Women Are Not Small Men! Why Fitness Advice Is Failing Half the Population

Key Takeaway

Women experiencing perimenopause should lift heavy weights (80% of max capacity, 5-6 reps) to combat muscle dysfunction and protect brain health. This heavy lifting stimulates neural connectivity in the prefrontal cortex, slowing Alzheimer's and dementia risk—benefits not seen with moderate weight training. Start with bodyweight exercises and progress over 2-3 years. It's never too late: even starting at 60+ shows measurable benefits for cognition, bone density, and muscle quality.

Episode Overview

Dr. Stacy Sims, an exercise physiologist and nutrition scientist, discusses how women's bodies respond differently than men's to exercise, nutrition, and aging. She explains the critical importance of heavy strength training for women, especially during perimenopause and beyond, to maintain muscle quality, bone density, cognitive function, and metabolic health. The conversation covers how hormonal changes affect women's bodies, the dangers of being 'skinny fat,' and specific training and nutrition strategies for women at different life stages.

Full Transcript

Transcript of Women Are Not Small Men! Why Fitness Advice Is Failing Half the Population from The Dr. Hyman Show. Auto-generated from episode audio; may contain minor errors.

we have a culture that actually has ignored women in the research field. You have this great line, which is women are not small men. What the hell does that mean? Well, we're told that we just need to do what the men are doing, but we're still not getting the same gains that the men are. Almost all the stuff you know with exercise and nutrition has been based on male data and generalized to women. What are the nutrition mistakes that women are making mostly now? They're listening to all the fat diets, and they're listening to the rhetoric that's on social media, and they're not really paying attention to, okay, who am I?

How do I respond? When am I hungry? You're not going crazy, you're just being compared against the wrong baseline. We need to stop the rhetoric of old Israel. What you're basically saying is that by lifting heavy weights for women, it slows down Alzheimer's risk. The very first thing I tell every woman to do is to put some hard meetings in their calendar. That's a wellness meeting with themselves. For longevity, you have your genetic code, but it doesn't have to dictate what's happening. Dr. Stacy Sims is a leading exercise physiologist and nutrition scientist whose focuses on sex differences in training, nutrition, and health, particularly for women.

Have you been dealing with anxiety, low energy, or trouble focusing, and still feel like you're missing something? You're not alone. And that's why I created the Brain Shaping Academy, a new program that looks in places most people never think to check, like nutrient deficiencies, the health of your gut, metabolism, your immune system, and lots more. So, join the waitlist and get special pricing at drheyman.com/brainshaping. Stacy, welcome to the podcast. Thanks. Great to be here. All the way from New Zealand. Yeah, but I'm home. From New Zealand to home.

You know, your work is really unique because because because um you're not a doctor, but you're an exercise physiologist, and you're a scientist, and you double down on things that are that are that are health, not disease. Correct. So, most medicine, most doctors are focused on disease, not health. They don't even know about health. In fact, I my joke is, you know, we never took a class in medical school creating health 101. Right. So, we have no clue what health is. We just think it's the absence of disease, which it's not.

And we don't know how to advise people on how to navigate the phases of their life to induce, create health. And your work is so great because, you know, know, know, men have had a lot of focus. We have a misogynistic culture. We have a patriarchal culture. We have a culture that actually has ignored women in the research field predominantly. And there are studies, but they're kind of like kind of mostly in the in the margins. And and what your work has done is really focused on how how do we think about advising women to take care of themselves through the life cycles, you know, pre-menopause, perimenopause, pre-menopause, all the all the different phases that are important.

And you know, I I I worked for worked for worked for oh, almost a decade at Canyon Ranch where most of my patients were, you know, 35 to 60-year-old women. Yeah. Yeah. Yeah. So, I kind of had an immersion course in all the things that women were experiencing, and it was just so clear to me how woefully inadequate it was to just sort of deal with them. And you you really taken this on, really setting a different conversation for how to think about women's health and fitness.

And and and you have this great line, which is women are not small men. Right. Yeah, yeah. What the hell does that mean? I know. know. know. Other than the obvious thing. Yeah. They're different. I I find it funny that that's become like the resonating mantra and tagline. Um because it or the origins were when I was at Stanford doing my postdoc, I was also doing some undergrad teaching. undergrad teaching. undergrad teaching. And in uh the afternoons, everyone's sleepy, and I would talk about training principles and practices, and trying to go through all the systems that were sex differences.

So, I would open it up, women are not small men, and that was the subtitle of the class that I was to be be be And you'd say that, and people are like, "What are you on about? What does this mean?" And I'd say, "Well, you know, the cardiovascular system, there are inherent differences. We know from Jennifer Trimmel's work that a heart attack comes on differently for women versus men. Why?" So, I'd get into all the nuances and hopefully enlightening all the students. And then when I started a sport nutrition company, I was like one of the very first people that ever was like, "We need different sport nutrition for women than men." So, we had a men's line and a women's line.

And the tagline for the women's line was, "Women are not small men." But it was way too early cuz we got a lot of pushback. But still kept trying to pursue it. And then I kept that tagline cuz people resonated with it so much. And basically, it's like almost all the stuff you know with exercise and nutrition has been based on male data and generalized to women. And I don't find that appropriate, especially if I'm a woman and I want to optimize my health and my life.

And so, I'm like, "Okay, I'm running with that." And that's how it kind of got out there. And you you've been one of the few people who've really like taken on the the task of researching women. Yeah. Specifically, cuz most research has been on men. And that's coming at great cost to women, unfortunately. Cuz we can't apply the same principles of health and nutrition and exercise to women as we do to men. So, can you kind of talk about that a little bit? How I fell into that?

Yeah. I'm a little bit bullheaded cuz maybe maybe not. Um I grew up in a military family and I mean, that's kind of how we to be a Navy SEAL. I did want to be a Navy SEAL. I mean, it happened just about an hour from where we are. So, my house this morning and uh yeah, growing up in a military household And you would have been a good Navy SEAL, actually. actually. actually. Maybe, but it wasn't allowable, right? I was was was I shook your hand.

I'm like, "Oh, wow. Okay. I can't wrestle this girl. She's like like like She'll knock me down." Yeah. And so, when you're [clears throat] used to not having any confines on you and you just your friends are boys, your friends are girls, you do this, you do that. As we ran cross country, my like teammates and I would all go for a run and we're all men and women and then you get divided into the two groups to run the girls race or the boys race and your times aren't that different.

