# Longevity Debate: The Truth About Weight Loss, Muscle, and Creatine!

An episode of [The Diary Of A CEO with Steven Bartlett](https://invisiblenetwork.ai/podcast/1291423644), 27 Oct 2025, 2 h 37 min.

Audio: https://pdst.fm/e/pscrb.fm/rss/p/mgln.ai/e/1390/claritaspod.com/measure/p.podderapp.com/2544644999/mgln.ai/e/1651/episode.flightcast.com/01K8BCF2KNE4NFXAJEXN8VNZ68.mp3

The 4 leading women’s health experts reveal what EVERY woman must know about perimenopause workouts, lifting weights, cycle syncing, perimenopause training, and VO2 max! This 2nd section of the female roundtable covers fitness, nutrition and performance, bringing together: Menopause specialist Dr Mary Claire Haver, longevity orthopaedic surgeon Dr Vonda Wright, fertility doctor Dr Natalie Crawford, and female physiology researcher Dr Stacy Sims. They explain: ◼️How estrogen and muscle are deeply connected to women’s metabolism ◼️Why osteoporosis prevention starts with building muscle in your 30s ◼️Why “strong not skinny” isn’t a trend, it’s a survival strategy ◼️The best way to train for VO2 max, longevity, and female performance ◼️Why resistance training beats cardio for female metabolism and anti-aging (00:00) Intro (02:50) We've Got Women's Health Wrong (05:07) Should Women Exercise Differently During Menstruation? (11:40) Low vs High-Intensity Training: When? (16:58) Pilates Is Not Good for Strength Training (19:56) Perfect Exercise Routine in Your 30s (26:15) Can I Get My Range of Motion Back? (27:41) Why Women Should Exercise to Gain Upper Body Muscle (30:42) Building Muscle Helps Reduce Inflammation (35:54) 70% of Hip Fractures Happen in Women—30% May Die (42:07) Hormone Treatment and Bone Growth (47:58) Best Exercises to Avoid Injuries (53:12) When to Work on Your VO₂ Max (54:18) Is It Okay to Be Super Skinny When Running Marathons? (58:13) Your Body Composition Isn't Your Fault (01:05:09) The Must-Do in Your 50s and 60s (01:13:54) Metabolism and Alzheimer’s Link (01:18:43) Best and Healthiest Way to Lose Weight (01:24:58) Is Ozempic Good? (01:27:12) How to Burn Belly Fat (01:31:42) Should You Do Liposuction? (01:35:52) Best Diet for Perimenopausal Women (01:36:32) Best Diet for Fertility (01:37:37) Is Fasting Recommended for Women? (01:44:15) Reach Autophagy Through Exercise (01:52:17) Juice Detoxing (01:58:37) Is the Keto Diet Good for Women? (01:59:34) What Supplements to Take for Fertility (02:05:07) Environmental Toxins (02:11:00) Focus on Your Sleep Before Anything Else (02:18:29) Sleeping 3 or 4 Hours Is Very Bad for You (02:23:14) Should I Take Melatonin? You can follow the guests, here: Dr Mary: ◼️Instagram - https://bit.ly/4ogsgwJ ◼️The Pause Life - https://bit.ly/48rycyv ◼️You can purchase ‘The New Menopause’, here: https://amzn.to/4nUOnt5 Dr Vonda: ◼️Instagram - https://bit.ly/46SMfvR ◼️Website - https://bit.ly/4n41GGg ◼️You can purchase ‘Unbreakable’, here: https://amzn.to/4n6xVEO Dr Natalie: ◼️Instagram - https://bit.ly/4nbZFI9 ◼️YouTube - https://bit.ly/3J5fLFw ◼️Website - https://bit.ly/3W6E0pG ◼️You can pre-order ‘The Fertility Formula’, here: https://amzn.to/3KRpobk Dr Stacy: ◼️Instagram - https://bit.ly/4hcRuKm ◼️Website - https://bit.ly/47dqkhS ◼️You can purchase ‘ROAR, Revised Edition’, here: https://amzn.to/4nbjDmr Independent Fact Check: https://stevenbartlett.com/wp-content/uploads/2025/10/DOAC-Female-Health-2-Independent-Research-further-reading-1.pdf The Diary Of A CEO: ◼️Join DOAC circle here - https://doaccircle.com/ ◼️Buy The Diary Of A CEO book here - https://smarturl.it/DOACbook ◼️The 1% Diary is back - limited time only: https://bit.ly/3YFbJbt ◼️The Diary Of A CEO Conversation Cards (Second Edition): https://g2ul0.app.link/f31dsUttKKb ◼️Get email updates - https://bit.ly/diary-of-a-ceo-yt ◼️Follow Steven - https://g2ul0.app.link/gnGqL4IsKKb Sponsors: Adobe Express - http://ADOBE.LY/STEVEN Apple: https://www.apple.com/mac/ KetoneIQ - Visit https://ketone.com/STEVEN for 30% off your subscription order

## Transcript

[0:00] So in this part of the conversation, I want to talk about exercise, nutrition, fasting, lifestyle, sleep, environmental factors.
[0:06] The first question is, why does muscle matter as a woman in particular?
[0:09] Muscle matters because it helps your brain produce more neurons and that's super important for brain health.
[0:16] As far as protection as we age, it's directly correlative to the amount of muscle that we have.
[0:21] And if you have something like PCOS or endometriosis, it's even more important for you.
[0:26] Because building muscle, it's gonna fight insulin resistance and inflammation.
[0:29] I've got two questions to ask. Should women exercise differently across the menstrual cycle?
[0:34] And what is the reason why women hear what you guys say and they don't do it?
[0:38] I'm so glad we're having this conversation.
[0:40] We're back with the leading voices in women's health to unlock the specific insights, data, and tools needed to combat the growing challenges women face throughout their lives.
[0:50] For women, forever it was all about aesthetics.
[0:52] I'm healthy, I'm thin.
[0:53] Because they are under the assumption through sociocultural ideas that a woman is coming to the gym to lose weight, not to get strong, not to gain muscle.
[1:00] But what we've ended up with is an epidemic of osteoporosis and frailty, really dementia.
[1:05] We're 40 to 50% of women will have low bone density, 70% of all hip fractures happen in women.
[1:10] And when you have that, 30% of the time you have a chance of dying in one year.
[1:15] Because most of it is based on male data.
[1:17] And I see a large number of women trying their hardest to be healthy.
[1:21] But what they are choosing to do is actually having a negative impact on their hormonal health.
[1:26] And it's not your fault. And this is where we have to educate.
[1:29] And it starts now.
[1:30] It brings me to questions from the audience.
[1:32] Like, what's the best and healthiest way to lose weight?
[1:34] Is there a diet for fatality? Should women fast?
[1:37] Is there a link between environmental toxins and early manopause?
[1:40] We think so.
[1:41] Also, if you were to design perfect workout regimes for menopause and carry menopause,
[1:45] what would you, oh, you stasis clapping?
[1:48] Go ahead.
[1:52] This is part two of my conversation with four of the world's leading experts and women's health.
[1:57] And in this episode, we go even deeper into actionable practical things you can do to improve your health.
[2:03] And by the way, if you're a man and you've been sent this episode by a girlfriend, a wife, a daughter,
[2:08] whoever it might be, I know you might not think this conversations for you,
[2:12] but more than 50% of this planet are women.
[2:14] You have a tremendous advantage in your relationships at work and just being a human being going through life.
[2:21] If you understand the majority of the population.
[2:25] And for so long, women's health, women's bodies, women's anatomy, their psychology and physiology,
[2:31] has been a mystery because there hasn't been the same amount of scientific research done to understand them.
[2:37] So in this conversation, we're going to demystify all of that so that you can understand your wife, your partner,
[2:42] your daughter, your colleague, your mother, your grandmother, even better.
[2:50] So in this part of the conversation, I want to talk about exercise, nutrition, fasting, lifestyle, sleep, environmental factors
[2:56] and all the things that we kind of alluded to when we were referencing hormones and menopause,
[3:00] but in a more actionable sense.
[3:02] And I guess the first question is similar to the first question in part one, which is,
[3:06] why does it matter for us to have a conversation about women in this context versus fitness generally or nutrition generally?
[3:14] Sport and exercise science in itself is a small subset of sports medicine and medical research.
[3:22] And most of the research has been done on men.
[3:25] We look inherently at most of the recommendations of exercise, recovery, nutrition is based on male data.
[3:32] And we established earlier that that's not generalizable.
[3:35] So when we really want to get into the nuances of how do we create an adaptive stress for women, we have to look at it differently.
[3:42] To look through the female lens, understand the female physiology, and acutely how hormones can affect adaptations
[3:49] and how women respond to different environmental cues than men.
[3:54] Yeah, our hormones distinctly control a lot of our environment and our other cells that are not what we think of as our hormone cells work with our hormones.
[4:04] So if we think about the gut, we think about the liver, our immune system.
[4:08] A lot of this is so hormonally derived, but it's a two-way street, meaning your hormones influence what is happening in your gut,
[4:14] but your gut influences what is happening in your hormones.
[4:17] And because women have different hormones than men, as far as what's predominant and when they are, we have to come at this and approach it a different way.
[4:25] There's so much to do with messaging that women receive as far as their health goes.
[4:29] And this, you know, be small at any cost, you know, get to that number on the scale.
[4:36] And I see it on social media that the conversation is changing.
[4:41] Hopefully, you know, GOP ones is tampering this a little bit, but strong over skinning, nutrition over calories, like we are trying to build bigger, stronger bodies and take up more space,
[4:52] is the message that needs to happen.
[4:54] I mean, forever it was all about aesthetics.
[4:56] You have to look young, feel young, be young, anti-age, you know, all those things.
[5:00] And what we've ended up with now is an epidemic of osteoporosis and frailty and really dementia.
[5:07] Should women exercise differently across the menstrual cycle?
[5:11] So this is the nuance. And this is something if you'd asked me maybe five years ago, I would have said, sure, from a molecular level, we see that there are certain things that happen with estrogen being in isolation for the most part.
[5:25] And then when you have estrogen progesterone, we see their metabolic shifts, we see their temperature shifts.
[5:30] But the caveat is, we don't know if women ovulates or not.
[5:34] And I'm sure that Natalie can, you know, give some stats about the Anne ovulatory incidences in most women.
[5:41] If we were to understand and know when a woman ovulates, in addition to how she fuels across her cycle, then she can individually tailor her menstrual cycle to her training.
[5:54] But for general plan, we can't do that.
[5:57] I think it's important that, you know, building muscle, using muscle consistency is a huge part of effectiveness when it comes to exercise or to building strength.
[6:06] And so one fear we have when we say, do this in one phase of your cycle and do that in another phase, is that if, you know, 15% of patients are not ovulating or they have no idea when their follicular and luteal phases are,
[6:19] are they then doing overall less because they're waiting on this directive to tell them what?
[6:24] What is not untrue though, and how I frame this to patients is that strength and resistance training should be the core of what you're doing, regardless of the phase of the cycle you're in, regardless of your pregnant, regardless of we're doing fertility treatments, building muscle, using your muscle.
[6:40] Now, what you do on other days is where you should allow yourself to say, how do I feel this day? What do I need this day?
[6:47] And be okay with giving yourself the grace that that may look different on your period, in your follicular phase, in your luteal phase, and saying doing something and moving your body is still ultimately we're all going to agree better than sitting on the couch.
[7:02] Exactly. Many women will say they have more energy in that late follicular phase.
[7:07] And so if you are looking at your workout structure, this is a day I want to try heavier weights or more reps.
[7:12] It can be smart to put that in a time where you have a higher chance of being successful.
[7:16] That's how I explain it. I'm like, if you have your own data and you know what stays, you feel really fantastic.
[7:22] That's where you want to put your higher intensity, your heavier lifting, because you know that you're going to hit those training metrics.
[7:28] What we don't want is for someone to go in to do a high intensity session on days if you're flat, because they won't hit the metrics that they need to get the stimulus we're after.
[7:37] Can you explain this to me like a 10-year-old, in terms of where in the cycle, typically women will have more energy and really be able to push themselves?
[7:47] Right here, five to seven days before ovulation.
[7:52] Some women feel really great around ovulation. Some have a transient where they'll feel really awful on an around ovulation and maybe 24 hours later.
[8:02] They feel really fantastic. Most women are variable through the early loodial phase.
[8:08] So if we think about day six to 14, that's when we see women feel really robust and strong and feel like they can take on the world.
[8:17] Because estrogen is rising.
[8:19] Yeah, exactly. And you see the physiologic changes, heart rate variability, resting heart rate.
[8:23] Your immune system is more prone to taking on virus and bacteria. It's not pro and flammatory.
[8:30] So you have that working for your core temperatures lower. You can ask access carbohydrate a lot easier.
[8:35] So you have more availability for fueling to hit high intensities.
[8:39] Then when we see with ovulation, like I said, some women feel really fantastic right around the time of ovulation because of the estrogen surge.
[8:48] Some have transient where they don't feel so great.
[8:51] When that follicle ruptures and the egg is released, the granulosa cells that are surrounding it, which is what actually makes estrogen get disrupted.
[8:59] And so some women feel that transient breakage and their estrogen is dropping before it reforms to become the corpus ludium and make again.
[9:07] So you have this high peak estrogen and then some women are really sensitive to these hormonal changes and they feel that drop.
[9:13] So that ovulation day may not always be your very best feeling day, which makes women feel like it should be and like something's wrong with them.
[9:21] On a side note, we did a survey on women experiencing pain on ovulation because it's something was never talked about.
[9:28] Middle schmarts.
[9:29] Yes, exactly. Middle schmarts.
[9:31] We had, so you can feel the follicle rupturing and that's called middle schmarts.
[9:35] So it's German for in the middle because it tends to happen in the middle of your cycle when you ovulate.
[9:40] And it's a painful.
[9:42] It's a pain. It can't be. It's just a pain.
[9:44] It's just bursting inside your body and then some women are down for the count because of it.
[9:49] So they can't, they don't plan any physical activity around that because they just can't from a physical and mental standpoint put themselves through anything.
[9:58] So that's why I'm saying like ovulation, some women feel bulletproof, other women who have this transient feeling of really flatness and pain.
[10:05] And then afterwards in these early luteal phase, so day 16 to about day 22 is a variable.
[10:15] Well, some women will feel like on top of the world still other women will feel I can't quite hit eye intensities.
[10:21] And then in general, these few days, about day 24 to 27 before those hormones actually drop.
[10:28] This is where you have your PMS, your pre-minstrual syndrome and cramping and fatigue and a lot of women are like, not so great.
[10:36] That's when you're progesterone.
[10:38] You win both of them drop.
[10:39] I just love how you guys explain it because what I see on social media is absolutes.
[10:44] You must do this doing funicular. You must do this at ovulation.
[10:47] You must. And I'm just like, really?
[10:49] You know, and so I love how you're like, well, some women, it may affect them this way.
[10:53] In others, this we generally tend to see x, y, z.
[10:56] So rather than like, you absolutely have to do this at these different times.
[11:00] I think learning to listen to your body and the signals that it's giving you across the stages of your life,
[11:06] that's really key to so many of the questions that we're talking about because you want to understand your own response.
[11:13] And where many women are falling short is that they've been suppressing their cycles.
[11:18] They don't know about it. And they were not taught all of these different changes that are perfectly normal.
[11:24] And so it's very hard to then hear a social media post that says, only do this in the follicular phase.
[11:30] And don't ever do cardio in the luteal phase.
[11:32] And you get a lot of mixed messages when in fact, there's no absolutes.
[11:37] No.
[11:38] And in terms of training, some people think moderate training is better for women.
[11:43] Some people think high intensity training is better throughout the cycle and sort of also considering what goals you might have in fertility.
[11:50] What would you say there is, should I be doing high intensity interval training if I'm a woman or throughout the cycle and throughout my life?
[12:00] So this is where we have to think about periodization first lifestyle, but also how women is feeling.
[12:06] We don't want people to do high intensity interval training every day because that's just not going to create an adaptive response.
[12:11] We have to think about the reason why we're exercising is to create a stress that the body is going to respond to.
[12:17] We don't get fitter during exercise.
