00:00:00
A lot of women come with their partners to see me and say, "I don't understand. We're both doing the same training. He's
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leaning up and getting fitter. I'm putting weight on getting slower." And that is because we have puberty. We have our reproductive years. We may not have
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pregnancy in there. We have permenopause. We have postmenopause. We have a menstrual cycle. Each one of those is a different hormone profile
00:00:17
that can affect the way we eat and the way we train. But no one told us this or what we can do until right now. Dr.
00:00:24
Stacy Sims is an exercise physiologist and nutrition scientist whose bestselling books and over 100 peer-reviewed studies is revolutionizing
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how women can optimize their health, fitness, and longevity by working with their unique physiology. We're looking
00:00:36
at sport science research. Everything from training to eating, recovery, it's based on male data, and women have been
00:00:41
generalized to that data. Things like we see men do really well on calorie restriction and fasting, but for women
00:00:47
doesn't happen that way and we'll talk about that. And we also know that during puberty, girls hips widen, shoulders
00:00:52
widen, which changes our angle of knee to hip, what we call the Q angle. So they don't feel comfortable running or
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swimming or jumping. And because they're not taught this stuff, we see that by the age of 14, girls who previously were
00:01:02
sporty, over 60% of them drop out of sport. The problem is it's never about how we can empower women to use their
00:01:09
physiology to their advantage. So let's change that. Let's go. As it relates to nutrition and exercise, how do I need to
00:01:16
adapt across the menstrual cycle? What's your view on cold plunges and supplements like creatine? And what's
00:01:21
the variant between men and women as it relates to sleep? And then let's talk about menopause. Starting with per menopause. I'm excited.
00:01:28
The diary of a CEO is independently fact checked. For any studies or science mentioned in this episode, please check
00:01:33
the show notes. This has always blown my mind a little bit. 53% of you that listen to this show regularly haven't
00:01:40
yet subscribed to the show. So, could I ask you for a favor before we start? If you like the show and you like what we do here and you want to support us, the
00:01:46
free simple way that you can do just that is by hitting the subscribe button. And my commitment to you is if you do that, then I'll do everything in my
00:01:52
power, me and my team, to make sure that this show is better for you every single week. We'll listen to your feedback.
00:01:58
We'll find the guests that you want me to speak to and we'll continue to do what we do. Thank you so much.
00:02:06
Dr. Stacy Sims, what is the work that you do and why is it so important that you do it?
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I look at sex differences in exercise and nutrition because when we think about everything that we know for
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protocols from training to eating recovery, it's based on male data. And as a female athlete and working with
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women across all ages, just trying to maximize their potential, you have to lean into different data, but people
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aren't aware of it. So as I'm looking at what I do and trying to empower women to
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understand their own bodies, realize that there's a lot of research that still needs to be done. So if we think
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about something like caffeine and caffeine intake, right? And people are
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talking about how it either boosts them or not. Yeah. If we look at all the data on performance about caffeine enhancing
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performance, there isn't anything that's been done on women. So if we're looking at how does that work for a woman, we
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have to look and say, okay, how much exercise have you done? Where are you using the caffeine? When are you using
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it? Because we fuel differently during exercise. So we go through blood sugar quickly. Caffeine clears blood sugar. So
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a woman is going to have to eat when she uses caffeine, whereas a man doesn't have to.
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You said it's based on male data. How can you quantify that? like paint the picture for me that proves this this is
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the case for someone that might not understand the significance of what you just said. So if we're looking at sports
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science research and I'll just bring it down to sport science because that's the exercise and nutrition research. If
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we're looking at who's around the room when we're recruiting for studies for the most part the language around
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recruitment is geared for getting men because we're using a lot of
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aggressive language in sport. So it's offputting to a lot of women. The other aspect about sport science research is
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there's limited funding. So then we're looking at okay, how can we get people in that can come in for day after day or
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week to week. Most often it's men. When we look at what we're doing, we
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might be doing muscle biopsies. We might be doing blood draws. And if that's not explained in advance, it's a little
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off-putting to people. So when we're looking at the major recruitment strategies and the people that will say
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yes, I'll come and do this study, it's 18 to 22 year old college age men. And that's just been the norm. And when we
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look at how studies are designed, and we're looking again at who's in the room who's designing the studies, primarily
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it's men. Why? because we see that most of the PIs on the studies and most of
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the um I guess scientists that are coming up in academia are primarily men.
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When did you realize this? The first time I realized it from an academic standpoint was when I was a second year
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at university and I was a participant in metabolism lab and I was one of the only
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women and I standardized properly. I did all the things I was supposed to do cuz
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I come from a military family. I know how to follow rules. And at the end of
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the two weeks of experiments, they threw my results out. Why exactly? So I asked
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why. And they're like, "Well, your results don't jive with what we thought we were going to see. They don't mesh
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with the results that we got from the men. So they're an anomaly. So we're not going to put them in for the the context
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of talking about how carbohydrate metabolism was going." And I thought that was very strange and I was
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like,"Well, I've done everything properly. How come mine are the anomaly and those guys aren't the anomaly? How
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do you know that?" And they didn't have an answer for it. So that was like the sticking point for me to understand why
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would my results be an anomaly when I have done exactly the same thing as what the men had done. And it came down to
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menstrual cycle. came down to understanding that one week I was in a low hormone state and then the next week
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I wasn't. So when I started talking about that, this is where the um
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professor who was in charge of the metabolism labs like well we don't study women because they have a menstrual
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cycle and we just study men because they're easier and we don't have to worry about hormone fluctuations
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interfering with our results. And at that point I was like, "Excuse me, what?
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What are you talking about?" So that was a defining point from an academic standpoint. But the seed had been
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planted two years prior when my dad who was a colonel in the army was like, "So
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what do you want to do when you finish graduate or when you graduate from high school?" And I said, "I wanted to be an
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Army Ranger or Navy Seal." And he said, "Well, you can't." And I said, "Why can't I?" And he said, "Cuz you're a
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girl." I was like, "What? what does that mean? And he said, "Well, they don't accept women in in the SEALs or the
00:06:57
Rangers. It's a special ops and they don't accept women." And that was the first time in my life I've ever heard
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that I was limited because I was a female and I didn't match what the norm
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was cuz my whole life I'd been playing with boys, competing against boys. I mean, like, it was just a normal. Didn't
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matter if you were a boy or a girl. It just was what you wanted to do. And then when my dad said, "Well, you can't
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because you're a girl." That was the first seed that had been planted and really made me upset and said, "Well,
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this doesn't make sense." And then when I got to university and that happened, that was the definitive seed that just
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really pushed me into the whole academic and sporting career that I've led over
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the past 20ome years. Give me an overview of that career, the sort of significant milestones and the research
00:07:45
that you've done that's fed into everything that you know today. I've been a competitive athlete most of my life. So I would I raced bikes
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professionally. I did Iron Man. I did Xterra. And I would have teammates who would ask me questions of um you like
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how am I fueling? How am I going to perform my best? So we take those questions into the lab. So we were
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looking at how do we optimally fuel or how do we optimally uh climatize the
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heat when we're at a point in our menstrual cycle where we don't have as much heat tolerance. So that we see when
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progesterone comes up after ovulation, our core temperature comes up, we don't have as much heat tolerance. So how do
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we adjust for that? So there are a lot of questions that would come through just by the nature of being surrounded
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by competitive athletes and being a competitive athlete. So, we look at things like we know now that when you
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want to do um acclimatization to the heat and I bring this up because if I
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live in New Zealand in the wintertime and I'm trying to train for something like Kona that happens in Hawaii and we
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max out at uh you know 10° C in the winter but we have to face 40° C to race
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Iron Man and we get into a sauna and we want to accommodate for that heat. We
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know that men can go seven days in a row and be fine to then race in the heat. But for women, depends on which phase of
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the menstrual cycle and if you are going in the high hormone phase, then we say,
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"Okay, well, you don't need a primer. You can just go in and do nine days in a row. But if you start in the low hormone
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phase, you actually have to go into the sauna for five minutes, come back out, and then go back in and do that during
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the low hormone phase for nine days in a row." So there are different nuances in the way that your body responds to the
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heat and is able to accommodate for those heat shifts versus a man can just
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go in and accommodate for that and be ready for the race. So give me your CV.
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Oh gosh, not the whole thing. It's it's pretty varied. Um what did you study? Uh
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exercise physiology and metabolism. Okay. And then um got into ultr running
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when I was doing my masters at Springfield. Um and then I started getting into more Iron Man distance
00:10:04
stuff um before I started my PhD. And you went to Springfield College as well. Yeah. So
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that was my masters. Your masters. What did you study in your masters? That again was exercise fizz and metabolism.
00:10:17
And then you did a PhD. Yep. Uh what was your PhD on as well? So my PhD was
00:10:24
looking at differences between men and women in heat performance. Okay. And how
00:10:29
you climatize to it and how you hydrate for it. Um as well as looking between
00:10:36
menstrual cycle phases and oral contraceptive pill use in women. Um and
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again all of these topics were designed because of questions I had for myself or
00:10:48
teammates had. And then from PhD I went to Stanford and was working um in the
00:10:54
high performance lab and then moved over to do a posttock with Marcia Stefanic who was the PI for the women's health
00:11:02
initiative. So looking at um hormone replacement therapy in menopausal women
00:11:08
but also looking at exercise as a cohort to that. And I had another hand in the
00:11:13
high performance um research in human biology. So I would mesh human
00:11:18
performance with public health and then that transcend into a lot of the stuff
00:11:24
that I do now looking at what can we do taking some of the ideas from high performance and apply it to general
00:11:29
population and how does that improve people's longevity well-being but also
00:11:36
for those who are trying to be parents who have a high performing job who want
00:11:41
to do well in their age group race whatever it is how can we maximize some of the things we know from high
00:11:47
performance with regards to sleep, heat, cold, and apply that to a person who's
00:11:53
just trying to get everything done, and what small things they can tweak to improve their own training and
00:11:59
performance. And you've authored more than 100 peer-reviewed studies on exercise physiology. Yeah. And you're a
00:12:07
research scientist at the University of New Zealand. I am a research scientist at AUT. It's where most of my PhD
00:12:14
students are. and we have a women's health program and then I also have an
00:12:20
adjunct with the lifestyle medicine um at Stanford. So that's where a lot of the public health research comes in. And
00:12:26
when we talk about the the differences between men and women, what exactly are those differences? Is
00:12:32
it just the menstrual cycle that causes these differences or is there other physiological differences that we need to understand in order to understand the
00:12:39
subjects we're going to talk about today around exercise, nutrition, and the variances between men and women there?
00:12:44
There are sex differences in uterero. I mean when we look uh what does that mean? So the sex differences when the
00:12:50
baby's developing. Okay. So we look at stress and the mom under stress. We see
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that there's a higher incidence of a miscarriage if it's a developing boy fetus than a girl fetus. And it has to
00:13:01
do with XX versus XY. Then after birth we see that there's relatively little
00:13:07
sex difference that is apparent until the onset of puberty. But when we're looking at those sex differences that
00:13:13
aren't that apparent, there are there. We see that there's a sex difference in what we call muscle morphology. So that
00:13:20
means that men are born with more fast twitch fibers. So they have more anorobic capacity as they get older.
00:13:26
They have more ability to produce power. We see that um girls are born with more
00:13:33
endurance type fibers. So this means they have more mitochondria for oxygen
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consumption and oxidative stress and being able to go along and slow. Then when we get to the onset of puberty, we
00:13:45
see an expansion of these sex differences with the exposure of the sex hormones. So what we're seeing is now
00:13:53
the boys are getting leaner, they're getting faster, they're getting more aggressive, but girls bodies completely
00:14:00
change because center of gravity drops from the chest down to the lower abdomen area because their hips widen and their
00:14:07
hips widen because you know being XX they have to then accommodate for
00:14:13
getting pregnant and eventually having a baby from a biological standpoint. Hips
00:14:18
widen, shoulders widen. This changes the um angle of the knee to the hip. So we
00:14:23
then have a Yep. So for anyone listening, this is there's an image I have here which I'll put on the screen and I'll also link below and it's called
00:14:30
the Q angle. Q angle. Yes. Which is like the angle of my knee to hip. Yeah. And
00:14:37
it's showing that women's Q angle basically like the shape of the gap between your leg is is it roughly 15°?
00:14:44
What is it? Do you know? Yeah. Yeah. And so when we're looking at girls whose
00:14:49
bodies are changing, we see that by the age of 14, girls who previously were
00:14:54
sporty, over 60% of them drop out of sport because they're not taught that their bodies are changing. So they don't
00:15:01
feel comfortable running or swimming or jumping or landing because they have a new um Q angle. They become quad
00:15:08
dominant. Their center of gravity is different. Their shoulders are wider. So they don't feel comfortable running
00:15:13
because their whole running mechanics change. So, you know, when we're looking at girls who are eight, they can keep up
00:15:20
with the boys, right? Their bodies haven't quite started changing yet. By the time they're 10, they're starting to
00:15:25
see a discrepancy. And I say that cuz my daughter's now 12 and I've seen it over the course of the elementary school
00:15:31
years where they used to be on par with the boys playing soccer and rugby and stuff on the field. And then you start
00:15:38
seeing a more where the boys are becoming more aggressive and they're kicking the balls faster and running
00:15:43
faster. And the girls are starting to develop a little bit more, getting a little bit more body fat, feeling a
00:15:49
little bit more comfortable running. They can't do the monkey bars anymore because their center of gravity is lower. So they can't get up and do the
00:15:57
monkey part bars as well. But no one explains this to them. So then when we see this discrepancy of being sporty,
00:16:04
not sporty, we see um you know changes in body composition and all of this is
00:16:10
in those early stages of the teen years which is another knock because we also have brain changes where girls become
00:16:17
more um self-aware and boys don't. They're like, "Okay, you know what? You
00:16:22
piss me off. I'm going to beat you up and we're going to get on with it." But girls are very self-aware and they hold things to themselves in a more negative
00:16:30
fashion. And this creates a lot of mood changes. And this also creates a feeling
00:16:37
of of of negative body positivity. So they don't feel that comfortable with
00:16:42
how they look or who they are. And society doesn't help that either. So this all perpetuates in a socioultural
00:16:50
as well as a biological change with regards to exercise.