You're like, "Yeah, okay, whatever. It's just the way things are." But when someone tells you that you can't do something as an occupation because you are not the right sex or the right gender, it really throws you for a curveball. Yeah. And you're like, "What?" So, that sat with me and then when I got to university and I'm in I'm in I'm in exercise physiology and all the PDFs and the journal articles and the textbooks represented he or they and the only time they talked about women was in a pathophysiological standpoint where they're like, "They're anemic.

They don't get their periods. They break their bones. They get stress fractures. They get overtrained." And I was like, "This is not representative of me." Like, I am on the crew team and we're training hard, but I'm not getting anemic. I'm not breaking my bones. Like, how do I train to prevent that?" And no one could answer that question. And I was like, "This is not right. Like, why do we put as much work into all the things that we're doing, but we're told that we just need to do what the men are doing, but we're still not getting the same gains that the men are?" are?" are?" And so, that was kind of the undercurrent which kind of pushed the trajectory forward of doing research to answer these questions for me as an athlete and then my friends who were athletes and then who became coaches and etc.

going on through the years of their careers, too. Amazing. Okay, well, let's let's get into it. Let's get into it cuz cuz if women are not small men, what's happening to them you know, metabolically, hormonally as they kind of move through their 20s, 30s, 40s and and beyond that? Yeah, so I like to tell people it really does start in utero when we're looking at sex differences versus hormonal differences. And then when we get to puberty, we really start to see the effects of hormones because we see boys typically get stronger, faster, more aggressive.

Girls their center of gravity changes their biomechanics change they put body fat on and then oh here's your period right and they drop out of sport and activity they start to feel very self-conscious and then that carries forward forward forward then we get into our reproductive years you have either there's no such thing as a 28 day menstrual cycle there's all sorts of variation within length right and then we have hormonal contraception what are you on what's the formulation what's the generation of the progesterone all those things have a hormonal effect or are you using an IUD or not so there's so many different things in there do you have endometriosis or PCOS all those effects do you as well and then we get into perimenopause and all the wide variations that happen with hormones and the undercurrent of aging which also is another factor and then we get to postmenopause and then we think about the data that accompanies that it's all male data who is in a more of a linear fashion fashion fashion Yeah Yeah Yeah so when we start unpicking it and we see all of these things where women think that they're going crazy it's like you're not going crazy you're just being compared against the wrong baseline Yeah and yeah so when we get asked those questions like how do you differentiate what is endometriosis versus PCOS as like actually in 2026 we don't have a definitive test definitive test definitive test we know that you have symptomatology and you can go for an invasive test to find out but there isn't anything simple to tell you what are our symptoms these are our symptoms do I really have it or not you have to go to your physician to find out Yeah that's true and and and there's a lot of changes you know I think you know my experience with you know working at Canyon Ranch you know taught me that there's this kind of chaotic period of of of shift in hormones that happens in women in their late 30s 40s early 50s and it's I I it's like the four horsemen it's like insulin which is all about blood sugar regulation and that leads to increasing you know belly fat which women tend to get but it's not inevitable No it's not and a lot of women think oh this just happens and you don't have to get that little belly little belly little belly to the stress levels go up because they're kind of in this generation of high stress work.

Their their parents are getting older, their kids are teenagers, it's and their marriages are stressed. It's like a pressure cooker. Yeah. Yeah. Yeah. And so that cortisol is going crazy and then they get thyroid which also tends to go kind of sideways a lot of the times and that can be caused by stress and environmental toxins and that's a big factor affects one in five women and then you got the sex hormones that are all over the place and they and they are affected by everything especially lifestyle.

What we eat eat eat how we move, sleep, how we navigate stress, relationships, all those things have massive impacts on hormones and affect how women feel and what they can do, what they can't do and also on their on their overall level of metabolic and and physical health. So that's kind of the soup that they're in and the real question I have for you is is how do women properly navigate this in terms of diet and in terms of exercise and you know there's a lot of sort of sort of sort of kind of trendy things like intermittent fasting or you know like protein or this.

I want to get into kind of all the nitty-gritty of it with you. So like let's sort of start with the big picture and then kind of go into some of these these subtopics. Okay, that sounds good. I'll unpack it all for you because I think the biggest thing is is women think it's happening to them and if you were born with the uterus you're going to go through this but if it's happening to you it doesn't have to be negative. It means that you're going to go through this but you can actually take control and see how you can improve and empower your body as it's going through this natural transition.

And I think that's one of the biggest things that women don't understand. They just think that they're going to become like an unfit really unhealthy person even if they've been active. So if we look at what's happening, we know that in the early 30s, you're you're fine. And then your mid-30s, you're like, "W- W- Wait a second. Something's happening here. The training that I'm usually doing isn't quite working. Maybe I'm not training hard enough." So, they start to really question what they're doing and try to find different plans to help them lean up or, you know, get a little bit stronger.

And then we really see a definitive switch in the 40s. And this is because we start to see a fluctuation of our hormones. We start to see a decrease in ovulatory cycle. So, we don't have as much progesterone. We also see a shift in our gut microbiome. Because when you start having a change in your sex hormones, you start having a decrease in your gut microbiome diversity. Mhm. And unfortunately, with that and the stress, we start to see a drive to increase the obesogenic phyla of the gut microbiome.

that means bacteria that make you fat. Exactly. Exactly. Exactly. In your gut. Right. It like makes you crave simple Sorry, I got to translate sometimes. it's good. it's good. it's good. Makes you crave simple carbs, you know, it it extracts more energy from the food. Yeah. And a lot of the times in this mentality this mentality this mentality Wait, just just the what you said there, I just want to double click on that cuz you you just said something people are going to gloss over. Your bacteria can control your appetite.

Absolutely. Absolutely. Absolutely. you have bad bugs in there, you got to figure out how to reset your gut in order to regulate your hormones and your appetite and your metabolism. There's actually a whole thing called metabolic endotoxemia, which means you get basically insulin resistance and diabetes from bad bugs in your gut. Exactly. And it changes your neurotransmitters, as we know, like serotonin, melatonin, even dopamine take a hit when you have more of the obesogenic phyla growing around. So, then that confounds all the variables that are causing anxiety and stress and depression.