[12:19] We get fitter from the stimulus of exercise and the recovery from it.
[12:24] So if someone's doing high intensity interval training every day or five days a week, they're not ever going to get that subsequent recovery to be able to hit those high intensities and that stress that we want.
[12:35] We talk about high intensity during our reproductive years, you can pretty much get away with whatever you want to do during your reproductive years because you have the benefit of our hormones working for us.
[12:46] We start getting into a parimenopause and we start getting into menopause.
[12:49] This is where we have to really carefully look at volume versus intensity.
[12:53] So that means if we're doing lots of stuff or we're doing really purposeful high intensity versus low intensity because we're trying to create what we call a polarization of the training.
[13:07] So that when we hit high intensities, we're actually hitting the intensities we need to create change.
[13:12] But on the other side of it, we want to hit really low intensity so that we can have recovery.
[13:18] It gets harder to recover as we get older regardless of your male or female.
[13:21] But in parimenopause, we don't have the benefit of estrogen supporting anti-inflammatory responses.
[13:28] So we have to be very cognit that we need more recovery.
[13:31] So I'll give you an example.
[13:33] So my office, my orthopedic office is in a fabulous performance center.
[13:39] Outside my windows, I floor to ceiling windows, there's a football field inside.
[13:44] That field is filled seven days a week with people taking a class I called Ignite.
[13:51] Ignite has a lot of midlife women in it who are never exercising at low enough intensity to recover
[14:01] and never exercising at peak intensity to change their body.
[14:06] So what happens five or seven days a week, they're out doing moderate mid-range intensity training.
[14:15] But they're not seeing body changes. They're not seeing recomposition.
[14:19] They're hurt every three weeks and in my office wondering why they're hurt.
[14:22] Because they're doing a lot of reps of medium intensity.
[14:26] So they're not really recovering.
[14:29] And they're not intense enough to really change their physiology.
[14:32] But that's really common.
[14:35] There are whole brands built around mid-intensity.
[14:39] And that falls into the whole sociocultural thing where we've grown up that
[14:44] if you don't have a good sweat sash and feel completely smashed when you leave, it wasn't a good workout.
[14:50] But that's a misconception.
[14:52] So they are smashed. They're stripping a sweat.
[14:55] But it's not at peak heart rate ranges for short bursts of time.
[15:00] So I know. Look, it's very confusing because I don't know.
[15:05] 20 years people have as they've switched from only cardio.
[15:10] They're like, now we're going to do high intensity, which is fine.
[15:13] I'm not opposed to that word. It's just that how do you define that?
[15:16] What is high intensity?
[15:18] And so like you, because I've read your books, that we're exercising people at pretty low heart rate,
[15:25] where they're about to flip from burning fat to carbohydrates,
[15:29] because that's really metabolically healthy.
[15:31] But not so intense that people are going to get hurt.
[15:35] And I also prescribe really peak sprint-interval training.
[15:39] And I did that myself in mid-life, you know, to recompose my body,
[15:44] sprint-interval training, because it's intense and lifting, right?
[15:49] It's the advice different for different women at different stages of life here.
[15:52] So if I'm before perimenopause.
[15:54] You get away with most stuff.
[15:56] Assuming you have a regular menstrual cycle.
[15:59] Right. I think there's different time periods,
[16:02] which we've mentioned before, PCOS, hypothelamic amenorrhea,
[16:06] time periods where you're not making estrogen or making it reliably,
[16:09] you can get away with less.
[16:11] And so we want to protect a little bit of that.
[16:13] When it comes to exercise, a variety is the name of the game.
[16:17] You want to adapt, so you shouldn't be doing the same thing every day.
[16:20] That doesn't mean you can't have a plan.
[16:22] There's seven days in a week.
[16:24] You don't have to move every single one, but you should pick these different activities
[16:28] based on your life, your schedule, what you want to accomplish.
[16:31] And it will vary some in different phases of your life,
[16:35] because your goals are going to be different.
[16:37] And so when it comes to exercise, we always have to think about what needs to happen.
[16:41] Are you somebody who is overweight and needs to lose weight?
[16:44] Are you somebody who's underweight and is trying to gain weight?
[16:47] Are you trying to get pregnant or going through fertility treatments or in menopause?
[16:50] So there's nuance to it, which always makes it hard.
[16:53] But there's not a one, do this one exercise every single day.
[16:57] That's pretty much not the answer.
[16:59] So the most popular class for females right now,
[17:02] I just saw the statistic somewhere is Pilates.
[17:05] And my daughter loves her lagre and gets on that machine slide.
[17:08] But where does that fall in all of this?
[17:12] I have a lot of Pilates.
[17:15] There's a social aspect to it.
[17:17] There's people hate you.
[17:19] Yeah, because we did this real talking about how Pilates was not appropriate as strength training,
[17:24] especially as we have.
[17:26] When we look at Pilates, it's a compliment to true strength training.
[17:30] What I mean by true strength training is you're lifting a load that's heavy in multiple planes.
[17:35] With Pilates, it's really good for high symmetric control, core strength, balance,
[17:39] proprioception, but it isn't a stress that's going to create adequate muscle gain
[17:45] and strength of the bone, which is what we want from strength training.
[17:49] So just like yoga Pilates has a place, it does definitely fit in the scheme of things,
[17:54] especially from the social and the fact that does give you control and proprioception,
[17:59] but it isn't the be all in all for strength.
[18:03] People that do Pilates frequently will be shouting.
[18:07] It hurts so much.
[18:11] Well, I'm sure it's hard.
[18:13] The times I've done it, it's not easy, but it doesn't set you up not to be frail.
[18:22] It is not building strength and power.
[18:26] And I have women who have done so many Pilates.
[18:29] 1500, it's like a badge of they count their classes.
[18:33] 1500 at the deficit of anything else.
[18:36] It's all that goes on.
[18:38] And I think that is another, you know, you've got to mix it up.
[18:41] Number one, number two, I say the same thing.
[18:44] So I'm not very popular in those crowds, but it's great for the standard that I ask people do
[18:50] of flexibility and joint range of motion so that you don't become really stiff and hunched over
[18:57] and shuffling old person.
[18:59] But it will never give you strength and power in the way to protect yourself from falling down.
[19:05] Because there's not enough weight.
[19:07] For the most part, yes.
[19:09] And we also have to think about when you're doing strength training, you're creating a multi-directional force
[19:14] through the muscle and the tendons and the bones.
[19:17] With Pilates, especially if you're looking at the reformer, it's not multi-directional in the movements.
[19:22] Each movement is one plane.
[19:25] And you can be in different planes, but each motion isn't multi-planar.
[19:32] So if we think about what are we trying to get out of Pilates, we're getting neuromuscular control,
[19:37] we're getting core strength, we're getting some breath work and all that has been official.
[19:41] But again, if we're trying to grow muscle and bone, take up space, be strong,
[19:46] it doesn't quite hit the points that we need to in order to create this new strength
[19:52] to bring us to that health span that women are looking for.
[19:56] So do it a couple times a week.
[19:58] Yeah.
[19:59] Not seven days a week.
[20:00] Correct.
[20:01] So if my partner, she's 33 years old, so she's not quite a perimenopause yet.
[20:05] If you were to design a perfect workout regime for her at that phase of her life,
[20:12] what would you...
[20:13] Oh, your state is clapping.
[20:15] Go ahead.
[20:16] So if she has three days that she can go to the gym,
[20:20] and I should say three one hour sessions that she could have at the gym in a week over seven days,
[20:27] each one would start with mobilization, so using resistance bands,
[20:31] or maybe you're doing a Pilates Reform or Warm-Up,
[20:34] so you're getting through the range of motion.
[20:36] What?
[20:37] Just to open up the joint capsules, make sure you don't have any restriction
[20:41] so that you can get really good range of motion for the movements you're going to do next.
[20:45] The next movements would be...
[20:47] Does that actually work?
[20:48] I do wonder this.
[20:49] So many of my friends are getting injured at this age because they're my age and a bit older,
[20:52] because they walk into the gym and they start picking weights up.
[20:55] Oh, yeah.
[20:56] No, I mean, I spend more time mobilizing, I think, than I do actually training now.
[21:00] Just to keep range of motion going and keep the joint capsules open.
[21:04] And so that's using the heavy resistance bands to stand and distract all the joint capsules to increase range of motion.
[21:11] Stretching doesn't do that.
[21:12] Stretching will get to an endpoint of the muscle to allow you to have more flex in the muscle,
[21:17] but it's not actually stretching in the joint capsule to give you range of motion.
[21:21] So when we talk about mobility work, we want to get into that full range of motion.
[21:26] So if you have a stiffening, so as I was saying earlier about the guy in my voodoo flossing,
[21:30] well, voodoo floss is a way where you're creating some blood flow restriction.
[21:34] Then you go in a range of motion and a blood flow restriction,
[21:37] you take the voodoo band off and the blood flow comes back and you go in the range of motion,
[21:41] get deeper in that range of motion.
[21:43] So it's all about accessing the tissues and making the tissues more viable for increased range of motion,
[21:48] so that when you go do the lifting, when you go put on a heavier load,
[21:53] you have better control, better range of motion,
[21:55] and avoid the small little sticky points that cause injuries.
[21:58] The microtairs?
[21:59] Yeah.
[22:00] So it's the microtairs that are going to lead to injury,
[22:05] and the microtairs come when I haven't warmed up properly.
[22:10] Here's why it's older, what would that look like?
[22:13] If you were your shoulder, I wish I had a rig.
[22:16] So you could take one of those thick big bands,
[22:19] the big and wrap it around a rig or something,
[22:22] and you can pull and descend.
[22:24] So you're actually pulling the shoulder out in different ranges,
[22:28] so you can rotate, roll, pull, extend, pull, extend.
[22:32] What about this?
[22:33] So this is more trying to work the muscle.
[22:35] Okay.
[22:36] And you have paleo press as well,
[22:38] where you're working rotation,
[22:39] but that's not getting into the joint.
[22:41] So if you're descending, you're pulling back,
[22:44] you're not bending your elbow.
[22:45] You're actually pulling through the shoulder and distracting.
[22:49] And then the band is going to pull you forward
[22:51] to give your resistance to pull your shoulder joint out.
[22:54] And it's not a painful,
[22:55] but you're just really getting into that full joint capsule.
[22:58] You can do that with the hips, you can do a band of pigeon stretch,
[23:02] just so many different ways of getting into the joint capsule,
[23:06] which not only gives you more range of motion and prevents injury,
[23:10] but it also gives you more of the flexibility
[23:12] of the flexibility that people think they get when they're stretching.
[23:15] The reason this is important as we age
[23:18] is because ligaments and tendons and the capsule,
[23:23] the inside skin of a joint is made of collagen.
[23:27] And the covalent bond, collagen is like,
[23:30] if you envision strands of rope,
[23:32] the covalent bonding,
[23:33] meaning the bonding between those strands,
[23:35] becomes stronger as you age,
[23:37] and you become more and more stiff.
[23:41] Well, when we lose joint range of motion,
[23:43] we're injured more.
[23:46] It's why we start shuffling down the street, hunched over,
[23:49] shuffling instead of striding,
[23:51] because we have full hip range of motion,
[23:53] or full knee range of motion.
[23:55] And so, one reason to do this
[23:58] is to maintain full range of motion
[24:00] through all of our joints.
[24:02] We want full range of motion,
[24:04] not only to avoid injury,
[24:07] but, for instance, if your knee is stiff,
[24:10] whether it's an injury,
[24:11] or because you just haven't maintained your motion,
[24:13] it will change something called your kinetic chain,
[24:16] meaning we really are from our big toe
[24:19] to through our spine connected,
[24:22] the big toes connected to the foot bone,
[24:24] the foot bone,
[24:25] because the way each of those body segments works
[24:28] activates the next body segment.
[24:30] So if you've got a glitch in the system
[24:32] because your knee doesn't move,
[24:34] or let's take this one,
[24:35] this is easier.
[24:36] Your ankles get stiff,
[24:38] because we've never worked on it.
[24:39] Your calves are tight, right?
[24:41] You're a jumper.
[24:42] You've got tight calves.
[24:43] Your ankle doesn't flex.
[24:46] Well, then your shin bone
[24:48] or your tibia is not going to interlink rotate.
[24:50] Well, without that,
[24:51] your knee is not going to bend as much,
[24:53] and your femur, your thigh bone's not going to rotate.
[24:57] You must have the rotation of these bones
[24:59] to activate your glute.
[25:01] So if you're not activating your glute,
[25:03] your butt muscle,
[25:05] people are very hurt,
[25:07] or they're not getting as strong,
[25:09] or they start having lateral thigh pain,
[25:11] so everything works together,
[25:13] and it starts with,
[25:15] among other things,
[25:17] the flexibility and range of motion exercises
[25:20] we're talking about it right now,
[25:22] so that the body works like a chain.
[25:25] Just give me 30 seconds of your time.
[25:28] Two things I wanted to say.
[25:29] The first thing is a huge thank you
[25:31] for listening and tuning into the show,
[25:33] week after week, means the world to all of us,
[25:35] and this really is a dream that we absolutely never had,
[25:37] and couldn't have imagined getting to this place.
[25:40] But secondly, it's a dream,
[25:41] where we feel like we're only just getting started.
[25:43] And if you enjoy what we do here,
[25:45] please join the 24% of people
[25:47] that listen to this podcast regularly
[25:49] and follow us on this app.
[25:51] Here's a promise I'm going to make to you.
[25:53] I'm going to do everything in my power
[25:55] to make this show as good as I can,
[25:57] now and into the future.
[25:59] We're going to deliver the guests that you want me to speak to
[26:01] and we're going to continue to keep doing
[26:03] all of the things you love about the show.
[26:05] Thank you.
[26:07] If I lose my range of motion
[26:09] because I never did all these things,
[26:11] can I get it back when I'm 50?
[26:13] So 33 now, I'm like, damn,
[26:15] I've not been doing enough of this stuff.
[26:17] Unless you're having bone changes
[26:19] due to arthritis and it's blocked.
[26:21] Yes, you can.
[26:23] So I can start if I could theoretically start at 40.
[26:25] Because if you think about your muscle
[26:27] and you're picking up a weight and you aren't right,
[26:29] you're going to build a muscle.
[26:31] So if you're creating a force within the tendon
[26:33] and the ligament and the collagen
[26:35] and as a repetitive force,
[26:37] a positive force, you're going to invoke change.
[26:39] So people that...
[26:41] So people that think they're stiff
[26:43] and they say, you know, I can't touch my toes
[26:45] and they can work on it.
[26:47] They can get it back.
[26:49] Here's another reason.
[26:51] So what happens in midlife, men and women actually?
[26:53] They remember what they used to do.
[26:55] They're like, I'm going to start working out.
[26:57] And I'm going to start there.
[26:59] Start there.
[27:01] This is when I get people who just show up on the basketball court
[27:04] after not having been there for quite some time.
[27:07] And they return to their memories of success.
[27:11] But because they haven't linked in their tendons,
[27:13] their joints aren't moving quite so well.
[27:15] They rupture tendons
[27:17] because the load outstrips
[27:19] the ability of the tissue to be compliant.
[27:23] And that makes sense.
[27:25] My friends have been getting injured
[27:27] and I think that's in part why
[27:29] because they're trying to work out like they used to work out.
[27:31] Yeah.
[27:33] And listen,
[27:35] they can return to a really high level
[27:37] but you can't stop.
[27:39] You can't start where you left off 20 years ago
[27:41] or 10 years ago.
[27:43] It takes a few weeks for me.
[27:45] It takes a minute.
[27:47] Yeah.
[27:49] So in mouse 33,
[27:51] every day.
[27:53] So I'm assuming,
[27:55] and I could be wrong,
[27:57] this year she already has a strength training history.
[27:59] Yeah, she does.
[28:01] Okay. So we do the mobility work for about 10 minutes.
[28:03] Really warm up well.
[28:05] Then we pick one compound movement we're going to work on.
[28:09] So it could be squats on the Monday.
[28:11] So we're going to work on loading
[28:13] in a squat pattern.
[28:15] So that's your knee forward,
[28:17] you know,
[28:19] you could do Bulgarian split squats.
[28:21] So we're adding load.
