A decade ago, Dr Amy Shah was constantly on the go.
'I was 37, my kids were young, I had a medical practice, and from the outside it looked like everything was going great,' she says. Inside, however, Dr Shah felt like she was 'falling apart'.
'I was always rushing,' she says. 'My cortisol, my adrenaline, was always going.' Rest felt like weakness. 'I thought that sleeping, stopping or going for a walk outside were for people who were retired or lazy.'
Her health and diet were negatively impacted by this constant state of alert. 'I would rush out the door on coffee, skip meals, graze on cookies and chocolate in the staff room, push through high-intensity workouts, stay up too late, and then do it all again,' says Shah. 'I told myself this was just what being a busy working mother looked like'.
As she entered the perimenopause (the transitional phase before menopause when a woman's hormone levels -- especially estrogen and progesterone -- begin to fluctuate and gradually decline), Shah also noticed her figure start to change. For example, she was putting on a lot of weight around her middle. 'I hated the person in the mirror. I hated what I looked like. Plus, I hated how I felt, and I hated how I interacted with the world, like I was just not a nice person,' she says.
Then came her wake-up call.
'Everything in my body was saying no, but I stayed anyway,' says Dr Amy Shah, who was concerned about looking like a less-than-dedicated working mum
Amid all the rushing and overwhelm came a day when a colleague asked for a last-minute meeting with Shah, just before she was supposed to leave work to pick up her kids from karate. 'Everything in my body was saying no, but I stayed anyway,' says Shah, who was concerned about looking like a less-than-dedicated working mum.
'When it finally ended, I ran out, already late, and drove off in a panic. As I crossed near the karate centre, I got into huge car accident,' she explains. 'The car was spinning and spinning, and all of the airbags went off, and everything came crashing on to me.'
'Even then, my first thought wasn't about my safety, it was "oh my God, I need to rush to the karate centre, because the lady's going to be so mad at me because I'm so late". It was only later that I realised, "This is it. I need to make a change. I can't live like this any more."'
From that moment on, Shah has spent the last decade reinventing her life - and helping others do the same. Here she details the changes she made that had the biggest impact - plus the wisdom she wants all middle-aged women to know.
I only do HIIT once a week
High-intensity interval training used to be a core part of Shah's regime, as she thought limited time meant she needed to push herself as hard as possible whenever she got the chance to workout. However, now she's rowed back on the amount - yet still toned up her body. How? By following the 4,3,2,1 exercise method.
'Four days a week I do something I love (such as walking, hiking, biking or swimming), three days a week weight training, two days a week I do heat therapy (such as hot yoga or a sauna) and one day I do a 'sprint' session (such as running or HIIT)' explains Shah.
The strength training is important, says Shah, because 'we reach peak bone and muscle mass around 30. After that, we either maintain it - or we lose it. If you work on it at least three times a week, you actually have the ability to be stronger than you were in your younger years.'
As for the heat therapy, 'anything you do for 20 minutes or so that raises your core body temperature helps release things called heat shock proteins, which are extremely beneficial to your hormones, to your brain, and to your metabolism,' she says.
That one sprint? 'It's shown in studies to anti-age the heart by 20 years.' Interestingly, Shah says that most people doing exercise classes never get to the 85-90% of our heart rate that is required from this sprint session. 'The key is avoiding the exercise grey zone of constant moderate stress that spikes cortisol and leaves you hungry and depleted,' she says.
I realised that more exercise is not better - recovery matters
'I was putting so much stress on my body all at once... and I was never allowing any kind of recovery' Shah recalls of the period before her accident.
So many of us believe that more is better, she believes. 'More workouts, more stress, taking on more responsibilities. We wear exhaustion like a badge of honour.'
But, points out Shah, if you look to elite athletes, they focus just as much on recovery as they do on the training itself.
Now, Shah has changed her exercise routine to mix movement with restoration. 'I allow myself a lot more recovery, and I also mix in a lot of like sunny walks, nature hikes, things like that, that would have been considered kind of not real exercise in my old life,' she says.
Shah now aims to walk 10,000 steps a day - often more - but unlike her old exercise regime it's not about punishment. 'When I looked at the medical literature, walking is literally the best thing that you can do for your body.'
I stopped eating to get smaller. I started eating to get stronger
'For years, I followed the messaging most women hear: eat less, shrink yourself, reduce calories,' says Shah. 'Then I realized something profound. No one gives women nutrition advice to actually get stronger. It's all about getting smaller.