So, when someone starts coming to me and saying, "What's going on?" I'm like, "Well, these are all the things. We're having sex differences, of course, with aging." And we see that when we have the aging conversation that's happening right now. Mhm. We know that a definitive difference between the way men's muscle and bone age versus the way women's muscle and bone age. For example, if I start to get a little bit geeky, I'll try to explain. We have two contractile proteins, so two proteins that grab onto each other to make the muscle fiber tighten to give you a contraction.

One of them is myosin, the other is actin, right? So, myosin and actin, they bond. We have different what we call isoforms of myosin, and we start to have a dysfunction dysfunction dysfunction there are different subtypes of the muscle contracting fibers called myosin, yeah. So, the main one that really bonds with actin to create a strong contraction starts to become dysfunctional. dysfunctional. dysfunctional. Then, when you also have a change in estrogen, it further exacerbates or or causes that change. So, women's first complaint is they don't feel powerful.

They don't have strength. Or runners go, "I don't know what happened. My pace dropped from a 7-minute mile to a 9:30, and I just don't know what's going on." It's because we're having this dysfunction in our fast-twitch fibers. Oh, wow. Oh, wow. Oh, wow. So, when we start going The quality and the function of the muscle changes related to the hormonal changes. Right. This episode is brought to you by Roe Nutrition. Now, every day, from the moment you wake up, your body is dealing with thousands of toxins you can't see.

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That's That's That's life.com/hyman. So, when we start to see that happens first and then you have cell death or loss of muscle mass. But for men, they don't have that. They lose muscle mass. So, they maintain their fast twitch fiber function and their strength capacity. Yes, you have to work on it as you get older because you're losing muscle mass. Things are work. I'm 66. I can tell you I got to work a little harder. harder. harder. It does. But when we start talking about strength training and the conversation out there about strength training, it's not just about lifting weights to failure.

To optimize women, we really have to get them to understand that neuromuscular connection. Like we want to work on the heavier end, but not only that, one of the other sex differences that's really apparent is dementia and Alzheimer's and cognitive decline. And that is exacerbated during perimenopause, partially because of the receptor changes with estrogen dropping, but also we see uh like neuron connectivity or the way that the brain is wired starts to change when we're getting older as well as having hormone shift, which [clears throat] causes anxiety and depression.

But we see in some of the research that came out even last month that if you're doing heavier load lifting, which is that power range where you're doing heavy loads, 80% of what you think you can do, five or six reps, then it stimulates neural connectivity improvement in the prefrontal cortex, which is, you know, primarily driving cognition. And then you have other changes in other parts of the brain that help, but all of this helps helps helps attenuate or slow dementia and Alzheimer's risks. So you're looking to slow down it.

So so you you just I want everybody to hear what you just said. What you're basically saying is that by lifting heavy weights for women, it slows down Alzheimer's risk. Yes. Okay. And the reason for that is I might stop you occasionally cuz like you're you're just like an encyclopedia and I want to make sure people understand what you're saying. Cuz I'm so excited about it. to hear you. I just If you don't mind, I'll just kind of just like pause occasionally. Yeah, that's good. Cuz I've got to translate.

Yeah, cuz I'm like part of the problem is we have brain metabolism change. So we know that glucose is not as effective as uh brain fuel as, you know, insulin resistance comes up. Glucose isn't as available for other systems of the body. And we want to increase neuro um plasticity. So that means how our neurons are forming and firing and talking to each other. Mhm. And we create a new motor pattern or we need a stimulus to recruit more muscle fibers, that's that neuro connectivity. And that's what you get at the very low end and heavy strength training.

It's a neural connectivity. And that's the important factor in the resistance training concept. I'm not telling people who have never done resistance training to immediately start on that end. Any resistance training is great. You have your want to start with 100 lb weights. No. No. No. Start with body weight, work your way up with the eye in 2 or 3 years of getting down to the heavy weights. this is honestly I I feel like I know a lot of stuff, but I never heard this before.

before. before. Oh my god. I never heard that you by by lifting heavy weights you're increasing your brain connectivity. I know exercise is good for your brain in general, but this particular piece is new to me. So I'm sure it's new to everybody out there listening. listening. listening. Yeah, it was a randomized controlled trial that came out out of 100,000 people that was just published from the UK last month. Mhm. I'll forward it. It's really fascinating cuz they looked at heavy lifting versus moderate intensity, which is your body weight and your and your lighter loads and and and longer rep ranges.

So your 10 to 15s. And it was only the heavy end that affected prefrontal cortex. The moderate weight and the higher reps affected other areas of the brain, which is great. It's a good improvement, right? Cuz you're still affecting neural connectivity. But for [clears throat] the concern of cognition, we need that prefrontal cortex increased connectivity and functionality. So when we're looking at what are we doing to optimize health, that's one of the first things I say. But is there is there any understanding of the timing of this?

In other words, if you start like when you're 40, obviously it's better, but can you start as late as 60? Yep. And is it going to achieve the same benefits? We don't know how robust it is, but that randomized controlled trial was looking at people who were 60 plus. I'm asking for a friend cuz I didn't start strength training till I was 59. You're good. You're good. You're good. You're excellent. You're protecting your brain. We're all going to be having Zimmer frame races not because of our brain and our bodies, because of our joints.

So it doesn't matter when you start. We say start when you can. It's never too late to start. And we're having more and more research come out in 70, 80-year-old individuals that are showing the heavier rep range, which is relative to what you can lift, improves not only bone and lean mass, but also brain health. That's amazing. It's like the one thing that everyone should be doing. And I come from a massive endurance cardio background, and I've always had strength training as the undercurrent, right? But now all the research is just pointing to how important it is in today's society where we don't move that much, that we have to do the push-pull motions and put our bodies under load.

Not necessarily cardiovascular load, but actual load. Yeah, I'm going to on the video version of this podcast, I'm going to give my team my picture cuz I had a I was like a runner. I would I was running like 5 mi a day for from 14 until like 55 or 6, right? And I was riding my bike 100 mi a day or 40 mi or 30 mi, and I I and I was lean, lean, lean, but I wasn't strength training. And then I started when I was 59, and then I had a pic comparison picture of me at 42, maybe, and at 62, and it's like you can't believe it.