00:16:55
And as it relates to we'll talk about the Q angle a little bit more in a second when we talk about exercise but the as it relates to the other changes
00:17:01
um fat differences in men and women. Yeah. So if we see essential fat for men
00:17:07
is around 4 to 8%. So that means what we need for our nerves and just survival.
00:17:13
Okay. For women essential fat is around 12%. Okay. So this is for nerves and and
00:17:20
looking around our essential organs to survive. We look at body composition itself, we see that women tend to sit
00:17:28
around 20% as a normal healthy individual, although the data has
00:17:34
changed over the years. Um, and men sit around 15%. And what about the heart?
00:17:39
How's the heart different in men and women? So, women have smaller heart and lungs. Yeah. Relative to relative body
00:17:46
size to men. We also have less hemoglobin. So, that means our oxygen carrying capacity is lower. uh because
00:17:53
if we are looking at our red cells and we have four different what we call heem
00:17:58
molecules in a red cell and each one carries oxygen our red cell count is lower as compared to men because the red
00:18:06
cell count is driven by testosterone. So men have around 100% more
00:18:13
um aromatized testosterone as compared to women. So this increases the carrying
00:18:20
capacity of oxygen which means it goes to the muscles can deliver more fuel to
00:18:25
the muscles to be able to contract better have more power more strength. Does that mean women breathe more
00:18:33
exercising the same? Not that they breathe more. When we're talking about oxygen carrying capacity, this is the
00:18:40
amount that you're taking into the lungs, how it transfers to the red cells to then be able to go to the working
00:18:47
muscles to give the muscles the available fuel to do a contraction. So,
00:18:53
it's not a respiratory rate, it's the ability for you to breathe in and how fast that can be conducted to the
00:18:59
muscle. But, so there's going to be an impact on endurance then. It's more of a power and speed factor. Okay. Okay.
00:19:06
Okay. Because the speed in which the oxygen can get to the muscles is what's being impacted and the volume of oxygen that can get to the muscles. Yep. Okay.
00:19:13
Fine. And then you said the lungs are s sort of I read 25 to 30% smaller
00:19:19
than a man's lungs typically. Yeah. And what's the impact of that as it relates to exercise?
00:19:25
So when we're looking at um I guess world records right that have been kept
00:19:30
and we see there's a gender gap there and this is slowly closing in the
00:19:35
endurance world but that has to do with muscle morphology with regards to being able to go along and slow. We're looking
00:19:42
at the sprint capacity where we have to have a quick transference of oxygen and
00:19:48
quick muscle contraction. that gap isn't closing and that is because we have smaller lungs, smaller heart, we have
00:19:55
less blood volume, we have less red cells. So the overall capacity for
00:20:00
quickly developing power and speed is at a smaller um I guess it's a limited
00:20:07
capacity in women versus men. And in your book raw and page four in
00:20:13
the opening of the book, you talk about how women are 52% as strong as men in their upper bodies and 66% as strong as
00:20:19
they are in their lower bodies. But when women train, they can become 70 to 80% as strong as men. Mhm. So when we're
00:20:26
looking at resistance training itself, we see that women relative to men can
00:20:31
accommodate and develop muscle just as well as men in the lower body, but upper
00:20:36
body not so much. Okay. Um, we talked about this Q angle thing. One of the things that I've I'm really fascinated
00:20:43
by is there's been a big conversation recently around ACL injuries in sport. Yeah. And from reading your work, it
00:20:50
seems that and just doing some research online, it seems that this increase in women getting ACL injuries links
00:20:55
somewhat to this Q angle situation, which again is the I don't know how to explain it for someone that is listening
00:21:01
on audio and can't see, but I will link it in this description. So, I highly recommend you look at this picture cuz
00:21:06
the minute you see it, it makes a ton of sense, but it's essentially like, and this is me probably butchering it, as a
00:21:13
man, because my hips don't widen, my legs are effectively quite straight. Yep. So, from my hip down to my toes,
00:21:20
it's quite straight, which means that I'm going to be more sturdy. Say if I jump up in the air, when I land this, I
00:21:27
know this cuz my dad's an engineer, the center of gravity being straight means that I'm less likely to get injured. But
00:21:33
if you're Is that right right? Yeah. Because your forces are going to be in a more linear fashion. So you have more um
00:21:40
even distribution of the force through the knee. Mhm. But for women, as you're going to describe, our hips are wider.
00:21:47
So we have more of an angle to the knee and the forces aren't distributed evenly
00:21:53
when we land. So when we look at that as well as the quad dominance that develops
00:21:59
for women because quad dominance so that means that we use our um front muscles of our legs our quads a lot more than
00:22:06
our hamstrings our posterior chain. So we don't use our glutes and our hamstrings by default um as well as men
00:22:13
do. So, we're being pulled forward more and we let we put more emphasis on the front of our body. Mhm. Um because those
00:22:21
tend to take the the quads tend to take the bulk of the muscle work that we're trying to do unless we're really trying
00:22:28
to train hamstrings and glutes to fire, which isn't the default for women's bodies because center of gravity again
00:22:34
is lower and you tend to lean forward. So, when we're looking at ACL injury,
00:22:39
again, it comes down to one, training stress, two, mechanics, and if we're not
00:22:45
taught again how to land, how to run, how to jump with the new angles, it
00:22:50
predisposes people to severe ACL injury. And how much more likely is a woman to
00:22:55
have an ACL injury than a man? it is a higher rate but the thing about
00:23:02
the research is that there hasn't been a direct comparison because we hear
00:23:08
incidentally that women tear their ACL and so we see a lot of observational studies that women have torn their ACL
00:23:16
and we have lots of retrospective studies that are going back to oh where are we in our menstrual cycle when we
00:23:23
ACL but there hasn't been a definitive comparison between men and women. If we
00:23:29
were to look at the current research, we see a 3 to four to one ratio of ACL
00:23:34
tears of women versus men. So 3 to four. So So either 3:1 or 4:1 depending on the
00:23:41
research that you look. So three women for every one man or four women for
00:23:46
every one man. Okay. So 300% difference. Yeah. Okay. So
00:23:53
interesting. I absolutely never knew that. And in fact, it wasn't until I was looking through your work that I I'd seen um I went and did some research and
00:24:01
there's a big conversation online, a lot of sort of news coverage around women's football because it's I think it's the
00:24:06
fastest growing sport in the world. But I read that this the probability that a woman tears her ACL muscle is
00:24:12
significantly like hundreds of percent more likely than a man because of this in part because of this Q angle. in
00:24:19
professional sport is not as much as when we're looking at recreational sport because when we get into professional
00:24:24
sport we have specific warm-ups especially for football um put out by FIFA to prevent ACL tear to make sure
00:24:31
that you are actually properly warmed up and engaging the right muscles and learning how to stop pivot because it's
00:24:38
a it's a a mechanism in action usually is a twisting angle. But if we're looking at more age group or grassroots
00:24:45
sports because people aren't aware of this Q angle, they aren't aware of the quad dominance, women haven't been
00:24:52
taught again how to work with these new mechanics. Then we're seeing a greater incidence of ACL tear. 30 female
00:25:00
football players missed Women's World Cup in 2023 due to ACL injuries, including in the UK, Lioness, Beth
00:25:06
Meade, and Leah Williamson. Mhm. Which is staggering to me. Yeah, it's very
00:25:12
high incidence. Y So, is there something that can be done if you're a woman that's exercising, that's doing things
00:25:18
like jumping and running and sprinting and the fast sort of twitch uh sports,
00:25:23
is there something you can do to avoid having an ACL injury? It's all about being strong. So, if we're looking at
00:25:30
how what is the biggest thing for ACL prevention? And I'll bring in one of my
00:25:35
PhD students just graduated looked at um ACL rehab after surgery.
00:25:41
And it comes down to the definitive difference between quad and hamstring strength. So if we're looking at
00:25:47
improving the um strength capacity of the hamstrings, then it offsets some of
00:25:53
the default strength that the quads are taking. So if we're able to balance it
00:25:59
from being front loaded to being more even loaded, it comes down to, you know, how we were talking about distribution
00:26:05
of forces through the knee with men being more linear and women having an angle. Well, if we're able to take that
00:26:11
angle and we can evenly distribute the load between the muscles of the hamstring and the quad, so the front and
00:26:16
the back, then it pulls the forces more centrally. Okay. Which reduces the stress of one point of contact. Got you.
00:26:24
So if we're developing the strength through the whole posterior chain, we're looking at glutes, we're looking at
00:26:30
hamstrings, we're doing a lot of calf work and we can develop that whole posterior part. It reduces the incidence
00:26:36
of being pulled in one direction and the misalignment of forces. The other is the cutting motion where we're looking at at
00:26:44
um lateral movement. So a lot of times when we're looking at warm-ups and you're observing on like kids sports,
00:26:50
there's not a lot of lateral development. So if we're looking at at um prevent prevention of ACL tear, we
00:26:57
have to work a lot of the explosive lateral movements as well as jumping and single length single leg jumping. And
00:27:03
these are things that aren't really done in grassroots. But as we start to get more into professional sport, it's
00:27:09
becoming more and more apparent that we have to do specific mechanism of injury prevention. So they're looking at the
00:27:16
sport. We're a football player. We have a high incidence of ACL potential. So, we have to really develop our posterior
00:27:22
chain. We have to work on our power for our lateral movements, our step and our jump. Um, so this is part of what FIFA's
00:27:30
put in for the warm-up because there is such a draw. And as you were saying that 33 women in the World Cup tore their
00:27:37
ACL. Part of it is loading, part of it is a little bit maybe overtrained before they go into the World Cup, but a lot of
00:27:44
it has to do with um this imbalance between the muscles and now having to
00:27:50
address it. Did science just look at women as
00:27:55
a different version of men? Like sorry, did they just look at women as like a smaller version of men? Is that what how
00:28:01
they looked? Yeah, for the most part because I mean a lot of the stuff when I
00:28:06
was going through school and even now textbooks. So, I was standing in the metro in DC uh a few months ago and
00:28:14
there was a young girl who has just gotten into exercise physiology and I overheard a conversation and she was
00:28:19
talking about some of the experiments that they were doing but it never she never talked about like we have to make
00:28:26
uh you know we're doing women specific, we're doing men's specific and I asked her I was like has anyone you know
00:28:32
talked to you about how women's bodies are different than men's from angles and muscle morphology? And she's like, "No,
00:28:38
what are you talking about?" I was like, "This is a second year in X-Viz." Now, if you look at the textbooks, it's still
00:28:43
a representation of men in the textbook with regards to images. You have him or
00:28:49
they. You never have her. They might have a very small section in there about the female athlete, but usually it's
00:28:55
about the female athlete and anemia or relative energy deficiency in sport.
00:29:01
It's never about how we can empower women to use their bodies and their
00:29:07
physiology to their advantage and it's what almost 2025 now.
00:29:13
Is there any element of it of people being too scared to talk about differences in physiology amongst men
00:29:18
and women? I don't think so. I mean I always explain it from historical perspective when we're looking at the
00:29:25
history and when we started seeing the modernization of medicine medicine prior
00:29:30
to the modernization of medicine it used to be women who are the caretakers if you're thinking about you get sick you
00:29:36
go and someone has an herbal remedy for you but when we started medicalizing and becoming more nuanced in the medical
00:29:43
education women were excluded. So when we start looking at at the origins of
00:29:48
medicine and who was in the room, it was men. We start looking at the origins of science and science development, it was
00:29:54
men. So all the scientific experiments and everything have always been a default to men. We look at AI now and
00:30:01
they're learning from algorithms based on male data. So even now, healthc care is still heavily maleoriented.
00:30:08
So when we start looking at why women haven't been included or why women have been generalized to male data, it's just
00:30:14
been the nature of how things have developed. Now that we're aware of it and now we have more research money
00:30:21
coming into women's health, we're starting to see a change. And part of the two definitive moments in healthc
00:30:28
care research that really invoked this change. One was when we started seeing a lot of incidences with ambient and the
00:30:34
dosage of medicines where women were getting into a lot of accidents, car accidents after they taken ambient
00:30:41
because it was still in their system the next morning. It's ambient. It's a sleep aid. Okay. It's a a prescription
00:30:46
strength sleep aid. So then people are like, whoa, what's going on here? Oh, the dosage for 180 pound man is the same
00:30:53
as 120 pound woman. And we also know that there's differences in body composition and metabolism. So a 180lb
00:31:01
man can take this dose and be fine in the morning. But 120 lb woman can't take that same dose and be fine in the
00:31:06
morning. And then we have COVID and the outcomes of um long COVID and the
00:31:12
differences between the sexes with regards to women ended up with more long COVID, men ended up dying. So then in
00:31:20
during the COVID time period, people were like, whoa, there's sex differences in the outcomes of this disease. We have
00:31:26
to really start looking at that. So there are slow things that are really impactful on society that now people are
00:31:33
starting to step and say, wait, we have to really look at women as women. We have to look at men as men.
