What We're Still Getting Wrong About Women's Health & Fitness: Dr. Stacy Sims Live

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Are you happy to have fun today? I think this promises to be a potentially life-altering conversation with one of the world's most renowned exercise pathologists and nutrition specialists. So without further ado, let's welcome the wonderful Stacey Sims. Thank you.

Stacey's what a delight to have you here today. I'm so excited to talk to you.

And I want to start with just the quote that gets the most traffic.

This thing that you constantly refer to, this idea that women are not small men. So what do you mean by that? What are you trying to communicate?

“Yeah, I think a lot of people don't really understand the biological and physiological factors”

that make us XX versus XY. Because from a cultural standpoint, you go in any shop and you have the men's section, the women's section, and it doesn't really matter, like you just go where you want to go. But when we're looking at scientific research, we're looking at health outcomes. We know that most of the research in health and sports sciences have been done on men

and generalized women, even small things like aspirin for heart attack. There were no women who were in the original study, so they're looking at men and generalized and women, same with osteoporosis research. So when we start going, women are not small men, it's because we, as women, deserve to have research done on our bodies and our physiology.

Because the dose of the X chromosome changes, if you have a double X versus the X, Y. And we see this from in Euro all the way through aging processes and into death. So the women are not small men kind of started as a funny when I was teaching in the afternoon and trying to wake my students up and was teaching sex differences in training principles and practice.

Women are not small men and this is why in the cardiovascular system. And then when I started as a sport nutrition company way back, we started with a women's line and the tagline was women are not small men to differentiate. And then that just became a rezoning mantra for so many people. How did we get here?

Why is it that so much of the fitness and dietary advice that you see out there is really oriented around men and not women? This is more of a historical kind of question to ask. If we think about the origins of medicine and science, women were not invited into the room. Because they were as much as I loved Darwin.

I also don't like him because he said women had smaller brains. And when we're looking at the origin of scientific design, it was a men in the room. And women weren't even thought of as we need to include them. Because at that point no one really thought that women could be different. They were just smaller versions of men.

So the origins of the scientific design of medicine all came through the male lens. But as we've progressed in sciences progress, we realize that that's not really adequate. So now we're looking retrospectively, well, how do we really look at women in a different light? How do we really investigate their physiology?

So we're going back and we're looking at methods.

“How do we actually nail methods down to accommodate for things like the menstrual cycle?”

Even that isn't really nailed down yet. We start looking at it's 2026. We don't have an answer for PCOS or endometriosis. Why? Because of the patriarchal way that medicine and science started and how ingrained it is in all

of society. So there is a little bit of a push now. I should say a little a big push now to really look at scientific methods and make sure that we are including women not from a hormonal status, but from a biological genetic status of XX.

So your sense is it is changing, maybe not changing fast enough, but there is change of

foot. Yes. Yes. What is the main thing that we need to understand about the fundamental differences at play here before we get into the specifics?

“How is it and why is it that women are different, what are those differences?”

So one of the studies that I was talking to Mary Claire about and she didn't even know this and she is an OB is in utero. We see that a woman who is pregnant with a baby in XX or a boy baby is under high emotional and environmental stress will have a higher chance of miscarrying than if she was carrying an XX because we see that some of the genetic coding that really protects an XX fetus

is driven by some of the epigenetic stressors at the mom experiences.

And then after the baby is born, we think that kids are pretty similar, but you'll see through development. They're just inherent things that boys will gravitate to versus girls. And then when we look at purity, the changes that have in it purity. We see that girls with the epigenetic exposure of their XX hormones, we see a shift in our

biomechanics. So women's heart hips will widen, their shoulder girdle widens to accommodate for the

“widening of the hips and that happens because in a reproductive sense, you need wider”

hips to have a baby with that we also see a really fast lengthening of our extremities. So women become more quad dominant and so they have to really relearn how to do all the fundamentals. And this is one of the play factors of why girls drop out of sport because their body

doesn't feel like themselves, whereas boys at puberty will get stronger and fitter or faster,

more aggressive because of testosterone. And then as we go through our reproductive years, we have ultimate changes in the reproductive years. No one really has a regular menstrual cycle, and even within that there's variation from month to month.

If you're traveling, if you're not day light, that kind of stuff. And then we have things hormonal contraception, IUDs, then you might have PCS, and no metriosis, all these things that affect women, but inherently, even aging is different. We know that not associate with hormones, women have more dysfunction than one of their proteins from muscle contraction that makes them lose power and strength early before they

lose actual muscle mass, whereas men don't have that dysfunction, they just lose muscle mass. So we're looking at aging from biological sex difference. We have to really say, are you x, y, or are you x, x because the aging factors differentiate not from a sex hormone decline, but actually from what's happening from a genetic code.

And I mean, I could spend the whole time talking about cardiovascular system, how our lungs are smaller. We have less hemoglobin, we have less oxygen hearing capacity from a sports standpoint. We also see differences in mood and anxiety, compared to men and women under the same stress. We also see that women become less, their bodies become less accommodating for cortisol

stress, even if they're exposed to the same stress, there were as men do. So they have less extremities of cortisol peaks when they're stressed with the same stress. So it becomes this whole big thing of, okay, it's becoming very complex. But if we just kind of look at male and male data, it'll be good enough, but it's not. Well, maybe the easiest way into this conversation is to start with a very common question

that a lot of women face when they enter parent menopause, which is, why is it that

“the things I used to do are no longer working, why is it so difficult for me to lose weight?”

I'm gaining weight and everything that I used to do to manage my weight and my well-being seems ineffective of all of a sudden. Yeah, and this is some new research that's coming out that's really interesting. So we're teasing out aging versus what's happening in parent menopause. So we used to think that the symptoms associated with parent menopause was just based

on hormonal dysfunction, because usually when you're thinking about what's happening in parent menopause, you're having more and more what we call an ovulatory cycles. So if you don't ovulate, then you don't produce progesterone. So you start to have wild disruption in our ratios of estrogen and progesterone. Why that is important is because we have estrogen progesterone receptors in every system of

our body. So as I was saying, it purity how everything changes, because of the epigenetic exposure of estrogen and progesterone. Same thing is happening because there are no wind down, and our body becomes very sympathetic driven.

The other thing that happens with it is all of our metabolism goes down. So our resting metabolism decreases, our sleep metabolism decreases. The energetics required for bone and bone turnover or muscle turnover also decreases, because the body is under extreme stress. So we see at any point when the body is under extreme stress, it starts to wind down its

So this is attributing to some of the weight gain.

We also see that about four years before that one point in time and menopause is an incredible

decrease in our gut microbiome diversity, which then exacerbates the body's ability to store body fat, because we start having an overgrowth of the phyla that is Obesigenic or prefers to grab all of the energy out of all the food they're eating and make you crave simple carbohydrates.

“What is the root cause of the microbiome dysregulation?”

This is your drop of your sex hormones because we look at how sex hormones are metabolized and distributed through the body. There's a point where it is, our sex hormones are released and then they are bound with sex hormone binding globulin to be effective in their work. This is excreted into the intestines through bio and then unconjugated or taken off the sex

hormone binding globulin and shot back out in circulation.

So our gut bugs do that. As we start losing our sex hormones or having wide variations in estrogen and progesterone and to some extent testosterone, those gut bugs die off. So what happens because the body is extremely stress and sympathetically driven, the phyla that it really thrives in those stressful situations starts to overgrow and unfortunately

that is that Obesigenic phyla, which is why when we start looking at what is one of the big things that women can do is increase the fiber and diversity in their diet to make sure that gut microbiome diversity stays. And also downstream of these hormonal shifts is correct me if I'm wrong.

“Is this signaling to the body that it needs to conserve its fat and its energy stores, right?”

So in conjunction with the kind of microbiome changes, is that hormonal signaling that's leading to a retention of that visceral fat and belly fat? Yes. And we know that estrogen is a very strong anti-inflammatory agent. So as that starts to decrease, we have a conversation that is happening between the liver

and free fatty acids. And because there is more inflammation in the body, the way the body responds is to change the molecular structure of free fatty acids to make them what they're called estrified and estrified as stored as visceral fat. So it's like we have this very stress body.

We have all of these things that are happening as causing inflammation. Our main driver of anti-inflammatory responses is decreasing. So then the responses we are in this tizzy, we have to be able to conserve things, have extra fuel. So we're going to down-regulate the things that take a lot of energy, which is bone and muscle.

We're going to up-regulate the storage of things that will provide fuel which is fat. And how does that evolve as women age up in the menopause from perimenopause? So it happens all across menopause. If we don't do anything, we're going to have significant body composition change. And we know that the peak of all the changes is the two years before that one point on the

calendar called menopause. In postmenopause, early postmenopause, we start to see some leveling out and then things start to get better on the other side. We're not going to have any real change in body composition unless you make an active effort to do things during perimenopause and also when you get to postmenopause.

If you haven't done anything, it's not too late.

So we always look at an exercise stress to create an adaptive response as well as what kind

of nutrition we're putting in to really support and kind of counter all the negativity that's happening in the body. Because we know that feedback mechanisms and some of the adaptation mechanisms from exercise stress really do increase anti-inflammatory responses, changes in epigenetic protein or causes in epigenetic response within the cells to be able to pull more glucose in without insulin.

So there are many, many things that we can do without pharmaceuticals for the most part to counter what's happening to the body, to improve body composition and mental health, to carry women through perimenopause and have a better baseline at postmenopause and keep building. But before we tease out some of those specific counters, what in your mind is the biggest

myth or misconception that gets propagated out there about this phase of life for women. That it's something we'd be afraid of because we see now that there is so much fear factor in the marketing around it that you shouldn't do high intensity exercise.

“You're going to get a cortisol belly, you're going to break your bones, you need to take”

this supplement, you need to take MHT, you need to do all of these things and in the reality come fragile. Right. And you become fragile. And in reality, we have to change that conversation, like let's do the basics, let's hit

the good sleep, the exercise, the nutrition, the mindfulness and community and then we build

But so many people will get so afraid that they drop out of everything that they're doing

“because one, they don't know what's going on and two, they feel awful, they don't want”

to exercise and then they feel like they're letting their friends down if they're the slow person in the group or they're not motivated or the headpour sleep. So it's like let's change that conversation and power them to understand what's going on. So they're not afraid and they can still keep doing all the things they love but with modifications.

So we're going to talk about nutrition, we're going to talk about fitness and then other just general daily lifestyle habits. But these things all overlap, like the Venn diagram overlaps. But let's begin with nutrition, you have a very specific kind of take on how women should be eating as they're, you know, inching into their later decades.

So what is your thesis on this? I've been doing a lot of reading and have some colleagues who are in the chronobiological world of research and what I really want women to understand is they're circadian rhythm. So men and women have different circadian rhythms where women's is a little bit shorter than men's and our circadian rhythm is tightly tied to different hormone pulses.

So hormones don't rise and fall in a linear fashion and they're pulsed out throughout the day. It says not only our sex hormones but our appetite hormones, it's our thyroid, everything that is part of the endocrine system. So if we are doing something like holding a fast to 11 or so and we are eating in a small

window because we'll stop eating at six because then we want to sleep well.