Night and day. Yeah, and I I never would have thought that was possible, but you know, it's never too late. No, it's never too late. I mean, I was full endurance, too. I ran 19 marathons before I was 20. I did Ironman, I did Xterra, bike racing. And I had strength training on the undercurrent, but I didn't let people know I was doing it because it wasn't appropriate for women to do. wasn't doing it. I I was telling myself lies. I got to do yoga, that's like strength training, man.

But we I you probably see this, too. We get DEXAs and it's women that look healthy cuz they look lean and they're runners and stuff. But you get the DEXA and they have a high amount of visceral fat Yeah. compared to what they should be. And their bone density is relatively low, and they're like, I don't understand. I eat clean, I run, I do all this stuff. It's like, you're not strength training and you're not eating enough. enough. enough. Because if you're not eating enough, then you're not supplying your body with the fuel that it needs to rebuild, so it's tapping into bone, of course, because it's part of the aging, but also the stress of exercise without enough fuel.

And that higher visceral fat is cuz there's a change in our lipids in a conversation between the liver and the um fatty acids that are circulating that esterifies them to then be stored as visceral fat. Yeah. So, we can fix that. So, basically what you're saying is, you know, women who look lean are what we call skinny fat. Yeah. Or we used to call it toffee. Thin on the outside, fat on the inside. And and and you can tell that by doing a special kind of very very low radiation x-ray called a DEXA scan that measures bone density for osteoporosis, but also measures fat in your body and muscle and the distribution, right?

Cuz a lot of these scales, you can't really tell the distribution these bioimpedance scales. scales. scales. And you can kind of kind of get a rough sense, but like your arms and legs could be like, you know, 10 15%, but your belly could be 30%. Right. And that's not good. And and you may look thin. Right. And And And And that and that actually leads to some of the same cardiometabolic risks of heart attack and diabetes stroke as as being overweight. being overweight. being overweight. Right.

Right. Right. You're under You're under You're under lean and over fat. Exactly. And I often give an example cuz I'll get women who come in and we get the DEXA, we get their bloods, and their LDL has suddenly shot up and they've never had problems with cholesterol before. It's like, well, yeah, that's a dysfunction of estrogen cuz estrogen kind of helps with cholesterol and risk factors. And when you start losing that, if you are not eating enough and you're not doing uh exercise stress to help the body understand what's going on, then you're going to have this increased lipid negative lipid profile as well as poor bones, bones, bones, not really fantastic muscle quality, and we see this increase in visceral fat.

So, let's sort of dig in on the on the on two bits of this. One is the food and one is the exercise. Yeah. Cuz those are independent variables that we have control over, right? We can't control our genes, we can't control our parents, we can't we can't we can't control our height, our age, but these are things we can control. So, on the exercise front, you know, is there a difference in what women should be doing when they're 20, 30, 40, 50, 60? And if so, what is it?

And and can you unpack that for us? And and what are the what's the right mix of cardio, hit training, or interval training, and strength training, and what kind of strength training? Cuz I'm hearing there's like body weight, there's light weight, there's heavy weights. So, can you kind of help us really unpack all that? So, when we're in our 20s and early 30s, pretty lucky. Our reproductive years, we can kind of get away with everything. I really impress women when they're in their 20s and 30s to pick up strength training.

And it doesn't matter what rep range you're doing, just as long as you were doing strength training and have an eye to being muscle-centric. Um and you can do variations of high intensity, low intensity. Your body recovers really well because we have the benefit of our sex hormones. Women also have the benefit of having more endurance fibers. So, we already have a robust amount of mitochondria, and we have more proteins for mitochondria respiration, better antioxidation responses, and these are inherent sex differences. This doesn't matter if you have estrogen and progesterone or not.

So, we're already really endurance. We need to work on our fast twitch. We need to do a little bit of intensity and strength training. When you start to get into your So, you can get away with a lot. Yeah, you can. That's the bottom line in your 20s, yeah. Yeah, that's why you're like all the Hyrox people are like in their mid to late 20s. You're like, yeah, when I was back in my 20s, I'd probably get picked that up, too, but now, not so much.

But when you start to get into your late 30s and start having more anovulatory cycles, which means that you aren't producing as much progesterone cuz you're not ovulating and you have a a change in your estrogen progesterone ratios. This is when we start to see a little bit of dysfunction in how you're training. You're training. You're training. You're so people understand this. So, you know, you you're when you're a guy, you make sperm your whole life. When you're a woman, you're born with a certain number of eggs, and it starts declining from the day you're born until you go through menopause.

And and as you go through 30s and 40s, you start to have less eggs, and you may not ovulate every cycle, which means you have estrogen but not progesterone. Correct. And when we start seeing more and and and more and more of those anovulatory cycles, people don't necessarily know that they're anovulatory cuz they still have a bleed. And this is why when we talk talk talk bleed heavier. Right. have heavier bleeding cuz progesterone stabilizes the uterus, and then when you have just estrogen without the progesterone, you get like clots and heavy bleeding and more cramps and all that.

that. that. Right. And that's what happens is when we get in our 30s, yeah, 40s, yeah. Right. And they're like, "What's going on?" on?" on?" [snorts] [snorts] [snorts] So, when we talk about like And then they get anemic. Yeah, and then they get anemic. So, they'll talk about like menstrual cycle phase-based training. It's like, "What? No. Let's Let's take that off the table cuz that's one of the conversations. You train according to menstrual cycle phase." As we get older, especially once we hit our 40s and beyond, our bodies actually become less efficient at using protein.

In functional medicine, we sometimes call this anabolic resistance. This basically means the same amount of protein that worked for you at 25 may not support your muscles the same way at 50. And that matters because muscle is one of the most important predictors of healthy aging. It supports metabolism, balance, strength, and overall resilience as we get older. And of course, I'm a huge believer in getting protein from whole, nutrient-dense foods, but that's always going to be the foundation. Yet, many people still fall short of their essential amino acids and their bodies need to support muscle maintenance and recovery, especially busy moms juggling careers, families, and everything else.

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Hyman. Hyman. And you're saying that's not a thing. We can't say that because, one, there's not enough robust evidence for whole human to be able to do that. It's too generalizable because we don't know when someone ovulates. Every woman's cycle is very variations of when they ovulate. So, it's more we know you roughly have X amount of days in your cycle. See how you feel and you can tweak your training accordingly because if you know on day 23, you always feel really shitty, then you're not going to go do a hard session.

