent of daily activities of living. So in theory you could wear bands while going up and down your stairs to do laundry or clean for 20 minutes. Some aerobic protocols use intermittent exercise. For example, intervals of pedaling for 3 minutes with bands used alternated with 2 minutes of removing or undoing the bands.

What Size are the Blood Flow Restriction Exercise Bands?

Larger cuff size requires less pressure but movement is restricted. Choose based on your frame and size. Typically, recommendations are 1-1 ½ inches for upper body (bicep) and 2 inches lower body.

These are the bands I am using. *




Aerobic Blood Flow Restriction Exercise Intro


The Exercise Protocol At-a-Glance



How Soon Can You Expect Results From Blood Flow Restriction Exercise?

For those more sedentary doing 1-2 times a day, approximately 3 weeks is suggested time to experience benefits. For those already exercising that incorporate BFR training into their program 3-6 weeks is the suggested time frame. (Think about weight loss, the more weight you have to lose the faster you’ll see progress. So it is with BFR, the more fit you are, the less impactful BFR training may be for you, though that slight increase in fitness can be significant when it happens.)

Bed Rest Implications

Studies suggest that even in instances where exercise is extremely limited or not possible, use of the BFR bands can prevent muscle and strength loss. Wearing the BFR bands intermittently 1-2 times a day even while sedentary is beneficial compared to not using BFR.

BFR show promise during times you might be recovering from surgery or plantar fasciitis. Whenever you’ve got weight bearing restrictions for a period of time and are unable to apply pressure to a limb, or you’re on crutches. For someone undergoing treatment with low energy levels deeming a regular exercise plan implausible, this opens up possibilities to prevent a downward spiral that can easily occur. The BFR bands may provide a means for sparing what can be devastating muscle losses, often the beginning of weakness if not frailty, making falls more likely.

Would You Like Support?

Interested in more information? The best next step is to get STRONGER! When I open the doors for enrollment a few times a year you’ll be the first to know. Click here.

I’m including some BFR training in this 12-week resistance training program. Whether you’re more athletic and want to keep your hormones balanced (not stressed) or you have limits about how much you can lift, or find it hard to reach intensity levels you need…. This is for you!

*Links to the Flipping 50 Amazon store will result in a small commission for me if you choose to purchase from that link.

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