We have effectively phase shift or circadian rhythm because the most powerful ways that

you can change your circadian rhythm is light and dark and food intake. So if you wake up and you're withholding food and maybe you're exercising or not and you're

“going through a stressful day, the body is like, well wait, what's going on?”

So we know that the hypothalamus comes into play because when a woman wakes up with her cortisol awakening response, that peak is higher than a man's. And with that comes acylated garylin, which is the active form of our hunger hormone and P-Y-Y-Y-Peptid-Y-Y, which is appetite suppressants, so it's a counter. If you don't have food, then with the rise in cortisol, it kind of stays elevated which

keeps that acylated garylin active and the peptide-Y-Y can't make you not feel hungry. So the hypothalamus is going, wait, what's going on? So then we start having a cascade of responses that starts to downregulate things like your incidental movement. We see less incidental movement, we see more of the walling in the afternoon.

We see more of a craving for simple carbohydrates in the afternoon because your body feels like it's in such a fatigue state. And then in that smaller window of eating that women are holding a fast, they are necessarily getting all the micronutrients they have, but then we also see from population research for those people who hold a fast later, they end up with no metabolic control that

a fast is supposed to give them. So when we start looking at how should women eat, like let's work with a circadian rhythm. We know that you want to eat within a half an hour so as you wake up, it doesn't have to be a large meal, but just enough to bring blood sugar up and signal the yes, there's some nutrition coming on.

Then we look at having protein and fiber at every eating opportunities. So that said, every meal, every snack, we want to stop eating with dinner, don't eat after dinner so that you have a good two to three hours before bed and then you have your overnight sleep, where you're having all your reparation. So for thinking about fasting, if you don't eat at seven or you stop eating at seven and

then you wake up at seven and then you don't have breakfast, so seven, third year, eight,

you're looking at a 12, 12 and a half, 13 hour fast, time or strict eating. So you're getting the benefit of having a break from eating as you are going in tonight, which has been official. It's how your body works, but then you're not interfering with key signals throughout the day that your body relies on to be able to overcome stress and be stressed, resilient

to have cognition and focus and to be able to understand what an exercise stress is and recover from it. So I think that there's this whole disconnect of like, I need to fast and whole calories because I've heard about all this stuff, how fasting helps with the top of G and helps with parasympathetic and tell a mirror length and metabolic control, but that's from male

data. So we start looking at the female data and looking at chronobiology, we see that

“the best way a woman can eat is according to eating during the day, fueling at hand and”

then having that break overnight. So we're not phase shifting, we're not going to bed with a full stomach where we can't get into a deep sleep and we are actually able to follow that rhythm, which improves our oxidative capacities, it improves our anti-inflammatory capacities and by the way, it improves our sleep.

How does everything you just shared correlate with a woman's age? Does this become more acute, the older that you get or did these principles apply across the board irrespective

Well, the circadian rhythm doesn't change with age, but what does change is sleep and

“sleep architecture? So the biggest problem that a lot of women have when they hit their”

40s onwards is sleep and having a lot of difficulty sleeping. And we see, yeah, there's a change in serotonin and melatonin production partly because of gut bug changes, but also we become more sympatheticly driven. So we're really trying to improve sleep. Then we want to really pay attention to what we're doing in the day. Because if you're eating well in the day in front of learning calories, then you aren't going to be sympatheticly

driven and unable to get into a parasympathetic response for good sleep. Why do we want good sleep? Because we can't have any kind of metabolic or body composition change if we have poor sleep. And that's the biggest fleeting factor, especially when we get into parasympathetic response with changes in body comp. And the inability to sleep and then they're fighting back and they're trying fat diets or they're trying to hold a fast and

“it's interrupting sleep even more, which becomes a big cascade of events where it's like”

just hold up. Let's look how the body works. Let's look at that circadian rhythm. Let's work on sleep. Because once we get sleep nailed down, become more stress resilient, your body can start making changes. It seems like those principles would apply to men also. You would think, right? But we see that face shifting is more difficult in men, because they are not as sensitive to calorie changes in nutrient density as women are. I pull a lot of the

examples out of what we call low energy availability, which is really high in active women and men. And we see that the calorie kind of intake bare minimum for women before they start have dysfunction is around 30 calories per kilogram of fat free mass, but for minutes 15. So we're looking at the baseline level for nutrient needs. It's different. So men can hold a fast and they're not going to get dysregulation. They're not going to have necessary changes

“in their pulses, because it's not a strong of a stimulus for change as it is for women.”

It becomes more of a protective factor from a biological standpoint. If there isn't a lot of

nutrition around, women's bodies start to really conserve. Right. So the translation is basically,

if men are undergoing some kind of fasting protocol intermittent fasting or whatnot, they're able to lean out and still maintain or build lean muscle mass. Whereas women's bodies, the signal is conserved. And so they're going to retain that fat. So the fasting is at cross purposes with the aim. Right. Granted, of course, they're outliers. Like if you have a really significantly obese woman, then fasting can be beneficial. Because we're trying to get

control and see we see that fasting can be more beneficial than severe calorie restriction. But when do we break the fast? Is the question right? So if we're looking at a woman who is obese and trying to get control, it's not breaking the fast late. It's breaking the fast early and then having the fasting window or the eating window in the day and then stopping eating it like four. So you have a long or overnight fast. It's not about working in the in the morning, because even in women who

aren't active, they still have this circadian disruption. Yeah. That was my question. I mean, obviously, if you're obese, that's a set up for a cascade of all kinds of lifestyle ailments. And I can understand why a fasting protocol would be efficacious in that regard. But what about, like how much of this is applicable to someone like yourself who is super fit, very active, versus the average 40 plus or 50 plus year old woman who doesn't not hear in there. But also

is working full time and as a mom and has all of these other kind of stressors or pressures in their life. Is there a use case where fasting might be beneficial from your perspective or you're taking it off the board? I'm taking the traditional idea of holding your fast to 11 or 12 off the board. Um, and that is, I'm like, I look like I'm really super fit and everything, but I'm not. I'm the mom who's rushing around and I have a really hard time like, yeah, yeah, you know, masks. I don't have

a lot of time to train, but no, across the board. It's like, Sun's out, guns out. Yeah, I wish. Yeah. Now, I got harassed last weekend because I wore jacket on stage. You'd be like, where are your arms? Oh, yeah. No, it was a thing. Um, but no, if we're looking at like the traditional case that I have, that'll come see me and say, I really, really need help is a woman who is intermittent 40s has two kids, super busy having intermittent sleep issues, highly stressed. Um,

exercises when she can. She's trying to, you know, eat clean, do all the things and she's like,

help. But then it's like she leans into, it's really easy not to eat first thing in the morning

because I'm so busy. I have a training session with my friends or I go to the gym at five and I get

and then it's like 10 o'clock before I've had any food. The very first thing that I do is like,

“let's re-examine the morning. Yes, I'm not going to have you have a full meal before you go work”

out at five or six in the morning, but let's have something something really small. We know that Abby Smith Ryan, who's a researcher at UNC has done research in this and shows that just 10 grams of protein before string training program significantly helps avoid phase shift and improves exercise adaptations. If you're going to do cardiovascular type work like a string circuit or putting in some metcon in there, adding 30 grams of carbohydrate to that does the same thing. So we just look, it's like,

how do we support the body in the times of stress where it actually needs nutrition? Because then we're avoiding any kind of phase shift and when women start to adopt that and even if it is just

the infamous protein coffee, they're like, oh my gosh, I feel better in my work out. I have more

clarity in the day. I have energy. Then when the three o'clock slump comes, I'm not craving symbol carbohydrates. I can actually reach for something that's good so that when I get home, yeah, I'm stressed and I'm tired from the day, but I'm not at that tipping point where I just can't

“deal anymore. So it becomes really important for the normal, really highly stressed woman,”

technology, the fact that not eating is not good. It doesn't make you stress resilient. It actually exacerbates the condition. But you can imagine the vicious cycle of, oh my goodness, I'm putting on weight. I'm working out more than I used to and I still can't seem to manage this. So I'm going to eat less so I'm going to skip breakfast or and then that impairs appetite control later in the day and you have all these sort of energy, lulls, etc. And you're just compounding the

problem. 100% see it all the time, especially in the age group of women who are in mid to late parry menopause, postmenopause that grew up with the supermodels and the cape mosses and the ideal that skinny is vast. And I hear the rhetoric all the time. I'm just trying to lose weight. But in order to lose weight in a highly stressed situation, you're not even a highly stressed situation, need food. So when I tell people, you actually need to eat more to lose weight. We need to look

at the quality and not volume of training. You actually need to eat more. And it's a mind switch. And people like what? I need to eat more, I guess. But it's not like calories. We don't talk about calories and calories out. We talk about the quality of the food and the timing of the food. And once we start getting that in place, then the body composition changes.

“In the Stacey Sims hierarchy of needs, though, sleep, it seems, is it the top of that pyramid?”

Nutrition and exercise can inform your sleep hygiene. But first things first, you got to dial in your

sleep. Yep. Yes, you do. One of the things you, you have also said is that women are often more metabolically flexible than men. So what does that mean? I mean, you're dancing around it in everything that you just share, but maybe just drill down on that. So when we talk about metabolic flexibility, this is where a lot of those own two stuff came out. Like we need to be able to train our bodies to burn more free fatty acids. And we look there is this is where we have

sex differences, not hormone factors. Sex differences that occur within the muscle itself. So women are born with more of the endurance type fibers or are slow twitch fibers. We're also born with more mitochondria, protein for mitochondria, respiration. So that means a more robust ability to use free fatty acids. And this is why we see women can go really long and slow without so much fuel. Men on the other hand are more, more fast twitch and glycolic fibers. And so they actually

have to do more of the long slow training to enhance their fibers to be able to build more mitochondria to be able to use more free fatty acids. The other thing is when we look at a reproductive years for women, they go through times of relying more on carbohydrate versus relying more on fat depending on ovulation and progesterone. Because after ovulation, the body is taking a whole bunch of carbohydrate to grow this really lush uterine lining in case an egg is implanted. So we

have more glycogen being stored in the uterus than we do in the muscles. So when we start looking at carbohydrate versus fat and exercise adaptations with carbohydrate versus fat, women are already metabolically flexible by the nature of the sex hormone coming into play. So we start looking at metabolic flexibility and the issue with that. It should we be telling every woman that we need to be doing zone two to improve free fatty acid metabolism, not necessarily,

because we already are metabolically capable of using those free fatty acids. Do we need it become more metabolically flexible? Well, actually no, because our body is already metabolically flexible. It's learned that. We start having hormone dysfunction. Yes, there is an uptick of not

right kind of exercise, then we are creating an environment where we become more metabolically flexible and can use that carbohydrate really well. So this is where we start getting into how older you, you're not getting any change. What you're doing isn't working for you. So yeah, let's look at how we can modify what you're doing to create an exercise stress that's actually going to create an adaptation the way hormones use the support or the way that you're training used to.