So, when you have reproductive years, that's what you do. So, when you start getting in your into your mid to late 30s and you start seeing these inherent changes, it's kind of an awareness factor of oh, what's going on. So, people start to feel a little bit less strong, they start to feel a little bit less like themselves, and they're starting to go, what's going like am I not training right? And unfortunately with the diet culture, most people say, oh, I need to increase my training and decrease my food cuz I'm starting to put on belly fat or I'm not responding as well.

So, they start to really kind of get into more of a low energy state. See this all the time, especially in recreational female athletes. athletes. athletes. And when we get into low energy state, that means that we don't have enough food coming in to support daily life and as well as support training. So, then we get a compounding variable of now they're going to put on more body fat and have more issues sleeping and definitely not recover well. So, becomes a negative feedback system. Yeah. And that becomes the worry.

So, then when they get into their 40s and really start to have issues, that plus the sympathetic drive of perimenopause causes a complexity of issues that then they go to their physician and the physician is like mm, okay, maybe it's because you're in this period of your life where you're highly stressed, you're not taking care of yourself, do you exercise? Yeah, I exercise, keep doing it. But they don't realize that the exercise that they're doing isn't appropriate for their bodies when it's going through this phase.

this phase. this phase. So, what should they be doing in that phase? phase? phase? Yeah. So, when we look from a sex difference, not a sex hormone standpoint, standpoint, standpoint, women are already super, super endurant by the nature of being XX. So, the long slow zone two stuff is not something they need to do all the time. We look at we need to now find an external stress that's going to create a signal in the body that's going to cause responses the same as estrogen progesterone used to do.

Mhm. So, what I mean by that is we need to have really super high intensity work and resistance training because we want to signal to the body with high intensity work that we can use glucose effectively. We need need need like sprinting and like that's the high intensity interval training. Because it causes what we call epigenetic change. So, we know that it's a lock and key. So, high intensity work is the key to unlock the cells to open them up to allow glucose to come in without insulin.

So, it's a GLUT4 protein that translocates, opens up, and we see that insulin isn't needed for glucose to come I I just want to I'll stop you there because this is such an important point you're talking about and most people don't understand it. People think that in order to get your blood sugar glucose into your cells, you need insulin. But, the muscle is a unique tissue and can actually absorb glucose without insulin, right? Yes, exactly. Especially in the post-exercise state because now And And that's right.

And the way you get that is by having healthy good muscle. Right. Exactly. Right. So, I mean, one of the things that diabetics do is like a 10-minute walk after a meal because it helps stabilize blood glucose. And that's what you can do when you do high intensity, you get a permanent change in the muscle to have the ability to have more GLUT4 proteins translocate to improve insulin um sensitivity because now you have other ways of getting glucose in without so much reliance on insulin. So, it makes the body more sensitive to the insulin.

So, it's a it's a double benefit. You get get get insulin independent uptake of sugar glucose in your muscles and you don't have to make as much insulin in order to drive the glucose into the the And when you don't have to make as much insulin, that's a good thing because insulin is a fat storage hormone and makes you store belly fat, which you were talking about. Right. So, it's uh you know, like convoluted. Yeah, it's a lot of time packed. I just want because I'm not really a doctor, a PhD like you or me.

Like I just think we I'm backing it's good. I'm just helping it out here. Yeah. No, I appreciate that. That's your job. job. job. And then the other thing about high intensity work is if we go back to brain and brain metabolism, we really do see a change in glucose reliance of a brain fuel and tissue. Um because it's not as effective in the brain when we start to get in perimenopause. And we see that that change in brain metabolism is also a risk factor for amyloid and tau plaques.

Or you know, our Alzheimer's plaques. So, if we're doing high intensity and producing lactate, lactate is a preferred fuel for the brain and the heart. So, if your body's exposed to lactate, it starts to use lactate and not having such a reliance on glucose, which improves brain metabolism and again reduces the risk factor for developing tau and amyloid plaques. So, so just people, what is that amyloid tau? That that's basically the the sticky proteins that cause dementia and Alzheimer's. That's that's you know, that's what we know is is the downstream effect of whatever the insult is.

It's not that amyloid causes Alzheimer's, it's that it's the result of some inflammatory or unhealthy process in the brain. It's kind of the body's band-aid. But but you what you're saying is the right type of exercise will actually attenuate it. attenuate it. attenuate it. prevent that the development of these tau like plaques and tangles in the brain. I wouldn't use so much prevention. prevention. prevention. Slows the rate if you have a risk for it. So, you could actually have a few but not develop symptoms. There are a lot of people who have a variation of amyloid and tau plaques that don't have dementia symptoms, which is what we're after.

Like you could have them as long as you don't have symptoms, right? So, we're looking at ways to improve brain metabolism, reduce inflammation. So, if we are producing lactate, then we're doing high intensity work, that's great metabolism for the brain. But also, when you do high intensity, you get a really strong post exercise anti-inflammatory response because the cells have been inflamed from such high intensity work. And the body's reading it as a signal of oh gosh, we have to be able to rebuild quickly in case that stress comes back.

So, it it increases antioxidation and increases anti-inflammatory responses. We see a boost of growth hormone, and we see a boost of testosterone post exercise. So, when we hear all this stuff about perimenopausal women shouldn't do high intensity work, it's like hold on, let's define high intensity because it's very beneficial if you do it correctly. But if you're doing a high intensity class that is at all these gyms where they're like, let's go after the perimenopausal women, we have these booty burns, we have spin, we have Orange Theory, F45, all of those.

I know. I've been there. Yeah, yeah, yeah. It's moderate intensity. It's not truly high intensity because we've all been conditioned to get out of one of those classes feeling sweaty and completely smashed thinking it was a good workout. But for true high intensity, you can't hold the intensity for as long as these classes. No, you can only do it for 30 to seconds to a minute, right? Yeah. So, that's the sprint. And when we look at the Norwegian 4 by 4, that's also a type of intensity, right?