[28:23] And we have a periodized program.
[28:25] So this is just a snippet of one day in a periodized program.
[28:27] What if she didn't have that strength training history?
[28:29] Well, then we work on adding load through our,
[28:33] I want to see how she moves first.
[28:37] And we want to make sure that you're moving well before you add loads.
[28:39] So this is where we work with lighter loads and more reps.
[28:43] What if she doesn't have you there?
[28:45] Yeah. That was my question.
[28:47] If you're not there, what if she went around?
[28:49] Yeah. So this is still like, how do you squat?
[28:51] Where are your sticking points?
[28:53] So you can assess, self-assess.
[28:55] If you've done your mobility, then you'll know,
[28:57] like, oh, my hips are really tight.
[28:59] So I need to work on that.
[29:01] So let me do some air squats to see how I move.
[29:03] Then the next time you go in to do squats,
[29:05] maybe you're picking up to 10 pound dumbbells
[29:09] and you're holding them and doing air squats with your dumbbells.
[29:11] And eventually you're going to move to the barbell.
[29:13] So it's all about small progression under load
[29:17] to get to a point where you feel more confident
[29:19] to use a barbell back squat,
[29:21] to get into more of those compound movements.
[29:23] Why don't people exercise specifically,
[29:27] if we just focus here on women,
[29:29] what is the reason why people hear what you guys say
[29:31] when you're talking about exercise?
[29:33] And they don't do it.
[29:35] They don't start.
[29:37] It's hard.
[29:39] What set of reasons make it hard?
[29:41] It's set up in a gendered environment.
[29:43] Like I always use the example of a woman
[29:45] who is an interest in strength training.
[29:47] If they go to a typical 24-hour fitness
[29:51] or another brand gym that's out there,
[29:53] they'll walk in and they'll say,
[29:55] yep, I want to join.
[29:57] And the membership person most often will say,
[30:01] great, here's a class schedule.
[30:03] This is where we have our spin classes.
[30:05] This is where we do our boot classes.
[30:09] They never direct them to the lifting platforms.
[30:11] They never look and say, hey,
[30:13] here are the way to get strong.
[30:15] Because they are under the assumption
[30:17] through sociocultural ideas
[30:19] that a woman is coming to the gym to lose weight,
[30:21] not to get strong, not to gain muscle.
[30:23] Not to recompassition.
[30:25] Right. But if a man walks in,
[30:27] then it's always the great.
[30:29] Here's the lifting platforms.
[30:31] We have X amount of barbells.
[30:33] We have X amount of bumper plates.
[30:35] How much weight do you want to gain?
[30:37] Do you want to work with someone to help you build that mass?
[30:41] Fund, why does it matter?
[30:43] Because there's a big social pressure on women
[30:47] to look a certain way.
[30:49] And it doesn't typically involve muscles,
[30:51] especially in the upper body.
[30:53] No.
[30:55] So we're still living under the times
[30:57] of being as small as you can.
[30:59] But small doesn't mean lean.
[31:01] There's a concept of skinny fat,
[31:03] which you know,
[31:05] you can be as tiny as tiny,
[31:07] but you can be 50%.
[31:09] You can have a body fat of 50%,
[31:11] which means you're neither strong.
[31:13] You're not metabolically healthy.
[31:15] You're just little, right?
[31:17] So there is also a misconception
[31:21] that lifting heavy
[31:23] is going to automatically turn you into a physique model,
[31:27] or a bodybuilder's shape.
[31:29] If that's your goal,
[31:31] that's probably going to take you five years or a decade.
[31:33] It's a lot of hard work for a long period of time
[31:35] with proper nutrition.
[31:37] So for a woman
[31:39] who's wants to feel better,
[31:43] the goal is to build muscle to be lean.
[31:47] To recompose, not lose weight, right?
[31:49] I'm not really interested in somebody's weight.
[31:51] I'm interested in their body fat percentage
[31:55] and their lean muscle mass.
[31:57] Because it's what you're made of that matters, right?
[32:01] Not the size of the shell.
[32:03] And why does muscle matter
[32:05] as I age as a woman in particular?
[32:07] It matters for everyone,
[32:09] but for muscle matters
[32:11] because it's not just part of locomotion.
[32:13] It's not just part of moving you around.
[32:15] It is a metabolic organ.
[32:17] It is critical for glucose metabolism.
[32:21] It's critical for insulin sensitivity.
[32:25] It talks to the bone.
[32:27] Bone and bone and muscle are endocrine organs,
[32:31] which cross communicate all the time.
[32:33] So both bone and muscle have access to the brain, right?
[32:37] Muscle will produce a hormone called irisin,
[32:41] which has multiple functions in the body.
[32:45] The access between muscle and brain helps your brain
[32:49] produce more neurons, right?
[32:53] Bone's access to the brain has a role in satiety.
[32:57] Isn't that amazing?
[32:59] Which means not hungry anymore.
[33:01] Why would you think these locomotive structures,
[33:05] if that's what you limit them to,
[33:07] would even have those functions?
[33:09] It's because we put organs in a box.
[33:13] So to answer your question, muscle in men and women,
[33:17] but women in particular for this conversation,
[33:19] we need as much muscle as possible
[33:21] to fight the insulin resistance that we get when estrogen walks out the door.
[33:25] We need muscle for glucose metabolism.
[33:29] We need muscle for the pure strength of it
[33:33] because we do not want to become frail
[33:39] and be one of the two thirds of nursing home residents who are women
[33:43] because we can't do something as simple as get up out of a chair.
[33:47] But I could just get muscle when I'm 70.
[33:49] You can, actually.
[33:51] So why does it matter for Mel to be thinking about it when she's 33?
[33:53] Well, here's a great part for Mel.
[33:55] Is she still has all her estrogen?
[33:57] Estrogen has a profound effect on muscle protein synthesis.
[34:03] It is a significant anti-inflammatory.
[34:07] So high inflammation, chronic inflammation
[34:11] if we've talked about decreases muscle synthesis,
[34:15] the decreases bone synthesis because inflammation
[34:19] with its high cytokine level,
[34:21] I've mentioned them before,
[34:23] IL-6 tumor-acrosis factor,
[34:25] those are all detrimental to these normal metabolic pathways.
[34:29] So the wonderful thing for Mel who is entering
[34:33] what I call the critical decade,
[34:35] which is 35 to 45 estimated,
[34:37] it's the prime time to set your physical activity standards
[34:43] and to build as much as you can
[35:13] and you can use it better.
[35:15] If you have another thing that is pro-inflammatory,
[35:19] such as PCOS or endometriosis,
[35:21] it's even more important for you
[35:23] because your inflammatory burden
[35:25] by default of what's happening at a cellular level is higher,
[35:29] we now need to not just say,
[35:31] I need to not make it worse by being exposed to things.
[35:33] We have to say, I need a plan to fight this
[35:35] because my world is pro-inflammatory on a daily basis.
[35:39] What is my game plan to fight this?
[35:41] And building muscle,
[35:43] it's not just exercise is better than no exercise,
[35:45] but specifically building muscle
[35:47] because as everybody's saying,
[35:49] it has a metabolic function in your body
[35:51] is going to help you the most.
[35:53] There's a term called geroprotective.
[35:55] So geroprotections.
[35:57] So geroprotections is the term used for aging.
[35:59] So gerontology is the part of medicine that focuses
[36:03] on the elderly patients.
[36:05] So when we look in females
[36:07] and the organs that are, you know,
[36:09] are the most geroprotective,
[36:11] it is the muscle
[36:13] and the ovary and the ovaries go away.
[36:15] We have a shelf life in our ovaries.
[36:17] So then we're just really left with our muscle
[36:19] as far as protecting us
[36:21] in those elderly years as we age.
[36:23] And it's directly correlative to the amount of muscle that we have.
[36:26] Because if you have a lot of muscle,
[36:28] you're going to have stronger bones.
[36:30] And this is where the intensity part
[36:33] where Dr. Rice is talking about seeing the ignite class
[36:37] and everyone's in that moderate intensity all the time.
[36:39] With moderate intensity,
[36:41] you don't have the post-exercise
[36:43] anti-inflammatory response.
[36:45] So if we're trying to build muscle
[36:47] and we're trying to dampen inflammation,
[36:49] if we're always doing this moderate intensity cardio,
[36:51] then we're not one going to be building the muscle we want.
[36:55] And two, we're going to have this baseline elevation
[36:57] of total body inflammation.
[36:59] So we need to mix it up
[37:01] and have that precedence on being muscle-centric
[37:03] and building that muscle,
[37:05] one to help with aesthetics.
[37:07] I mean, that's the byproduct of lifting weights.
[37:09] You tend to look better.
[37:11] But it's more than that.
[37:13] We see it improves brain health
[37:15] because of the neuroconnections
[37:17] and the neuroplasticity of the brain.
[37:19] And I tell all of those things.
[37:21] You get an incredible parasympathetic response
[37:23] when you've done a significant heavy lifting session
[37:27] or a sprint interval session
[37:29] which you don't get with that moderate intensity
[37:31] cardiovascular work.
[37:33] Two questions to add to what you're better say here is,
[37:35] am I right in thinking that
[37:37] at the end of that golden decade
[37:39] that you referenced 45 years old
[37:41] because you have changes in estrogen,
[37:43] one will expect to see a natural decline in muscle.
[37:47] And an increased chance of osteoporosis,
[37:51] osteopenia bone issues later in life.
[37:53] This is several questions I apologize,
[37:55] but do women then also tend to have
[37:57] more frailed bones in late life?
[37:59] And is that linked to the muscle loss?
[38:01] So this is how it works.
[38:03] So both men and women build bone and peak
[38:05] about up to 25, sometimes 30.
[38:09] And then bone loss plateaus
[38:11] for a little while,
[38:13] men continue to lose about 1% a year.
[38:15] So men do not arrive
[38:17] with hip fractures or devastating fractures
[38:21] until their 70s or 80s or older.
[38:25] Women also decline slowly
[38:29] until we lose our estrogen.
[38:31] And then the rate of decline
[38:33] and I'll tell you why it happens for bone,
[38:35] doubles or triples, such that you will lose
[38:37] 15 to 20% of your bone density
[38:39] during your perimenopausal period,
[38:41] just from loss of estrogen alone.
[38:43] Because estrogen plays many roles.
[38:47] I've already talked about estrogen
[38:49] being a huge anti-inflammatory.
[38:51] Bones are very sensitive
[38:53] and inflammatory chemicals in your body.
[38:57] Estrogen also directly affects
[38:59] the balance of the two main cells
[39:01] that subtract minerals from bone,
[39:05] the osteoclast,
[39:07] and the cell that builds the bone,
[39:09] the osteoblast.
[39:11] And in well-hormoned times,
[39:15] there is a balance.
[39:17] The body loves balance.
[39:19] We take what we need, we build it back.
[39:21] And estrogen has such a profound effect
[39:23] on the osteoclast,
[39:25] the Pac-Man bone-eating cell.
[39:27] There's an unbalance.
[39:29] And we take more bone
[39:31] than we're capable of building.
[39:33] We're still building bone.
[39:35] But the rate cannot keep up with this.
[39:37] So with the inflammation,
[39:39] with the direct effects on the osteoclasts,
[39:43] women will lose bone density
[39:45] if they do nothing.
[39:47] Well, number one, they're going to lose bone density.
[39:49] But they must do something about it.
[39:51] So critical for a 33-year-old
[39:55] is because you still have your estrogen.
[39:57] So let's learn how to lift heavy.
[39:59] Let's take advantage of the estrogen circulating.
[40:03] Let's learn to have a jumping practice
[40:05] and impact our bones.
[40:07] So the way our body tells our bones to build more
[40:11] is there's another little cell
[40:15] called the osteocyte.
[40:17] It sits encased in bone.
[40:19] It sits encased to these other cells
[40:23] by little tunnels that contain fluid.
[40:25] When you jump,
[40:27] the biomechanical impulse
[40:29] of that fluid shifting
[40:31] in the little tunnels
[40:33] is translated
[40:35] into a biochemical stimulation
[40:37] that tells the bone,
[40:39] oh my god, she's jumping around.
[40:41] I need to build more bone.
[40:43] So we need that impact
[40:45] to stimulate
[40:47] what you were describing.
[40:49] Many women are that far away
[40:51] in terms of bone mass.
[40:55] So this is showing the fact
[40:57] that because of the way testosterone interacts
[40:59] with a man's bones,
[41:01] he will peak at a higher bone mass
[41:03] than a woman will.
[41:05] So he's starting at a higher level.
[41:07] So I would want young women
[41:09] to do everything humanly possible
[41:11] to start at the highest possible level.
[41:15] But I see lots of 20-year-olds,
[41:17] 30-year-olds, really young women
[41:19] with poor bone density
[41:21] for a lot of reasons.
[41:23] And so I'm a big proponent
[41:25] for having bones measured early.
[41:27] Don't wait until you're old
[41:29] so you know where you're starting.
[41:31] But that's not the standard recommendation.
[41:33] No, the standard recommendation is 65,
[41:35] which...
[41:37] South of our long way.
[41:39] For that.
[41:41] But because I do do either a dexascane
[41:43] or sound a look at bone quality on everybody,
[41:47] we can catch it earlier.
[41:49] And that's really important to get in front of it,
[41:51] because it's estimated research says that
[41:55] in order to affect bone density,
[41:57] if you're going to use estrogen, for instance,
[41:59] you need to have do it for 10 years.
[42:01] And why should people care about bone density?
[42:03] Everyone cares about muscles,
[42:05] but very few people talk about bones.
[42:07] Can't carry a muscle around if you have weak bones.
[42:09] So without bone,
[42:11] muscle is just a heaping pile of
[42:13] steaming metabolic tissues sitting there, right?
[42:15] There would be no bicep to complement, right?
[42:19] Because it has to be connected to a bone.
[42:21] So they're important for locomotion
[42:23] and giving support to the muscle.
[42:25] But bone is an endocrine organ that secrets hormones
[42:29] that go to your brain to help build neurons,
[42:31] to your pancreas,
[42:33] to be active in insulin release,
[42:35] to the muscle for glucose metabolism.
[42:39] In men, to the testes, to build testosterone.
[42:43] And that's only one of the many hormones
[42:45] that the bone produces.
[42:47] The bone is not only structural,
[42:49] not only hormonal.
[42:51] I've already talked about it being a storehouse,
[42:53] but it's an incubator.
[42:55] In our palvus is where we build all of our blood cells.
[42:59] And so it has these multi-functions.
[43:03] But to marry Claire's point for women,
[43:07] 40 to 50% of women will have low bone density.
[43:11] And when you have that,
[43:13] 50% of the time you'll break a bone.
[43:15] So if we're looking around at this table,
[43:17] if we all have osteoporosis, which we don't,
[43:19] one in two of us will fracture.
[43:23] When that fracture is a hip fracture,
[43:27] which is very common, 70% of all hip fractures happen in women.
[43:31] 30% of the time when you hit the floor
[43:35] and something breaks,
[43:37] you have a chance of dying in one year,
[43:39] this quick, your life changes.
[43:41] 50% of the time,
[43:43] even if you survive,
[43:45] you will never return to pre-fall function,
[43:47] meaning you can't go home.
[43:49] And that puts your family
[43:51] in this situation of having to figure out
[43:55] 24-hour care,
[43:57] or you move in with your eldest daughter,
[43:59] or you go into a facility
[44:01] where you use your life savings
[44:03] until you have no more.
[44:05] And then you have to apply for Medicaid
[44:07] and the government will pay for it.
[44:09] These are terrible situations
[44:11] to get at something
[44:13] that we could have prevented
[44:15] had we started early enough.
[44:17] So you want to start early?
[44:19] So I have malts.
[44:21] Malts is going to be doing strength training,
[44:23] not just for the muscle benefits,
[44:25] but also because it's going to help
[44:27] build strong healthy bones
[44:29] in that critical decade.
[44:31] Jump training.
[44:33] So apply a metric type work,
[44:35] or if we're looking at
[44:37] not having the robustness
[44:39] of doing straight plios,
[44:41] then you can do band-assisted pogos,
[44:43] you can do low-death jumps,
[44:45] so you're getting some impact,
[44:47] the bone, because as Dr. Roy is talking about,
[44:49] it's a multi-directional stress.