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Let me just back up and say, basically on this idea of like a cascade of wrongs,

like you're in this phase of life, what you have done in the past isn't working,

“you're off your rhythm in terms of what you need to be doing nutritionally,”

but you're kind of literally and figuratively on this treadmill, where you're just upping the cardio because that's the solution to the weight gain problem, right? And so the nutrition's off, the sleep's off, but you're doubling down on the orange theory and at 45 and all of these fitness classes, what say you, Dr. Stacey Sims? So I'm going to preface it with any movement as good movement, right? And I come from it from how do we optimize? So if I'm looking at a woman

who's journey is, I'm just going to start exercising because I'm having all these changes and I don't know what to do. Then yeah, do what you love. But if we're looking to optimize, we want to make sure that we're really polarizing the exercise. So this is where we're very specific in our interval or interval training. We're very specific in the type of strength training we're doing because we know

“that any beginner is going to get massive gains, but as you are more and more trained, you have to”

really look at what kind of stress you're putting on the body to get absolute change. So if we're looking at someone who has been a lifelong exerciseer and has been doing lots of running, doesn't really like strength training. Stirs to have body composition change and it's like, oh, I need to do some high intensity work and our friend goes to F45. Hey, come join me. And this is

in the first couple of months. See some change. But after that, it's not, there's nothing,

“there's going to be no change because it's not truly high intensity work. So we're looking at an F45”

or an orange theory. You're sitting 45 minutes at an intensity that is in high intensity. It feels that way because we've all been conditioned to come out of a workout feeling really sweaty and wasted, but that's not effective. And I say that because when we look at the intensity needed to invoke change has to be really, really strong. This is a survival mechanism for the body. So we're looking at high intensity exercise. 45 minutes is really moderate intensity. So it's not

hard enough to be hard to invoke change. It's not easy enough to be easy for recovery. It's just kind of put you in the middle. So then we start to see an increase in cortisol. We don't have a post-exercise

response for growth hormone and we don't have a post-exercise anti-inflammatory response. We are

sympathetically driven so that doesn't help us sleep. So it becomes a continuation of the problem that we already have. So when we start looking at optimization we have to look at okay high intensity interval training is really good when we do it right. So the Norwegian 4x4 that everyone talks about 4 minutes at about 80% where this 4 minutes feel like 4 hours. And then your 4 minutes recovery where you're like gosh that felt like 4 seconds. Because we're really working to one develop

“lactate which is really important for brain health. But too we want more metabolic control.”

So for holding a threshold intensity for 3 to 4 minutes then our body is like I need carbohydrate. So it creates a response within the muscle and in the cells to what we say translocate glute for protein. So it's taking proteins from within the cell. It's pushing to the cell wall to open up the cell wall so carbohydrate can come in without insulin. And if we do the stimulus enough then we are reducing our insulin resistance because now the body has more of these proteins.

Understand carbohydrate and glucose can come in without having to rely so much on insulin. And when we look at lactate will lactate is super important for women to produce because one we have less glycoletic and fastrich fibers than men. But too is preferred fuel for the brain. And we know that there's a massive sex difference in things like dimension Alzheimer's and part of it is our brain metabolism and dysfunction that occurs with glucose metabolism in the brain.

“So if we're introducing more lactate and the body understands what lactate is it helps”

equalize some of that metabolism which is a reduction in the risk factor for dimension cognitive decline. Did everybody follow that? You're going to be tested at the end of this. I need a flow chart. Yeah I have plenty to say about that but before I do is is anyone does anyone want any clarification on that or do you have any questions that come up about what Stacy does share? Just a question on the interval training. You know you say 40

five minutes is too long or sorry maybe not long enough but can you can you do effective training in shorter months of time? Can you do like a 30 minute workout that's as effective as 45 minutes or an hour? Is it? Yeah. And is it just like the intensity level and the break level that you need to dial in? Yeah that's more it. So I mean like if we're thinking about a 45 minute to an hour in that you would have someone that warms up early well and then leads into really dialed in

intervals. So we know it could be one to four minutes of variable of variable intensity from 82

90 percent and variable recovery. So your whole work time within that might be 20, 25 minutes with

your interval and your recovery. So then if you have a long warm up and a cool down you could easily fill up an hour but when we're looking at the classes they don't do the interval part rate so if anyone's ever been to an F45 or an orange theory I know they already have targets on me so I'm happy to just talk about them now. They don't they're all about go go go go go go go go go and they don't really explain what you're supposed to be doing or how you're supposed to be feeling

is all about the fast move and is about the sweat. It's like go go go from station to station to station should not really doing the interval properly. So this is why when you're looking at those classes yeah it's a sweat slash but what did you really get out of it? For me I don't want to take it away from people because it's their social connection. So I tell them if you understand what you're trying to do and you go these classes you can modify this classes for yourself. So you know F45

instead of doing more reps with less weight why don't you use that interval and lift heavier with less reps so that you can make it work for you and your body and still get that social connection and we're seeing that happening more and more and more in these classes where people owning it and saying I know I need this for my body and I don't want to give up the time I have with my friends or the camaraderie that comes. It's just what are you doing specifically for that

interval. Thank you. Yeah. The the TLDR of all of this is women need to be lifting heavy weight

you know some some polarization some zone ones and walking. For my perspective this gets translated and help me clarify this. This gets translated on the internet to stop doing zone two and just lift heavy weights and if I could translate a little bit what you just shared

which I'm totally on board with basically what you're talking about is most people are you know

generally unbeknownst to them engaging in like zone three. They think they're doing zone two or zone five so they're in that gray zone where they're not really developing their aerobic capacity you know getting that might a conjureal density recruiting those slow twitch fibers and increasing their ability to utilize fat for fuel and they're also not going hard enough to get the stimulus to increase muscle mass and bone density and the like and when you're in that middle

zone and your new to fitness you will like all movements good movement you will have you know you will have gains and you will get more fit but you will quickly plateau and people who are in

that zone either think they're doing the hard work or they think they're doing the zone two work

and they're not doing either. Right I mean I've had people come after me go you're such an absolutist and you're telling women things they can't do you can't do zone two you can't do this you

“must do lifting in the heavy range and you must do interval training and I come back and like look”

to optimize women who are already been exercising these are the things we know that work but I'm not saying that's the only thing they can do that's not what I do. I go to the gym three times a week specifically for lifting it's taking me a very long time to learn how to lift heavy properly and I'm also adding plyometrics in there because one of the other things that you really lose is you get older as per perception and the ability for power so it's like let's work some plyo in there.

On the weekend you're not going to find me at home or in the gym I'm either going to be out oceans swimming for a couple of hours because we have a seven k loop or I'm going to be on my gravel bike none of that is zone two or zone five it's my sulfate so when we're looking at optimizing and for women who have a very short amount of time and let's face it every woman and man who get up on purpose to exercise it oh my god it's still night is an athlete in my mind and I want people

to think like an athlete and you know from being an athlete that there's a specificity for every

“session that you do so I'm like I'm not going to tell you that you have to do high intensity interval”

training every day of the week and then throw in some heavy strength training and the only thing you can do let's look how many days do you have to exercise in a week let's optimize if we hit two high intensity sessions and we have two heavy lifting sessions that's great so what is that maybe an hour and half to two hours of your entire week so what are we going to do the rest of the time let's move how you want to I don't want to restrict anybody but we're looking to optimize for brain health

for bone health for muscle these are the things we know that work inherently really well for women who are not only having an age factor that diminishes muscle power and capabilities well as bone we also have a fluctuation in our hormones it also affect those same systems so let's look at how the body is aging and going through perimen and pause and using to optimize the body for change so women lifting heavy weight I know what do you say to the woman who says I don't want to do that

because I don't want to get all bulked up I know I hear this all the time you won't get bulky if you have a genetic predisposition for putting on a lot of muscle mass then yeah you probably will but it's really really difficult for women to get bulky and when we start looking at the power based end of ranges which is your 80% of one rep max and we're looking at that heavy load it's a neuromuscular connection that we're after we're looking at how is the nervous system now going to

come down and stimulate the muscle fibers to create a really strong contraction and a powerful

contraction we want to lift a heavy load so we have a neuromuscular connection because estrogen is not there on your side anymore and when I talk about myosin dysfunction which is you have acting in myosin is your two contractile proteins the form of myosin becomes dysfunctional with age as well as a drop in estrogen so with age we want to do some heavy power based stuff when we lose estrogen same thing because then we are changing the molecular or the isopharm of myosin so

that it will grab on to act in the way it used to and this is why the basis of that power based

“stuff is really important but the other thing is we see from a randomized control trial that”

came out last month that those people who lived on the heavy end both men and women lived on the

empowering the neurons in the prefrontal cortex more so then those people that are lifting

moderate weight or body weight those people are lifting moderate weight and body weight do affect other areas in the brain and it's like beating up increases we have a little bit more connectivity but only the heavy end of lifting really does affect the prefrontal cortex so there's a neuro plasticity exactly and essentially what you're saying is as estrogen goes down

“you need to replace that stimulus with a central nervous system stimulus and lifting heavy”

weights accomplishes that yes and then you can look at we get that increase in our neuromuscular stimulus in this pure strength and power and then if you really want to try to put lean mass on you have to eat a lot and you have to eat in the gym a lot and you have to look at what are some of the other rep ranges to cause hypertrophy because I think the confusion in the space is people are missing the mark when they're talking about strength and resistance training

or people are thinking about building muscle mass is also strength yes you're going to get strong but you're not going to get as strong as if you were to stay at the lower end and the way I try to get people to understand this is you can train to do 50 push-ups are you going to have more strength a little bit or you have a lot of muscle mass and endurance from that yes I'd rather you train to do 10 push-ups with a 20 kilo pound on your bar 20 kilo plate on your back because then we know

you're going to be strong are you going to have more endurance yeah a little bit are you going

to have more lean mass probably not that much but you're going to be really strong and powerful

and that's the eye that we want for women because we know that power strength is really really

“important for longevity it is a critical factor for how we age in a proprioception so I'm now at”

the point where I'm like let's optimize women not so that they are in the moment now aesthetics yeah that's part of it but we know that women live for a much longer period of time than men but in really poor state of health so all the things we do now is kind of banking that we aren't going to get in that poor state of health we're doing everything to protect our bones our muscle our brain our heart and these are the things that women need to start thinking

about to get really specific like how many like you're going into the gym okay how many reps like what is that how do I set the weight how many reps should I be able to do how many sets of those exercises like what would be a typical like routine like on this day I do these muscle groups and I do this many sets of this and that like what does that look like