So, 4 minutes at about 80%, and those 4 minutes are super slow. You're like, oh my god, hurry up. I can do it, I can do it. And then the 4 minutes recovery go too fast. I want to loop back on something you said cuz it's also so important. You kind of said that the the effect of the exercise and the post exercise effect is to reduce inflammation in the brain. Mhm. And there's I don't know if you know the work of Rudy Tanzi and others who really looked at this subtype of of the population with some weird genetic variant where they have a brain full of amyloid and full of of tangles and plaque and and tau, but they have normal cognition, and they have a weird mutation that prevents inflammation, which is really wild.

So, without inflammation, without inflammation, without inflammation, bottom line, Alzheimer's is an inflammation disease of the brain. So is heart disease, inflammation of the blood vessels. That's kind of what causes it. Right. Right. So, we look at all the ways that we can reduce inflammation. I mean, that's why estrogen or estradiol internally is so protective because it's an anti-inflammatory agent. So, we start losing it, the body becomes more inflamed and systemically driven, and we see that we have more of the sympathetic drive that's just also that hype that people feel tired but wired.

It drives even more inflammation. Let's look at how we can reduce that. People are like, "Oh, high intensity. I can't do that. It's going to make me more tired." But, they do it properly and like, "Oh, I feel amazing. I have this kind of euphoria." euphoria." euphoria." What is doing it properly? So, we have high-intensity interval training, and the subset of that is our sprint interval training. So, we look at high-intensity interval training. This is about 80% of your max when you're doing the intervals. So, it could be 1 minute on, 1 minute off.

And that 1 minute on is eight out of a 1 to 10 when you're looking at 10 being max and 1 being you're sitting on the couch. And then that 1 minute off is just really super cruisy so that you can do the next 1 minute at that 80%. Or that's kind of how you start. And then ideally, we're holding it for 3 to 4 minutes, and then you have variable recovery, however fit you are. Cuz if we can hold it for 3 to 4 minutes 4 minutes 4 minutes you do like four times.

Like a minute minute minute 1 minute off, 1 minute on like twice, that's 4 minutes. No. So, if we're doing 1 minute on, 1 minute off, we try to build that up to um total of 10 to 15 minutes. So, you would end up doing five to seven sets of the 1 minute on. Um and then if we're looking at producing more lactate, then we do longer intervals with a shorter recovery as you get more tolerance to it. So, this could be 3 to 4 minutes at 80% and 2 to 4 minutes recovery depending on how you're feeling and how fit you're getting.

getting. getting. So, the other way to think about it is on in the class situation, especially something like CrossFit or some of these other classes where they have every minute on the minute, where you have 1 minute that you might be doing um burpees, and then right into the next minute you're doing walking lunges with a weight, and then the third minute you might be doing box jumps, and then the fourth minute fourth minute fourth minute Right, the recovery is switching from minute to minute until the very last minute is a full minute off.

So, you have 4 minutes of hard work, 1 minute off, and then you can repeat that a couple of times. That's true high intensity. intensity. intensity. And then the sprint interval is very short and effective. So, this is your subset of high intensity where it's 20 to 30 seconds as hard as you possibly can go. can go. can go. Like you're running from a tiger. Yeah, exactly. Or a shark if you're in the ocean. Yeah. [gasps] And then it's a full two to three minutes recovery.

And I have a lot of women go, "Why do I need to recover that long?" It's like, "Because if you don't recover that long, your central nervous system and your energy systems have not recovered enough to then be able to do that same intensity at that running from a tiger speed that you need to do. Because if you are consistently doing 30 seconds and then a minute off, 30 seconds a minute off, you are failing to hit that high intensity. And how do you how many times And how do you how many times do you do that?

No more than five. You work your way up. Some people are like, "Oh, no problem. I'm going to do five." And after two you're like, "Oh my god, I can't do anymore." So, like a minute and then then then 4 minutes off, and then another minute, and doing that five times. Uh yeah, and then if you are doing a separate session of sprint interval training, cuz they're two different sessions. So, you can have a high intensity interval training as one session. one session. one session. And then when you're short on time, or you want more of your um epigenetic change for glucose, then you're looking at doing the sprint interval stuff.

That's a completely separate session. Might take 10 minutes total. Where you have a warm-up, you do two to three sets of the 30 seconds on, two to three minutes off, and you're done. Okay, so that's the that's the cardio part. Yeah. And that you're saying women should start when? In their 30s, 40s? could start it earlier, but it's really beneficial when you start getting in your late 30s, early 40s. And continue out through your life. Yeah. Yeah. I'm sure speeds are going to reduce, but not that much, right?

much, right. much, right. much, right. Yeah. And that's what interesting research is. Like most of us have this uh belief that as you get older you decline and become more frail and slower and so forth. But but I remember reading this book, I think it was a Deepak Chopra book, like maybe 30 years or more ago, where he talked about the Tarahumara Indians in Mexico, where they had a belief in the culture that the runners, cuz they had would run long distances, 100 miles, that the third 20-year-olds are good, 30-year-olds are better, 40 better, and the 60-year-olds were the best runners.

I love that. And they actually were. And then they went down, there's a group from Harvard went down and studied their VO2 max and their pulmonary fitness and their and they actually were better. And I think we've seen we've seen this in, you know, these isolated people who were like, I started, you know, at 65 rowing or I started biking at, you know, 65 and I'm now 105 and I'm like I'm better. Yeah. And it it's like so the body is quite amazing that we think it is going to fail, but actually it can continue if you continue to take care of it.

Right. meeting this guy, it was my my stepfather's stepfather's stepfather's shiva, which is like the after the funeral. funeral. funeral. And he was 95 years old and he was like running around like a spring chicken and he I'm like, he looks so fit and sharp and I'm like, what are you doing? He says, well, whatever I did yesterday, I do today. If I did singles tennis yesterday, I do singles tennis today. And I'm like, that was a great lesson for me. I love that. Yeah. Okay, so that's the cardio part.

What about the the strength part? And how do women think about that? So strength training is scary for a lot of women of women of women especially in in this age group because we didn't really grow up with being gym-centric, right? It hasn't been kosher for women to have muscles or to be in the gym during strength training. Jane Fonda aerobics. Yeah. Yeah. It was actually here at this conference we're both speaking at. For years my diet and my fitness were pretty dialed in and yet I still felt like something was missing, especially during the darker months and light was the variable I struggled to get right.