'As we enter our late 30s and 40s, our bodies change. Perimenopause can begin. Hormones shift. Weight redistributes - especially around the middle. I gained about 10 pounds and felt completely disconnected from my body. What helped wasn't restriction. It was structure.'
Shah has spent the last decade reinventing her life - and helping others do the same. Here she details the changes she made that had the biggest impact
Now Shah follows her 30-30-3 protocol; this means 30 grams of protein in the morning, 30 grams of fibre throughout the day and three servings of probiotic foods.
During her research she found that 'eating protein, fibre and probiotic foods are three things that scientific literature kept supporting over and over, especially for hormone health for women.'
I swapped coffee for a proper breakfast
Prior to her accident, Shah would survive off coffee for breakfast (and inevitably end up snacking on sugary treats later on). Her 30g protein breakfast has been game-changing.
'Having that amount of protein in your first meal is like a game changer, both for your brain, your hormones and your cravings for the rest of your day. Instead of coffee and chaos, I now eat a real breakfast - things like eggs with vegetables, Greek yogurt, probiotic cottage cheese and tofu scramble. Then I build the rest of my day around fibre-rich foods and fermented foods.'
I prioritise getting enough fibre in my diet
A staggering 95% of people don't get enough fibre in their diet, according to Shah.
'Fibre is one of the strongest predictors of longevity and hormone health, yet we barely talk about it,' she says.Her top foods for increasing your fibre intake include chia seeds (5 grams of fibre per tablespoon) and raspberries (8 grams of fibre per serving). Others include avocado,lentils,beans - simple foods with a powerful impact.
I have probiotics with every meal
'Probiotic foods are essential for our hormones,' says Shah. 'They were part of our culture not too long ago,but with the advent of all kinds of processing,we're able to make foods without fermentation,and so they've really dropped by the wayside.'
This is unfortunate,says Shah,because 'When we look at groups of people who eat fermented foods they have about 18% lower inflammation in their body.One of the biggest,easiest ways we can lower inflammation in our body and become healthier is by incorporating those foods into our life.'
Probiotic foods Shah incorporates into her meals include yogurt,kefir,sauerkraut,kimchi and miso.
'I'll have something in the morning - a little bit of yogurt or probiotic cottage cheese with my breakfast - then I'll add either some sauerkraut or raw apple cider vinegar to my lunch;' she says.'The third one will either be a kefir or kombucha in the evening with my dinner.So with every meal,you’re adding a little bit of probiotic.'
I don't white-knuckle my snack cravings
It's all very well eating healthy meals,but most of us are familiar with that 3pm biscuit craving,or the sudden desire to down a bar of chocolate when you're sitting in front of the TV at 8.30pm.
'I usually try not to eat anything two to three hours before bed - and if you do want to,I advise it be something small,' says Shah.
One of her big tricks for cravings in general,howerver,is to 'pair it smartly.'
So;if you suddenly want something chocolate,having it but 'pairing it with some protein and fibre.' Add chocolate to yogurt with chia seeds.Crumble a cookie over protein-rich yogurt.You still get satisfaction but buffer blood sugar spike and hormonal fallout.
I realised that my circadian rhythm was not optional
'One of the biggest changes I made had nothing to do with calories,' says Shah.Instead it was about embracing her body's natural circadian rhythm; 'getting sunlight in the day,and darkness at night.'
'When you are outside in the day and you get darkness at night,it improves your energy levels and your mood and hormones in ways that are even hard to quantify,' says Shah.'My advice is simple:first thing in the morning before you dive into everything else...you step outside just for a couple minutes—even if it’s two to five minutes.It sounds small,but it can have a huge impact.'
I stopped accepting that everything negative was 'just ageing'
'One of the biggest things I want women to hear,is that you don't have to feel rubbish and think "this is all a normal part of ageing,"' says Shah.'It's not normal to feel tired all the time,to feel out of control,to have sleep issues,and to feel that your hormones are all out of whack.'
I stopped trying to be a superwoman
The final shift wasn't nutritional or physiological.It was psychological.'I decided that I'm not going to do it all,'said Shah.'Trying to do everything was costing me my health,my patience,and my joy.Doing it all just means you're pleasing everybody else.'
Now she prioritises what truly matters - her children,meaningful work,and her health - and outsources anything else she can.'The biggest thing that I've noticed in my life is like slowing down actually has improved my life in so many ways,'she says.'I'm more patient,more present and more myself.It's the healthiest I've ever been.'