[44:51] People think, oh, I run,
[44:53] I'm going to have strong bones,
[44:55] but running doesn't do it.
[44:57] You need multi-directional stress.
[44:59] So it's called the ground reaction force
[45:01] that comes up through the bone
[45:03] to create that strength.
[45:05] So that ideal situation
[45:07] in a workout for her would be
[45:09] some ability, some heavy lifting,
[45:11] for doing plio that's also
[45:13] sprint type training
[45:15] so you're getting a metabolic stress.
[45:17] So you're hitting all the major factors
[45:19] in one hour workout.
[45:21] I read that there was a study
[45:23] done with some Australian
[45:25] elderly ladies on bone growth.
[45:27] On lifting and bone growth?
[45:29] Yes. Yes.
[45:31] And the lift more study.
[45:33] But Dr. Beck,
[45:35] she was trying to dispel the myth,
[45:37] which I hear every day,
[45:39] that you've got osteoporosis,
[45:41] you can't lift weights.
[45:43] And so her study,
[45:45] because we're big proponents
[45:47] of teaching people to progressively
[45:49] lift heavier and heavier,
[45:51] and that scares people,
[45:53] but especially if you think you're going to break.
[45:55] You have reps, five sets,
[45:57] under a supervised situation.
[45:59] So five reps means
[46:01] that it was heavy enough
[46:03] that at five reps they were near failure.
[46:05] Right?
[46:07] So these women,
[46:09] all osteoporotic,
[46:11] not only were capable of lifting heavy under supervision,
[46:13] none of them broke.
[46:15] And they built bone.
[46:17] Yep.
[46:19] So that answers the question.
[46:21] Right. Can you lift? Yes.
[46:23] And the other thing that
[46:25] isn't really brought up into these conversations
[46:27] is when you hit parimenopause.
[46:29] Not only is estrogen
[46:31] sort of the stimulus for satellite cell,
[46:33] where we're building muscle cell.
[46:35] But it has a distinct,
[46:37] I guess, influence on myocin.
[46:39] So myocin and actin
[46:41] are two contractile proteins.
[46:43] So if you think about a sliding filament
[46:45] or coming together,
[46:47] you have myocin and actin that bond together
[46:49] to then pull a move,
[46:51] and pull a move,
[46:53] and that's how you have a muscle contraction.
[46:55] Estrogen is responsible for how tightly myocin bonds
[46:59] to actin.
[47:01] When we start to lose estrogen
[47:03] or we start to have variability in our estrogen,
[47:05] we get myocin dysfunction.
[47:07] So that means we're not going to get
[47:09] a very strong contraction.
[47:11] So we get weaker.
[47:13] And this is one of the very first things
[47:15] that people complain about to me.
[47:17] I can't...
[47:19] my group's strength is gone.
[47:21] But their body composition hasn't changed yet.
[47:23] So if we think about lifting heavier loads,
[47:25] it's a neuromuscular response.
[47:27] And that direct stimulus
[47:29] creates the adaptive change in myocin
[47:31] that now estrogen isn't responsible for.
[47:33] It's a different
[47:35] external stress that creates
[47:37] that change in myocin to go,
[47:39] yep, I have to grab on to actin
[47:41] and have a very strong contraction.
[47:43] So we see that this dysfunction happens first
[47:45] before we start seeing a change
[47:47] in our lean mass development.
[47:49] So if we are already in the habit
[47:51] of lifting heavier loads,
[47:53] then we can offshoot some of that
[47:55] myocin dysfunction that occurs
[47:57] with the estrogen change.
[47:59] So when my patients come in
[48:01] and they are looking to prevent osteoporosis
[48:03] or they've gotten a diagnosis of low bone density,
[48:05] you know, what can they do?
[48:07] I've discussed the lift more trial.
[48:09] The new study just came out
[48:11] May of this year of 2025
[48:13] and they looked at very similar
[48:15] to the protocol used in lift more.
[48:17] So there was a control group
[48:18] where they just did nothing.
[48:19] Then a group that did the
[48:21] they did three days a week
[48:23] and they did resistance training and jump training.
[48:25] And then the third group did
[48:27] all the same exercises and added HRT
[48:29] and depending if they had a uterus,
[48:31] they got estrogen or estrogen plus a progesterogen.
[48:33] And so, of course, as expected,
[48:35] the do nothing group lost bone.
[48:37] You gained bone as expected
[48:39] in the resistance group,
[48:41] it would be synergistic
[48:43] when we added hormone therapy
[48:45] and the resistance training together,
[48:47] they grew even more bone.
[48:49] They had even better results.
[48:51] So when my patients are like,
[48:53] I want to hedge my bets,
[48:55] my mother fell in fractures,
[48:57] she's broken her hip,
[48:59] in a nursing home, whatever,
[49:01] and I'm trying to avoid this.
[49:03] I'm we're hitting all the points
[49:05] and the only medication event.
[49:07] Now we have other medicines
[49:09] that are more effective.
[49:11] So to me, prevention is always
[49:13] better than cure.
[49:15] So I'm trying to get them
[49:17] and get them early.
[49:19] I just ignore the guidelines that say
[49:21] you have to wait till 65
[49:23] unless you have some chronic medical condition
[49:25] to get a bone density.
[49:27] I'm telling patients,
[49:29] you can find it for about $99
[49:31] around what I work in Houston.
[49:33] And that is worth the investment
[49:35] for you to go get your baseline bone density.
[49:37] So if you have osteoporosis,
[49:39] who thinks 65 is a good idea?
[49:41] So if your listeners are like,
[49:43] oh, well, my insurance won't pay for it,
[49:45] I'm like,
[49:47] there are centers popping up now
[49:49] where you can go and get a Dexascan
[49:51] and just pay out a pocket
[49:53] and get a great, you know,
[49:55] and figure out where your starting base is.
[49:57] A Dexascan is a bone scan
[49:59] to see your bone densities,
[50:01] the easiest way to describe it.
[50:03] And your muscle mass.
[50:05] And you have a lot of people
[50:07] who are very, very menopause
[50:09] that there are women of reproductive age years
[50:11] who have profound periods of low estrogen,
[50:13] who are also at risk for serious problems
[50:15] with their bone density both now and down the road.
[50:17] And so if you come to me
[50:19] and you say, oh, I haven't had a period for seven years,
[50:21] no big deal,
[50:23] well, that is a big deal.
[50:25] And depending on the reason why,
[50:27] many of the causes will result that
[50:29] you had low estrogen
[50:31] and you were not ovulating
[50:33] the graph you showed,
[50:35] while you're building your bone,
[50:37] that person's on a different trajectory.
[50:39] And those women do need bone scans much earlier
[50:43] so that we can see where they are
[50:45] and see what treatment we need.
[50:47] But it's one of the biggest reasons
[50:49] bone health is one of the most acceptable medical reasons
[50:51] for why we should put younger women
[50:53] who have low estrogen time periods
[50:55] onto estrogen treatment
[50:57] because it can so profoundly change
[50:59] their bone health long term.
[51:01] My niche of active women,
[51:05] we see there's a very, very high incidence
[51:07] of recreational active women
[51:09] and low energy availability,
[51:11] meaning they're not eating enough
[51:13] to support daily life as well as their training.
[51:15] So the subclinical aspect of not eating enough
[51:19] creates a myriad of issues
[51:21] that does create lower bone density,
[51:25] menstrual cycle dysfunction,
[51:27] greater inflammatory responses.
[51:29] So, you know, the end result would be
[51:31] hypothalamic amenorrhea
[51:33] so their periods have stopped,
[51:35] which is that low estrogen standpoint.
[51:37] So, you know,
[51:39] keeping track of your period
[51:41] make sure you're eating enough
[51:43] is one of the first stop gaps
[51:45] that we have in the athletic realm.
[51:47] It's like, we want you to eat enough
[51:49] and if you're looking at book ending,
[51:51] our calories on either end of the day,
[51:53] that's not appropriate.
[51:55] We have to look at how your circadian rhythm works
[51:57] with the circadian rhythm,
[51:59] like we talked about in the first half
[52:01] was about the pulses of our hormones.
[52:03] So, for holding our calories on either end of the day,
[52:05] then there's this big space in the middle of the day
[52:07] where your body thinks it's under a starvation threat.
[52:11] So, you start to have this downturn
[52:13] of all of our metabolic functions.
[52:15] We see after four days of low energy availability,
[52:17] there's a direct impact on thyroid function.
[52:19] So, we have to be very cognit
[52:21] that women who are saying
[52:23] I haven't had a period in seven years
[52:25] or my periods are really irregular,
[52:27] we have to bring it back to the energy function as well.
[52:29] So, I know, unfortunately,
[52:31] we're still in this environment of aesthetics
[52:33] and I'm always like, we need to eat.
[52:35] And if you eat in and around your training
[52:37] and fueling appropriately for what you're doing,
[52:39] it has a positive impact on body composition.
[52:43] You're not going to gain body fat,
[52:45] you're going to gain lean mass,
[52:47] you're going to gain bone
[52:49] and you're going to see a decrease in body fat.
[52:51] But it's entrusting the process
[52:53] but it's entrusting the process
[52:55] that out in general sociocultural concepts
[52:57] is just not acceptable for so many women right now.
[53:01] And with that exercise regime,
[53:03] I asked you to make for a woman
[53:05] that's pre pre-menopause.
[53:07] Was there anything left off there?
[53:09] We had day one, which is mobility works,
[53:11] strength, training.
[53:13] So, if you were to do three days a week in gym,
[53:15] that would be pretty similar
[53:17] except for the compound movement.
[53:19] What are we doing for each of those compound movements?
[53:21] So, it would be the knee forward squat motion one day,
[53:23] push pull, upper body,
[53:25] and then posterior.
[53:27] So, you're hip thrust,
[53:29] you're dead left, that kind of stuff.
[53:31] Because women are quad dominant.
[53:33] To prevent injury, we really need to build
[53:35] the posterior chain.
[53:37] And this is your glutes, your hamstrings,
[53:39] your dead left.
[53:41] Yeah, so you're getting really strong
[53:43] around the knee joints, the hip joints
[53:45] because again, that feeds forward
[53:47] to better movement, movement economy
[53:49] and prevention of a misstep for a hip fracture later down.
[53:53] What about cardio?
[53:55] So, that's where, like,
[53:57] if we're looking at those three days a week
[53:59] and we're finishing with plios or some sprint work,
[54:01] then the other days,
[54:03] just walking low level intensity walking,
[54:05] or maybe you have soul food.
[54:07] You want to go for a bike ride,
[54:09] you want to go for a run.
[54:11] If you're not training specifically for something,
[54:13] then those three strength training days
[54:15] are your key workouts.
[54:17] That's the things that you like to do.
[54:19] I hear a lot about VO2 maxes,
[54:21] so I thought,
[54:23] but we should all be driving our cardiovascular performance up
[54:25] to get a high VO2 max.
[54:27] Well, that's where the intensity is.
[54:29] Yeah, I think it's the only one.
[54:31] Correct me if I'm wrong,
[54:33] but my understanding after reading and watching
[54:35] everything doesn't take that much to build VO2 max.
[54:37] It's that high intensity that's a little bit uncomfortable
[54:39] where you're pushing at that max
[54:41] for, you know, about four minutes
[54:43] to build that VO2
[54:45] with the sport science world.
[54:47] It's always been the four by four,
[54:49] then the more weight you're in.
[54:51] Four minutes on, four minutes off,
[54:53] four minutes off, four minutes off,
[54:55] four minutes off.
[54:57] But that's not three days a week.
[54:59] No, no, no.
[55:01] We should protocols once a week.
[55:03] Once a week at the most.
[55:05] Right.
[55:07] And the other sprints,
[55:09] just to give you,
[55:11] I tend to give my examples,
[55:13] 30 seconds, I'm taking my heart rate as high as I can get it.
[55:17] And then I'll completely recover,
[55:19] which takes me two to three minutes.
[55:21] I just happen to do it on a treadmill,
[55:23] but the reality is you can do it on anything.
[55:25] It's a heart rate function,
[55:27] not an apparatus function.
[55:29] So for me,
[55:31] on a treadmill,
[55:33] after I'm done warming up,
[55:35] you can't do it cold or you hurt something.
[55:37] Exactly.
[55:39] After I'm done warming up,
[55:41] I'm a really short person.
[55:43] I punch the treadmill up to 11,
[55:45] and I am just working so hard,
[55:47] I don't fly off the back.
[55:49] But that gets my heart rate up really high,
[55:51] about 186.
[55:53] Everybody's top heart rate is different.
[55:55] And then I completely recover.
[55:57] And I do that four times.
[55:59] It doesn't take that long.
[56:01] And you feel so good when you're done.
[56:03] So I can't run at the moments.
[56:05] This morning I did explosive kettlebell swings.
[56:07] What kind of you run at the moment?
[56:09] Torn, hamstring, and meniscus.
[56:11] So I can't run at the moment.
[56:13] Running is in.
[56:15] Run clubs have come in strong.
[56:17] It's back in.
[56:19] Are you at all concerned with the fact that
[56:23] people are running all the time
[56:25] and doing resistance training less?
[56:27] Because running is cool now.
[56:29] It's how people date.
[56:31] They're not going to night clubs.
[56:33] It's a sacrifice of other things.
[56:35] We said about Pilates.
[56:37] You know, if all you do is running,
[56:39] then that is definitely not the best way to be.
[56:41] It's not the healthiest for your whole body.
[56:43] It's not that you're unhealthy.
[56:45] But we're really talking about how are we optimizing
[56:47] your body and your hormonal health
[56:49] for a variety of different goals.
[56:51] But also if we look very micro at running.
[56:55] 58% of runners have a ludial phase defect.
[56:57] That means that the second half of their menstrual cycle
[56:59] is not going to be able to last as long as we want it to.
[57:03] Likely due to what Stacey was talking about earlier.
[57:06] This relative energy deficiency coming back to the brain.
[57:10] The brain signals.
[57:12] It's not as strong to keep that corpus ludium
[57:14] where happens after the follicle alive.
[57:16] And a lot of women, I still have my period.
[57:18] So I'm okay.
[57:20] But if we're using our cycle as a vital sign,
[57:22] we can actually say the ratio of energy balance is not great.
[57:26] And it's often because we're doing it at sacrifice of other things.
[57:30] So if you're doing the strength training three times a week.
[57:34] And you're running however you're spacing out your other days.
[57:37] That's such a healthy balance.
[57:39] It's hard that you're going to be in a bad position with that.
[57:41] And you'll actually improve your running more so
[57:43] than if you're to run every day or every other day.
[57:46] Because if you're getting strong through full range of motion,
[57:48] then that feeds forward to better running economy.
[57:51] Then you can vary your pace without getting injured.
[57:54] But for people who are running every day,
[57:56] and they're shuffling and they're getting stronger
[57:58] in their strong muscles and weaker in their weak muscles,
[58:01] then it perpetuates this problem.
[58:03] People are very keen on doing marathons and half marathons at the moment.
[58:08] And a couple of friends that are doing a lot of marathons at the moment
[58:11] and they're very, very, very skinny.
[58:13] Oh, welcome to my world of Dexas.
[58:15] Yeah, is that healthy?
[58:18] I'm not even sure if that's the right question.
[58:20] One can judge from just looking.
[58:22] But being extremely skinny in that regard,
[58:24] being that's what a marathon runner physique.
[58:26] There are some that are naturally predisposed to that.
[58:29] All right.
[58:30] So naturally predisposed to having really good running economy,
[58:33] running biomechanics, having a leaner body.
[58:36] And this is what we were talking about the Olympics earlier,
[58:38] where you can see the ideal body type for that particular sport.
[58:42] And then there are those like me who build muscle naturally.
[58:45] It's pretty easy.
[58:46] So I'd never be a skinny little runner.
[58:48] And my running economy is a little bit off
[58:51] because of where I build muscle versus not.
[58:54] So not everyone is meant to be a long distance runner.
[58:57] And there are some that are meant to be long distance runners.
[59:00] So if we're talking about your friends who are like super skinny,
[59:03] are they economically viable for being a long distance runner?
[59:07] Possibly.