“I mean obviously it's customized it's very specific to the person but in general sense”

so this one is hard to answer everyone is journeys different and how they approach weight strength training if you are a woman who has a long history in strength training and you're like I'm

going to start to embrace this heavy your lifting stuff first you want to periodized program so

if you're coming in you're like this is the the strength like the really hard base building part then we look at five by five and that's five reps five sets at about an eight on a scale of one to ten more talk about our rain received exertion you're working hard so meaning you could probably do two more reps or so yeah you're not going to failure correct but you probably are by the time you get to that fifth set and maybe the third or fourth rep so you are pretty much

going to failure but that's not necessarily the end goal and you're not doing a lot of every muscle group we talk about compound lifting because you have your stabilizers as well as the actual major muscle groups so maybe Monday you're doing a squat focus and it's that knee hinge type focus and then you do some subsidiaries around it so your main focus is your compound squat focus and that's your five by five then maybe you do some residual resilience or some split Bulgarian split squats

so you might be doing eight to ten reps but it's more about further fatigue the muscle and getting more of a stimulus for the strength as well as some of the muscle hypertrophy maybe Wednesday's a push pull so it's upper body you're doing overhead press major doing bench press major doing a pull so it's all the push pull and then Thursday or Friday or doing posterior chain so it's all like these are the major muscle groups and the compound movements we want you to do

but how do you do it we need you to have a program we need you to go okay I'm going to do this for six weeks and then I'm going to have a d-load and then I'm going to move into this so we're continuously adding load and we're recovering from it and then we're changing up the loads because the body likes to have a challenge so to see progress we need consistency and we need to be able to challenge the body it's very difficult to adhere to a truly periodized program without a plan

the typical experience in this applies to men and women you go to the gym you kind of have your thing you do your routine and that's just what you do and it's the equivalent of zone three I

think you know in for endurance athletes like and you just kind of hit this ceiling and you never

really see the gains because you're not taking those d-load weeks off you know you periodized daily weekly monthly yearly right to really be able to figure out how to like optimize what you're doing and you need somebody guiding you yeah and for a lot of people it's hard right and so one well there's two things I tell both men and women where you're looking in a periodized program if you don't have a coach and you don't have a plan then we're kind of wasting time but

“not really so if you want to do a quick hit let's d-load during school holidays so you know your”

kid has a week off and instead of focusing on going to the gym let's spend more time with a kid or know that that's a point where you need to de-load because the school year is broken up into

pretty good breaks where you have a week off and then maybe two weeks and then you have summer break

so you can use that as like a baseline for how am I I'm gonna focus for this before the next school break just gives you an eye to a calendar and the other thing I have for women because they're more afraid to push themselves to lift heavier I go okay I want you to go pick up the weights that you're going to use for a Romanian deadlift and I want you to tell me how many can do with that weight they'll go pick up some lighter weights they might do a set of 20 I might that's way too

light let's go pick up the next set they'll go to from like the 10s to the 12 and a half make skip the 12 and a half let's go to the 15 and there's a prize they can still do 15 reps

“without an issue so it's like really trying to challenge yourself instead of doing more reps let's”

pick up a heavier weight and it's getting that mindset of okay for this block before the next school break let's focus on lifting up a heavier weight even though you're doing the same routine let's just change up what routine you're doing by increasing the load or maybe we're doing resistance bands and some poggos as a warm up instead of a static stretch it's just small little things because I don't want people not to go to the gym I don't want to break up their consistency but it's just

reframing what they're doing by adding a little bit or taking away a little bit and breaking up the calendar and something that makes sense on the other end of the spectrum we have the high intensity work you mentioned the Norwegian 4x4 like everyone likes to talk about that that's just one example of many yeah of many of course but what is something else that somebody should like what does that look like like you're talking about like all out efforts with plenty of

recovery other than you know some kind of indoor cycling or treadmill sprint situation like what is another type of high intensity sprint based workout is the circuit training like fall into that category yes or no like what are some other options that women can think about yeah so if we think about circuit training I tell people we can go on the the aspect of every minute on the minute or every two minutes on the on the two minute where one minute you're doing one exercise and you

might have 20 seconds we get to the next one see a four exercises in a minute of recovery and then you might do that two or three times and you could do that outside on the playground right you could do air squats and then you can go into hang on the on the monkey bars you can do walking lunges you can do some setups and there's lots of availability Rebecca Rush she goes and she lifts rocks on a run so there's lots of things you can do outside of the gym and it's it's about the intent and the

“intensity it's not necessarily where you are that you have to do it so there I mean gym intimidation”

is real I get gym intimidation depending on where I am in some things and I've been in and out of gym since I was 16 so I know gym intimidation is real so I'm not going to push every woman to go to the gym might not be time effective also fear factor so let's look okay maybe we start with 10 minutes in your house and we're just doing body weight circuits where again we're doing 30 seconds on a minute off maybe we're doing a minute on a minute off just starting slow so

it does become more feasible when people start to think about that it's not about running for two

minutes on the treadmill jumping off and doing 30 second kettlebell swing 30 seconds off and then

getting back on like that's more personalized and and really high intensity but if we're a woman who's just starting this journey and she's used to walking for five miles in the morning or three mile loop during that walk let's pick up the pace or maybe you have some stairs instead of avoiding the stairs let's do a couple of ups and downs of the stairs so that becomes an intensity factor or you're meeting your friend in the park to walk your dogs well let's see let's do a

body weight circuit while we're there you walk to the end of the the you're going around the

or maybe do some jumping lunges there's lots of ways that you can fit it in but I think we've

all just been so condition that high intensity means XYZ in the gym and string training has to be in the gym or has to be I know in personal training session but it isn't like that it's like it's available to everybody we just have to know who the person is the personality do they need a body or not would they like an app or not do they want to go to the gym or not are you more of an outdoor person I go to the gym so that I can be strong enough to do things I love to do outside

I didn't go to the gym because I love it I go to the gym for protection against injury so there are a lot of people like I don't want to do the gym or want to be outside great let's see

what can we do outside that's going to hit these marks you mentioned jump training and when I hear

“that I think about bone density you know obviously when women age up you know we hear a lot”

about osteoporosis and bone density loss what are the exercises that drive bone density retention or improvement the most and what are some miss out there about that myths are rampant we're running improves bone density we think about yoga like all these modalities they don't they're not a strong enough stress so if we want to improve bone density we need a multi-directional stress coming up we ground doesn't move our body does so we want something it's really hard to

come up through the skeletal system to invoke that stimulus for for bone turnover and bone strength

when I talk about jump training so many people especially um Harry Menopausal women like I can't

my joints hurt it's like I'm not talking about plyometric high box jumps it could be something as simple as a toe raise and hard heel slam because you're dropping hard in absorbing all this forces that's a multi-directional force through the skeletal system there's a fantastic um research program over in Australia called lift more and they look at strength training and proper jump training where it's hard landing and they're getting significant improvements

and women who have had osteoporosis into the bone density of normalcy in men as well out of New Zealand as well osteo gains it's all about the kind of jumping and hard landing that you're getting not soft land we've all learned to absorb the forces and it's three minutes a few times a week to really improve bone density over the course of three or four months you mentioned plyometrics earlier i don't know that i even know what that means does that include

things like yoga and pilates no so where do those where do they fit yeah so plyometrics is power based training explosive training so this is your box jumps this is your counter movement jump so all that stuff that's really fascinating reactive um we talk about pilates in yoga uh there's a whole subgroup of people who are pilates lovers that hate me because they think i hate pilates i was in a pilates class before i got here not today but a couple of days ago i don't hate it

“i think it's really good and people should look at it as really fantastic for uh proprioception”

for balance for isometric cold we need all this stuff especially for tendons and ligaments same thing with yoga if you heard um Keith Bart talked about tendons and ligaments he really does like yoga in the last bit of the hold where you're shaking because that gives you a stress in the ligament in the tendon to instigate more plasticity and and in strength within those tendons they're complimentary they aren't strength training in the way that we're viewing strength training for brain health

and neuromuscular connection they all can all fit together so if you're someone who loves pilates you don't have to give it up but add one day of a pure strength training in if you're someone who loves yoga same thing you don't give it up it's like how are we going to change what you're doing to optimize your life i don't want anybody to give up their love it's like how are we going to look at what you're doing in the time in the week and strength training doesn't have to take

a long time it could be 10 to 15 minutes if it's focused it's not an hour and a half in a gem that you don't like so again it's the individual and how do we look at it and what are we looking

“to do i think yoga and pilates are really important as we get older because we lose”

proprioception we lose the ability for flexibility and mobility and those two modes of activity really do help with that but again it doesn't tax the bone in the muscle the way we need to to age well so little over nine months ago i underwent spinal fusion surgery and since then my focus has shifted away from chasing these really big audacious performance goals like i did in the past to now accepting my limitations in this current reality and learning how to build a daily rhythm that

actually feels sustainable for where i'm at right now today and whoop this wearable health and fitness

insights into all the things that influence how i feel and how i perform my sleep my recovery my

strain and my overall health so that i can better understand how my habits are influencing how i feel and what's interesting is how these insights translate beyond training better sleep changes improve how i show up at work recovery changes how patient i am with my family and when i'm planning for bigger goals like lining up to participate in the New York City marathon to celebrate my 60th birthday this fall whoop helps me stay grounded in what my body needs right now not what

“my ego wants it to do or what i used to be able to do and i think that's really what adding”

more life to your years needs making decisions today that allow you to show up more fully tomorrow

go to join dot woop dot com slash roll for one month free of work

eight is what time i typically go to bed for those of you wondering how i managed working out it for a m because eight hours of sleep is not negotiable for me as for ensuring i get eight quality hours this is where eight sleep comes in a smart cover that goes on your existing mattress and cools or heats each side of the bed from 55 to 110 degrees so you can find your ideal sleep temperature and stay there all night why is this important what eight sleep does and does

extremely well is ensure the optimal temperature conducive to optimal sleep which it does by tracking your sleep and recovery automatically no wearable required and using that data to make adjustments

over time to hone in on exactly the best temperature changes throughout the night to produce the

deepest most restorative sleep states the result up to 34% more deep sleep individual results may

“vary but for me it's the difference between waking up foggy and actually feeling rested honestly”

eight sleep just might be my favorite possession i honestly can't imagine life without it i want everyone to sleep as well as i do because once you do it really is utterly life changing use my code ritual at atsleep.com/ritual for up to $350 off the pod five ultra that's atsleep.com/ritual from a weight management perspective what is your message to the person who says you're asking me to dial back my favorite aerobic exercise that i've relied upon for decades to keep my weight

in check and you want me doing three to five reps of these heavy weight like how is that going to impact like my bottom line which is like i got to keep the weight you know yeah i like to talk about what we stand again not what we stand a lose because in the diet culture it's all about weight

“loss and fat loss i'm very conscious not to say those words i don't use them on my youtube channel”

i don't want to instigate anything about loss i want to think about what we what we stand to gain if we get into the weight room we stand to gain muscle muscle is a very active tissue that helps regulate all sorts of things body weight our blood glucose our immunity to so many things we get into the gym we're also projecting our bones so we stand to gain so much more from those few times in the gym then we do pounding and increasing cortisol doing our favorite aerobic

90 minute aerobic session and when we start thinking about what do we stand to gain more in the gym and gaining all those things for brain health and muscle health and bone health and longevity versus what we stand to lose if we stop doing the 90 minutes we actually aren't losing if we stop doing the 90 minutes we're gaining so much more because if we're looking at the more muscle that we have and the more muscle centric we are and the more that your body composition is in a

better place and it is it's really hard for all of us that grew up in the idea of 90 minutes step aerobics and going for a massive long run on the weekend and all of these things to keep our weight in check we're doing fasted training because it keeps our weight in check when we get this mental shift of being in the gym to help with all that it's time effective and we also see significant body composition change but it is a significant work on the brain to do that a lot

of times the body system is really helpful because you don't want to let a friend down if you're both starting on this journey sometimes all have run groups are like we're going to start the run with doing some strength training and then we're going to now we've prep the muscles that you're going to run more effectively and more economically so it reduces injury risk so then we can

love let's get in let's do these these preps and let's stimulate the muscle in a way that it does