00:31:40
And is there an element of hormones impacting injury at all? There's always an in an impact of hormones when we're
00:31:48
looking at the overlay of hormones and sex hormones and then the protocols that
00:31:53
have been developed, they don't take into account estrogen, progesterone, and
00:31:59
to some extent testosterone. So, if we're looking at injury and the way that estrogen makes more um laxidative
00:32:06
ligaments. So, that means that our ligaments become more lax when estrogen comes up, which is why people assume
00:32:12
that around ovulation is when people will have more ACL tears. It's not
00:32:17
because we also see that progesterone comes in and can have a different effect on the tendons. But that isn't accounted
00:32:25
for in a lot of of the protocols that are out there for training and
00:32:31
prevention of overtraining. We see that when we're looking at male and testosterone, there tends to be the more
00:32:37
testosterone, the better for developing muscle and recovery, but that's not necessarily true either. So there's
00:32:43
nuances in the socioultural idea around sex hormones that also impact on our
00:32:49
actual guidelines and protocols. If a man and a woman came to you and said, "I want to lose weight." They said, "I'm
00:32:56
200 lb um and I'd like to lose some weight." Would you give them different advice on what to do? Absolutely.
00:33:02
Absolutely would. And it comes down to a lot of we see this on social media all
00:33:08
the time, calories in, calories out, right? So when we're looking at calories in, calories out, that idea of that
00:33:15
algorithm can work well in men. And the reason for that is the hypothalamus. So
00:33:21
if we're looking at the hypothalamus, which is an area in the brain that controls appetite, it also controls our
00:33:26
endocrine system. So for men, they don't have as many of what we call our kispin
00:33:32
neurons activated. So this is uh neurons that are responsible for when we have
00:33:40
nutrients coming in, they fire and they're like, "Yeah, okay. We got enough nutrition coming in that we can now
00:33:46
accommodate for developing muscle and losing body fat." For women, we have more areas that are very sensitive
00:33:53
sensitive to to nutrient density. So when I say this, when we're talking
00:33:58
about uh four grams of carbohydrate that come in and say they're carbohydrate from
00:34:05
fruit and veg, not from ultrarocessed stuff, those four grams of carb will affect the bodies differently between
00:34:11
being a man and a woman. For a man, this four grams of carb coming in primarily
00:34:16
will go blood sugar and then be stored as liver, muscle, glycogen. For women, it's blood sugar. it doesn't get stored
00:34:23
because for women in order to store muscle um and liver glycogen you have to
00:34:29
have an activation of uh some enzymes from the liver as well as some enzymes
00:34:35
within the skeletal muscle itself to say yeah okay we want to store this we don't want to circulate it so then we start
00:34:42
looking at how the brain is perceiving that so if the brain is saying yeah we can store this because there's still
00:34:47
enough muscle tissue around there's still enough blood glucose that we can keep going and we can survive survive the day. But for women, it sits there.
00:34:55
The blood glucose sits there and when it starts being used, the hypothalamus is like, "Okay, where's the extra food
00:35:01
that's coming in so we can keep going and countering the stress that's coming in?" And the best way from a numbers
00:35:08
perspective to look at it is when we are looking at calorie, baseline calorie intake just to exist and not get into
00:35:16
any kind of endocrine or hormone dysfunction and appetite dysfunction. For men, it's 15 calories per kilogram
00:35:23
of fat-free mass. For women, it's 30. So, we start to see men do really well
00:35:28
on things like fasted training. We see men do really well on calorie restriction because the hypothalamus is
00:35:35
not as sensitive to lower calorie intake or to low carb intake or to high protein
00:35:44
and um high fat intake. But for women, because the hypothalamus has more areas
00:35:50
that are sensitive to nutrient density. What does that mean? Sorry, I'm not even sure what the hypothalamus is. So, the
00:35:56
hypothalamus is an area in the brain. Yeah. And it's sensing. So, you have blood that circulates through the brain.
00:36:04
It senses temperature, how hot your your blood is. Like the thermostat or something of the body. Yeah. Okay. So,
00:36:09
it's Yeah, it is a thermostat. It's the appetite control center. It's how your body responds to salt, how your body
00:36:17
responds to protein, carbohydrate, do I need more, do I need less? So, it's it's
00:36:23
like the control center for the most part. So, for women who come in and they're doing fasted training, the
00:36:28
hypothalamus is like, "Wait a second, we don't have any blood sugar. We don't have enough carbohydrate to actually do
00:36:34
this kind of training." So, what I'm going to do is I'm going to create a little bit of dysfunction here and I'm
00:36:40
going to start downturning all the other systems that need the same kind of fuel
00:36:46
because I don't have enough just to do these muscle contractions. So, that means you could end up losing muscle.
00:36:52
Absolutely. So, if a woman comes to me, it's like, I want to lose weight and I've been doing fasted training. I get
00:36:57
up, I have a black coffee, I go to the gym, I do my lifting, I do some of my cardio. So, my girlfriend does exactly
00:37:04
that. and then I'm not that hungry because I did a hard workout at the gym. I might have a protein recovery shake
00:37:10
and then I'll hold off eating my first meal until noon. I always turn to them
00:37:15
and go, "Well, why did you go to the gym?" Because all you've effectively done is burn through your lean mass.
00:37:21
Your body needs to have some fuel and the first thing that goes is lean mass because it's a very active component of
00:37:29
the body. So, it would be better for you as a woman to have maybe 15 grams of
00:37:35
protein if you're going to do strength or 15 grams of protein with 30 gram of carb, which isn't a lot before you go do
00:37:44
cardio and strength because this is just enough to raise your blood sugar to circulate to the hypothalamus that yes,
00:37:50
there's some nutrition coming in. I'm able to get that blood sugar working. I'm able to get that blood sugar into
00:37:57
the muscle. I'm able to stimulate the mitochondria in the muscle to actually use some more free fatty acids. I'm a
00:38:04
able to tell the liver that I can actually get through this and use these free fatty acids instead of storing
00:38:10
them. It only takes a little bit of food to then have benefit for what you're doing. For a man, if he's like comes in,
00:38:17
I have a black coffee, I go to the gym, I do my strength, I might do a little cardio, I have my protein afterwards,
00:38:23
and then I might delay my meal. like that's all right because you have a longer window for recovery. The
00:38:29
hypothalamus isn't as sensitive. You're not burning through lean mass. You're developing a stress on the body and we
00:38:35
know that it's really good that you had that protein post exercise because that's going to create some muscle
00:38:40
protein synthesis and hold you over till you have your meal. Okay. So, I'm going to try and explain this to you um like
00:38:47
I'm a 10-year-old, which is the exact level of IQ I have on this subject matter. So, you've got this hypothalamus
00:38:54
in the brain, which is basically this sensor. It's trying to figure out, make sure everything is in I'm trying to
00:38:59
think of that big word that someone taught me. Homeostasis. Homeostasis. Everything is
00:39:06
level, right? Yeah. And a woman's hypothalamus is more sensitive. So if my
00:39:11
partner wakes up, goes to the gym, has her black coffee, goes to the gym, does a big workout as she always does, her
00:39:18
body, her hypothalamus is going to panic a little bit more because it's
00:39:26
going to assume that there's stress on the body now and it's going to look
00:39:32
around to see if it has sufficient blood glucose levels. And it's and it's not
00:39:37
going to because she's not had anything for a while. She's not going to have the sufficient blood glucose levels. So, it's going to start burning her lean
00:39:43
muscle mass. Exactly. Which means that she's she's essentially going to it's like one step forward, one step back.
00:39:49
Right. Super simplified. For a guy has his black coffee in the morning, goes to
00:39:54
the gym, does the workout, the body looks, and because the hypothalamus is less sensitive, it's less requiring of
00:40:01
there to be higher blood sugar levels, doesn't care as much. So, it's going to
00:40:09
it can also tap more into our liver and muscle glycogen stores. So, it's going to say, "Yeah." Okay. Well, we have a
00:40:17
little bit of blood glucose. We need a little bit more. So, let's tap into those stores and pull them out. So, it's less reluctant to go straight for my
00:40:23
lean muscle mass. Exactly. It has an alternative fuel source. That's interesting. And what's the
00:40:30
evolutionary story of this? Why why does this make sense? When we look tribally like there and I might get hit by some
00:40:37
sociologists are like wait this isn't completely true but for the exception
00:40:42
there are some tribes that didn't fit into this but for the general idea from a biological evolutionary standpoint
00:40:49
when we had times of low calorie intake so we had to go find the beast or we had to go out and find calories. It was at a
00:40:57
disadvantage for the woman to be pregnant or to have a baby an extra mouth to feed. So in times of low food
00:41:05
intake, the reproductive system or the endocrine system of a woman would wind down. So she would become amenoric or
00:41:12
lose her menstrual cycle for a while. But it didn't affect men in that same
00:41:17
way because they had to lean up and get fitter and faster because they had to go fight the beast or they had to go find
00:41:24
the calories and bring it back. So, when we're looking from that evolutionary standpoint, in times of low calorie
00:41:31
intake or low food intake, a woman's body will start to conserve and wind down because it thinks that there's a
00:41:37
famine coming. But for men, they're not as sensitive and the body's like, "Oh, not a lot of calories coming in. That
00:41:43
must mean there's a fight that I have to prepare for. So, I'm going to lean up. I'm going to address all of my fuel
00:41:50
systems so that I can tap into all these alternative fuel systems so that I will have the energy to be able to go and
00:41:57
fight the beast to bring the calories back. Mhm. So when there's adequate calories available, we see that women
00:42:03
will lean up. They'll become uh more acutely aware. Cognitive function comes
00:42:09
up. Carbohydrates are really important. So we see that there is a development of
00:42:14
egg maturation. we have better endocrine pulse. So that means that our hormones that pulse on a daily basis, they
00:42:20
actually have the full pulse um and return to baseline to encourage the body
00:42:27
to have a really robust endocrine system. So that's thyroid, that's our menstrual cycle, it's all the things.
00:42:33
But when we start pulling the calories back, all that stuff winds down. So what does that say about fasting?
00:42:39
So this is the big debate, right? So we look at fasting and where it first came
00:42:44
out and it's like okay we see that obese sedentary individuals who had to lose
00:42:50
weight rapidly for surgery they're put on a fasting type program to lose weight
00:42:56
quickly in order to survive surgery. And unfortunately a lot of the times we look at clinical research and it gets
00:43:03
transposed over to health and fitness without actually asking if it's viable.
00:43:09
So then we look at the lower end of the fitness population, people who are just learning to move and wanting to move and
00:43:15
like I also want to lose more body fat so that I can move better. Oh, I'll start fasting. And when we see a lot of
00:43:22
the like push on it, it comes from male data again. So when we start looking at
00:43:28
women and a lot of women used to come with their partners to see me and say, "I don't understand. We're both doing
00:43:34
the same kind of fasted training. He's leaning up and getting fitter. I'm putting weight on and getting slower.
00:43:40
I'm like, okay, well, we have to separate it out, right? If you're a woman and you want to fast for all the
00:43:46
health reasons that we hear about with regards to telmir length, improving
00:43:51
longevity, improving our body's metabolic control. Then we work with our
00:43:56
circadian rhythm where we stop eating at at dinner. So, we have dinner, we don't eat 2 to three hours before bed. We have
00:44:03
that overnight fast. And then you want to have food within a half an hour of waking up to blunt that cortisol peak
00:44:09
that's natural upon waking. For men, you can have variations of fasting. You can
00:44:15
do intermittent fasting, you can do a warrior fasting, and you can still have
00:44:20
benefit. But for women, when we look at the data, and if we were to do a warrior
00:44:26
fast, which is a 20-hour fast, 4-hour eating window, for men, we see more
00:44:31
parasympathetic drive. So, they get that more focused They have better blood glucose control. They get uh an
00:44:38
acceleration of body fat loss. They become more metabolically flexible, meaning their body's able to transfer
00:44:43
between carbohydrate and fat utilization. For women, it doesn't happen that way. For women who do a
00:44:50
warrior fast, so that's a 20our uh fasting and 4hour eating window. They
00:44:57
end up with less blood sugar control. We have higher resting blood glucose. We
00:45:02
have more fat storage. we have more sympathetic drive. So that means the body's under stress and you're not going
00:45:08
to be able to sleep or recover well and we see a downturn of the thyroid within
00:45:13
4 days of doing this. So when we're looking at the data of fasting again,
00:45:18
it's pulling from the men and generalizing to the women. But when we start really looking and narrowing it
00:45:23
down and looking at female specific data, the type of fasting that's out there in the health and fitness world is
00:45:30
not appropriate for women. But you would say that the sort of overnight fast
00:45:37
eating dinner at a earlier time at 6 7 6:00 and then eating breakfast when you
00:45:44
wake up at say 8 in the morning or 9 or something 6 or 7. What about the like 3-day fast you hear about to get into
00:45:50
like autophagy or whatever is? Exercise is a stronger stimulus for autophagy
00:45:56
than fasting because if we look at exercise in itself is a fasting state.