[59:08] But we also have to look, are they male or female?
[59:11] What is their injury rate?
[59:13] What is their fueling?
[59:14] And then for me, I'd want to see the Dexas of the women
[59:17] that are just training long distance and super skinny.
[59:20] Because most of the time we see a higher visceral fat
[59:25] in and around the organs as we're talking about,
[59:28] even though on the outside, they're super lean.
[59:30] But they have a really high percentage of visceral fat
[59:33] because of the inflammation, the low energy intake.
[59:37] And most likely, estradiol suppression.
[59:40] And that's the skinny fat thing you talk about earlier.
[59:43] Is there an evolutionary lens on this?
[59:45] I always think about this when we're having these conversations.
[59:47] What used to happen thousands of years ago?
[59:49] We talk about the evolutionary biological theories.
[59:52] And there are a lot of sociologists that go counter
[59:55] when I'm getting ready to say so I'll apologize in advance.
[59:58] When we look at original hunter-gatherer type communities,
[1:00:02] the male body was designed to go out to find the calories.
[1:00:06] The woman body was designed to stay and take care of the offspring
[1:00:10] and make sure that home was set.
[1:00:12] If it was low calorie, menstrual cycle would stop
[1:00:15] because you didn't want to reproduce in a time of low calories.
[1:00:18] Body fat would come on because there weren't a lot of calories.
[1:00:21] And so the equivocal in the time now is that I'm not eating enough
[1:00:24] or I'm burning more than I'm consuming.
[1:00:26] Exactly.
[1:00:27] So I'm going to calorie deficit in some way.
[1:00:29] Exactly.
[1:00:30] And energy deficit.
[1:00:31] So with the male body, and we see this,
[1:00:33] their brain and hypothalamus is not as sensitive
[1:00:37] to those nutrient deficits as much as a woman's body
[1:00:42] because we have menstrual cycle or menstrual cycle function.
[1:00:45] A man will lean up and get more cognitively focused
[1:00:49] in times of low calorie intake.
[1:00:51] So this is what we see with fasting data
[1:00:53] and we see with restrictive diets.
[1:00:56] And that was when you bring it back to that biological lens,
[1:00:59] low calorie, I have to go find a calories.
[1:01:01] I have to be fit to go find a calories.
[1:01:03] Low calories, I need to not have to eat as much,
[1:01:06] so I need to store fat.
[1:01:08] And I can't have a baby because we don't have enough calories.
[1:01:10] And then stress?
[1:01:12] When we add modern stress onto that,
[1:01:14] that's a comprehensive addition of cortisol
[1:01:18] and addition of inflammation
[1:01:20] and that also perpetuates body fat.
[1:01:22] I mean, like stress 10,000 years ago
[1:01:24] would have been like a lion.
[1:01:25] Oh, yeah.
[1:01:26] It's a lion's exotic.
[1:01:27] Yeah.
[1:01:28] Right?
[1:01:29] We had stress in that this is a natural stress response.
[1:01:31] We have to have them to survive.
[1:01:32] Right?
[1:01:33] These were episodic stresses.
[1:01:35] Well, and your hormones would change
[1:01:37] for a very specific purpose that you would then go do.
[1:01:39] Your body would free up glucose from your liver,
[1:01:42] you're getting it ready in your bloodstream
[1:01:44] so you can go run from the lion.
[1:01:46] And then things would shift back to normal.
[1:01:48] And what's happening with chronic stress
[1:01:50] is you're getting all the hormone shifts
[1:01:51] because your body's really getting ready for the lion,
[1:01:53] except it's just that bad meeting you had.
[1:01:55] Yeah.
[1:01:56] And then you're just sitting there longer
[1:01:57] and you're not using that glucose up.
[1:01:59] Exactly.
[1:02:00] Exactly.
[1:02:01] All women increasingly overtraining.
[1:02:03] I think the problem in this country is not
[1:02:07] maybe in the women who are really intentional,
[1:02:11] maybe there are some that are overexonizing,
[1:02:13] but if we look at a population,
[1:02:15] nobody is exercising enough.
[1:02:17] Exactly.
[1:02:18] I mean, people ask me all the time.
[1:02:20] Tell me the first thing people need to do.
[1:02:22] I'm like, I'll take anything.
[1:02:24] I mean, I'll take getting off the couch
[1:02:26] with any method, whatever makes you happy.
[1:02:28] I'll say, get off the couch and do 10 air squats.
[1:02:30] Thank you.
[1:02:31] That's enough.
[1:02:32] That's enough.
[1:02:33] That's enough.
[1:02:34] So in the crowd,
[1:02:35] it's like, I'm going to invest in my health every day.
[1:02:38] That is not the majority of people.
[1:02:41] Yeah.
[1:02:42] That's my bubble.
[1:02:43] And the people who listen to your show, though,
[1:02:45] might be a different demographic.
[1:02:47] We have to acknowledge, right?
[1:02:48] Then population of America.
[1:02:51] I mean, like a lot of people who listen to your show, Stephen,
[1:02:53] are interested in health and their body
[1:02:56] and achieving minds and goals.
[1:02:58] And so certainly, you know, I have practiced fertility
[1:03:02] in North Carolina and in Austin.
[1:03:04] And I see a completely different patient population,
[1:03:07] you know, in Austin, Texas,
[1:03:08] which is a very fit area.
[1:03:10] Women are constantly overtraining.
[1:03:13] But to Stacey's point earlier about this,
[1:03:15] maybe evolutionary, what happens.
[1:03:18] Women go into this hypothalamic dysfunction.
[1:03:21] Even before it's what we call like amenorea.
[1:03:23] Hypothalamic amenorea is essentially where the brain,
[1:03:25] where the hypothalamicis shuts off,
[1:03:28] says, can't reproduce right now.
[1:03:30] XYZ reason.
[1:03:31] No FSH and LH are coming out.
[1:03:33] You're not ovulating.
[1:03:34] You're not making estrogen.
[1:03:35] You're not going to get pregnant.
[1:03:37] So you're more likely to survive?
[1:03:38] Yeah, so it's a sort of viable mechanism.
[1:03:40] Pregnancy is dangerous in hunter-gatherers.
[1:03:43] But there's state modern medicine acts like you're perfect
[1:03:47] or it's turned off.
[1:03:48] And the reality is there's all these shades of gray in between
[1:03:51] where these different chronic stressors
[1:03:53] and your insulin resistance and your inflammation
[1:03:55] and your overexercising and your underfueling
[1:03:58] come in and make it so the hypothalamicis
[1:04:00] is not responding correctly.
[1:04:02] And that's what we're trying to get people to intervene there
[1:04:05] before it gets too bad.
[1:04:07] And I see a large number of women who do fall into that zone
[1:04:11] where they are trying their hardest to be healthy
[1:04:15] but what they are choosing to do is actually having a negative impact
[1:04:19] on their hormonal health and how their brain is interpreting
[1:04:22] their hormones.
[1:04:23] And it's very rare to see that in a man.
[1:04:25] The number one reason why I will see low testosterone
[1:04:28] is purely because many men are taking testosterone
[1:04:31] or because of other exogenous factors like marijuana use.
[1:04:34] It is very rarely my brain is not sending out the signals
[1:04:38] to cause my testicles to make testosterone.
[1:04:41] I like to frame it where women are under recovering,
[1:04:44] not overtrain.
[1:04:45] So if we're under recovery, then it makes it more acceptable
[1:04:49] to fuel.
[1:04:50] And I always want to bring it back to,
[1:04:52] it doesn't matter because I come from high performance,
[1:04:55] I'm going to use those words where it's like you're not recovering enough.
[1:04:59] We want to focus on recovery on these days.
[1:05:01] We want to make sure that you're eating and fueling around.
[1:05:04] So it's never overtraining.
[1:05:06] It's always under recovery.
[1:05:07] It's like a balance as well.
[1:05:08] So what do you say to all the voices on social media
[1:05:11] that are just yelling at mostly women and telling them
[1:05:15] it's just a matter of well power?
[1:05:17] And you don't have the body composition you deserve.
[1:05:20] Well, you swipe left and don't talk to them.
[1:05:22] Yeah.
[1:05:23] But that's me, right?
[1:05:25] I'm talking to the woman on Ohio who's feeling defeated
[1:05:27] and stumbles across someone screaming at her on the internet.
[1:05:31] That her body composition that she's not happy with is her fault.
[1:05:35] I hate that because it's a construct of society, right?
[1:05:40] Especially Western society.
[1:05:42] This is where we have to educate.
[1:05:44] It's not your fault.
[1:05:45] These are the things that have come in to play and lined up
[1:05:48] to create the situation.
[1:05:50] But now we have tools to offer you to take one step out of that situation.
[1:05:55] And let's see how many more steps we can get you away
[1:05:58] from the situation to improve your health.
[1:06:01] And are the rules of exercise slightly different
[1:06:04] once you've entered perimenopause?
[1:06:06] So this is where we really need to look at how
[1:06:09] we can use exercise and some environmental stress
[1:06:13] to create a really strong adaptive stress
[1:06:16] and a really strong recovery stress.
[1:06:18] Can you explain adaptive stress?
[1:06:20] Yes, I'm thinking of the 10,000 people who follow me
[1:06:22] who have no idea what adaptive stress is.
[1:06:25] If I go and I do some resistance training, some heavy lifting,
[1:06:30] I want to create a stress on my body
[1:06:33] that's going to then have a signaling cascade
[1:06:37] to repair the muscle in a stronger way than when I first went.
[1:06:41] Because lifting the muscle damages the muscle?
[1:06:43] Yes, and it creates a series of feedback mechanisms
[1:06:46] that make it repair stronger than when you first went in.
[1:06:50] So that's an adaptive stress.
[1:06:52] And we're looking at what levels of stress we can put,
[1:06:57] so it's a training stress or what levels of stress we can use
[1:07:00] through exercise to really, really create an environment
[1:07:05] that improves our health.
[1:07:07] So if we talk about sprint interval training,
[1:07:09] the 30 seconds on and the two to three minute recovery,
[1:07:12] the reason why we want that super high end stress
[1:07:16] of our heart rate is it then creates
[1:07:19] a eventual epigenetic change.
[1:07:22] So it's that environment that's going to create a change
[1:07:24] within the muscle that's going to allow that glute 4 protein
[1:07:28] that I mentioned earlier to open up and have glucose come in
[1:07:31] reducing insulin resistance.
[1:07:33] Also, with that really high, high heart rate,
[1:07:36] we're having a lot of stress on the muscle that's going
[1:07:38] to really some myocons, which are little hormone signals
[1:07:42] that then will go to the liver and say,
[1:07:44] wait a second, we don't need to store visceral fat.
[1:07:47] We need to create non-estrified fatty acids,
[1:07:51] which can then go into our skeletal muscle
[1:07:54] to be used in the mitochondria as fuel.
[1:07:56] So we want to have the stress that's strong enough
[1:07:59] to create these cascade of feedback mechanisms
[1:08:02] to improve our overall health.
[1:08:04] If we stay in that moderate intensity zone,
[1:08:07] we aren't creating a strong enough stress to create that signaling.
[1:08:11] What are we doing?
[1:08:12] We are exacerbating inflammation or exacerbating cortisol.
[1:08:17] Now cortisol isn't the demon,
[1:08:19] but when we have an elevation of it,
[1:08:21] and especially in perimenopause,
[1:08:23] when we're sympathetically driven,
[1:08:25] and we already have a higher level of baseline cortisol,
[1:08:27] if we are continuously in this modern intensity zone,
[1:08:30] we never get a signal to allow that to drop.
[1:08:34] So if we're looking at polarizing,
[1:08:36] which is top-top end and low recovery end,
[1:08:40] then with the top end, we get the signal cascade
[1:08:43] of improving body comp,
[1:08:45] improving insulin sensitivity,
[1:08:48] as well as getting growth hormone
[1:08:50] and testosterone responses,
[1:08:52] which then feed back to drop cortisol.
[1:08:54] So am I right in thinking the solution?
[1:08:56] If I'm a perimenopausal,
[1:08:57] is to do high-intensity interval training
[1:08:59] for short periods of time?
[1:09:01] So we look at the quality of the training,
[1:09:04] not the volume of the training.
[1:09:05] So if we're in our reproductive years,
[1:09:07] then yes, you can do the modern intensity stuff
[1:09:09] because you have estrogen
[1:09:11] and some of our other hormone feedback signals
[1:09:13] that are going to drop cortisol,
[1:09:16] it's going to allow your body to recover and repair.
[1:09:19] And what makes quality training?
[1:09:21] What is quality training?
[1:09:22] So this is your polar.
[1:09:23] So you have a very specific session
[1:09:25] that you're going to do.
[1:09:26] So from Vonda,
[1:09:27] it's your 30 seconds on,
[1:09:28] as hard as possible,
[1:09:29] two to three minutes recovery,
[1:09:31] do that four times at your session.
[1:09:33] Okay, I'm going to try and summarize this.
[1:09:35] Let's see if this is a test.
[1:09:37] See if I understood all of this stuff.
[1:09:39] So if I do a lot of volume,
[1:09:42] but I play in that sort of medium intensity range,
[1:09:46] I'm basically just like stressing out my body
[1:09:48] in all the worst ways.
[1:09:49] Exactly.
[1:09:50] Like the inflammation,
[1:09:51] it's just not good for my body necessarily.
[1:09:52] If I don't do vigorous enough exercise,
[1:09:55] then that's also bad
[1:09:57] because nothing's going to break in there for built.
[1:10:00] It's nothing's going to adapt.
[1:10:01] Nothing's going to grow.
[1:10:03] If I do it for long periods of time,
[1:10:06] really anything for long periods of time,
[1:10:07] that's also stress.
[1:10:08] But the key thing to do is to do shorter,
[1:10:13] higher intensity exercise
[1:10:16] that will cause my body to adapt
[1:10:18] but won't put it into that inflamed stressful state.
[1:10:22] And you also have to pepper in some lower intensity work.
[1:10:25] So this is your flexibility.
[1:10:28] So that you have recovery.
[1:10:30] You're getting blood flow circulating.
[1:10:32] You're tapping into some mitochondrial work.
[1:10:35] So that you are still getting benefit of exercise
[1:10:38] but it's not in that modern intensity.
[1:10:40] So that's what we mean by polarizing.
[1:10:42] So if we were to talk in like the zone talk
[1:10:46] that everyone talks is out there, right?
[1:10:48] We're looking at it.
[1:10:49] So if we're talking about heart rate
[1:10:51] and the way that your body works,
[1:10:53] we have zone one,
[1:10:54] which is just sitting around.
[1:10:55] Yeah, like you're.
[1:10:56] Yeah.
[1:10:57] We're in zone one.
[1:10:58] We're in zone one.
[1:10:59] Zone two is the broscience kind of thing
[1:11:02] where you're like,
[1:11:03] let's work in the zone two area
[1:11:05] where we're working.
[1:11:07] I was in zone two when you were talking about menstrual cycle.
[1:11:09] Yeah, there you go.
[1:11:10] That's it.
[1:11:11] Your heart rate is elevated.
[1:11:13] Still a little bit have a conversation.
[1:11:15] For women, it's good for recovery stress release.
[1:11:19] For men, it's good to improve metabolic flexibility.
[1:11:22] We're looking at zone three, four.
[1:11:25] That's the area you want to stay out of.
[1:11:27] Unless you're specifically training for something
[1:11:29] that requires you to be there.
[1:11:31] That would be your half marathons,
[1:11:33] your endurance races, that kind of stuff.
[1:11:35] Everyone wants to stay out of zone.
[1:11:37] Three, four.
[1:11:39] They're in training.
[1:11:41] They're in training.
[1:11:43] That's the medium range, right?
[1:11:44] Yeah, that's medium range.
[1:11:45] So you want to jump into zone five,
[1:11:47] hang around for.
[1:11:48] Five, six.
[1:11:49] Okay, a couple of minutes and then get out of there.
[1:11:50] Yeah.
[1:11:51] But in a week.
[1:11:52] This is what.
[1:11:53] Yeah, it's crystal clear.
[1:11:54] So two to four days a week,
[1:11:56] you should be lifting progressively to lift heavy,
[1:12:00] meaning have your weights fewer reps, right?