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And yes yes yes Big 5-lb dumbbells? I know. I know. I know. The ones on the back of the Peloton where you're like trying to ride at the same time. same time. same time. No, that's metabolic cardiovascular work. work. work. Uh-huh. Uh-huh. Uh-huh. And when we look at strength training, gym intimidation is real. Like sometimes I get gym intimidation when I go to the gym near place. It's very real. I know. I I'm like I go to the gym and I'm like have my own little workout thing in my house and I was in Venice, California and I went to Gold's Gym and it's like it's like it's like Oh my god.

Like it it's like Arnold Schwarzenegger Muscle Beach. Like everybody's like humongous and probably on so many anabolic steroids and they have like videos of Arnold flexing in his prime on the video screens going while you're trying to I'm like and I'm you know, I'm fairly muscular, but I'm I'm 66 and I'm like looking at myself like I feel like a 98-lb weakling here, you know. I know. I like I need to leave. No, no, but I I stay there. I go at 6:00 in the morning and just got to do it.

do it. do it. to do it, yeah. I like try to find off hours, but then that's not even great cuz then everyone's looking at you. You're like, "What are you doing on the lifting platform?" Yeah. But yeah, because of gym intimidation is real, I don't want to like tell every woman you have to go to the gym. Yeah. Um so, we start with wherever they are in their journey. It could be you 10 minutes a week where you wake up and you do a body weight circuit, right?

And then as you get stronger in your body weights, you put a front pack of a backpack on, not back because if you're doing a squat, you don't want to lean forward. So, if you put weight in a front pack, then it teaches you how to squat upright and use your glutes. So, there's ways of like improving your technique while adding load. load. load. Uh. Uh. Uh. And then we know that isolation is killer. So, if you have a friend who's also interested, well, there's lots of apps out there that are really powerful in getting women connected and actually have proper programming to improve from going body weight and light weight to dumbbells to lifting a bar.

So, there's different ways of doing it. If you want to join a CrossFit gym, that's great cuz they'll teach you stuff. If you want to join a proper gym with a personal trainer, that's fine, too. But I think the mistake that people have is not having a plan and relying on other people to tell them what to do. Mhm. We need a periodized plan wherever you are in your journey. So, if you're just starting with body weight, let's look at what that first 6 to 12 weeks is so that we can progressively overload you and get you comfortable in those movements and then we can add some load.

If you are resistance trained, it's really hard to get gains. So, how are we going to change up what you're doing so you can keep getting gains? If you're somewhere in the middle and you're used to doing 8 to 10 reps, well, don't change your program per se, but let's add more weight and reduce the reps. So, it's looking I can't give it to you. a trainer to do this or how do you kind of how do you get started cuz it's like I'm like you know, I mean honestly, I was so into it.

I I I had to get a trainer cuz I didn't want to hurt myself. I was scared and I didn't want to just do something stupid. Yeah, that's very real. A lot of women are are very afraid of getting hurt. That's why they don't go and do heavier weights. I work with a few people that have really fantastic apps we've written together and so the program is designed that way so that you can go into the gym with the app, see the videos, get instructions to understand how to do it with video queuing.

Mhm. You can um like in New Zealand, we have playgrounds that have like tires that you can do tire flips with your friends. We have outdoor classes, so people are there to tell you what to do. It's really finding your community that's going to help you. And part of it also leans into isolation is a killer and a demotivator. I I mean I I not isolating muscles, but social isolation. social isolation. social isolation. Social isolation, yeah. Okay. Social isolation is a killer of motivation, and we know that it's not very good for anybody.

So, if you have a buddy, it makes it fun. You're It makes it sustainable, sustainable, sustainable, and then you have ownership in what you're doing. you're doing. you're doing. It's amazing. Okay, so I think is there anything else we want to share about strength training or or fitness training before we jump to nutrition? Just get started. For a lot of people in our society, like I was asked the other day about about about you know, why do I have to do all of the stuff that you're talking about when we see all these people who are 100 and they never did any of that stuff.

Right. Right? Right? Right? Well, they they lived in a way where they had to do the stuff. Exactly. So, I brought up the example of my grandmother who lived to be 106. Yeah. And she grew up on a farm, and then she moved into the city with my grandfather. He had his own business. She was running around doing the gardening, the housecleaning, looking after her mother-in-law, like always busy, lifting, moving, that kind of stuff, and that was the lifestyle of the people who are now in their 90s and 100s.

100s. 100s. But our lifestyle now is not like that. Yeah, in my book Young Forever, I I did some research and I went to Ikaria, or Icaria, however you say it, in Greece, one of the blue zones, Yeah. and I met this couple. He was like 97, she was like 87, and in they they live on the side of this sort of hill mountain, and she had she had she had like the most extensive like I wouldn't even call it like garden, it was a farm.

There were fruit trees, there was animals, there was like so much food she was growing and they and and she was like walking up and I couldn't keep up with her. She was 87 years old and you know, telling me what she was doing and having to lift stuff and move stuff and take care of the whole thing, and I was like, "Wow, you know." And if that had happened in in our country, people would be like, "Oh, wait, wait, no, don't lift that. I'll get that for you." Right?

Because we're so There was an editorial that came out a couple of weeks ago that was talking specifically to health care providers and to PTs that we need to stop the rhetoric of old is frail. We need to stop pushing the 10 to 20 rep range of strength training. We need to really look at challenging the body cuz it can handle it. Yeah. We know We know We know have to be careful with your tendons and ligaments cuz you if you you cuz you're you can if you're not slowly building up.

Right. Exactly. Like I I noticed that for myself when I started I I kind of overdid it cuz my muscles could do it but my tendons weren't ready. So then now I can do like, you know, double the weights. Right. But I can I don't have the pain. Exactly. So that's part of the whole periodized program, right? But if you never never never Periodized means just like phases of training like over time like doing different things in different weeks like a graded increase in strength training.

Right. So you one, you don't get bored and two, you keep increasing load without getting injured and your body recovers properly and it And are there good resources for people like that want to That want to jump in on this? So there's a woman called the Betty Rocker and she's really good if you want to get started with body weight stuff. And she has some really good um perimenopausal menopausal programs. If you're looking to like get into lifting, Vonda Wright has a program with Haley that's learn to lift.