00:46:01
What happens during exercise? You start exercising, your body is trying to provide fuel. So, it's breaking down
00:46:07
fat. It's breaking down glucose. It's breaking down amino acids. It's also
00:46:13
creating in a recovery standpoint a boost of growth hormone, a boost of testosterone in both men and women that
00:46:19
creates the cell cleanup, which is autophagy. Right? So, if we're looking at the difference between fasting and
00:46:24
exercise, exercise is a stronger stress. All the things that we hear about fasting and longevity, exercise does the
00:46:31
same. It's a stronger stimulus for it. But the problem is we've become a lazy society and people think exercise is too
00:46:38
hard. As an exercise physiologist, it breaks my heart to see people who are struggling to walk down the street
00:46:45
because we are so used to being conditioned to a certain temperature in
00:46:50
a room to having a car automatic opener or Uber come so we don't have to walk down the road. And I bring up that movie
00:46:58
Wall-E from the early 2000s with the little robot who's like wandering around
00:47:03
society and you see all these people on these floating beds watching a screen and one of the guys gets kicked off by
00:47:10
Wall-E accidentally falls down. He can't get up and he's looking around going, "What? Why can't I get up? What what's
00:47:16
going on?" I'm like, that's today's society where people are are not able to
00:47:21
actually pull their own body weight around for a significant amount of time
00:47:26
because it feels too difficult. Whereas, if we look at all the stuff that comes out with nutrition and all the trends
00:47:33
that come out with nutrition from fasting to carnivorous diet to, you know, the oldfashioned paleo, all these
00:47:39
things that people are trying to do, we turn to exercise and we change the modalities of exercise. Are we doing
00:47:45
intense exercise? Are we doing low intensity? Are we doing resistance training? Are we doing cardio? What are
00:47:51
we doing? All of these things in exercise are significantly stronger stress on the body that create more
00:47:57
adaptive changes than all these crazy diets, but people find exercise too hard
00:48:02
or they don't have time. So, if I in that example where a man and woman come to you, you would you wouldn't recommend
00:48:09
the woman to fast in the same way that you'd recommend a man to fast. Is there any differences that you'd recommend in
00:48:14
training if they were if their goal was to lose weight? Yep, absolutely. So, when we're looking at regardless of age
00:48:21
for women because we see that women don't age in a linear fashion like men. So, we had definitive points. We have
00:48:27
puberty, we have our reproductive years, we not have pregnancy in there, we have pmenopause, we have postmenopause. Each
00:48:34
one of those is a different hormone profile that it can affect the way we train. for men, you know, you just kind
00:48:39
of go and we start to see a decline of testosterone, we get into our late 50s.
00:48:44
So, we're talking about women and training. If someone is coming in and
00:48:50
they're in their mid30s and they're like, I want to lose weight. Okay, resistance training. If someone comes in
00:48:56
and they're in their mid-40s and pmenopause, resistance training doesn't matter. Resistance training is key for
00:49:04
mobilizing abdominal fat and for creating more lean mass and also
00:49:10
increasing the amount of cross talk between their skeletal muscle and our stored fat through little things called
00:49:16
myioines which are hormone signals that are released during exercise and released from the skeletal muscle. So if
00:49:23
we say okay let's do resistance training to really recmp the body we also want to increase our protein intake because we
00:49:29
see if you're doing resistance training with a higher protein intake then we have complete remp over the course of 12
00:49:35
weeks and it's a very powerful motivating tool for women because for
00:49:41
the most part women have been excommunicated from the strength world until recently it wasn't kosher for
00:49:46
women to have a lot of muscles we see like I grew up in the '9s with the supermodels that were super skinny,
00:49:53
right? It wasn't kosher for women to be in the gym lifting weights. But we see this evolution change. And so we're
00:49:59
starting to see more research come out in women in resistance training. And it's so imperative for body composition
00:50:05
change to invoke that resistance training. What about a Zmpeek? A Zimp.
00:50:10
Yeah. So I find it interesting because of all the impact it's having on society
00:50:19
and it is a very powerful tool. The problem with it is no one is being
00:50:26
necessarily taught how to come off it. So if we look at osimp and how powerful
00:50:32
the GPL1 is, we see it does invoke an appetite switch where it mutes the
00:50:38
appetite. It dampens cravings. So we see as rapid weight loss, but the rapid
00:50:44
weight loss is lean mass. So that comes back to the wallally picture where you can't get up because you don't have lean
00:50:50
mass. I fear for society who doesn't have the opportunity to learn how to come off it through proper strength
00:50:57
training, exercise modalities, and nutrition to support the weight loss that comes with those impecc. It's
00:51:04
absolutely brilliant tool. is absolutely a brilliant tool, but we're falling on the behavior change. If we were to
00:51:11
really teach people how to create that behavior change while they're using the tool, then they can come off it and not
00:51:18
be afraid of putting weight back on. Okay. So, would you recommend it for
00:51:23
your for people that come to see you or ask you for advice? No, because most of the people that come to see me have
00:51:29
those 10 vanity pounds they want to lose. I call them vanity pounds because they're the ones that creep up and you
00:51:35
can instigate little changes within the daily life to actually lose them and
00:51:41
keep them off. For people who are struggling who have severe obesity, they're pre-diabetic, they have other
00:51:46
medical conditions and exercise is definitely in the too hard basket because they get breathless just getting
00:51:53
up out of their chair. We need to lose some weight first so that we can then implement some of the adaptive changes
00:51:59
of exercise. And do you think women should be eating immediately after they
00:52:05
exercise and men or is it does it is there a variance there at all? There is a variance because when we look at um
00:52:11
what we call metabolism coming back down to baseline. So that's your overall body coming back down to its resting state.
00:52:18
For women it happens within 30 to 40 minutes after exercise. For men it's 2
00:52:23
to 18 hours depending on the intensity. So in that we see that if we want to
00:52:28
maximize our body's resistance training and muscle building capacity, we need to give it some food. We need to give it
00:52:34
some really good hit of protein. For women who are in their reproductive years, we see 35 grams of protein post
00:52:42
exercise within 45 minutes will tip the muscle into muscle protein synthesis.
00:52:48
For men, it's 20 grams and it can be two, four, whatever hours later. When
00:52:54
we're looking at returning our muscle glycogen back to normal, we don't need as much carbohydrate post exercise as a
00:53:01
woman as men need more because they tap more into their stores. So the window of
00:53:06
opportunity for women post exercise is around that 45 minute mark, but for men it's open a lot wider. What about the
00:53:13
keto diet for women? I am kind of anti- keto for both sexes.
00:53:21
And I say this because when we look at the gut microbiome, that is so important. We see a decrease in
00:53:27
diversity as we become more and more I guess city dwelling and we are having
00:53:34
less and less of uh variety in our food chain. We have to take care of the gut microbiome. If we look at the ketogenic
00:53:41
diet and the high fat intake that comes with it, it significantly decreases that gut microbiome diversity, which reduces
00:53:49
the body's ability to synthesize vitamins, to produce serotonin, to have this conversation between the gut and
00:53:55
the brain. And for women, we're already metabolically flexible by the nature of
00:54:01
being born with more of those endurance fibers that there's no reason to try to do a ketogenic diet. Could I not take a
00:54:07
prebiotic or something or just eat more fruits and veggies and stuff? So, if
00:54:13
you're eating a lot of fruit and veggies, sorry, not fruit, veggies. No, if you're eating a lot of fibrous fruit
00:54:20
and veg, then that's how we increase the diversity. Taking a probiotic pill, it just affects the upper intestines. But
00:54:27
even that is a little bit suspect because there's only two to three companies that are making all the
00:54:32
probiotics that are B2B. So that means business is business and we don't really know the long-term outcome and we can
00:54:38
have the overgrowth of some probiotics that again can cause some dispiosis. Could I be on the keto diet and still
00:54:45
protect my gut microbiome? I don't think so. Not from what I've seen. Cuz I thought the gut microbiome
00:54:51
was predominantly about like plants. It is. But you also need some protein
00:54:57
that comes from a wide variety of different sources. And the amount of fat that is taken in through a true
00:55:04
ketogenic diet is 70 to 80% of your total intake coming from fat. And then
00:55:10
that will cause the overgrowth of the bacteria that relies primarily on fatty acids, which downregulates all the good
00:55:19
bacteria that relies on our fibrous fruit and veg. because you're not going
00:55:25
to be able to consume as much fiber as you need on a ketogenic diet to really invoke this diversity. For thinking
00:55:32
about invoking diversity, you want 30 different plants across the week. And on a ketogenic diet, you're just not
00:55:39
capable of being able to eat as much to create that diversity. And the reason why it's really important for women to
00:55:46
have that diversity is because we have some gut bugs that are responsible for our sex hormone metabolism. So, we think
00:55:52
about estrogen, progesterone. People think, "Oh, yeah, well, it's released from the ovaries and the adrenals and it goes and it hits our target tissues."
00:55:59
But we have this thing called a second pass where our sex hormones will be
00:56:04
taken up by the liver, bound by sex hormone binding globulin, shot into the intestines through bile, unconjugated or
00:56:11
unpacked by these little gut bugs, and then shot back out in the circulation to work. If we have a lower diversity of
00:56:17
the gut microbiome, we don't have those bugs that will help with our sex hormone. um I guess reactivation and the
00:56:24
ability for the sex hormones to work optimally. What about things like sauners and cold
00:56:30
plunges? Yeah. Is there a difference of variance there between men and women? Absolutely. So if we're looking at cold
00:56:37
plunge and it's all the rage, right? So we're seeing let's get into ice water.
00:56:42
It's going to invoke this massive parasympa parasympathetic response. I'm going to have lots of cognition and
00:56:48
focus. It's going to create a hormonal response that improves my blood glucose. It's going to invoke a lot of autophagy
00:56:55
and all the things that we see with fasting as well. And it gives me this incredible sense of being in control.
00:57:03
Male data. We look at women who are in ice bath. It's too cold to invoke those
00:57:10
responses. And the reason for that is we have differences in um our skin
00:57:16
sensation between men and women in with regards to thermmorreulation. So women
00:57:21
have more um subcutaneous fat. So more fat under the skin and we tend to vasoc
00:57:27
constrict and vasoddilate first. So that means that um blood vessels will
00:57:32
constrict tightly and then we'll start to have some internal changes or if we're too hot we'll vasoddilate first
00:57:39
and then we'll have internal changes to create sweating. So we look at a cold plunge there's too much constriction and
00:57:45
it becomes too much of a threat to women and their bodies don't have the same
00:57:51
response to ice water. We see that 15 to 16° C or around 55° F is optimal
00:57:59
temperature for women to experience the same effect that men have with ice. So there's a sex difference in the
00:58:05
temperature to invoke the same response between cold water um immersion responses. In the sauna, everyone
00:58:12
responds. And we see that the adaptation for sauna
00:58:17
is different again for men and women because for women with the difference of
00:58:23
the vasoddilation in the heat before they start sweating, it takes a longer time for core temperature to come up. So
00:58:29
women can spend more time in the heat before they start to get changes in their hormone responses and blood volume
00:58:37
adaptations. For men, they can go in and I kind of laugh. My husband will come in
00:58:42
with me in the sauna and I'll sit there for like 10 minutes. I'm not sweating yet and he's like pouring. He's like, I
00:58:48
got to get out. And it takes me like 20 or 30 minutes in order to get the same response. So when we look at the the
00:58:54
actual research and data that looks at acclimatization and looks at sauna invoking changes, we see again that
00:59:02
women need more time both long longer time for an acute bout and longer time
00:59:08
across the weeks in order to get the same cardiovascular adaptations as men.
00:59:14
Interesting. Didn't realize that. A typical ice bath is what temperature? It's what? Minus 1 or something. Or is
00:59:20
it I think it's 0 to 4° C. Oh, okay. 0 to 4. Okay. So, you're saying that a
00:59:27
woman should be nearer 15. Mhm. For the same benefits. Mhm. Yep. At my company,
00:59:33
Flight Studio, which is part of my bigger company, Flight Group, we're constantly looking for ways to build deeper connections with our audiences,
00:59:40
whether that's a new show, a product, or a project. It's why I launched the conversation cards. I've relied on
00:59:45
Shopify before, who's a sponsor of today's podcast, and I'll be using them again for the next big launch, which
00:59:50
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00:59:56
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01:00:21
That's shopify.com/bartlet or find the link in the description below. One of the um conversations I had
01:00:28
with my partner last year at New Year's Eve was about creatine. Yeah. Um, I had
01:00:33
it had some with me on the counter in our in our home and we were away from home and I said to her, I said, "Oh, you
01:00:39
should take some." And her response was, "No, that's not for women." And she went on to explain that she felt it was for
01:00:47
effectively like bodybuilders. Yeah. And that it would like put on weight. And I was like, I don't think that's true. I said, some people on my podcast have
01:00:53
told me that that everyone should be taking it. And so we sat there and Googled it. and after googling it for a couple of um minutes, she was like
01:01:00
scooping it into her drink as fast as she possibly could. But there is a prevailing narrative here. Actually,
01:01:06
before you came, I asked AI a couple of questions about women's perceptions on creatine and the number one thing was
01:01:12
women thought that it would gain muscle and gain weight and they thought it was
01:01:19
um for bodybuilders. Yep. That is the prevailing myths surround creatine. And
01:01:24
what's the expression people use? The dose or the poisons in the dose, right? So that's part of the creatine. So if
01:01:31
we're looking at the bodybuilding set and how it increases muscle capacity and
01:01:37
training status, so if we're using a lot of creatine, the dosing for bodybuilding is five grams four times a day with one
01:01:44
gram of carbohydrate. And we see that creatine helps store water within the
01:01:49
muscle with glycogen. And we want that for muscle performance because the idea of being able to train harder with
01:01:57
creatine is to enhance the amount of of enzymes that are available for muscle
01:02:03
contraction. And creatine is part of the buffering system of that. If we're looking at creatine for health and for
01:02:09
women, the dose is 3 to 5 grams only once a day without carbohydrate. And the
01:02:16
reason for that is women have around 70% of the stores that men have by the
01:02:22
nature for the most part don't eat as much creatine fil food as men and we see
01:02:28
that we use it for a lot of our fast energetics. So like for our gut health, for our brain health um and then also
01:02:34
for muscle performance. So, if we're having women take three to five grams once a day, it does not have the same
01:02:41
side effects as the bodybuilding set of taking five grams four times a day. Yeah. Because on the label, it tells me
01:02:48
to take it a few times a day. Yeah. You don't have to. And it says about loading. So, this is all the
01:02:53
bodybuilding stuff, right? So, if you want to load, we see a loading protocols over the course of two weeks and you're
01:02:59
starting to really saturate the body with those five grams four times a day. But for women, we see that 3 to five
01:03:05
grams will fully saturate the body over the course of three weeks. So that means that all our fast energetics, like I
01:03:12
said, our gut, um, the intestines, and we're looking at the integrity of the intestinal cells and the mucosal lining,
01:03:19
and we see that there is a greater incidence of GI distress in women. I think it's something like a 5:1 ratio of
01:03:26
women to men having GI distress running. And it has to do with estrogen, but also has to do with what we call the mucosal
01:03:33
lining of the intestines. So we want to maintain the integrity of the mucosal lining. And creatine is really important
01:03:39
for that. So if we're looking at saturating the body over 3 weeks with 3 to 5 grams, we improve that integrity.