[1:12:05] One compound lift a day,
[1:12:07] plus the augmentive lifts that go behind it, right?
[1:12:10] So you're warming up first,
[1:12:12] then you're going to do one lift,
[1:12:14] and then you're going to do your jumping
[1:12:16] or your balance work.
[1:12:18] The other days of the week,
[1:12:20] you will do preferably low intensity doing anything,
[1:12:24] walking briskly down the New York street could count as that.
[1:12:28] It's continuous motion.
[1:12:30] And then a couple days a week,
[1:12:33] add in your sprint intervals.
[1:12:35] You're really high zone five, six, high intensity.
[1:12:40] And then when you've got that,
[1:12:43] you can add in your four by four VO2 max
[1:12:49] on one of the other days,
[1:12:50] because it sounds like a lot.
[1:12:52] But when I work with non-pro athletes,
[1:12:54] I layer on behaviors.
[1:12:56] Absolutely.
[1:12:57] Because if I say all of this nuance,
[1:13:00] nobody's going to do anything.
[1:13:02] Always describe it as we have these pillars, right?
[1:13:05] First, we have to nail sleep.
[1:13:06] It doesn't matter who you are.
[1:13:07] You have to.
[1:13:08] Because you cannot.
[1:13:09] It's not negotiable.
[1:13:10] Yeah, you cannot invoke any kind of metabolic
[1:13:12] or body composition change without adequate sleep.
[1:13:15] Also improves stress resilience.
[1:13:17] Then we look at nutrition and physical activity.
[1:13:20] The behaviors that go with both of those
[1:13:22] are somewhat independent.
[1:13:23] You have some people that are more motivated
[1:13:25] to do physical activity.
[1:13:26] And some people are more motivated
[1:13:28] to change nutritional habits.
[1:13:30] Most of the time,
[1:13:31] there are two different personalities.
[1:13:33] So we have to look at what comes next.
[1:13:35] And then we also have,
[1:13:36] which isn't lesser importance,
[1:13:37] but often neglected,
[1:13:38] is the mindfulness and community.
[1:13:40] So this is being out in nature.
[1:13:41] It's connecting with friends.
[1:13:43] It might be going to group exercise class.
[1:13:45] It might be just having coffee.
[1:13:47] But that is really, really important
[1:13:49] for parasympathetic and whole,
[1:13:51] like, whole beings response.
[1:13:53] Exactly.
[1:13:54] So there's a new book out coming out called Joy Span.
[1:13:57] I don't know if you've spoken with her.
[1:13:59] So she's a geriatric entologist
[1:14:00] and works with the very elderly.
[1:14:02] And she has a very specific,
[1:14:04] you know, what determines
[1:14:06] who's going to kill it in that last decade of life?
[1:14:09] And that community part,
[1:14:11] using your brain,
[1:14:13] you know, having interactions with human beings
[1:14:15] seems to be the key.
[1:14:17] And if you don't keep that going
[1:14:19] through this 40s, 50s, 60s,
[1:14:21] when you get to 70 and 80,
[1:14:23] you're not going to have a great end of your life.
[1:14:26] And what about the last phase then?
[1:14:27] So someone's post-menopausal.
[1:14:29] Does their exercise recommendations change at all?
[1:14:33] We like to start the habits early
[1:14:35] and continue them through.
[1:14:37] If you haven't started,
[1:14:38] it's not too late.
[1:14:39] As we're seeing, like,
[1:14:40] with lift more and some other
[1:14:41] of the older age resources coming out,
[1:14:44] it's never too late to start.
[1:14:45] We just have to be very careful
[1:14:47] of how you start to have support
[1:14:49] and phase you into these different exercise modalities.
[1:14:52] Is it the same exercises there?
[1:14:55] Meaning.
[1:14:56] You know, the three days a week,
[1:14:58] the mobility, the strength.
[1:14:59] I am firmly post-menopausal
[1:15:01] and I am doing all these things.
[1:15:03] But it's different.
[1:15:04] Different people always ask me,
[1:15:06] what does heavy lifting mean?
[1:15:07] Right. It's relative.
[1:15:08] It's relative. My heavy
[1:15:10] is not going to be Stacey's heavy
[1:15:12] or I should say the other way.
[1:15:14] Stacey's very heavy is not going to be my heavy.
[1:15:16] In lift more,
[1:15:17] they just, the authors described the one,
[1:15:19] the one rep max.
[1:15:20] And so one rep max is like,
[1:15:22] safely.
[1:15:23] What is the heaviest you can do?
[1:15:25] One rep, you know.
[1:15:26] So far by a step curl,
[1:15:27] what is the heaviest weight I can do?
[1:15:29] One to fail, you know,
[1:15:30] I'm going to fail after this one.
[1:15:32] And for me, that was about 20 pounds.
[1:15:34] With good form.
[1:15:35] Exactly.
[1:15:36] Safely with good form.
[1:15:37] And so I could nail 20.
[1:15:39] And so then they took them down to
[1:15:41] about 70, 80% of that,
[1:15:44] which for me was about 15, 16 pounds.
[1:15:47] So that you can usually do about five reps
[1:15:50] before you hit failure.
[1:15:51] And that is what they consider lifting heavy.
[1:15:54] And that seemed to really resonate with my followers
[1:15:56] to understand what that meant.
[1:15:58] And there's so many women that underestimate their strength.
[1:16:01] See them?
[1:16:02] And they gravitate towards the 10 pound dumbbells.
[1:16:05] It's like, put that away.
[1:16:07] Go to the next one.
[1:16:09] Do a couple of lifts with that.
[1:16:11] And then ideally, I want you to put that away
[1:16:13] and pick up the next one.
[1:16:14] Because that's going to challenge you.
[1:16:16] Because women have been so conditioned to do 10 to 15 reps
[1:16:20] to get, quote, toned and not really put in the work
[1:16:23] they need to build muscle
[1:16:25] and to get the benefit out of strength training.
[1:16:27] And I'm always telling them you're underestimating yourself
[1:16:30] and so many facets don't cheat yourself
[1:16:32] with the strength training as well.
[1:16:34] Because people have to remember
[1:16:36] what we're what we're training for now.
[1:16:38] It's different than I had a woman recently say,
[1:16:41] I was taught to do biceps curls, five pounds, 30 times.
[1:16:45] Well, after 30 times, not only are you bored,
[1:16:48] but you probably could be at failure 30 times.
[1:16:51] That will build endurance.
[1:16:53] I am training to be as strong as possible.
[1:16:55] And when I have strength down,
[1:16:59] then I start playing with tempos
[1:17:01] so that I could replace some of the explosive muscle fibers
[1:17:05] that I'm going to lose over time.
[1:17:07] To your point, Ronda, I just been writing my book
[1:17:10] in Cape Town as I was told you before we started recording.
[1:17:12] And one of the studies that I read about
[1:17:14] while I was writing the book was a study done by a guy
[1:17:18] called How Hershfield and his colleagues
[1:17:21] where they asked, they put people in these MRI scanners
[1:17:24] and they asked them to think about a famous celebrity.
[1:17:27] And then they asked them to think about themselves today
[1:17:29] and then they asked them to think about themselves
[1:17:31] in 10 years time.
[1:17:32] And in 10 years time, the same brain regions lit up
[1:17:35] as if they were thinking about the celebrity,
[1:17:37] which kind of led them to conclude that in our brain,
[1:17:41] we almost see our future selves as a bit of a stranger.
[1:17:44] Yes, that's right.
[1:17:45] And so when we think about long-term planning,
[1:17:47] this is in part why a lot of this advice
[1:17:50] is often most effective when it's put in the context
[1:17:52] of short-term performance or cognitive benefits.
[1:17:55] Because we really do struggle to care about ourselves at 90.
[1:17:59] And I think we all kind of think we can figure it out later.
[1:18:03] I think what's different for women, especially in menopause
[1:18:06] is because we're also taking care of our parents in so many ways.
[1:18:10] We're in this raising kids going through our own hormonal upheaval
[1:18:14] and then watching our mothers, our grandmothers, our aunt's age.
[1:18:17] And the way society is set up, women become the caretakers
[1:18:21] of their parents, generally the oldest daughter.
[1:18:23] And I have to give full credit to my sister
[1:18:25] who lives in the same town as my mom and as a nurse.
[1:18:28] So she really is bearing the brunt of taking care of mama
[1:18:30] because I'm living this life.
[1:18:32] So thank you, Lee, if you're watching.
[1:18:34] It is such a tremendous stress.
[1:18:36] And so our motivation, my sister and I,
[1:18:39] is like, we don't want to do this to our daughters.
[1:18:42] Exactly.
[1:18:43] The other thing I want to bring in is the brain health component.
[1:18:47] We talk about Alzheimer's and dementia.
[1:18:49] And one of the reasons I really preface doing high-intensity work
[1:18:54] is to lactate production.
[1:18:55] Because we're finding more and more research coming out
[1:18:58] of this showing that part of the development of dementia
[1:19:02] and Alzheimer in the plaque is a misstep in brain metabolism.
[1:19:05] So when we're looking at brain metabolism
[1:19:07] and the brain uses a lot of glucose,
[1:19:09] it also uses lactate.
[1:19:10] Now for women, we have less of the glycolytic or lactate producing fibers
[1:19:15] and we tend to lose those with age.
[1:19:17] Men are born with more, tend to hold on to them more.
[1:19:21] So it's not necessarily as big an issue for lactate production.
[1:19:25] We then need to spend more time in the low-intensity
[1:19:28] being able to produce more of our fat-burning capacity.
[1:19:32] But for women doing that high-intensity work
[1:19:34] and being able to produce lactate
[1:19:36] to then allow the heart and the brain
[1:19:38] to use that preferential fuel feeds forward
[1:19:41] to reducing the misstep in this brain metabolism component
[1:19:47] that occurs and it's such a sex difference.
[1:19:50] When we're seeing a change in glucose metabolism
[1:19:53] in and around perimenopause and to menopause.
[1:19:56] So it's that lactate production that I
[1:19:58] is kind of the offshoot of the high-intensity work
[1:20:01] that's super important for brain health as well.
[1:20:05] When you look at glucose metabolism in the brain,
[1:20:07] I'm talking specifically coming out of Arizona
[1:20:10] and from Lisa Muscone's work
[1:20:12] and they looked at glucose utilization in the brain,
[1:20:15] especially the forebrain through the transition,
[1:20:18] it's wildly different based on what phase
[1:20:22] of perimenopause, menopause, and postmenopause
[1:20:25] that they're in and it's absolutely astounding
[1:20:28] and they're seeing patterns that can give clues
[1:20:30] that may be the women who are headed towards
[1:20:32] the dementia route versus those who aren't.
[1:20:35] And women are significantly more likely than men
[1:20:37] to develop dementia and Alzheimer's,
[1:20:39] because they have certain unique biological risk factors
[1:20:42] and also because they live longer.
[1:20:44] And the sociocultural component,
[1:20:46] I keep bringing it up because I stress.
[1:20:48] Yeah, but also if we're looking at women who are
[1:20:51] 89 years old now,
[1:20:53] they're upbringing to this point
[1:20:56] is completely different than ours,
[1:20:57] meaning that the job availability
[1:20:59] and the brain stimulation they had
[1:21:01] when they were in their 30s, 40s, 50s,
[1:21:04] completely different than what we have now.
[1:21:06] Better of Fort West.
[1:21:07] Of course. So they didn't have necessarily
[1:21:09] opportunity to be scientists, lawyers, medical doctors.
[1:21:12] So they didn't have as much stimulation of brain
[1:21:15] and implications on that neuroplasticity.
[1:21:17] So we're seeing a higher episodic issue
[1:21:22] of dementia and Alzheimer's and older women now
[1:21:26] because they didn't have the same lay-down effect
[1:21:29] that we have now as 50-year-olds,
[1:21:32] 40-50-year-olds,
[1:21:33] and the stimulus we have for neuroplasticity.
[1:21:36] Oh, so okay.
[1:21:37] Like you're laying down brain pathways and neurofibers.
[1:21:40] So neuroplasticity.
[1:21:41] Think about it like the bone,
[1:21:42] but you're creating pathways in your brain
[1:21:44] to make you healthier,
[1:21:45] but more resilient to dementia.
[1:21:48] But they're also going to have a stronger brain younger.
[1:21:51] Are they not going to have more stress
[1:21:53] if they're working in more hours?
[1:21:55] And fascinating study,
[1:21:56] and this one shot me out of a cannon emotionally,
[1:21:59] was if you choose to become a caretaker of a parent
[1:22:03] with dementia,
[1:22:04] you have a 60% increased risk.
[1:22:06] Now there's a genetic component,
[1:22:08] but when they took the genetics out of it,
[1:22:10] and they feel like it's the stress of caregiving
[1:22:13] for that parent,
[1:22:14] you are signing your own death warrant,
[1:22:16] because now you are increasing your risk of death.
[1:22:18] Because, yeah,
[1:22:19] because I'm right in thinking
[1:22:20] that women are still both caregiver
[1:22:22] and now in the corporate world.
[1:22:24] Yes, yes, that's right.
[1:22:27] So it's both.
[1:22:28] Yeah.
[1:22:29] Stress from both ends.
[1:22:31] Lactate production for the win.
[1:22:33] But you also have an active plan to combat this, right?
[1:22:37] Yes.
[1:22:38] We're not going to live in a world that is stress-free.
[1:22:39] If you're a woman in the world,
[1:22:41] you are likely to have a caretaking role in some fashion.
[1:22:45] Even if you are chasing other dreams
[1:22:48] when it comes to professionally,
[1:22:50] building good brain pathways
[1:22:52] is wonderful as far as a way to help start
[1:22:55] from a higher standpoint before you have brain loss.
[1:22:59] However, we've just like we've said on these other standards,
[1:23:01] the brain is that too.
[1:23:03] We need to think about active ways.
[1:23:05] We're going to combat what is happening
[1:23:07] in today's world naturally.
[1:23:09] And some of the factors are modern society
[1:23:11] that put us into this pro-inflammatory state.
[1:23:15] But we need to think about making lactate,
[1:23:17] what's important for us.
[1:23:19] And it really is a plan.
[1:23:21] I'm going to figure it out when I'm 90
[1:23:23] and the problems in front of me is too late
[1:23:25] for these medical problems.
[1:23:27] So in back to your point about neuroplasticity,
[1:23:29] we're not reading as much.
[1:23:31] We're on our phones.
[1:23:32] And so...
[1:23:34] In my house?
[1:23:35] Yeah.
[1:23:36] And so, as a culture,
[1:23:38] there's this worry that all this time on the phone
[1:23:41] and these dopamine hits,
[1:23:42] but not creating stories in your head
[1:23:44] and reading for pleasure at night,
[1:23:47] a lot of women are on their phones now before bed,
[1:23:50] rather than developing that neuroplasticity
[1:23:53] that we get from storytelling.
[1:23:56] I did something at 24 years old
[1:23:58] that has had a profound impact on my life.
[1:24:00] I set myself the challenge of posting
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[1:24:04] And at the time,
[1:24:05] I was doing it to grow my following.
[1:24:07] But it had this profound impact on my life
[1:24:09] and two remarkable things happened when I did that.
[1:24:11] I managed to learn faster
[1:24:13] because every single day I'm capturing what is happening to me
[1:24:15] and trying to distill it down into something
[1:24:17] that I can share with the world.
[1:24:19] But more remarkably,
[1:24:20] it led me to building a following
[1:24:22] of many millions of people
[1:24:23] and that's the basis that I used to launch the diorevascio.
[1:24:26] And that's why I want to tell you about our sponsor today
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[1:24:59] The next question that came in from the audience,
[1:25:01] we asked 1,000 women to submit their questions.
[1:25:04] The next one is, what's the best
[1:25:06] and healthiest way for a woman to lose weight?
[1:25:09] Lift weights.
[1:25:10] And eat.
[1:25:11] And eat.
[1:25:12] And eat.
[1:25:13] Yes, absolutely.
[1:25:14] And you could have a very slight calorie deficit
[1:25:17] towards the end of the evening.
[1:25:19] Running?
[1:25:22] As a way of burning calories,
[1:25:24] the problem is people think that they can
[1:25:26] out-exercise a bad diet.