“I made a big to do about this being participatory I don't think I've actually lived up to that so”

like let's get some questions the others one in the back there I was just curious regarding where you're saying earlier regarding circadian rhythms and how it pertains to the optimal time for women to fuel and you know start their day with nutrition and everything else how does that factor into training schedules is there an optimal time of day for women to train and how does that compare with men I don't know that hasn't actually been done from a research standpoint

we know from behavioral standpoint that anybody who exercises first thing in the morning is probably going to stick with what they're doing we also see at the end of the day tends to drive a little bit more low energy availability and sleep disruption because people are going into a session not that well fueled or they come home and it's too late they don't feel that hungry or they feel hungry and our before beds so they overeat and that's both men and women so from a

behavioral standpoint we always try to say let's do more in the morning if we can but really fit it in

“and if you have to do it and there are things that we can do to help mitigate metabolism”

and help with the refueling and help with sleep they do we need some women questions yeah okay I have a question this is Sarah thank you for basically outlining my upcoming nutrition and workout plan you're welcome that'll be $8,000 okay thank you so for the interval piece that you're mentioning you just kind of mapped a few different versions of that are there specific modalities or movements within that interval plan that you would consider more optimized than others

right you mentioned a few few movements in there but like is cycling versus running versus mixed movement more optimized you know whatever you like whatever is going to motivate you if you're

learning how to go super hard I always tell people to get on the salt bike with a friend next to them

telling them go go go go go because you cannot cheat on the salt bike once you know what that

“feels like then anything goes we are very behind on the research and women's bodies are complex”

how do we get there faster so that we can know more and make more advances in women's health this becomes a group of people working together because we see especially in academics or in academia and in the research world there's lots of silos and people are like elbows out this is my realm but there is quite a group of us that are coming together to really try to close that gap finding that I'm an expert one thing but I'm not an expert in all things that Emily's an expert in

so it's like let's gravitate and bring all of us together because we can really put an impact on and have a louder voice and find money and grants and distribute it and then part of it is we're launching company about that same thing where we're going after AI and we're really vetting research to be able to give output an insight for women that's going to drive research and improve the touch points so there's behind the scenes we're all really trying to close that

gap and address the funding issue and find innovative ways to actually go after that but it isn't it isn't an individual it's a team and we're finding that there is a really good group of men and women who are doing research in the space that are coming together and being complimentary to really hone in and try to close that gap and in the different areas we have the oncology area that is really booming with all sorts of different techniques and you have a lot of researchers

coming together help each other, same in the sports space, same in the reproductive rights and reproductive research space so it's an exciting time. Hi thanks to Ambrose. I'm the dad to a 14-year-old young woman and I want to be the best parent I want to be the greatest parent I can to her. What are some habits that I can help and still with her and support her in and she's in this part of her growing up? Girl dads, I love girl dads. My husband's a girl dad.

So one of the biggest things is communication. A lot of times girls will shut down especially with their dads so if you just have a like we still instigate family dinner every night and have conversation. So it's like how was your day? What were some of the high points? What were some of the low points? And then at night having conversation with her and I show off load and I might just vent I'm not going to fix. So when they know that you're safe place to vent and not looking for

solutions or they know that they can come to you and say things and not be judged it's a really important especially as they're going through their teenage years. There's going to be ups and downs

not judging and they can vent it's like I told my daughter when you get to the point where you you might be going to parties and you feel unsafe call me. I'm not going to judge I'm not going to mad until maybe in the next day but I don't tell her that. She'll know now because she'll watch this

“but it's just really important to understand that both physically and mentally is an enormous change”

right now and we wouldn't do everything to foster a positive environment so it's like we don't have any kind of body language in the family so we are we talk about being strong and how fast you can run and all the things that she loves for soccer we don't talk about food in a negative way. If you want chocolate you can have some it's a sometimes food just remember your soldiers don't want to grow on sugar or soldiers or your immune system. So just really coming to a place where I understand

you I got yeah I'm not going to judge you unless I really have to because I'm the parent but for the most part the undercurrent of just being supportive because immensely far and then the other thing that is really important is your phone put it in the phone jail when you first walk in the house that way you're not on the screen all the time which becomes a habit for all of us and then they leave by example because if everyone puts their phone in the phone jail then you end up with a very safe

environment in the house. Thank you. Welcome. Hi I'm Meredith. I guess my question is about sleep.

I am chronically a terrible sleeper always have been and in the last probably 10 years it's gotten

so bad that I am well and people around me are also like looking for ways to get through the night to stay asleep to go to sleep and so it's like there's pharmaceutical options there's herbal options there's you know friends that can't go to sleep without a glass wine and I'm just curious is like is sleep sleep or does it have to be good sleep does it have to be un like sleep that naturally comes to be able to have that recovery. We want to see that you have a really good sleep

architecture because you need REM sleep you also need slow wave sleep. We know that if you're using alcohol then you don't get into slow wave which is your deep reproductive sleep. One of the things that is really effective is cognitive behavior therapy there's a group out of the Veterans Association that has ice sleep and it is was designed to help people with PTSD coming back from af again to stand to be able to sleep and it's really effective so one of the the most effective ways is

like cognitive or shuffling or some other cognitive behavior therapy with things like healthy and and magnesium theorinate across blood brain barrier to have an active part in parasympathetic

responses. It does take some time and it is a bit of a frustration when we first start but stick with

it because it significantly improves sleep and sleep architecture. Hi my name is Emily thank you so much I'm getting so much from this as a 304 year old woman you realize how little education you have on your own body and so I'm all here to optimize everything you're saying one thing I'm coming to is working with the cycles of my body especially as someone who has endometriosis and it's on a fertility journey so I hear about these three to five workouts a week and then I think about

how I might be during my period or something like that. What are some of the ways that we can help to support ourselves instead of looking at every week is the same I know that that's where I'm

“gonna drop off with that consistency. Yeah so it's it's doing that three times a week you should”

be doing strange training right so doesn't mean you have to go do the same thing every Monday every Wednesday every Thursday or Friday. No you have your periodized by him but sometimes you're going like I just want to lift really heavy or I don't I just want to work on technique. It's it's feeling how you are and I tell people when you go to do a session there's two things you have a physical and mental and if you show up to session mentally you're a two but physically

you might be a six. Let's do a little bit of a warm-up with mobility maybe we do a couple of heavy lifts to stimulate central nervous system it's here mental goes. If your mental doesn't come up call it having active day just do what you love but most often that mental comes up and then you're like I'm super motivated I feel great so maybe your physical now comes up to an eight and your mental

comes up to an eight and people usually will give up within the first ten minutes when they come in feeling

that way but if you are doing specific things it's a kind of boost mental in this ten minutes you're like

“I'm here I feel great let's go and then again listening to your body because I think that's so”

many people disregard how you feel and the mental aspect of how you feel so if you are suffering from severe endometriosis and the symptomology that comes with it then you're not going to push yourself and that's

can be very systemic and and be very impactful so then maybe you want to look at an environmental stress

“so we look at heat and we look at cool water not ice water but cool water because those both”

induce a massive anti-inflammatory response that helps with endometriosis so instead of going and pushing yourself through exercise maybe you just look at an environmental stress one it brings more mental and parasympathetic activation to calm but it also does great things for inflammation in the body in favour of that how do things like birth control and hormone replacement therapy impact training how one how one should think about their their nutrition and just overall health and

energy levels I'd like to say we have solid answers for that but we don't because with hormonal contraception there's so many different variations of the formulas and a lot of research hasn't been done on it we do know that in general a combined oral contraception knowing that we have estrogen

“progesterone and it increases oxidative rates we see it increases inflammation so those are factors”

to consider if you're trying to adapt so we look at having more anti-inflammatory foods we look at what can we do to calm post exercise inflammation and recovery but for the most part how does it truly impact training and adaptation it's an individual response and depends on the formulation when we get to a menopause hormone therapy part of it's a wild west because we had the women's

health initiative in the states versus the UK million woman study in the UK with vastly different

outcomes so depending on where you are in the world you hear mixed messages what we do know is that when you're using menopause hormone therapy it slows a rate of change but doesn't stop it so if you're looking at body composition it isn't going to help just on its own preserve body composition it will slow the rate of the laying down of this real fat it will slow the rate of

“muscle loss but it doesn't stop it the only thing it does help we know and radically helps with”

is bone and bone density it's very protective so when someone's considering hormonal options it's like yes have an informed choice but you can't neglect the lifestyle parts that come with it and if you I have younger reproductive your clients and athletes and if they're changing their pill or they're going from a pill to an IUD we want to track how they're feeling because symptoms really will dictate how they're responding because if you feel awful you're not going to

be able to put in a good session so we want to know what the patterns are over their hormonal contraception or their IUD and if they change it how that affects them too so that we can dial back and we can push forward when we know that we have the opportunity you you open to answering that question with a sort of we don't you know we don't know enough like so what I take from that is like how is it possible that these aren't studies that are being done like

it's there's clearly not enough research being performed on this no but I will borrow from Lisa Mascone issues like we don't know this yet we have studies that are down the track and we're planning for them and she has a massive grant to really look at and a pause hormone therapy in the way it affects the brain there are other people that have along there's the menstrual cycle research group that's doing it's co-living across the world to really nail down

what's happening with hormonal contraception and the different formulations so it's in the pipe it just hasn't been done yet it's in the process of so hopefully in two to three years I'll have more definitive answers you mentioned hot and cold water so let's talk a little bit about that like sauna coal plunge everybody loves to talk about their protocol their routine you know where do you stand on this from a women's point of view women's health point of view and what's different

about women with respect to men when you're thinking about these yeah activities so this is where I bring it down to sex differences not hormonal differences there is an inherent sex difference in thermoregulation where men will start to sweat and they'll really offload heat through

sweating when they get hot but women will basically dilate first before they start sweating women's

thermoregulation baseline also switches across the menstrual cycle because progesterone increases your core temperature and the body adjusts to accommodate for that so we're looking at the sauna

so when they go there the body's like hey I know what this is and it will really improve or

metabolic control improve heat shot protein responses men will still have the same but they have to have higher or get more times in the sauna for that actual longevity if we're looking for heat acclamation it takes women longer because the body is used to the perturbation of the temperature so we see men who are doing sauna exposure for performance they need less time in there because they get big boost to cardiovascular responses faster than women so when we're looking from

health outcomes women they can tolerate the heat more they can get in there they can stay in their longer and they get more robust responses than men called different staying on sauna just to be

really specific like how long and what temperature threshold like where do you set the thermostat