01:03:46
So we have less GI distress. We also see that there have been randomized control trials looking at u mood and with
01:03:53
specifically with regards to depression and anxiety and women who are taking three to five grams of creatine
01:04:00
will come out of a depressive episode more so than women who are just using an SSRI. So it's really important for brain
01:04:08
metabolism. And when we're looking at that whole loading strategy for men, that's all
01:04:13
about muscle performance. It's not about gut health. It's not about brain health. about muscle performance.
01:04:20
Just looking at some studies, creatine supplication, creatine supplementation for both men and women enhances muscle
01:04:25
strength, increases lean muscle mass, improves highintensity exercise performance. Yep. Improves recovery, has
01:04:32
potential cognitive benefits, and supports in neurodeenerative diseases. Yes. So Abby Smith Ryan is a colleague
01:04:40
out of UNCC and she's done a lot of work in creatine for women. Um, and yes, we
01:04:45
see that there is an improvement in muscle capacity because you're increasing the amount of buffer that's
01:04:52
available for muscle contractions, but it doesn't have to be the same loading dose as men. If you are looking for
01:04:58
performance enhancement because you want to improve a training block or you're in
01:05:03
physique building or you're going to do something like high rocks and you need to have greater muscle capacity, you
01:05:08
might want to try the loading strategy. Yes, you will gain water weight because you're also storing more within the
01:05:15
muscle. But for the general woman who's looking for health and performance benefits, you don't have to do a loading
01:05:21
strategy. You just have to do that 3 to five grams a day. That loading strategy, for anyone that doesn't know, is basically some of the creatine boxes
01:05:27
will tell you the labels will say for the first week or two weeks, whatever, have a huge dosage of it, and then
01:05:34
thereafter you can kind of ease down the dosage. M but I think that's kind of been debunked as something that we all
01:05:40
need to do in all cases. Yeah. Are there any other supplements that you recommend women to take based on the way that we
01:05:46
live our lives and the food that we eat? Vitamin D. Okay. Um and why and what
01:05:51
does that do? So if we're looking at vitamin D, especially vitamin D3, what's the difference? So you have vitamin D2
01:05:57
and vitamin D3. Vitamin D2 is more of a storage form. It's not converted to being a functional form. So if you take
01:06:04
D3, it's already a functional form. So that means your body is going to take it in and use it as it should be. So we're
01:06:10
looking at a vitamin D3 supplement. Then we are able to boost circulating levels of vitamin D3 or vitamin D that's usable
01:06:17
and it's used for every system in the body. And it's really important now especially I'm coming from the southern
01:06:23
hemisphere just out of winter. You're in the upper parts of the northern hemisphere in the middle of winter and
01:06:30
we don't get enough sun. And when we're looking at now all the worries for skin
01:06:35
cancer, people are slip, slap, slop, you know, sunscreen, hat, clothes, and we don't get enough. And then if we're
01:06:41
looking at our food supply, there's not a lot of proper vitamin D rich foods. You're looking at mushrooms or fortified
01:06:47
dairy products. And those tend not to be consumed a lot nowadays. So, if we're
01:06:52
improving the amount of vitamin D3 that we're taking in and the amount of vitamin D that's circulating, we have
01:06:58
better recovery. We have better muscle function. We have better brain health. We have pretty much every system is
01:07:04
affected in a positive way. Omega-3. Yep. Omega-3s are good. Especially as we
01:07:10
get into perry and postmenopause, we want to look at uh how inflammation affects the cells. So, if we look at
01:07:16
using a really good vitamin or sorry, a really good omega-3
01:07:22
um and omega uh I guess we're looking at the types of omega-3s that are in there.
01:07:28
then we're enhancing cellular integrity that our estrogen used to help with
01:07:34
anti-inflammatory properties. It's not something that everyone needs to take. It's something that we have to consider
01:07:40
when we start getting into our late 30s, early 40s. Maybe get a blood test for it. See how your omega-3 levels are and
01:07:47
then consider dosing with a really good fish oil. What about iron levels? Because I've had
01:07:53
a friend of mine who is a woman um tell me that their iron levels were low. This is common and we see that there's
01:08:01
the incidence of a change in the
01:08:08
norms when we're looking at the reference ranges. And I find it really interesting that
01:08:15
the reference ranges that we have for all of our blood markers are shifting to a sicker population. What's that mean?
01:08:22
So if we're looking at the bell curve and we're taking population data, overall our society has become sicker.
01:08:29
So now we're seeing that the norms for iron used to be a ferotin of 50 or lower
01:08:36
was considered low ferotin. Now it's 26 for women. We look at testosterone.
01:08:42
Lower testosterone now for men is normal. And it is because that is just what a sedentary population now
01:08:49
presents. But if someone is active and comes to me and says, you know, I had my
01:08:55
iron tested and it's sitting at 26 and they say that it's normal, but I feel awful. It's like that is not normal. If
01:09:01
you were part of my high performance athletic crew, we want to see minimum 50, preferably 100. So, we have to
01:09:08
supplement you to bring it up. And it's a really specific area of how we supplement. It's supplementing every
01:09:14
other day with a very high bioavailable iron. And when we start looking at how
01:09:22
we are supplementing every other day with either carbonyl or glycinate, then we're really able to boost that ferotin
01:09:29
and people start to feel better. What does iron do and how does someone who's iron deficient feel? So iron is
01:09:36
responsible for that those hem groups that I was talking about with oxygen carrying capacity, hemoglobin, the
01:09:42
blood, the blood cells. Yeah. Their blood cells. So iron is responsible for allowing those hem groups to carry
01:09:50
oxygen. If we have low iron, then we don't have enough oxygen circulating throughout the body or being used by the
01:09:56
body. So you feel very flat, very tired. You start to get really dark circles under your eyes. Um it a mission to do
01:10:05
anything. So it's like a deadended fatigue. And people are like this this
01:10:10
isn't stressoriented fatigue or jet lag oriented fatigue. This is fatigue where I can't even walk up the stairs without
01:10:17
getting winded. What foods have iron in them or iron rich? So, primarily red
01:10:23
meat is where a lot of people turn to. But if you are more plant-based, then we
01:10:28
look at leafy greens. We look at nuts and seeds, but using a lot of vitamin C with that, preferably adding um a little
01:10:36
bit of olive oil on our salads. uh maybe cooking in an iron skillet to improve
01:10:43
the amount of iron that comes into the food. And we also know that we have to
01:10:48
time it with what we call hepsidin or hepsetin depending on where you come from in the world. It's an enzyme that
01:10:55
decreases the body's availability of iron absorption. It increases with
01:11:00
inflammation. So it's higher after training for about 5 hours in men and in
01:11:06
reproductive women. And it can be elevated for up to 24 hours in late perry and early post-menopausal women.
01:11:12
So basically, how do I supplement? Supplement before training or at night away from training. When you think about
01:11:19
men's and women's diets, is there anything to be aware of when we're thinking about because you know, me and my partner will sit down for dinner and
01:11:26
we share the food. Yeah. So we the food comes out, we even when we go to a restaurant, sometimes we'll order the
01:11:31
exact same thing and we'll both finish it. Yeah. Is that okay? Is it is it working for
01:11:38
you guys? I think part of the reason I ask is when I did some um blood glucose
01:11:43
tests. Yeah. I think I I think if I recall this correctly, my partner was
01:11:48
more sens glucose sensitive than me. And I recall them telling me that women are have a greater blood sugar sensitivity
01:11:55
than men. So this is the interesting part. So when we're looking at blood glucose and insulin sensitivity,
01:12:03
it changes across the menstrual cycle. So it depends on is she in the high hormone phase or not. If she's in the
01:12:10
high hormone phase which is after ovulation uh we have more insulin resistance and
01:12:16
the reason for that is when progesterone comes up it's trying to take in everything as a building block for the
01:12:23
uterine lining. Insulin resistance what does that mean? So insulin is the hormone that that is
01:12:31
a signal for your muscles to uptake glucose to store it. Okay. So it sends a
01:12:37
signal to grab the glucose out my blood, store it, which brings my glucose levels down. Exactly. Okay. Exactly. When
01:12:44
progesterone's in the picture, insulin doesn't do its job very well. Okay. Because pro progesterone wants to have
01:12:51
more carbohydrate available to be able to then send it to the developing
01:12:57
uterine lining, the endometriosis, because the endometriosis becomes a really thick layer of
01:13:05
tissue that is really rich in glycogen. So progesterone increases lean mass
01:13:11
breakdown or you increase your protein intake to have more circulating amino acids. It also makes your body less apt
01:13:19
to store glucose because it wants both amino acids and glucose to build this lush uterine lining. When we get into
01:13:27
pmenopause, we have more insulin resistance because there's confusion across all systems of
01:13:34
the body and the body is like, I don't know if I'm going to need this glucose or not, so I'm not going to store it.
01:13:40
And there's a misstep in the liver and a misstep in the mitochondria which is responsible for tapping into
01:13:47
using free fatty acids with carbohydrate. So the body is having a higher level of blood glucose because
01:13:54
the body doesn't know if it should store it or not. So when your partner gets tested depends on how old she is and
01:14:00
what phase of the menstrual cycle or if she's well beyond that. So that the part
01:14:06
of the menstrual cycle where her progesterone is highest is when she's
01:14:12
going to be most sensitive to sugar. Exactly. And that is typically between day 19 and 23 if she has a normal cycle,
01:14:20
a regular cycle or whatever. Well, the caveat there is ovulation. Is she ovulating or not? Okay. And
01:14:27
unfortunately, we're seeing in the modern fertility literature that women are having more and more anovulatory
01:14:33
cycles. But you won't necessarily know that because you'll still have a bleed. What's an an ovulatory cycle? You don't
01:14:39
ovulate. Why? They're looking at a lot of the stress that's coming on today's
01:14:44
society, the food system, a lot of the um I guess trendy diets that are out
01:14:51
there. A lot of women aren't eating enough to support their immune or their menstrual cycle function to allow the
01:14:57
egg to actually develop to then instigate ovulation. And it's not just in active women, it's across the board.
01:15:05
So, as it relates to this menstrual cycle, 28 days, I'm going to put it on the screen for anyone that doesn't
01:15:12
understand it, um, or doesn't know what I'm referencing right now, but I'll also link it below in the comments in the
01:15:17
description. Sorry. Um, 28 days long. There's the early felicular stage, the
01:15:23
late felicular stage, the mid lutulu lutio. It's exactly what I said. Yep.
01:15:28
And the late lutio phase. Yeah. Yeah. Yeah. Yeah. As it relates to nutrition and exercise. Yeah. How do I need to
01:15:35
adapt across these 28 days and why do I need to adapt? So again, it comes down
01:15:41
to the ovulation. Right. So if we're looking at the low hormone phase, so that's your follicular phase. Day one to
01:15:48
six roughly. Yep. And even up to ovulation, which is where? So around day 12 or 13 on 28 day cycle. So right at
01:15:57
that peak 12 to 13. Oh yeah. Yeah. Yeah. there. So, this is where um the immune
01:16:03
system is really robust and we're really resilient to stress and we can have a
01:16:10
lot of carbohydrate and protein intake and we're not going to be that affected. We're more sensitive to glucose. It's
01:16:16
going to be pulled into places it needs to be. If we ovulate after ovulation,
01:16:22
like I said, progesterone comes up. It's only produced if we ovulate because progesterone is produced from the
01:16:27
breakdown of the housing of the egg. Progesterone, like I said earlier, will
01:16:33
hold everything in the blood. It will it will tell the body, we need more blood glucose, and we need that glucose to
01:16:38
come to the endometrial lining. We also need more amino acids. So, we're going to break down lean mass or I'm going to
01:16:45
make this person crave more protein oriented foods so that I can have amino acids to come in. So, if we're looking
01:16:51
at adapting, right, the only real thing that we need to be aware of is after ovulation, if we're going to do a
01:16:57
highintensity workout, we need to make sure that we have some more carbohydrate. So, we're actually eating
01:17:02
before and after having some good carbohydrate that comes in, which is from day 14 onwards. Yep. So, from day
01:17:10
14 onwards, if we are going to do a lot of high intensity workout or high um a
01:17:16
big workout, y then we need to just make sure we're having more carbs. Yeah. And then we have around a 12% increase
01:17:23
in our protein needs because we have a higher amount of amino acids that are needed. One, because we're developing
01:17:29
tissue, but two, we also have skeletal muscle turnover that we need to keep up with. Interesting.