[1:25:28] And you can't.
[1:25:29] Composition of your diet matters immensely.
[1:25:31] And I hate calling it lose weight.
[1:25:33] I now call it recomposition.
[1:25:35] Yeah.
[1:25:36] But let me put it in context.
[1:25:37] Yeah, go run.
[1:25:38] You're going to burn 100 calories a mile.
[1:25:41] Three girls scout cookies,
[1:25:43] three thin mints,
[1:25:44] U.S. favorites,
[1:25:45] is 180 calories.
[1:25:47] So you have to run two miles
[1:25:50] to eat three cookies.
[1:25:52] Most of us,
[1:25:53] if you're going to eat cookies,
[1:25:55] don't eat three thin mints.
[1:25:57] You eat the whole sleeve.
[1:25:58] Right.
[1:25:59] To your point,
[1:26:00] it is impossible to out-exercise food
[1:26:03] unless you're a high-level athlete.
[1:26:05] And even then, no.
[1:26:06] Thousand calories.
[1:26:07] And then, no.
[1:26:08] Because we look at diet composition.
[1:26:10] And we see that endurance athletes
[1:26:12] who use a lot of high sugary,
[1:26:14] time carbohydrate,
[1:26:15] like did gels and the sports stuff,
[1:26:17] they've interrupted their gut microbiome
[1:26:19] so much that they have sugarapples.
[1:26:21] Yeah.
[1:26:22] Well, it's not even that.
[1:26:23] It's the phylochange.
[1:26:25] We're seeing a decrease in the diversity,
[1:26:27] but we're exercising.
[1:26:28] And we see that exercise increases
[1:26:30] the diversity of the gut microbiome,
[1:26:32] is what they're eating during the training
[1:26:34] with the heat and hypoxic stress.
[1:26:36] Wow.
[1:26:37] That is creating the growth of the,
[1:26:39] from a kudis phylo,
[1:26:41] that's associated with obese outcomes.
[1:26:43] So that's,
[1:26:44] it changes the gut.
[1:26:45] The gut bacteria.
[1:26:46] Yeah.
[1:26:47] Yeah.
[1:26:48] So we have this,
[1:26:50] yeah, we have this misconception
[1:26:52] that if you're an elite athlete
[1:26:54] and you're burning all these calories,
[1:26:55] then you're just eating a fuel, right?
[1:26:57] But it's not.
[1:26:58] It's the quality of the diet.
[1:27:00] If we want to perform well,
[1:27:01] whatever performance means,
[1:27:03] if you're Olympic athlete,
[1:27:05] down to recreational person,
[1:27:06] who just wants to accomplish a 5k,
[1:27:08] the composition of your diet
[1:27:10] is immensely important.
[1:27:12] What about a Zempac?
[1:27:13] Everybody seems to be on a Zempac,
[1:27:15] JLP ones.
[1:27:16] I prescribe it.
[1:27:17] And our clinic is all perimenopause and menopause.
[1:27:19] And so we always start with,
[1:27:21] let's see how you do
[1:27:23] with lifestyle changes first.
[1:27:25] So we give that three to six months.
[1:27:27] When they come back,
[1:27:28] every time they come back,
[1:27:29] we're doing another body composition chain
[1:27:31] for probably 50% of the patients,
[1:27:34] lifestyle plus or minus HRT,
[1:27:36] their body composition changes,
[1:27:38] they're happy,
[1:27:39] they're health, you know,
[1:27:40] they're much healthier,
[1:27:41] everything's moving in the right direction.
[1:27:42] So now we're left with the people
[1:27:44] who are doing all the things.
[1:27:45] This isn't the typical story of people
[1:27:47] that start at Zempac.
[1:27:48] They see it on the Instagram
[1:27:50] and then a week after I'll be at their house
[1:27:52] and they'll tell me,
[1:27:53] yeah, I'm on a Zempac.
[1:27:54] And it's really,
[1:27:55] it's usually just someone sees it online.
[1:27:57] They hear it on a podcast
[1:27:58] and they're on it within a couple of days.
[1:28:00] The access is getting easier.
[1:28:02] The price is coming down.
[1:28:03] And there is for any medication,
[1:28:05] there are risks,
[1:28:06] there are benefits.
[1:28:07] And there's ways that will promote health.
[1:28:11] And with any medication,
[1:28:12] you can not promote health if you give.
[1:28:14] I mean, JLP ones can be revolutionary
[1:28:17] for certain people.
[1:28:18] A lot of people are not training
[1:28:19] for a 5K,
[1:28:20] let alone anything else.
[1:28:21] And we know if we go very simply,
[1:28:23] that sells, right?
[1:28:24] They make a different type of estrogen.
[1:28:26] They're inflammatory.
[1:28:27] You have insulin resistance.
[1:28:28] And all of this sets you up at a deficit
[1:28:31] to say, I want to get healthier.
[1:28:33] For women, we'll say you have PCOS,
[1:28:35] who already have a predisposition
[1:28:37] for insulin resistance.
[1:28:38] They have a harder time losing weight
[1:28:40] because now they're also storing visceral fat.
[1:28:42] We know they get on this cycle
[1:28:44] with hormonal change.
[1:28:45] You know, being on a Zempac
[1:28:47] allows them to lose weight
[1:28:49] and combat insulin resistance
[1:28:51] in a faster way
[1:28:53] than they've ever been able to do before.
[1:28:55] And especially when it comes to fertility
[1:28:57] and you're on a timeline,
[1:28:58] that can be really revolutionary.
[1:29:00] When you lose weight
[1:29:01] because that estrogen decreases,
[1:29:03] many women with PCOS,
[1:29:05] if they were overweight,
[1:29:06] will start ovulating again
[1:29:07] because that suppression
[1:29:08] from the additional estrogen is gone.
[1:29:11] And their inflammation markers go down,
[1:29:14] their insulin resistance decreases.
[1:29:16] So there's a subset of people
[1:29:17] who have found their life changed by them.
[1:29:20] And we never want to discredit that.
[1:29:21] Many people have a difficulty losing weight,
[1:29:24] chronic medical conditions,
[1:29:26] have been able to reverse them,
[1:29:28] and this has been a tool in the toolbox.
[1:29:30] Because about 70% of Americans
[1:29:32] would fit in that category of chronic health conditions,
[1:29:35] difficulty losing weight.
[1:29:36] They're 73% right now
[1:29:38] or overweight or obese in the US.
[1:29:40] So should 73% of Americans be on GLP once?
[1:29:42] And it was higher in women.
[1:29:43] Well, we always...
[1:29:44] One common thing is
[1:29:46] having tools in the toolbox
[1:29:48] and being able to know when to use them,
[1:29:49] when to offer them.
[1:29:50] Just like when we have the HRT discussion,
[1:29:53] we don't want to see people
[1:29:55] say women for this discussion,
[1:29:56] not being offered a therapeutic option
[1:29:59] or not choosing it out of fear.
[1:30:01] Well, when I hear that,
[1:30:02] it's going to help me lose weight.
[1:30:04] And I've got two options.
[1:30:06] I can go out and lift all these weights,
[1:30:08] they see, and I can...
[1:30:09] Which, you know, one day, I don't...
[1:30:11] Yeah, it's hard, isn't it?
[1:30:12] Go to the gym after what my shoes are,
[1:30:13] and all these things.
[1:30:15] Or I can take this injection.
[1:30:17] And lose all your muscle and lose your bone
[1:30:20] and end up like the little floating figure
[1:30:22] in Wally movie that I've talked about before, right?
[1:30:25] And that's my fear of just blanket people use you.
[1:30:29] You're also...
[1:30:30] Whether you mean to or not,
[1:30:32] giving the illusion that, you know,
[1:30:34] willpower is all you need to lose weight
[1:30:37] by what you said.
[1:30:38] I can either do these hard things
[1:30:40] or I can choose this medication
[1:30:42] which appears to be the easier way out.
[1:30:44] And two things can be true at once.
[1:30:46] People can work extremely hard.
[1:30:47] Maybe they don't understand exactly
[1:30:49] what they should be doing.
[1:30:50] And that's part of what we're trying to change the discussion on.
[1:30:53] But reversing some metabolic change,
[1:30:55] even initially, can make a big difference in their game plan.
[1:30:58] But you will lose body weight on these medications.
[1:31:03] And so you have to have somebody guiding the ship.
[1:31:06] I think what we all don't love is the access without oversight.
[1:31:11] I mean, nobody's helping you say,
[1:31:13] how are you not using muscle?
[1:31:15] How are you doing this in a safe fashion?
[1:31:17] You can just text somebody on an app
[1:31:19] and suddenly get medication to your house.
[1:31:22] You know, in our clinic,
[1:31:23] it is an hour long.
[1:31:24] Now they're coming in to discuss the GOP one option.
[1:31:27] It is an hour long visit of risk benefits, side effects,
[1:31:31] protein intake, resistance training, mandatory.
[1:31:34] We will follow your bone density.
[1:31:36] We will follow your bone mass.
[1:31:38] I mean, your muscle mass here.
[1:31:39] We have these scanners.
[1:31:40] These are great.
[1:31:41] Available.
[1:31:42] And we're not going to get to a number on the scale
[1:31:44] and sacrifice your long-term health.
[1:31:46] And my patients are drinking the Kool-Aid.
[1:31:48] They're coming in.
[1:31:49] They've found, you know, they...
[1:31:50] They're coming to you for a reason.
[1:31:51] Yeah.
[1:31:52] And so I'm a little bit unique in my clinic.
[1:31:54] And now I have a social media following
[1:31:56] and people kind of watch a few things before they come see me.
[1:31:58] So they know my...
[1:31:59] They're not shocked by me giving this advice.
[1:32:01] Because I give it all day on social media.
[1:32:03] So if you give them the...
[1:32:04] Is MPEG?
[1:32:05] But they still don't go to the gym.
[1:32:07] They still don't do anything else.
[1:32:08] Then we'll stop giving it to them.
[1:32:09] They won't be healthy.
[1:32:10] And they know that.
[1:32:11] We've talked to them about that.
[1:32:12] We've explained it on the front end.
[1:32:14] That this is a tool in your toolkit.
[1:32:16] Because we can see their muscle mass.
[1:32:18] We won't renew the prescription if they've lost the muscle mass.
[1:32:21] So if you are losing weight
[1:32:23] and not lifting and eating enough protein,
[1:32:26] on ozemic or any way else,
[1:32:28] and you do a body composition,
[1:32:30] you may see total weight lost.
[1:32:33] You will see pounds of muscle loss.
[1:32:38] You may see body fat percentage loss.
[1:32:40] But if you do this correctly
[1:32:42] with enough protein in your diet and lifting weights,
[1:32:45] the amount of muscle loss will be very small
[1:32:49] versus amount of fat loss.
[1:32:51] So we know we are going to lose a little muscle
[1:32:55] but you can't lose eight pounds of muscle.
[1:32:57] Right.
[1:32:58] So we can tell.
[1:32:59] And I give them the hard numbers.
[1:33:01] Like 10% is acceptable.
[1:33:03] We're going over that.
[1:33:04] We're getting into the danger zone.
[1:33:06] We're going to cut back on your dose.
[1:33:07] We're going to, you know,
[1:33:08] but they commit to the work on the front end.
[1:33:12] I think that's the important point is that these job
[1:33:15] who are antagonists don't burn your fat.
[1:33:18] They burn.
[1:33:19] They stop you eating as much.
[1:33:20] They stop.
[1:33:21] They stay tight.
[1:33:22] Which is going to mess them,
[1:33:23] which is going to reduce everything.
[1:33:24] Because I was thinking about myself.
[1:33:25] I was thinking, well,
[1:33:26] I go to the gym every day.
[1:33:27] I'm going to keep going.
[1:33:28] So maybe if I had a little bit of a Zampek
[1:33:30] or whatever it's called,
[1:33:31] then it would burn my fat.
[1:33:32] But actually, that's not what it is.
[1:33:33] It's not no.
[1:33:34] I'm going to stop me eating,
[1:33:35] which is going to reduce my muscle, my burn.
[1:33:37] That's right.
[1:33:38] Goodbye, biceps.
[1:33:39] That's the thing.
[1:33:40] It's like,
[1:33:41] No, these are my subscribers.
[1:33:42] Yeah.
[1:33:43] Exactly.
[1:33:44] Exactly.
[1:33:45] Exactly.
[1:33:46] Yeah.
[1:33:47] Okay.
[1:33:48] That makes sense.
[1:33:49] So to this person asking what's the best and healthiest way
[1:33:51] to lose weight,
[1:33:52] the response is stop eating the cookies
[1:33:54] and start lifting some ways.
[1:33:56] The 80-20 rule.
[1:33:57] Right.
[1:33:58] So 80% of the time you're on it, right?
[1:34:00] You're paying attention to
[1:34:02] a high-quality diet.
[1:34:04] You are eating,
[1:34:05] according to circadian rhythm.
[1:34:07] You are doing this strength training,
[1:34:09] you're getting the good sleep,
[1:34:10] and then 20% is life.
[1:34:12] Where I'm going to stay up late.
[1:34:13] I'm going to have some wine or whiskey.
[1:34:15] I'm going to go out.
[1:34:16] I'm going to be on vacation.
[1:34:17] So you're not excluding all the fun things in life.
[1:34:20] If it comes to a point where you're like,
[1:34:22] I'm still not budging the needle.
[1:34:23] Then maybe it's a 90-10 rule.
[1:34:25] Or 90% of the time you're on it.
[1:34:27] And 10% is the life factor.
[1:34:30] There's these hard and fast rules
[1:34:32] I've been accused of giving.
[1:34:33] I don't give rules.
[1:34:34] I give optimization ideas.
[1:34:36] So it's not following strict 80-20 or 90-10.
[1:34:40] It's what fits in your life.
[1:34:42] And if you're really motivated on losing weight,
[1:34:45] the first thing I tell people to do is ditch alcohol.
[1:34:48] Everyone wants to lose the part on the belly.
[1:34:51] Yeah, sure.
[1:34:52] Is there not like an exercise I can do just by the partner?
[1:34:54] No, there's no exercise.
[1:34:57] So visceral fat's a little bit different.
[1:34:59] It's like a whole different organ.
[1:35:01] So when we talk about visceral fat,
[1:35:03] it has different drivers.
[1:35:06] We drive fat to the intral abdominal cavity.
[1:35:08] It creates a different cytokine.
[1:35:10] Subcutaneous fat is a storage facility.
[1:35:12] It is when we overeat calories.
[1:35:14] We will drive fat under the skin.
[1:35:16] And it's kind of genetically determined.
[1:35:18] Females tend to gain about their hips and thighs.
[1:35:20] And actually that hip and thigh fat
[1:35:22] is protective for cardiovascular disease
[1:35:25] and the pre-medipausal women.
[1:35:27] Not in men, but in women.
[1:35:29] But when that fat shifts to the intral abdominal cavity,
[1:35:34] it starts.
[1:35:35] That fat is metabot much more metabolically active
[1:35:37] than the fat under our skin.
[1:35:39] And it creates these pro-inflammatory cytokines.
[1:35:41] And then you end up in this negative feedback cycle.
[1:35:44] Your liver starts becoming dysfunctional.
[1:35:47] Insulin resistance increases.
[1:35:48] That drives more fat to the visceral cavity.
[1:35:51] Increases inflammation.
[1:35:52] And it just goes on.
[1:35:53] So get liposuction.
[1:35:54] No, no, no.
[1:35:55] You can't lipose this way.
[1:35:56] They're inside the fat.
[1:35:58] That's really inside the abdominal cavities
[1:36:00] that we're talking about.
[1:36:01] That visceral fat, which is the worst kind.
[1:36:03] Well, what about liposuction?
[1:36:04] Can I just suck it out?
[1:36:05] People are doing all kinds with that fat.
[1:36:06] Under the skin.
[1:36:07] Under the skin you can.
[1:36:08] That's an aesthetic decision.
[1:36:09] The stuff under the skin.
[1:36:11] Oh.
[1:36:12] Liposuction it out.
[1:36:13] Is that a good idea or bad idea?
[1:36:15] No, it'll come back.
[1:36:16] All these things we're talking about.