“and where do you set your kind of timer on how long you need to be in to get that response yeah”

the response so in research we can't keep people in heat when their core temperature goes up above 39 and a half degrees so that's about 104 degrees Fahrenheit so when we're looking at how does that play into responses you get responses will be low that because I'm saying that because I think Brian Johnson was like I have to keep my core temperature yeah it's like no we said I hadn't been I wasn't in long enough I didn't have it hot enough I had to stay in there crazy long yeah no

that's that's hazardous like we can't get ethics to drive people to get their core temperature up so 39 five year out so we're looking at all the responses that we're seeing is well below that so we see about 38 and a half degrees so what is that I don't know quick dude did the math someone

“do you do the math on that out there because I'm just going to stay with metric as a scientist and”

someone is an expert we talk metric all the time okay I don't want to tap yes time of day duration okay time in a ideally if you can do it after training for 10 minutes it extends the training stress so you actually get more out of your training than if you were not to go in this on a but if you're timing it generally whenever you can right we know at the end of the day when you're passively dehydrated and your core temperatures is a little bit more elevated then that can promote

more red blood cell responses but for general health and continuing aspects of actually getting a heat exposure 10 to 15 minutes three times a week tends to be the minimum and we're looking at 80 degrees C because some people crank it all the way up and it's way too hot and so it's it's

“pretty moderate it's like we sit in an environment that's so controlled all the time we have central heat”

we have central air we get in our cars we turn the air on and roll the window down we're not really used to being above 80 degrees because we become very uncomfortable women find 80 degrees super comfortable men start to find a little bit too warm but that's beside the point so we're looking at heat exposure it's a moderate dose more regularly and we get really good health benefits from it we're talking about heat acclamation we know that five days in a row

at that 80 degree C mark for up to a half an hour is what your body needs as a man take a cardiovascular meaning blood volume expansion sweat rate changes to be able to perform well in the heat for women it's nine days because we have to extend it because our bodies are really used to that fluctuation for health is not the same thing so we look the minimum dose is 10 minutes three times week coal plunge oh yeah I caused an international shit storm with this one and it wasn't my opinion

I was just reading the research has been around since the 90s where again we look at sex differences in thermal regulation so the ice water the ice bath that comes along is way too cold for women it causes more of a sympathetic drive and once we get over that sympathetic drive then the responses for parasympathetic still are not as robust as we see for men so men can do fine in ice water but for women to go on our parasympathetic changes and metabolic changes cool water so we're looking

at 55 degrees Fahrenheit around 14 to 16 degrees Celsius it is in the research women do well in that where it's cold enough to create a stress where the body will adapt but it's not icy cold that causes an opposite response why did that cause a shit storm because of the people of

their their ice baths yeah their billion dollar ice plunge yeah where's Julie Julie should be happy

about a little bit more about nutrition fair to say you're a pro protein person I am yeah

underscore your perspective here so when we look at protein I'm glad it's making the hey

“day right so we look at it as when you're looking at the initial RDAs people have to remember”

the recommended daily allowance is the bare minimum someone needs to prevent malnutrition so when we start looking at protein the recommendation that is there in general for women in the US guidelines is enough just to exist but when you start adding activity you start adding age we need more not only that higher protein diet association because we're in an ultra-process world where a lot of people are gravitating to really fast foods meaning not fast food but fast to grab and eat

and there's ultra-process they don't really feel associated but if we have a higher amount of protein

not only are we able to contribute to more muscle generation and bone building and all the things that we think about with protein we also get better appetite control so we start looking at the guidelines for protein we know from the research that 1.6 to 2.2 grams per kilo which is about

“that 0.8 to 1 gram per pound is optimal as we get older we become more and a ballically resistance”

so that means our body doesn't use protein as well doesn't respond to strength training as well so we really do have to make sure that we stay on an upper end of it intake they're in some research recently that shows that it doesn't matter what time of day you take it or how much you have at any meal as long as you get what you need in the day there's a caveat for that because as you get older and you're more resistant to protein intake try to get it as close to the end of

exercise as you can because that's going to really enhance this post exercise mechanisms for muscle repair tendon repair all of the things that we think about with protein intake and that's more particularly acute for women versus men we see yeah because the metabolism aspect for women post exercise comes back down to baseline a wave faster than men we see that for women we're back down to a eugolicemic or a blood glucose control of baseline within about

“90 minutes for men it's two to 18 hours depending on what they've done so more important to make”

sure that you're replenishing your protein post workout in that 30 to 60 minute window then that's more important than it is for men. Yes and the other thing is women tend to under eat anyway so if we're looking at let's nail food before and after exercise then we can make sure we're keeping you out of signals for low energy availability and now Emily Dr. Emily Carl's here and she does a lot of work in reds and low energy and the eating opportunities

that are available we look at every eating opportunity most people are like yeah post exercise is a shitty what away when awaited it it's like okay well let's make sure we really maximize that post exercise eating window to help eliminate low energy availability. No fasted training correct you yes yeah this is another controversial flashpoint for you on at least as far as the internet goes yeah exactly and that's that's sort of flies in the face of somebody who's thinking

well if I'm trying to lose weight like if weight loss is like what's guiding those decisions like I should just get up and get after it without eating anything and then just you know try to manage portion control throughout the day of course your appetite is going to spike in the

aftermath of that and you're depriving the body of the nutrients it needs to basically create like

a stasis point right and repair itself exactly and I mean when you think about why are you going to do exercise you're not getting fitter in the exercise session you're trying to create a stress and the stronger that stress is the better your body adapts so if you're going to create a stress without food you're not going to create a really strong stress you feel like you are but from the body from a cellular level it's not a strong of a stress to create the adaptation that you want

you're going to have more uh catacolyme so that your cortisol and your breakdown hormones that are being produced so that it can fuel your workout but let's just take that negative stress way by putting a little bit of food in before you go training so that you can really maximize the exercise stress and then get the adaptations that you want from the post exercise recovery your critics out there say that your position on fast at training or just intermittent

fasting in general for women is is not supported by the evidence so I wanted to give you an

rumor that only site rodent studies and that's not true either um so when we're looking at the evidence for fasting and fast at training most of the stuff that people are coming out with yeah

“you should do fast at training it doesn't matter you should do intermittent fasting is still”

guided by male data you go into chat GDP it tells you the same thing why because there's just echo chamber in the bell curve that's just pulling up the rhetoric that everyone is talking about when we go into the research and we're looking specifically from things like in the chronology and we're looking at fertility and we're looking at population research with appetite and appetite control it all gravitates to women do better in a fed state we look at

the studies that have been done in the sports science world there aren't a lot but there are ones that are done it's still points to women do better in a fed state we have this variation in appetite appetite control like I was talking about with chronic biology we look at the exercise stress points and how people adapt and we see that women their bodies respond when there's fuel on board we look at the people that are pushing out well she's not based on evidence

it's because they're looking at that bell curve of just sports science evidence there's so much more to exercise training appetite than this it's really small amount of sports science research

so I'm always like here's the evidence it's not coming from the general sports and exercise

science no it's coming from interconnectology or it's coming from this population but these are randomized control trials this shows the the variation of exercise versus bed and here's the evidence and I give that to them and they'll still critique so maybe just walk us through a day in your life of eating like what does that look like you're like oh you should feed before you work out and after all of that but like what are you doing specifically yeah so there's the ideal and then there's

reality and I'm more than happy to share reality because I'm here and I don't eat very well when I'm just as real this is real this is real this is real we're having a real moment I know we are so regardless where I am I do get up and I have something first thing in the morning that's where

the protein coffee fame came in because people are always asking what do you have first thing in the

morning if you're going to go swimming or training I'm like I'm not hungry I know most people in the five and six a.m. club aren't hungry but I love coffee and I want to maximize that so I'm also going to put in some proteins mom and milk so I'm going to use some protein ingredients from

“carbohydrate and that's how the protein coffee thing became a thing it doesn't mean that you have to”

do it there's no evidence behind it but it's what I do because then I get a boost of proteins some carbohydrate I'm going into a training session I can maximize my training and I have caffeine and everyone loves that well for the most part then I come home and I have real breakfast and I try to have it with my daughter before she goes to school I'll have a bowl of overnight oats with some chia seeds and some nuts I put in some protein powder I'll have another espresso and then

I get off my day lunch is a variation of a bootable afternoon as we call it in New Zealand afternoon tea when you come home from school is another variation of nuts and veggies crackers hummus and then we have dinner and my husband isn't plant-based my daughter is an either but we all start with the base of the same thing so it is more of the bootable we're having different grains you're having different veggies you're having different greens then I put in some sweet potato or other

roasted veggies some tempéed nomines some garbanzo beans and then I put tahini on top is my dressing because I'm not a big fan of salad dressing but I love tahini and then mix it all in some avocado and then there's a bowl of about 40 grams of protein and some fat and it's great and then later I'll have some dark chocolate because I love dark chocolate I mean that all sounds like very

“doable and reasonable yeah you know and I think when you see a 1.1 grams of protein per”

pound of body weight like that's intimidating that sounds like a lot but walking through like what you eat in a day and like yeah it sounds basically like what I do without really thinking about it's not like it takes some kind of ultra focus on the protein aspect of this to meet that requirement no and also leaning into like fiber and 30 different plants really right and so it's like if we can get protein and fiber at every eating opportunity people get what they need in a day they get the

higher protein intake they get the diversity they get the fiber that's not make it difficult I

quote the research and those are all numbers but the reality is it's pretty easy for thinking

I just want regular normal food you know if people like to make it difficult I know they

another topic that's there's a lot of discourse happening right now around this this supplement

“that's been around forever kind of began in the body of a building world and now has made its way”

into mainstream discourse and there's a lot of discussion around amounts so first maybe

explain what creatine is what it does and how women should think about using it. Yes so creatine if we're thinking and I'll get a little bit biochemical right now we're talking about the fast synergetics the first zero to 20 seconds of inner any cellular process requires creatine because we have ATP and CP so that's a didn't seem triphosphate and creatine phosphate so when ATP splits to produce energy you have this floating thing that then gets taken up by creatine so

when we're looking at why we need creatine we need it for every fast energetic in the body anything about the brain the heart the gut the bone everything requires creatine for women by the nature of being women we have less lean mass than men for the most part so we have less stores just by the lean mass part of it we also tend not to eat as much creatine containing foods which we think about you have to eat five chicken breasts to get your you know dose of five to six grams of creatine

if we're looking at supplementing we know a lot from Darren Candow's work and Abby Smith Ryan's work that it takes about three weeks to saturate the body with three to five grams so what does that mean when you're fully saturating your body has more availability for those fast synergetics the brain works better the heart works better we see that we have better new coastal lining

integrity so the very first thing that arose when you're exercising or it gets stressed is the

new coastal lining of our intestinal cells and if we don't keep that then we know that we get some into talks and release which people call the he cut we see more of an IBS situation for women that are running so for just boosting the levels of creatine and have more available for all the fast synergetics than the body works a little bit better you can not use it and that's fine your body naturally produces one to three grams a day from the liver but we want to maximize and

optimize and that's where the research is coming we're like okay every fast energetic works really well we see now from brain research and TBI or concussion research that creatine begins really