01:17:38
So, is there any day in the cycle where we shouldn't be working out hard? That's individual. So, it used to be early days
01:17:46
when menstrual cycle research was coming out. We saw on a molecular level that the low hormone phase was where we could
01:17:53
really push it and we could really get really good adaptations because our body was really responsive to stress. Then
01:18:01
after ovulation, we see a fuel shift. Like I said, progesterone is is really conserving or pulling glucose away.
01:18:08
Estrogen's also sparing it and saying, you know, you need to go to the uterine lining. So, with the change of hormones,
01:18:14
we have a change our fueling system. We also have a change in our core temperature where it goes up by about
01:18:21
0.5 or 0.5 degrees Celsius or around 1° Fahrenheit. So our heat tolerance isn't
01:18:26
as great. But because we're seeing more and more an ovulatory cycles, we have to
01:18:31
rely on the woman to track her own cycle, which is hard. Well, it doesn't have to be as hard as what people think.
01:18:38
Okay? It's the nuance of how do I feel today? So, I tell women instead of really dialing it in and saying, "Oh,
01:18:44
well, I think I ovulated today, so that means I should back it down." When you go to the gym, use what we call
01:18:50
sessional rating of perceived exertion. So, I tell people most of the time you're going to go in, you're going to
01:18:55
have a physical and a mental, right? Physical, how are you on a 1 to 10? Mental, how are you on a 1 to 10? If
01:19:02
physically you're an eight and mentally you're a two, warm up really well and see if that mental capacity comes back
01:19:07
up. If not, then we're not going to push too hard. We're not going to work on technique because mentally you're just
01:19:12
not there. Physically, maybe you are. If you go in and you're low on both of them, then it's going to be a technique
01:19:18
and recovery day. You're not wasting time at the gym. You're going to make it work for you by really working slow
01:19:25
under the bar, nailing technique, not getting the heart rate up so much. And as we're going through and tracking how
01:19:31
we feel, we're going to start to see patterns across our cycle. And we can
01:19:36
anticipate those patterns and say, "Okay, well, I know on day 21 I always
01:19:41
feel flat. So, I'm not going to schedule a highintensity workout that day. I'm going to sleep in, maybe do some
01:19:48
mobility, recover, and really know that I'm not going to nail it that day. So,
01:19:53
I'm not going to go push myself because I don't want to beat myself up mentally." Because women do this. They're like, "I suck. I don't know
01:19:58
why." But it comes down to that physiological variability. And for a woman to track her own cycle, understand
01:20:04
her own nuances. If you're really on to it and you know when you ovulate, then
01:20:10
you can take those molecular structures into play where you know you can hit your PR and you can really push it in
01:20:16
the low hormone phase. After ovulation, you're going to switch it to more endurance, maybe not so high intensity,
01:20:23
but more tempo type work. And then about the four or five days before your period starts where your immune system's more
01:20:29
compromised, you just kind of want to dial it down, use it as D lo because we can take the strength and conditioning
01:20:35
ideas of building up macro micro cycles and de lo across the menstrual cycle. So
01:20:41
where in the cycle am I going to be strongest if I'm a woman? So if we're looking from a cognitive and a
01:20:46
physicality aspect, it's right around where that estrogen starts to come up.
01:20:53
So around day six. Day six to about day 13. Day 13. Yeah. Okay. And where am I
01:20:59
going to be least strong? Theoretically from about day 23.
01:21:05
Yeah. Yeah. Yep. As those hormones start to come down. Yeah. To 28. Oh, okay. To
01:21:12
the very end. Okay. The very end. And the variation of those hormones coming down is what instigates a total
01:21:18
inflammatory response. So if we're looking at inflammation which drives the menstrual cycle to start the bleeding
01:21:25
phase, we have a change in our immune system. Bleeding happens at 28 around day 28. So we say bleeding is day one in
01:21:32
a cycle is day 28. Of course. Yeah. Day one to day six typically. Okay. Fine. Yeah. What questions should I be asking
01:21:39
about the menstrual cycle? Well, you know the questions that are never asked is like what is a typical menstrual
01:21:45
cycle? Yes, we have a textbook like from 1 to 28. That's very, very rare. Most
01:21:52
women have a cycle that might be 21 to 40 days. The bleed cycle is something
01:21:57
that's never talked about. What does a bleed cycle look like? Is it really six days? No. Every woman has a different
01:22:03
one. And if you're tracking what that bleed is, maybe you have two heavy days, a light day, and another couple of days
01:22:08
of spotting, and then a heavy day. That's your norm. When you start having changes in the norm, that's when you want to look and say, "Am I getting into
01:22:15
low energy availability? Am I not recovering well enough or am I in my late 30s early 40s and I started getting
01:22:21
into pmenopause. The bleed pattern is so important for people to understand
01:22:27
because that's how we have a true inherent
01:22:32
identification of stress. So we see changes in the bleed pattern as well as
01:22:37
the length of the menstrual cycle itself when the body is not adapting to stress. And stress isn't just our daily life
01:22:44
stress. It's exercise stress. And that disruption could also be just not having a a bleed. Yes. Because a lot of women
01:22:52
talk about that. They talk about having irregular periods or just the period didn't come this month. Is that often an
01:22:58
indicator of the body being under stress. Yes. And that stress can be not just a bad emails at work, but it could
01:23:04
be you're working out too much or something. Yeah. Working out too much, not eating enough is a big one. We've
01:23:10
done some really interesting research looking at recreational female athletes. So, people who go to the gym three or
01:23:16
four times a week, right? They're not training specifically for anything but life. Mh. And they tend to fall into
01:23:23
some of these trendy diets like fasted training or maybe they're eating too low carbohydrate because they're on a low
01:23:29
carb, highfat or high protein diet and they're missing on the carbs. And again, that interrupts the hypothalamus. So, we
01:23:35
call it low energy availability. when someone isn't eating enough for the
01:23:40
hypothalamus to say, "Yeah, all of our systems can work and we can adapt to exercise." So, we see on the upwards of
01:23:48
55% of recreational female athletes in a low energy state or subclinical low
01:23:54
energy state and it comes out as changes in the bleed cycle or a missed period.
01:23:59
That's why I tell women, look, if you're tracking, you can do sessional RP, but really track that bleed pattern and the
01:24:05
length of the cycle because if you start to see changes in the length and changes in the bleed pattern or just changes in
01:24:12
the bleed pattern, it's an opportunity for you to take a pause, say, what have
01:24:17
I done from a training perspective or a sleep perspective or somehow increased
01:24:22
my stress that my body's not adapting well? Because if we do that first then we don't get into a clinical position of
01:24:29
amenorhea which is no menstrual cycle and poor bone health and psychological
01:24:34
issues and things that all come with endocrine dysfunction. Why is bone health so important for women in
01:24:40
particular? When we see bone it is
01:24:46
driven by estrogen progesterone and an interplay between estrogen progesterone. we see a peak velocity or peak bone mass
01:24:55
hitting around the time we're 20ish and then we'll start to degrade it if we're
01:25:01
not creating multi-directional stress on the bone through jumping
01:25:06
through resistance training and if we start to lose bone density and we become
01:25:13
osteopenic or osteoporitic meaning we have very thin bones they break easily
01:25:18
and it's really really difficult for someone who is in their reproductive years to to be able to do all the things
01:25:26
they want to do if they don't have a really strong robust skeletal system. And this is why vitamin D is also so
01:25:31
important. Yes. Okay. And men and women have different bone density. Yep. Men
01:25:36
have thicker bones and tend to not have as much degragation of the bone because
01:25:42
they don't have estrogen progesterone perturbations that are changing the signaling to
01:25:48
increasing bone density or stopping the growth of bone. Right? So women have
01:25:53
this perturbation throughout their menstrual cycle that will change how their bones are responding. And then
01:25:59
when we don't have a menstrual cycle or we get put on an oral contraceptive pill, we have changes in that signaling
01:26:05
which changes our bone density. And you mentioned sleep a second ago. Yeah. How is sleep relevant and what's the
01:26:11
variance between men and women as it relates to sleep? Sleep's really important because that's where we have our parasympathetic drive and our
01:26:18
ability to recover. So the whole I shouldn't say the whole reason because nobody really knows why we need to sleep
01:26:24
other than the fact this is where our physical and our mental capacities become solidified. So that means that
01:26:30
our body fully repairs while we're sleeping. Our memories get solidified. Our brain becomes a little bit relaxed
01:26:36
and can repair itself while we're sleeping. For women, we see changes across the menstrual cycle in our sleep
01:26:43
phases. So when we are slow sleep phases meaning our deep sleep versus our late
01:26:48
sleep versus our dream sleep and we need to get in that really super deep sleep in order to have optimal reparation.
01:26:55
When we are getting close to the bleed phase then we see more interruption in
01:27:01
the sleep and it's really really apparent for women who have really bad PMS or uh other conditions that happen
01:27:09
to affect estrogen progesterone. We have an increase in our core temperature from progesterone. We have changes in
01:27:15
melatonin pulse because of of estrogen. So when women are talking about having
01:27:20
really poor sleep right before their menstrual cycle, it is because we have these sex hormones that are interfering
01:27:26
with our sleep phases. For men, they don't have that perturbation. For men, we see that um chronologically they tend
01:27:34
to have a melatonin peak that's later than women. So they tend to want to stay
01:27:39
up later and they can sleep in but they can also have shorter sleeps. So there's a chronobiology aspect that comes to it
01:27:46
with regards to how our body actually falls asleep and wakes up. And there's a sex difference in that chronobiology. Do
01:27:54
men or women suffer more with jet lag? Women suffer more with jet lag. And if
01:28:00
so, why? Why is that? Because if we're looking at our circadian rhythms and how long they are, like I said, melatonin
01:28:07
peaks earlier for women than men and we have a slightly different What does that mean? Sorry, melatonin. So melatonin is
01:28:13
what allows our body to actually get into sleep and our wind down for that is
01:28:19
melatonin production. So a lot of people will start to feel really sleepy at like 4 in the afternoon, right? It's just a
01:28:25
natural occurrence. Our core temperature comes up, we start to have melatonin production. And for women, a melatonin
01:28:31
peak for sleep to for sleep onset hits around 900 p.m. on average. For men,
01:28:37
it's about 10 or 11 p.m. because our circadian rhythms are different. So women are on a shorter side than men. So
01:28:43
if we're talking about jet lag, for women going east, it's a little bit easier because it's a shorter. For women
01:28:50
going west, it's a little bit harder because it's longer. So there's a difference. Men will do better going
01:28:55
west and worse going east. Women go better east than going west.
01:29:03
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01:31:03
Zoe. Use this term chronobiology. Mhm. I have
01:31:09
no idea what that word means, but that's the biology of our chrono circadian rhythm. Yeah. Okay. Yeah. Yeah. And is
01:31:15
there anything else that men and women should understand about our chronobiology that's pertinent to making sure that
01:31:21
we're high performing and healthy? Yes. So this comes down to our hormone and
01:31:27
pulses throughout the day. So we see that cortisol which everyone talks about as being a bad thing. It's not a bad
01:31:34
thing. We have a peak about a half an hour after we wake up. And for women we need to eat in order to dampen that
01:31:40
peak. For men it just naturally dampens. So you don't need the food to instigate dampening of that peak. We see a
01:31:47
luteinizing hormone pulse in both men and women. But the um amplitude of that
01:31:52
pulse is greater in women because it's responsible for how our body responds to
01:31:58
developing an egg so that it can be fertilized. We also see estrogen pulses
01:32:03
again to pulse throughout the day and then throughout the week before we can come to one of those estrogen peaks. So
01:32:10
our body is is aligned for these pulses and we have a 20ish 24ish hour clock and
01:32:17
within that we have cellular clocks. So we have a cellular clock that's telling us to pulse luteinizing hormone every so
01:32:25
often. We have a internal cellular clock that's telling estrogen to pulse every
01:32:30
so often. And we can change that through differences in sleep, change that
01:32:36
through our light wake time, and through food intake. How important is it to time
01:32:42
our meals and be intentional about when we eat? It's pretty important if we're looking
01:32:47
about how our clock is aligned. Yeah. And how we are repairing while we're sleeping. Because if we're eating late
01:32:55
and we've shifted everything late because people eat late, they go to bed, they wake up, they're not hungry, they
01:33:00
don't dampen that cortisol peak for women and then they don't sleep very well because if you are eating right
01:33:06
before bed, your body is using parasympathetic response to digest instead of invoke really good sleep. So
01:33:14
we see a lot of this circadium misalignment that's occurring. We see it a lot in shift workers. We see it a lot
01:33:20
in our global society of staying up late and working and having screens. And the
01:33:25
impact on metabolism is that it changes appetite hormones for women where it will increase the craving for
01:33:32
carbohydrates and the desire to eat more and they don't ever feel full. For men,
01:33:38
it's just a craving aspect and so they'll eat according to cravings. It's
01:33:44
called hedonistic eating rather than a true change in appetite hormones. So
01:33:49
people who are having difficulty sleeping and difficulty changing body composition for overall health, we shift
01:33:55
it. We're like, okay, we want to shift to be able to eat during the day and to have regular food at regular intervals
01:34:02
so that our body has fuel to do what it needs during the day. We stop eating at
01:34:08
dinnertime, which is around 6 or 7, have a good 2 to three hours before we go to
01:34:13
bed. so that when we do go to bed all our parasympathetic responses can go into getting really good sleep
01:34:19
architecture. So that means that we get really good um phases of sleep for
01:34:24
optimal physical mental recovery because if we have that then we have better blood glucose control so better insulin
01:34:31
responses. We're able to have more energy during the day and our all of our systems work better. I I had noticed
01:34:37
something intriguing about me which is when I wake up early to go to the
01:34:43
airport. So, say I have to wake up at like 4:00 a.m. to go to the airport. I am so hungry. Yeah. And I've never
01:34:49
understood why. Because if I wake up at, say, 9:00 a.m., I don't wake up as hungry. Yep. Why? Your brain is
01:34:56
perceiving a stress. And this is that hedonistic where you're like, uh, my brain is like, I'm under stress and I
01:35:03
need fuel. I need glucose. So, it thinks like a line has woken me up. Yeah. [ __ ] hell, that makes so much sense.