[1:36:17] It sounds like a lot of instructions.
[1:36:19] And it is, actually.
[1:36:21] But when you layer them on, it becomes your lifestyle.
[1:36:25] Yes.
[1:36:26] It's not a diet.
[1:36:27] It's not an exercise program.
[1:36:29] It's just how I live.
[1:36:31] You're right.
[1:36:32] Which brings me to my next question from the audience,
[1:36:34] which is, what is the best diet for a woman who is perimenopausal?
[1:36:38] Plant forward.
[1:36:39] Plant heavy.
[1:36:40] Yeah.
[1:36:41] Because you're getting, you're getting, so when I'm talking to patients,
[1:36:45] we talk about the quality of their nutrition.
[1:36:48] So is your pattern of eating?
[1:36:50] I hate to call it diet because it's for a little word now.
[1:36:53] But is the pattern that you're eating pro-inflammatory or anti-inflammatory?
[1:36:57] What's pro-inflammatory?
[1:36:59] So meaning, the things that you put in your body are they likely to cause inflammation.
[1:37:02] And we know there are certain things that do that, like heavily ultra-process foods,
[1:37:07] you know, in large amounts.
[1:37:09] Everybody can tolerate a little bit of everything.
[1:37:11] But if the majority of your diet and for most Americans,
[1:37:13] the majority of their diet is 60% as ultra-process foods.
[1:37:17] Okay.
[1:37:18] Those are by and large pro-inflammatory.
[1:37:20] What about red meat?
[1:37:22] Red meat and moderation, and especially leaner,
[1:37:25] one seems to be a very reliable source of protein.
[1:37:28] As far as inflammation goes, it seems to be neutral in small amounts.
[1:37:32] Not heavily, like high fat meals or processed meats,
[1:37:35] then you're flipping over into pro-inflammatory.
[1:37:37] Is there a diet for fatality?
[1:37:39] It's very much what we're saying right here,
[1:37:41] that plants have fiber that's going to feed your gut microbiome,
[1:37:44] that's going to decrease inflammation.
[1:37:46] So fruits and vegetables, getting enough fiber,
[1:37:48] is the number one change that most people need to make.
[1:37:51] From there, we want to, of course, decrease all your ultra-process foods.
[1:37:55] Healthy fats.
[1:37:56] Fat is the backbone of cholesterol.
[1:37:59] Is the backbone of your steroid hormone.
[1:38:01] So if you want to make hormones, we've got to have some cholesterol,
[1:38:04] some healthy fats coming in to provide the backbone for that.
[1:38:07] That's essential.
[1:38:08] So things like olive oil, nuts, your avocados, seeds.
[1:38:13] These are going to provide some of those healthier fats
[1:38:15] that are easier to use for you.
[1:38:17] And when it comes to protein, there's a lot of different protein sources.
[1:38:20] We know that the data is so hard on nutrition,
[1:38:23] because I can quote a study that says for every serving of plant protein
[1:38:26] that you take over animal protein,
[1:38:28] you have a higher chance of ovulating regularly.
[1:38:30] And that's true.
[1:38:31] A lot of that, though, is nuanced by the fact
[1:38:33] that people who eat plant-based sources of proteins
[1:38:35] tend to eat other plants in general and less ultra-process foods
[1:38:39] than people who have the highest quartile of meat and take.
[1:38:42] If we go to a micro-level, though, not all meat,
[1:38:44] animal meat is created equal.
[1:38:46] Animal meat does not have fiber in it.
[1:38:48] So we know it's not feeding our gut microbiome.
[1:38:51] So if we want to talk about carnivore diet,
[1:38:54] things like that is definitely not microbiome friendly for you
[1:38:58] and not hormonally healthy.
[1:39:00] So we really want to really have those whole foods,
[1:39:02] the fruits, vegetables, the healthy fats,
[1:39:05] the proteins that are going to be good sources.
[1:39:07] And just like we talked about other things,
[1:39:09] it's not all or nothing.
[1:39:10] Red meat every day is probably going to be inflammatory.
[1:39:13] Having it on the weekend is probably okay.
[1:39:16] And the way I describe this to patients is,
[1:39:18] let's imagine a scale where every decision you make
[1:39:21] can kind of tick up the inflammatory marker
[1:39:23] or bring it back down.
[1:39:24] If you are making active decisions that are more anti-inflammatory,
[1:39:28] you can tolerate the glass of champagne, the birthday cake,
[1:39:32] these little things that we know will cause inflammation in your body,
[1:39:35] but your body is meant to respond to inflammation and get back to normal.
[1:39:39] The problem is when it's constantly challenged,
[1:39:42] when 70% of the things that you eat cause this chronic inflammation inside of you,
[1:39:47] your body can no longer respond appropriately when it's challenged again.
[1:39:51] Things that are pro-inflammatory tend to also disrupt the gut microbiome,
[1:39:55] tend to like it all makes sense when you think about it.
[1:39:58] And there's quite a few studies that are coming out
[1:40:01] in the four to five years before the one-point time called menopause.
[1:40:07] So in late perimenopause,
[1:40:09] that there's a significant decrease in gut microbiome diabetes.
[1:40:12] Oh, Zoe, did that work?
[1:40:14] Yes, yeah.
[1:40:15] And it's really interesting because of the second pass
[1:40:18] and the way that hormones are metabolized.
[1:40:20] When we have our natural cycle,
[1:40:24] and we have an exposure of our sex hormones,
[1:40:28] the common cycle,
[1:40:30] then we have more of diversity
[1:40:32] because the gut bugs help unwind, I guess, as a...
[1:40:36] So we metabolize estrogen into inactive metabolite,
[1:40:39] and then they get excreted in the feces.
[1:40:41] So it goes through the liver and then dumped into the bile.
[1:40:44] Does that mean that if my microbiome is likely to be less diverse as I age,
[1:40:48] I need to be thinking more about...
[1:40:50] The diversity of your plant foods.
[1:40:52] And this is what's really...
[1:40:53] Artex, probiotics, etc.
[1:40:55] Not over the counter.
[1:40:56] Okay.
[1:40:57] We want to...
[1:40:58] You first start with food.
[1:40:59] Yes.
[1:41:00] But not a pill that you're trying to take.
[1:41:01] Right.
[1:41:02] Actually, the food that you're putting into your body
[1:41:04] is the best source for all the microbiomes as fiber.
[1:41:07] What about protein?
[1:41:09] Bonda.
[1:41:10] The way I like to approach nutrition for people
[1:41:12] is first having people notice what they're eating.
[1:41:15] And then from that, break it down into,
[1:41:18] well, how much of it is protein?
[1:41:20] How much it is fat?
[1:41:21] How much just carbs?
[1:41:22] Without that kind of education,
[1:41:24] it's almost meaningless.
[1:41:25] So when we've done that,
[1:41:27] and I'm making recadent mandations for protein,
[1:41:31] we will not build the muscle we need to build.
[1:41:36] We will not get stronger the way we're capable of getting stronger.
[1:41:39] A, if we're not eating enough,
[1:41:41] and B, if we're not taking enough protein.
[1:41:44] So the RDA recommendations of 0.8 grams per kilogram
[1:41:49] is survival doses of protein,
[1:41:52] like sitting on a chair like a mushroom.
[1:41:54] Providing malnutrition is the goal of it.
[1:41:56] It's just too horrible.
[1:41:57] It is not for active people.
[1:41:59] It is not for living your best life people.
[1:42:01] 0.8.
[1:42:02] The recommended daily intake is 0.8 grams per kilogram
[1:42:07] of lean body mass.
[1:42:08] So it's low.
[1:42:09] It's very low.
[1:42:10] So the research supports easily supports,
[1:42:17] let's use pounds,
[1:42:19] 0.86 grams per pound
[1:42:22] for lifting people.
[1:42:24] I recommend over a gram,
[1:42:26] a gram for ideal pound
[1:42:29] because I'm presuming
[1:42:33] that the people I'm taking care of
[1:42:35] are going to start being active,
[1:42:37] that we're trying to build muscle,
[1:42:38] that we're not in starvation mode.
[1:42:41] So 0.8 grams per pound.
[1:42:46] I recommend one gram per ideal pound.
[1:42:52] So there's some other resources
[1:42:54] come out looking at skinny fat.
[1:42:56] So that's normal weight obesity.
[1:42:58] So as we're talking, normal VMI,
[1:43:01] normal VMI, but internal...
[1:43:03] 5 body fat.
[1:43:05] And then what happens is they have low muscle mass.
[1:43:08] Low muscle mass.
[1:43:09] So they took a group of women split them up
[1:43:12] so you had a control group.
[1:43:14] And then you had this intervention group
[1:43:16] and the only change they made,
[1:43:18] there's no exercise
[1:43:19] and they only changed they made,
[1:43:21] was they brought the intervention group
[1:43:23] up to 1.6 grams of protein per kilogram.
[1:43:26] So this is 0.8 per pound.
[1:43:29] And over the course of 12 weeks
[1:43:31] of eating that protein intake,
[1:43:33] this intervention group
[1:43:35] completely recomp their body.
[1:43:37] So their muscle quality came up,
[1:43:39] body fat went down.
[1:43:40] Control group, of course, nothing happened.
[1:43:42] So it just shows the importance
[1:43:43] of having that higher protein intake
[1:43:45] just to support basic muscle function.
[1:43:49] And the frailty data out of the WHO,
[1:43:51] so the Women's Health Initiative
[1:43:52] looked at multiple things,
[1:43:53] not just breast cancer and heart disease,
[1:43:55] but they followed these women
[1:43:57] even off of HRT for decades.
[1:43:59] And when they looked at frailty scores
[1:44:02] in the elderly and protein intake
[1:44:05] above 1.6 grams per kilogram,
[1:44:09] had the lowest frailty scores
[1:44:11] just based on protein intake alone.
[1:44:14] Yep.
[1:44:16] What about fasting?
[1:44:18] I know so many people that are doing
[1:44:20] water fasts and juice fasts.
[1:44:22] So they told you why?
[1:44:24] I've had an evolution with the way I think about fasting.
[1:44:26] When I first kind of, you know,
[1:44:28] was stepping out of the box
[1:44:30] and what's happening in menopause
[1:44:32] and why was my body composition?
[1:44:34] I didn't know what to call it back then,
[1:44:36] but what was all this going on that was new
[1:44:38] and all my patients were having it as well.
[1:44:40] And these were my girlfriends.
[1:44:42] And these were PhDs.
[1:44:44] And we're running marathons.
[1:44:46] We're doing all this stuff.
[1:44:48] And everyone's kind of complaining of the same thing.
[1:44:50] And so fasting seemed to be helpful.
[1:44:52] And my girlfriends were trying,
[1:44:54] we all kind of did this fasting thing.
[1:44:56] And I was like, super excited about it.
[1:44:58] Everybody felt better.
[1:45:00] Blah, blah, blah, blah.
[1:45:02] Okay. So fast forward.
[1:45:04] I'm learning more about hormones,
[1:45:06] body composition, protein intake,
[1:45:08] all of these needs.
[1:45:10] And I quickly realized,
[1:45:12] if we're looking at health span,
[1:45:14] if we're looking at body composition,
[1:45:16] there may not be a lot of room for fasting
[1:45:18] for these patients, you know,
[1:45:20] or for my girlfriends, you know.
[1:45:22] And it is really difficult for my patients
[1:45:24] to reach their nutrition goals,
[1:45:26] so never at the expense of meeting
[1:45:28] your basic nutrition goals
[1:45:30] and your calorie needs.
[1:45:32] And it is really, really hard to do while fasting.
[1:45:34] So you may get a short-term benefit with weight loss,
[1:45:36] but there really doesn't now.
[1:45:38] Distressions can get into the nitty gritty.
[1:45:40] All, you know.
[1:45:42] But the basic idea of fasting,
[1:45:44] if we want to use the term fasting,
[1:45:46] we have to look at it as,
[1:45:48] are we talking about intermittent fasting
[1:45:50] or time restricted eating?
[1:45:52] So intermittent fasting is kind of like,
[1:45:54] you know, your water fast,
[1:45:56] your five day, two day,
[1:45:58] all that kind of crazy stuff,
[1:46:00] which for the most part,
[1:46:02] men can get away with,
[1:46:04] and have a positive impact on body composition,
[1:46:06] restricted eating,
[1:46:08] and working with their circadian rhythm,
[1:46:10] which is optimal,
[1:46:12] then you have breakfast within a food
[1:46:14] within a half an hour of waking up
[1:46:16] that helps dampen that
[1:46:18] Gareland and cortisol response
[1:46:20] I talked about before,
[1:46:22] so that everything is coming down,
[1:46:24] your hormones are starting to work properly,
[1:46:26] and your body is like, great,
[1:46:28] I'm ready to go.
[1:46:30] I can handle this.
[1:46:32] And then you're eating at regular intervals,
[1:46:34] and protein and fiber intake.
[1:46:36] Then you have dinner,
[1:46:38] and then you don't eat after dinner.
[1:46:40] Every eating interval.
[1:46:42] So breakfast, maybe you have a snack
[1:46:44] before looking at training
[1:46:46] or exercise.
[1:46:48] If you're splitting your breakfast,
[1:46:50] then you're having some protein
[1:46:52] and carb before,
[1:46:54] you're having the rest of your protein
[1:46:56] or more protein afterwards,
[1:46:58] and then you're having
[1:47:00] some protein and some fiber at lunch,
[1:47:02] so every time you're eating,
[1:47:04] you have a protein and fiber focus.
[1:47:06] So time restricted eating is
[1:47:08] within a 24 hour period?
[1:47:10] So you're looking at,
[1:47:12] I'm going to eat during the day
[1:47:14] when my body needs it,
[1:47:16] and I'm going to stop eating
[1:47:18] when I finish dinner,
[1:47:20] so I have about a two, maybe three hour break
[1:47:22] before I go to bed.
[1:47:24] So that when I go to bed,
[1:47:26] I'm not trying to digest food.
[1:47:28] My body can get into the parasympathetic responses
[1:47:30] about 12 hours of eating and 12 hours of not.
[1:47:32] So you're trying to follow that circadian rhythm
[1:47:34] and work with your hormones.
[1:47:36] It can also, when we do have that period of time,
[1:47:38] which maybe that sounds very intuitive,
[1:47:40] but a lot of people are eating at 10 p.m.,
[1:47:42] they're snacking on food,
[1:47:44] then they're trying to go to bed,
[1:47:46] and then they're getting up.
[1:47:48] When you give your body a little bit longer,
[1:47:50] so at 12 hours time,
[1:47:52] is when your body will really
[1:47:54] efficiently be using up all your glucose,
[1:47:56] really dropping some of those insulin levels,
[1:47:58] so much that it's stressful,
[1:48:00] and we're using stress very generically here,
[1:48:02] but on a cellular level,
[1:48:04] long periods of fasting for women,
[1:48:06] specifically, can be very stressful to the body.
[1:48:08] And that's why, if you think about
[1:48:10] Stacy's example of what happened
[1:48:12] in two fasting periods to a man and a woman,
[1:48:16] different things are going to happen to your body
[1:48:18] if it thinks it's being an starvation.
[1:48:20] So we don't want to put your body in a starved state.
[1:48:22] We're just trying to give it a time period without food,
[1:48:26] so that it can start to process the energy
[1:48:56] of the diet.
[1:49:06] We're just trying to give it a time period
[1:49:58] to a good sleep because your body is like,
[1:50:00] it's not time to go to sleep.
[1:50:02] Your melatonin peak in women usually peaks around 9 o'clock,
[1:50:04] so you start to get sleepy.
[1:50:06] That gets shifted to 11, 12,
[1:50:08] so you're not actually going to get good sleep
[1:50:10] because you now have reset your melatonin responses.
[1:50:14] So we want women to understand that time restricted eating
[1:50:18] when you're not eating in the dark is really beneficial.
[1:50:22] That is way to say it.
[1:50:24] Easiest way to say it.
[1:50:26] We're just trying to give it a time period
[1:51:18] because we're just trying to give it a time period
[1:51:40] because we're just trying to give it a time period
[1:52:02] because we're just trying to give it a time period
[1:52:24] because we're just trying to give it a time period
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