“important for improving brain metabolism and helping getting over the concussion why is that because”

it's trying to repair itself as well as still function so improving the amount of creatine is

available it can do all the fast synergetics it needs we see that for building bone we need some creatines part of the fast synergetics so we're starting to see all this research come out and there's a systematic review that was published two weeks ago that was looking at all the studies not in the fitness world but actually in the health world of the studies that have come out to synthesize who should optimize their health by using creatine there are 153 studies in the systematic review

of it the conclusion was women 18 to 60 should be using 35 grams of creatine supplementation to optimize and improve overall health and so that's where the research is leaning into yes you have outliers like if you're a shift worker or jet lag or if you have overnight combat missions then there's a time in a place to use higher doses I think the circulation is 0.38 grams per kilogram which ends up being about 20 grams for 130 pound per a sin so there's variations within

it but for the baseline to improve fast synergetics and overall mood heart brain all those things it's just three to five grams yeah the the the conversation now is sort of creatine maxing you know yeah oh if you didn't sleep well or your jet lag take 20 grams and it will compensate for that it will give you some degree of mental acuity to overcome the lag and your sleep yes but it takes more time for the creatine to cross blood brain barrier so an acute dose actually isn't effective

“on that acute time you need to do it dosing up to knowing when you are going to be traveling”

so you have to you have to you have to predict the future and take it before you have the night of sleep where you're not going to sleep so consistently consistently take low dose or it helps but yeah is this something that should be cycled or is it safe to just take if you're taking like five grams a day just do that keep doing it yeah we look at cycling creatine in the higher doses and that's a lean into the bodybuilding muscle performance side of things where was five grams

to lose some of the water weight and then cycle it back on for different training modalities so we're

“looking at cycling on the lower doses it's it's a kind of a move point because when we look it”

takes three weeks for your body to fully saturate and then if people cycle off it then it comes back down to baseline so if you're just taking the continuous low dose your body fully saturates and then stays there the same woman who has the concern about getting to bulky from lifting heavy weights may have this concern around creatine that it's going to lead to bloating and water retention and there's you know there's some other things that come with that you can

get you know like some diarrhea some stuff like that so what do you what do you say to that person

there are two things that we want to kind of nip in the bud here first is how much is she starting

with because a lot of women who start with a five gram dose and they're smaller and physique then they might have retention because with creatine you're also storing more water in the muscle

“so that's a given it's transient it will go by the wayside within two to three weeks and most”

women who are freaking out about bloating and water retention are they don't want to wait the three weeks so let's start as smaller dose let's start with one to one and a half grams and work away up to the five grams over the course of a month that way your body is starting to saturate it's getting used to it you don't get the bloating in the side effects the other one that's really

critical is the quality of the creatine that you're using the cheaper versions of creatine use more

of an acid wash and so we're looking at the residual acids that are in there it's not that great it causes side effects so the higher qualities like our good friends momentists they use a water wash and that reduces any kind of the residuals that cause side effects so first make sure you have a high quality and to let's start with the lower dose and work away up because we're not looking for an acute hit here we're looking at how we're going to saturate and really improve

and optimize over time any burning creatine questions out there i have a question about creatine in different stages of your life so you know you talked about perimenopause if you're on a fertility journey if you're pregnant like what is like the optimal time and are there times to avoid using it um so there's even been pregnancy research that shows that supplementary creatine is beneficial so we look at creatine is beneficial across the whole lifespan

there are individual cases where it's like if you're iron deficient with endometriosis it's probably not a good idea because there's an interplay between some of our fair potons and and things that affect iron absorption and increasing endometrioso cell proliferation so there's some small research that suggests that so then that becomes more of an individual case by case let's see what are your symptoms are you iron deficient house of yours

endometriosis so yes there are causes in cases within each that we have to be aware of but in general you are safe to take creatine across a lifespan other than creatine what are the other supplements that you would suggest women be taking and maybe some supplements that they should be avoiding so i will also say vitamin D3 is really important for those of us that live in the extremities of the hemispheres it's really important in the low light for people living places like Seattle where

you have winters that are super grize well and just in general get your vitamin D levels checked because we know that low vitamin D is associated with more severe pms and pmdd in women more severe parymenopausal symptoms we also say there's a suppression immunity we also see vitamin D is really important for things like bone and bone density so it is pretty important it works as a hormone within the body to facilitate a lot of the responses we also see that women who have low iron

and low ferritin also tend to be low in vitamin D so in general i tell women just taking a vitamin

D supplement will help boost if you are worried about having super high vitamin D levels get tested first

“then when we start looking at what you should not take we see that there that like nitric oxide”

is a very widely used one for sport performance we see oh yeah it's a vasodilator we know from the research that it doesn't work in premenopausal women but it works really well in postmenopausal women because estridial or estrogen is really tightly tied to indithelial cell function so that's a lining of our capillaries or our blood vessels so when we start introducing nitric oxide

will have a negative response they don't have as much vasodilation they might end up

“having more of an orthostatic like a stand up with head rushes so orthostatic hybrid”

hypertension so low blood pressure but women who are a postmenopaus who don't have estridial and more benefit greatly they have improvement in circulation they get really good vasodilation we see women in late perimenopausal with severe hot flashes can have some benefit by using nitric oxide because it helps with the vasodilation constriction so there's like this is the efficacy of of knowing that there's been research done in women in the supplement

a lot of the other supplements have been studied women so we're looking at beta alanine

there's been very few studies done in women so a lot of the sport performance supplements haven't

been studied but we know that protein supplementation has been studied it's beneficial for women we know that vitamin D has been and omega 3s have been so most of our general health ones that are promoted have been studied in women in our beneficial on that topic of all the things that you share today what where is like the strongest evidentiary basis and where is the evidence like more emergent where we need more research for women yeah cross the board at say we need more

research and everything with that is a baseline okay as that is a baseline yeah within that world you know you've shared a lot of insights today and I'm sure there's a spectrum in terms of like what's what's you know where there's enough kind of evidentiary

“basis and where you would like to see more studies being done yeah I think for the most part I really”

want people to understand there's a significant division line between what's clinical and what's health and fitness and there tends to be this blur so we're like dividing the line down and going okay from optimization and health and fitness everything I've talked about has evidence behind it what do I want to see more of I want to see more research in string training and how does the methods within the health and fitness world crossover to the clinical instead

of everything in clinical crossover into the health and fitness so for example I won't say who is given us the grant because it hasn't been announced yet but we now have a grant to look at strength training in Alzheimer's prevention and the heavier end of things so like that kind of stuff I want the merger from high performance to come over especially in women so we have some

“pretty good tight controlled studies in high performance because when we're in that world we can”

really garner and leverage we're in the clinical world with randomized control trials we can't really generalize we can say in this population of pre-diabetics we know that this works and women like here but then the biggest thing is we need more diversity in all research was on the stage of this week and at longevity and women's health summit and someone stands up and says as a black woman my symptomology is is more apparent and I've heard that it's worse for a pyramid of

pausels symptoms and black women and there is just because shepherd and she's like yes this is true but no one really knows it and I'm like I'm a white woman and I know that most of the research has been done has been done on a white upper class women so regardless of if it's clinical or if it's health we need to be able to look at other populations the idea of a human or acre naturally cycling woman with really spot on periods and menstrual cycles no pun intended

is a rare so when we start saying we need to do really tight control trials on women with menstrual cycles that are X amount of days and we know that have specific phases it's a very very very very very small population that can't be generalized out so we have to look at those nuances too so what is the big foundation of evidence we look and say okay well let's look at the

methods first and what is that and where does it come from can I say what has a lot of robust

research a lot of the stuff that has the the population research in the anecdotal studies as well as some of the randomized control trials so we see that in muscle development we see that in bone development we see that in sleep and mood but every area needs more research and every area needs to be more diverse in the population of the research if funding wasn't an issue there's no budgetary constraints what is the dream research project that you would like to see happen like

how would you design a study that would answer your most pressing questions I don't I have so many pressing questions I don't think there's enough money in the world to answer them well no there's money just pick one there's money in the world but it's the time factor so I think it changes like

controlled heat exposure so I'd like to do a really large study on a whole bunch of different

“ethnicities and cultural nuances in women who are having fertility issues because if we see that”

post-controlled hypothermia we have an increase in ester dial loonizing hormone and both they're stimulating hormone can we get that to a point where we can use it as fertility treatment so that's one really massive pressing question I have right now so if anyone wants to fund that and has a team that could research it so it's like looking at those environmental conditions that the world is now entering into we have severe heat we have severe cold how is that affecting

different pockets of populations with the big fertility issue like that's not something that someone like me coming from high performances as an environmental actually because yellowish would really come out with but I'm really concerned I'm like okay well we know this happens in controlled heat but we also see this whole change in global environment and this uptick in infertility well let's see what happens if we're using these little things to our advantage

so that would probably be a big pressing question because if we're killing off the human race because of things that we're not doing right well is that a good thing or not maybe that's the bigger plan for whatever is out there but right now I'm like I want to be able to make an impact and really investigate this with regards to what's happening from a global impact as well as a population impact I don't know if you all know this but last year's stacy appeared on some of the

biggest podcasts in the world diaries you know Mel Robbins you were right you did heberman also yeah and not only was she a star guest on these shows your episodes on those shows were the most

viewed or listened to like for that show for that year which is kind of an amazing thing right

so it it really catapulted you you know into like this different kind of sphere of influence in your areas of expertise but I'm curious like what is the what is the question that you're not being asked or that you wish you were being asked that that just doesn't come up in these sorts of scenarios yeah um one I can't believe that that's happened because I'm still like dearest mom and I still like to like do research and I like to help people so when I'm stopped in the bathroom

washing my hands oh my god you doctor say seems like who's that person right so it's just been like

“this big push I think one of the conversations that has been had is the optimization versus general”

and we had that today so I thank you for that so like what are we doing to optimize health and what are we doing just improve health and those are the nuance performance and longevity and general health are are you know sometimes contradictory right exactly it's like what you do to help someone when an Olympic gold is completely different than what you would do for someone who's just trying to optimize their health for a long period of time but a lot of times that research

in this conversation skip alert so again thank you for asking about optimization versus general because that is is something that hasn't been asked one question I want to ask you is what do you what can you share with men to help them understand the women in their lives to support them like this is a mystery box you know for someone like myself and you know it's just like there should be a woman up here and talking to you about this not God but I want to understand and you know

just as a as a sort of an avatar of all men out there like help me understand how to you know be as supportive as possible and that comes with greater understanding of course but you know

“help us out yeah well first we need men in the conversation so you should be in that chair”

interviewing not a woman so I appreciate that too and all the men who are in the audience because more we understand the more we can be supportive it's like if your wife comes to you is like

I'm having this horrible time I have severe anxiety it's like just listen just like I always

talking about with his daughter and being a girl dad it's like listen don't try to fix because that becomes a problem where women feel like they go to talk to their partner and their partner is listening to fix something not listening to be empathetic and I also want to I'm not doing this to promote but I'm doing it to say that Joe Warner is a guy in the UK who used to work for men's health he's a journalist and we had a podcast episode and he was really like wanting to know

more about the Perry menopausal journey for his partner and he interviewed a whole bunch of experts

what's going on and how to listen to their wives and help them so there are more more resources