01:35:09
Honestly, it's so it's so it's always confused me because sometimes I have to wake up super early, so 2 3 a.m. to go
01:35:15
get a plane or something. And when I get to the airport, I'm so hungry. But like a day today, what time is it? It's 1:00
01:35:22
p.m. Mhm. And I haven't eaten yet. I know you're mad at me, but I haven't eaten yet because I don't want to eat
01:35:28
before I do a podcast because then it's going to like it like messes with my articulation. So, I can't get the words
01:35:33
out my mouth. Okay, that's maybe that's [ __ ] I'm saying this to someone that knows what they're talking about, but maybe there's something else I could
01:35:39
eat. But I just find that if I eat something heavy or if generally if I eat the way that I've always rationalized it
01:35:45
is all the oxygen's like going to my digestive system. Is that nonsense? That's nonsense, is it? Actually, yeah.
01:35:51
So, can I eat before I do a podcast? Yes, you can. And it won't impact my ability to articulate myself. If you're really worried, then you can have like a
01:35:57
protein shake or protein water. You could sip protein water while you're having a podcast. So, then you're getting amino acid circulating. Your
01:36:03
hypothalamus is like, "Sweet. Okay, we're all good to go. But I hear you because I don't like to have a lot of
01:36:08
food in my stomach when I'm going to be concentrating a lot or trying to articulate. So, I eat things that are
01:36:13
high in protein but easy to digest. Okay, try that. So, like protein, water, a protein shake would be a good idea
01:36:19
before or hard-boiled eggs. Hard-boiled eggs. Okay. Okay. Let's talk about menopause then. Yeah. Starting with
01:36:26
permenopause. Yeah. You got a smile on your face. Oh, it's something that I'm
01:36:31
really excited is coming into conversations now because three years ago, no one would say the word. I knew
01:36:36
we had made it as women in society when the nightly news was talking about menopause. So, let's go. I'm excited.
01:36:42
One thing I saw which was quite an interesting observation is in the UK this year on Apple. Mhm. The most shared
01:36:48
podcast episode in the whole country of all podcasts was a conversation I had
01:36:54
about menopause. Nice. And congratulations. That's awesome. It gets even better. And in the US, the most
01:37:02
shared podcast episode of all podcasts in the US on Apple
01:37:08
was the same guest on Mel Robbins podcast talking about menopause. I go, that's that's incredible. And also crazy
01:37:16
that in both countries, the number one most shared podcast episode was the same
01:37:22
guest talking about the same topic. Yep. That doesn't surprise you? Nope. Why?
01:37:27
Well, I know this guest and she's very good at articulating, but also we have seen this upsurge of women like myself,
01:37:36
my age group, put myself out there. We all grew up on the understanding that we
01:37:42
were women, we were a little bit different from men, but no one told us about menopause.
01:37:49
And now all of a sudden, there are these extreme changes that are going on. And
01:37:56
people are like, "What's going on?" And if I were to take a typical case scenario of a woman who's in her 40s and
01:38:04
goes to a doctor and goes, "You know what? I can't sleep. I am trying to
01:38:10
exercise, but I'm so tired. I can't do it. My body is changing, and I just
01:38:16
don't know what's going on." The general response to her three years
01:38:21
ago would have been, "Well, look, you're a woman in her 40s who's highly stressed. You have kids on one side. You
01:38:28
have older parents on another. You're trying to You're right in the middle of your career. You have a really busy life. Here's an SSRI for anxiety and
01:38:35
depression is going to help you sleep. But now with all the conversations that have been going on, a woman in her 40s
01:38:42
will go to a GP and for the most part will be told, "Well, you're in your 40s.
01:38:48
It might be permenopause." And this is such a relief to so many women because they're not being gaslit
01:38:55
anymore. They're not being told that what they're feeling isn't true. It's just something to do with stress. Now
01:39:02
they're being told, "You know what? All your systems in your body are being affected because your sex hormones are
01:39:08
changing. So remember puberty when everything was changing and no one wants to live through puberty anymore. You're
01:39:14
on the other side of that. You're in reverse puberty where all of your hormones are starting to downregulate.
01:39:20
So every system in your body is being affected. Let's unpack it. Let's see what's going on. So when Mary Cla comes
01:39:27
on and talks about menopause as an MD and talks about all the things that she's seeing in her clinic, women are
01:39:34
like, "That's me. Now I understand I'm not alone." And that's the power that's
01:39:39
coming through all of these conversations and all of these groups like Naomi Watts Swell Group, right?
01:39:45
They're talking about menopause. So now women are listening and keying in and going, "Wait a second. there actually
01:39:51
are things that are occurring to me and I can get information which is why these podcasts are taking off because now
01:39:58
women are like I'm not just crazy there are actually things happening to me and
01:40:04
people understand that now what can I do to help myself because it isn't being taught in med school a lot of the
01:40:10
doctors that are out there are getting information because they are seeking it out themselves
01:40:16
and looking to people like Mary Cla and other like Louise Nuome in the UK who
01:40:23
are actually talking about it and saying these are the things that are happening and these are the things that we know that we can do. Gosh, it's a shame,
01:40:30
isn't it? It's a shame that there must have been so many women over the years that went to their doctor and got really bad advice. Yeah. And were given
01:40:35
anti-depressant medications and stuff like that. M well the other side is women who are in their reproductive years who have something like PCOS or
01:40:42
endometriosis or they're having irregular periods and they're put on an oral contraceptive
01:40:48
pill because the doctors don't understand that there are other things that are going on that will cause a misstep in menstrual cycle. So I get
01:40:56
frustrated when teenage girls go to a doctor with irregular cycles and they're
01:41:02
handed OC's like Skittles. It's like that's not appropriate either. We have to actually understand what's going on.
01:41:07
We know that there's irregularity in a menstrual cycle until people are around 3 years post the onset of their first
01:41:14
menstrual cycle. It's not unusual and OC is not the answer. If someone's still
01:41:20
having irregularity, we have to look at lifestyle and say, "Hey, what's going on?" They're having really heavy menstrual bleeding. It's not about using
01:41:26
an OC to control it. Let's look and see why is that happening. Maybe we use an IUD or maybe we use some other
01:41:32
medication to help. But there's a lot of things that are not taught in med school that women are having to find out for
01:41:38
themselves. And so when we listen to podcasts and we're hearing information from medical doctors who now have a like
01:41:44
a vocal aspect of being able to touch so many people, it resonates. So now
01:41:49
doctors are trying to find that information if they have the time. But we know the health care systems in most
01:41:54
countries, doctors are so pressed for time, they don't have that opportunity. So let's talk about perry menopause.
01:42:02
What do I need to be thinking about? What what age group typically is pmenopause?
01:42:07
Um I guess it can be a wide spectrum, but when does that typically start and how do I need to be thinking about my nutrition and exercise in that phase? So
01:42:14
around age 35 up to I think they say now the average age of menopause is 52 years
01:42:21
old. Okay. So what's happening in that 15 to 17 year span is you're having such
01:42:29
a change in the ratio of estrogen and progesterone. Early days, a lot of it appears as I'm
01:42:37
not adapting to my training. It's not working well. I'm putting on more body fat. I'm becoming squishy. I'm not
01:42:45
sleeping well. I'm having lots of mood changes. It must be. This is why a lot of doctors
01:42:50
say, "Oh, it's because you're busy and stressed out. Here's a serotonin reuptake inhibitor." But no, it's changes in the ratios. How can we dial
01:42:58
it in? We look at menstrual cycles and is it becoming shorter or longer? What's our bleed phase? We get into our mid to
01:43:05
late 40s. It's very apparent because there are a lot of different changes that are occurring. We're seeing a
01:43:10
change in our blood lipids. There's an increase in our low density lipoprotein, which is the quote bad cholesterol. Even
01:43:17
if a woman's never had an issue with it, now all of a sudden she's having issues with her cholesterol. We see A1C coming
01:43:23
up, which is a marker for diabetes, pre-diabetes, without any real change in
01:43:29
what they're doing other than the fact that their exercise isn't working. Their
01:43:34
sleep is a little bit disrupted and their body composition is completely changing. And when we're looking at
01:43:41
what's happening, we see that decrease in gut microbiome diversity because we
01:43:46
don't have as many sex hormones. So that impacts serotonin, that impacts vitamin production, that impacts parasympathetic
01:43:53
drive, and we're also seeing a misstep in the way liver is reading fat and fat
01:43:59
circulation. So we're seeing free fatty acids that are coming around. And because we don't have as much estrogen,
01:44:05
we don't have as much anti-inflammatory responses. So we can't pull as many free
01:44:11
fatty acids into the mitochondria and the skeletal muscle to be used as fuel. So they circulate and the liver has a
01:44:18
signal that goes we're going to change that free fatty acid into what we call estrified fatty acid which then gets
01:44:24
stored as visceral fat and visceral fat is that dangerous fat that gets stored around the organs which is why women
01:44:30
start to get like a minnow pot or develop a lot of abdominal atyposity. So people will start seeing this and going
01:44:36
I don't understand what's going on over the past six months I put on 10 pounds or or I put on four stone right what's
01:44:44
going on my training is not working become very despondent and if they don't know they're in perry menopause then
01:44:50
they don't know that that's what's happening and how can they find out if they are well it's really symptomatic
01:44:55
because we can't use blood tests there isn't a definitive blood test to say hey you're a permenopausal you have to have
01:45:02
a a history of everything of getting blood tests like every week and no one
01:45:07
does that. So we have to go on symptomology really using the socioultural aspect of
01:45:14
how a woman is experiencing life with her symptoms and really listen and say
01:45:20
okay well here are the things that are going on and we try to instigate non
01:45:26
hormonal options there's exercise. there's lifestyle and then if all else
01:45:31
is really going to [ __ ] then we can look at using some menopause hormone therapy just like we were talking about oimpact
01:45:37
being a tool so hormone therapy can also be a tool does it matter my pre-existing
01:45:44
health when I approach menopause if I'm if I've got more weight on my body is
01:45:49
that going to impact the amount of symptoms that I experience of menopause it can yeah it can we see that there is
01:45:55
a greater incidence of vasom motor symptoms or hot flashes es for women who have a greater amount of body fat. Um we
01:46:03
also see that if you have more lean mass then you're going to have less of an
01:46:08
incidence of insulin um resistance. So body composition has a huge play in
01:46:14
symptomology. And then you also have to look at what your mom went through because if your
01:46:20
mom had a really really horrible time with lots of vasom motor symptoms and body composition change there's a
01:46:25
genetic link. doesn't necessarily mean that you're going to experience the same thing, but you have a greater
01:46:31
predisposition to having more severe symptomology. How should I be thinking about exercise as I'm going through my
01:46:38
menopause journey? So, we look, as I said earlier, exercise is a really good
01:46:44
stress for adaptive change. So, when we start getting into all these ratio shifts of estrogen, progesterone, we
01:46:51
can't rely on our hormones to create those adaptive changes. And so what I
01:46:56
mean by that is like estrogen is responsible for muscle protein synthesis and and strength and power for women.
01:47:03
Progesterone and estrogen responsible for bone bone growth, bone density. We
01:47:09
can't rely on our hormones for that anymore. We have to look for an external stress. So this is where exercise comes
01:47:14
in. So if we're looking specifically at how to invoke a stress to change our
01:47:19
insulin sensitivity in in other words improve our blood glucose control we need to do proper highintensity work. So
01:47:26
that's sprint interval or it's true highintensity work to create a stress
01:47:31
that's high enough to have the brain say hey this is a really really really
01:47:37
strong stress I need to invoke changes within the skeletal muscle to be able to store more glucose. I also need to
01:47:44
invoke more changes in the mitochondria so that it can use and store more free fatty acids and I'm going to have more
01:47:51
miaakine released from the skeletal muscle to tell the liver don't estify those fatty acids. I want to use them at
01:47:58
rest so we don't get viscerial fat gain. So hit workouts. Yeah. Plyometrics.