“coming up too but I think the bottom line is listening understanding and trying to be empathetic”

and not trying to fix awesome let's put it out for any questions before we wrap it up this is a little bit of a follow-up to the creatine conversation um I have two daughters and they are athletes so I think my curiosity and question really is more about what how should we guide female athletes young female athletes on this journey in terms of supplementation nutrition understanding what would be your suggestion that I would refer to the faster women's program at

Stanford but in general when we talk about it we want to change that diet culture like we don't want to introduce that so we're talking to our young female athletes is all about fuel for what you're doing if you are fueling your body you're becoming stronger you're becoming more resilient and then we also have to think about the mental mental stress of trying to grow develop understand your personality and become part of this world so it's also having the eye to what is the mental

status today like how am I talking to my daughter how am I using empowering language instead of negative language um we're looking at a supporting culture as well unfortunately the default is to be compared to boys we see this in coaching and and it's really disenheartening for girls to

always be compared to that norm so if we're trying to change a sporting culture we're trying to

encourage our girls it's talking about being fueled it's talking about being fast and powerful and

“strong and all of that positive language and not talking about oh calories oh you need to eat this”

it's not about that it's like let's put it in that performance space let's talk to them like they are athletes because they are you need to eat enough you need to fuel for your training you need to fuel for your brain you need to fuel for your indecrines system it's all about fueling because your body is growing you're learning you want to be the best that you can be in your sport and you want to do all of these things we need to fuel for that would you suggest supplementation as they start to get

more serious about their sport depending on their sport I would I would hesitate to say yes it's trying to do real food first because the problem with it even though there is some evidence that creating helps in young girls and protein supplementation helps but then it opens the whole Pandora's box and we want to not we want the training to come through for adaptation we want the

fuel to come through for supporting that adaptation I always think about when I was back in the

day when inner bike was in Las Vegas I was sharing a cab back to the airport and his guy got in and he didn't look healthy at all and he was talking about how he's going to go to a bike on a bike ride but he had to use his beta alanine and beat juice first and I was like what do you

“talking about he goes oh yeah well that's how I can go hard on my bike as I can be tried”

training without it because why would I do that and I was like okay where do I start but because that is an enhancement we want your body to understand first before you try to enhance hi stay see another class thanks for the shout outs I am surprised this question has it come out yet but when I ask about wearables oh yeah oh yeah there are a lot there's a lot of data out there and it can be overwhelming for women to interpret whether it's sleep whether it's recovery sometimes

some athletes have unhealthy relationships with data so what do you recommend as far as

wearables and how we can interpret wearables as as girls women so first of formus when we look at

wearables the algorithms are based on male data and I like to use the example of heart rate variability how many people have a wearable and pay attention to heart rate variability yeah okay so there are a lot of women who are like what's going on my garments yelling at me you're in the red what's going on what's going on you're sick you're sick but actually they just ovulated and these algorithms are not picking up the fact that when we look at physiology for women there's

an inherent change across the menstrual cycle with regards to automatic nervous system so we know after ovulation with progesterone or respiratory rate comes up our resting heart rate comes up our heart rate variability goes down the algorithms read it as you're not recovered so when I tell women with the wearables look at it trends over time so that you can compare your follicular to follicular or impairment of pause you can see things going all over the show knowing

for trends over time with sleep and sleep architecture they're not fine enough to actually pick up

“sleep architecture the benefit of using a wearable overnight that I find for women is if they don't”

eat enough they have a lot of awakenings at night from hypoglycemia so you're having a lot of poor sleep and you're like oh I've got a lot of awakenings it couldn't be you haven't fueled well enough in the day and getting hypoglycemic when you're sleeping we see this in some of the see the continuous glucose monitor CGMs that that are being used so there is usefulness in them but only for trends over time I really appreciate that you spoke about not fearing perimenopause I'm definitely

still a little scared of it don't be how can women know that they're entering that face like what what are the signals that will specifically tell you that you're you've entered that and if you

could boil it down to one thing like what's the first thing to tackle when when you do enter that

face there isn't any one like bell that's goes ding ding ding you're in perimenopause it could start as early in your mid-30s maybe it doesn't start until you're in your mid-40s with your guys to symptomology but we knew do know that you have more and more in ovillatory cycles as you get older so we generally say that once you hit 40 then we know you're in perimenopause it is a rough guide some people have really severe limiting symptomology some people

will breeze through until like the last couple of years before that one point time menopause hits but it's a it's a significant individual journey and although everybody who's born with the uterus goes through it we're still not sure why why do we have this ovarian wind down why are we having all these changes and what are the definitive tests that we can do we don't have those so it is an individual journey um if you're like I'm starting to be really anxious and

we're not sleeping that's probably perimenopause you are finding more soft tissue injuries that's most likely perimenopause one of the big tells for runners is they start getting more more planar fascia issues because we start having disruption in tendon tensile strength

and we are getting weaker in our cat muscles because we lose strength and power first so we

start getting more and more tendon opportunities and soft tissue injuries so all those are in line with yes your perimenopausal but don't be afraid because there's lots of things you can do I'd like to follow up on these two questions I'm Rachel some of a researcher and I do a lot of diagnostic testing in my labs so you've mentioned many of the tests the blood tests specifically and these are becoming more and more available in the commercial space

everybody's talking about testing 9,642 biomarkers particularly hormones and I'm wondering if you have blood tests that you recommend and if you do

“how regularly you think that you should be getting them thinking about the difference between”

what you're calling out as general health and maybe some of the more sophisticated things that you or I might like doing the lab yeah I'm not a fan of hormone testing because it's just giving a snapshot of that time of day if you're really to optimize getting something like estrogen you have to know day two well when the cycles are all over the place so I really don't put stock in getting hormone testing unless you have fertility issues when we look at blood tests I find it

it really useful to have things like ferretin and to know your baseline cholesterol we also look at CRP so some of the basic inflammatory markers we want to keep track of one of the the tells for parymenopause actually is a change in your cholesterol and you have an increase in LDL so we see this you haven't had any cholesterol problems all and then all of a sudden your LDL is elevated and your HGL is dropped out and then your total need to eat more fiber actually is

parymenopause what do we do about that so having a baseline of just your basic blood tests for trends over time is very useful because if you start having symptoms and you go get a blood test that's just telling you that one point time confirming something you already know but you don't know

“what your previous norm was so that's why I tell women's like get a dex at every year know what your”

bone mineral density is know what your body composition is hold on to that get your ferretin tested every three to six months if you have a history of low ferretin keep track of your cholesterol every year see your CRP get your vitamin D tested at the beginning and end of the season so end of summer and the beginning and end of winter so just small things to be able to optimize but you don't have to go spend $500 a month to get all these biomarkers because we just need to take

like I normally it's like 45 degrees Fahrenheit which is like seven degrees Celsius but like

is that inherently bad it's not it's not bad for you it's if you're very calamitized to it great I'm not going to tell you not to do it but for all the rhetoric of every woman needs to do really cold ice baths it's intimidating because you don't have to there are other things like if you're already doing it great if you're a cold water ocean swimmer it's really beneficial say you're doing it but if you're someone is looking to optimize health and you're trying to see

“what environmental stressors do cool water if you want to examine that but for the most part”

I try to push women to the sauna that other people are like I can't handle the heat is like okay well maybe cool water plunges good for you if you're already doing ice and you're already doing

cold your body's adapted it's fine but maybe you also want to add sauna to get some better

health benefits oh I've got the sauna to hurt yeah I find I have so many women in my life who have mysterious chronic illnesses or women's health issues and they're exhausted by they come into clinical settings where they are not believed or it doesn't feel like the doctors are necessarily asking the right questions um what's your advice I hear you speak today and I actually have so much hope and excitement for where women's health are going now that we're

included in studies but for today we are still in that sticky period what are ways that we can

“advocate for ourselves in these clinical spaces and advocate for ourselves outside of these clinical”

spaces yeah so I come from because I don't live in the state so I navigate a different kind of environment with regards to health care where we can go and advocate and say I want to I want to get a dexa and you can even pay out a pocket for like a hundred bucks or you can get a referral and wait three weeks to get it here's completely different so when we're looking at advocating for ourselves is having conversations it's empowering each other as a women it's talking to your

physician and saying these are things I have I'm not Dr. Coo Google but I have been talking to other women it's similar and you just really try to be on the level of the conversation and there's not a lot of time it's like maybe 15 minutes of an appointment so if you can go in and and have a more of an empowerment approach because I'll talk to physicians of like 15 minutes isn't enough because I don't know what the history is I don't know what they've tried I don't

know if they googled it I don't know so the more information that you can provide and you can bring in scientific articles or whatever just to put them on the right track is very helpful both they learn and to they realize that you're coming in with something that's genuine you're not just coming in as high of a contract the other thing is to look at the physicians that are available that are in the known as space so if you're looking for female fertility issues you get a

someone like Natalie Crawford who's in Texas but you can also see her list of friends and her network across if you are an endurance athlete and you're having issues you can again an Emily's program at Stanford and see what her network is so we're all coming together and creating these networks it's just trying to figure out who's the person to follow and that's where the conversations can really be beneficial. Hi I'm Julie hi um in the large world of

peptides oh yeah do you have any input on that? Oh yeah we're just having conversations about this so um in the large world of peptides I really lean into there's no evidence for them and it's a wild

“wild at Guest right now um they're not regulated uh I think someone was telling you that they just”

read a New York Times article that the peptides in general bought from refugee places still had a lot of lead and things in them so it's like you don't really know what you're injecting because they aren't controlled therefore research purposes only. Most of the research has been done on the peptides are still rodents days are very very small like in a five or six men so we don't have any of the robust research. I'm hopeful because people are putting such stock in it that there's going to be more

research. We know that GLP1 is a peptide and there's lots of research going on because of all the benefits there and that's kind of the push for all these other peptides so the bigger demand there is the more research is going to go into it. It's just kind of a holding pattern but other people will be lab rats for themselves while you see what happens and then you can make a decision. Thank you you're welcome. Hi um we talked about strength training as part of this conversation and you've

expressed the need for women to really lift heavy what is heavy like how should a woman think of

about where they should be targeting with that? Yeah so I often tell women if they're first starting

their strength training journey I don't want them to think about lifting heavy. I want them to go in

start looking at increasing load and we talk about lifting heavy on a scale of one to ten the effort

“needs to be about an eight or if you go pick up a dumbbell or a barbell and you can do five or six”

reps really well with really really good form and you think maybe you can do one or two more that's

where you stop because it is very relative. Thank you. Yeah. Stacy I just wanted to acknowledge you

for the tremendous public service that you are providing people you're you're a powerful and

“important voice. We need more women like you out there who are advancing women's health”

and I just want to commend you for the work that you're doing and I appreciate you coming here and sharing so openly with all of us so thank you. Thank you. Yeah so let's hear for Dr. Space Senior. Thank you. And thanks for coming. Yeah thanks for coming. Yeah thanks for coming.