01:48:03
Yeah. Which is what jumping and stuff. Resistance training. Absolutely. Weights, right? Yeah. But specific to
01:48:10
the type of weights that you're doing. What about frequency of training and how long I train for? We want to think about
01:48:16
less volume and more quality. Okay, so we're not going to the gym for an hour
01:48:21
and a half every day. We're looking at doing short, sharp, highintensity cardio or we're looking at doing powerbased
01:48:29
resistance training three times a week and the cardio can be uh two to four times a week. Why why shorter durations
01:48:36
of training? We're looking at intensity. So, if we're doing long slow stuff or we're doing moderate intensity zone 2
01:48:43
stuff, that's not really going to create the kind of stress that we need to invoke change. What about um sauners and
01:48:49
stuff like that? Yeah, absolutely. We see that women who go into the sauna um
01:48:56
get better control over things like hot flashes because it's all about temperature and temperature control. So
01:49:02
if the blood going through the brain is really hot, it understands, hey, this is what hot is and can then have subsequent
01:49:09
peripheral changes for controlling heat and understanding heat as well as sensual changes to understand heat. And
01:49:16
what about food through menopause? Is there a specific diet that I should be thinking about for menopause? We want a
01:49:23
higher protein intake, of course, because as we get older, we become more anabolically resistant to protein. So
01:49:30
that means our body isn't responding as much to the amino acids. So we need a higher dose to invoke muscle protein
01:49:38
synthesis and bone regeneration, nerve regeneration. Also knowing that the recommended daily
01:49:45
allowance that's out there for protein, especially for women, is based on sedentary older men. So it's not really
01:49:51
adequate for what we're looking for. Uh so we want higher incidence of protein
01:49:56
at regular intervals across the day. And again taking care of that gut microbiome. So we want a lot of colorful
01:50:01
fruit and veg that also helps with uh blood glucose control as well as
01:50:07
creating that diversity so that we are able to reduce the amount of of bacteria
01:50:15
that is responsible for storing body fat. We want to have that great amount
01:50:20
of diversity of gut microbiomes to or great diversity of the gut microbiome to
01:50:26
have more of the bacteria that says, "Hey, you know what? We want more lean mass. We want to have less body fat." I
01:50:32
noticed earlier on when you talked about hormone therapy, you referred to it as menopausal hormone therapy as opposed to
01:50:40
hormone replacement therapy. Yeah. Most people say HRT, right? Right. Why do you
01:50:46
say something different? Yeah. I got a lot of my chops and menopause work through the women's health initiative
01:50:52
and I'm not going to apologize for that cohort because this study was designed
01:50:59
to look at older women going through perry menopause or going through menopause and does it work. So there's a
01:51:05
whole issue around WHI and other things, but when we look at specifically women
01:51:10
who are going through menopause or pmenopause into menopause, we're not
01:51:16
looking to replace hormones. We're looking at a therapy to attenuate change. If we're looking at hormone
01:51:23
replacement, that could be thyroid, that could be uh premature ovarian failure
01:51:28
that we need to have some um estrogen, progesterone. We're looking at menopause
01:51:34
and pmenopause in itself. We're looking at using a hormone dose that is a very
01:51:40
low physiologic um level so that we don't have symptomology. So the body is not going
01:51:46
to have vasom motor symptoms and is not going to have mood changes and is not going to really have an incredible
01:51:55
amount of body composition change. If we're replacing hormones, people have the idea that it's going to be the same
01:52:01
physiologic level as when we were in our reproductive years, and that's not the case. Is there also bit of an underlying
01:52:08
notion that women are using these hormones to as a way to stay young? And when you say replace, you're kind of
01:52:15
implying that they're fighting against something. Yep. That we are replacing our hormones to stay young and be in our
01:52:21
reproductive years. So if we look at western society and I like to use um the
01:52:28
cast of friends as an example from you know 90s to now right and we see that
01:52:34
the cast of friends women all have a certain look that they've had to maintain in order to be viable in
01:52:40
Hollywood which means that they're thin they have good body composition they are don't have any wrinkles they have really
01:52:45
good lustrous hair and that's the image that women have now of how they're supposed to age where men not so much we
01:52:52
see the images of men who are aging becoming more uh demure I guess so they
01:52:58
have gray hair they have some wrinkles they're very distinguished and that's the image we have of men aging there's a
01:53:03
huge disconnect in society so when women start to experience pmenopause it's a
01:53:09
definitive point of aging and people are afraid to age everyone's afraid to age
01:53:14
for the most part the idea of aging gracefully or embracing it hasn't quite
01:53:20
gotten to mainstream So when someone's like, "Here's some hormones to replace so you can stay young." People are like,
01:53:27
"Great." But we look at the research and it's not about staying young. It's about slowing the rate of change that's so
01:53:34
severe that creates quality of life distress. And we also see that the research isn't there for maintaining
01:53:41
brain integrity to prevent dementia, which is the other thing that's floating around. It's not there. there's no
01:53:48
evidence to show that taking hormone therapy is going to stop dementia. So, there's lots of things out there that's
01:53:54
a a disconnect and trying to say it's menopause hormone therapy is one way of
01:54:00
getting people to understand that it's not an anti-aging agent. It's something to help with this phase of a life and to
01:54:08
help get through so that we don't have severe changes to our daily life and who
01:54:13
we are as a person. Is there anything else that we need to talk about as it relates to menopause? Just want to make
01:54:18
sure we've covered it all. Covered it all. It gets better on the other side. I
01:54:24
think that's something people don't talk about is pmenopause is such the conversation now with all the the
01:54:31
conversations around hormone therapy, exercise, lifestyle, but no one talks about the other side once you've gotten
01:54:37
through pmenopause. Do my joints stop hurting? Do I stop having all these sleep interruptions? Do I stop having to
01:54:44
worry about my bones? And if you're putting in the right lifestyle changes to maintain bone health, yes. On the
01:54:52
other side, everything becomes a new normal without the pain and dysfunction
01:54:57
because it's the shift in hormones that's creating so many different issues with every system of the body. So if we
01:55:05
get through this with really good um interventions for preventing or
01:55:10
attenuating the changes that are happening, the other side is much better. And for women with PCOS or
01:55:16
endometriosis, is there anything that they need to be thinking about as it relates to exercise or nutrition? Yeah. So there's
01:55:24
I guess a huge misstep in the understanding that endometriosis uh is an inflammatory
01:55:31
um response. Yes and no. There's some more emerging evidence that it could be a bacterial or
01:55:38
a viral um cause. But with regards to endometriosis, we see that if you're
01:55:44
able to use some cold water uh therapy for the most part, so a cold water plunge around the time that you
01:55:52
think about ovulation where after ovulation you have endometrial growth.
01:55:57
It reduces the total inflammatory response so that the endometrial lining
01:56:02
doesn't grow as much. So you don't have as much growth of endometrial tissue outside of the uterus. Okay. So we're
01:56:09
looking at how do we stop that extra growth. We can use environmental cues to help with that. So that's that cold
01:56:16
therapy. If we look at PCOS, it's all about um a higher androgen count and we
01:56:22
have more insulin resistance and how we're training for
01:56:28
exercise is all about how do we control that insulin resistance. So we look at high intensity, we look at using
01:56:34
resistance training. So women who have PCOS, they have irregular cycles. So we
01:56:40
can't use the menstrual cycle as an indication of stress. So we have to look at things like heart rate variability.
01:56:46
We have to look at properly putting in intensity and resistance training to work with blood glucose levels to again
01:56:54
attenuate some of the symptomology that comes with PCOS. What is the most important thing we
01:57:00
haven't talked about that we should have talked about? That this conversation isn't just for women.
01:57:06
I'm very grateful that you're very excited about the menstrual cycle, but um I think a lot of people kind of tune
01:57:13
out when we start to hear conversations about women and conversations about sex differences, but it's for everybody
01:57:21
because if we're going to push forward and understand how we need to do research to improve the health of women
01:57:28
and men, then it's a combination in the conversation. So I yeah I'm very appreciative to men
01:57:36
who come into the conversation and men who are in the room and very appreciative of you for having these
01:57:41
conversations because then it pushes it out and makes it normal across the board. Yeah. And the reason I I have
01:57:47
these conversations is because it's a lot of my conversations at home with my partner. We spend so long talking about
01:57:52
her menstrual cycle and about uh when she's ovulating and she talks to me a
01:57:58
lot about how she's feeling because of that and uh certain things we should be doing even when we're thinking about
01:58:03
like how to spend the weekend. It's often decided through the context of like her cycle and then obviously we're
01:58:09
trying to we're in the phase of life where we're going to try and have kids now. So we're thinking a lot about it there. But then just more broadly, you
01:58:15
know, if something is having such a significant impact on a woman's life, which I think it does. I think it does
01:58:21
have significant impact, things like menopause and the menstrual cycle generally, then I'm going to interface with women my whole life. If I have a
01:58:28
daughter, I have sisters, I have a mom, I have a partner. So, if I can better understand um them because I understand
01:58:35
how their body is working, then we're going to have more successful relationships. And frankly, a year ago,
01:58:40
I didn't even know what menopause was. Yeah. So, yay. To be fair, I didn't even know what a menstrual cycle really was a
01:58:46
year ago. I knew that women had periods, but I couldn't tell could have told you with great confidence that different
01:58:52
things happen throughout the cycle and that it was 28 days long. I really had no idea. And I'm like 32 years old and I
01:58:57
don't really care about admitting that. People like you, but I don't really care because I know there's a lot of people out there that feel the same way and and
01:59:04
we're like not allowed to admit that because then you get people attack you or whatever, but who cares? I had a PhD
01:59:11
student who came up to me and he's like, "My partner has something to tell you and it's going to come through me." I
01:59:17
was like, "Okay, what is it?" He said, "She said to tell you that I know more about the menstrual cycle than she
01:59:23
does." I was like, "Awesome." Cuz he was looking at women in the heat versus men
01:59:29
in the heat. So, we had to understand the menstrual cycle and how all that came. And then that upskilled her. So,
01:59:34
it came in the opposite. Instead of her trying to upskill him, he upskilled her. We don't really learn about this stuff
01:59:40
in school. No, nobody ever told me about it in school. Do women learn about it in school? Not anymore. It's been cut. All the health programs and everything have
01:59:46
been cut. So, um, yeah, it's really like I give talks and the rooms get full of
01:59:52
parents who want to know what's happening. Like I give talks for young kids who are, you know, surf life-
01:59:58
saving or whatever, just explaining it all. And then I'll get questions for women, well, what about pmenopause? What
02:00:04
about menopause? What about IUD? What about this? What about that? because it's not taught and it's it's um yeah,
02:00:12
it's really scary. All of the subjects we've discussed today are in these two excellent books. Well, there's even more
02:00:18
in the books, but all the subjects that I touch on pretty much all of them are in either of these two books. Next level, which is your guide to kicking
02:00:23
ass, feeling great, and crushing goals through menopause and beyond, and your book raw, which is match your food and
02:00:29
fitness to your unique female physiology for optimal performance, great health, and a strong body for life. I would not have been able to read that if I had
02:00:36
eaten today. I would not if you if you had had a protein shake, you would have been able to read it. Even better, maybe
02:00:42
we have a closing tradition on this podcast where the last guest leaves a question for the next guest, not knowing who they're going to be leaving it for. And the question that's been left for
02:00:48
you is, if you have children, what is the most important message you would
02:00:55
pass on to them? If you don't, then what is the most important message you would
02:01:00
have passed yourself as a child? I have a daughter. Mhm. And the most important
02:01:06
messaging that I keep giving to her is to be empowered, to ask questions and to
02:01:11
be empowered. And she'll often say, "Well, what does that mean, Mom?" I'm like, "You have a question, you ask it.
02:01:17
Don't be afraid to ask it because if you don't know, you don't know." So, society is very changing. I want you to be
02:01:23
empowered and be educated to and have the confidence to ask questions. Stacy,
02:01:28
thank you so much for the work that you do. It's incredibly important and it's so wonderful that people are shining a light on some of these differences between men and women. Um because yeah
02:01:35
like me and my partner train together we work out we it's a big part of our relationship in life and now having
02:01:41
studied your work which was absolutely fascinating to me because it was again it was a first for me to understand that there was any differences in these sort
02:01:47
of things that have been pushed on us in ter in culture in terms of exercise nutrition cold plunges fasting etc.
02:01:54
Absolutely fascinating. But it's been a huge conversation now between me and her. We were talking before I came on air um about this and it's really turned
02:02:01
the lights on and it's actually made a lot of things make sense. Excellent. A lot of things make sense that we were pondering. So, thank you so much for the
02:02:07
work that you do and I highly recommend everybody goes and checks you out. Thanks so much. I appreciate it. Are you going to make her eat before you go
02:02:12
training now? Well, I don't know. I actually did send her a screenshot of that of that particular part. Um because
02:02:18
we have the same routine, especially on like the weekends when we're together. We get up, we have the coffee, then we
02:02:23
go to the gym. Yeah, we train and then we go and try and find something to eat after.
02:02:28
So, she could have cracking coffee. Yeah, maybe that's a good idea. Maybe I'll leave it up to her. I listen, I'm
02:02:34
never going to tell her what to do, so I just sent her the research. Okay. Encourage her. Yeah. I was like, look at this. You'll find this interesting, so
02:02:41
we'll see. Awesome. Thank you so much, [ __ ] [Music]
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