And then if you're already lifting and really wanting to optimize then you can go into Haley's power happens programs which I helped her her her um dev- or devise and write. Great. We'll put all those in the in the show notes, links and everything. Um let's talk about nutrition. Yeah. Cuz uh you know you know you know I think people are confused and and you know, there's all this sort of hype about protein, there's intermittent fasting, there's fasting, there's fasting, there's do we eat before exercise, only after exercise?

Like what what should people be thinking about and how do we you know, how do we start to think about that? Yeah. that? Yeah. that? Yeah. I always pull it back now to help clear kind of clear up all the confusion of chronobiology. chronobiology. chronobiology. So what are we doing for our circadian rhythm? And we know that women's circadian rhythm is different from men's. Mhm. So, if we're looking at even our cortisol peak, our cortisol awakening response, so that's how our cortisol comes up, women have a higher peak than men, and it's tightly tied to appetite hormone.

appetite hormone. appetite hormone. So, we know that when cortisol in the morning comes up, we also have an increase in what we call acylated ghrelin, which is our active form of our hunger hormone. We also have an equivalent rise in peptide YY, which is a satiation hormone. But, if we don't eat within an hour of waking up, there's dysregulation of those hormones. So, as we go through the day, we start to feel more cravings for simple carbohydrates, we get what I call the walling because we don't move as much incidentally throughout the day, start really feeling tired and hangry about 4:00 or 5:00, no matter [snorts] if you've eaten a little bit later in the day, and then dinner is a little bit uncontrollable, where you're like snacking before dinner, and then you have dinner, and then an hour later you feel hungry, so you're eating something before bed, and you've effectively phase shifted because you're eating in the wrong times.

So, regardless of the intermittent fasting, the keto, whatever it is, let's first go back to basics. Let's look how the body optimizes hormone pulse, how it optimizes melatonin peak to sleep well, how it optimizes how it repairs itself, it's all in the circadian rhythm. So, if we eat during the day and try to front-load our calories more towards the beginning and middle of the day, then when we get to the evening, we're not as starving, so we can make wiser choices at dinner, and then we aren't wanting to have snacks after dinner, which then improves sleep.

sleep. sleep. So, I tell women, if you're having really horrible sleep and issues sleeping, it starts in the morning, like when you wake up, and if you have food within the first hour or not. So, we want to drop that cortisol, we want to stimulate the hypothalamus to say, "Yep, there's some food coming in so we can have some more control of ghrelin and leptin so that it pulses properly throughout the day." And then your body is able to have more of an even blood sugar throughout the day.

I think it's important and what I what I think when I think about intermittent fasting, I think for women it can be challenging because of the reason you're saying. saying. saying. I like to think about it on the back end. I like to think about it as not eating after dinner. Right. So, if you eat dinner at 6:00 and you wake up at you know, 7:00 and you eat at 8:00, that's a 14-hour fast. Exactly. Exactly. Exactly. So, that's that's that's necessary. We want to at least have at least a 12-hour Right.

break in our bodies to allow our bodies to repair, heal, and do autophagy and all the clean out stuff. But, it doesn't have to be this 16-hour thing. It doesn't have to be like waiting till noon to eat. I mean, that's a bad idea for women. for women. for women. Have you seen the research about early versus late fast break? Mhm. So, there's been some population research looking that for those individuals both in women and men, but more robust responses in women, who break their fast by 8:00 in the morning and then they finish their daily intake by 5:00 p.m.

that they do have metabolic control and all the things that you think of. And it's just I I wrote my first book was called Ultra Metabolism and I wrote a chapter there called the Sumo Wrestler Diet. Ah. And and the joke was, you know, how do you have small little Japanese men become these enormous 300-plus pound guys? Well, they have a science in how they do that. that. that. They basically feed in this massive food called chankonabe, which is like a giant stew of stew of stew of Also all kinds of rice and pork and this and that.

and that. and that. Uh is that processed food? It was like a lot of food and then they they make them go take a nap. And then they do the same thing at the end of the day that for dinner and then they make them go to sleep. So, basically if you eat before you go to sleep, it's all going to store and you're not going to burn it. Right. And think of I would sort of flip the intermittent fasting to be on the back end, like on the Yeah.

the night before and not eating and snacking at night. Right. Right. Right. So, that's the best way to do that is to front-load your food so you're not starving at the end of the day. Right. And so, I explained the difference between intermittent fasting and time-restricted eating. Mhm. What you and I are talking about is technically time-restricted eating. Cuz when you start talking about intermittent fasting, that's when people are like, "Oh, I'm not going to eat till 11:00 or 12:00 and then I'm only going to eat till 4:00 or 5:00." Yeah.

And in that window, one window, one window, one you're not going to get the micronutrients you need or the fiber that you need. You get a whole bunch of dysregulation, so let's just not even go there. And this is this is a great take-home for people. So, if you're a woman and probably I would say anybody, you want to front-load your your your calorie restriction, which is after dinner, and don't eat after dinner. Yeah. And and have an earlier dinner if you can. You're going to sleep better, you're going to feel better, your metabolism is going to be better, you're going to probably lose more weight, you're going to have a better time, and you're going to feel better.

Now, let's talk about protein. Yes. So, protein is the thing. It used to be low fat, then it was low carb, then it was high fiber, now it's like high protein. Like, Like, Like, All the things. deal? I don't know. I think we're running out of things to be high or low in. I know. I'm wondering what the next thing's going to be. Initially, I was really happy that protein was getting its heyday cuz it has been under underutilized. underutilized. underutilized. Yeah, it's the only, by the way, it's the only macronutrient that we need in large amounts.

Exactly. Like, fat and essential fatty acids we need in small amounts, like gram amounts, like maybe in milligram amounts. amounts. amounts. You carbohydrates, we have no actual essential carbohydrates. Right. But, protein we we have a requirement for fairly large amount of amino acids and carbohy- and protein every day. Right. And I always start protein conversations with reminding people that the RDA is a representation of the lowest amount of protein that you need to prevent malnutrition. Yeah. It is not optimal. Yeah. And if we are looking for optimal, we have to dig into the most recent research that shows that between 1.6 and 2 g per kilogram of body weight is ideal.

So, that is about that 0.8 to 1 g per pound per day. Yeah. So, if you're 150 lb, it's 150 g or you know, maybe 130 or 120 to 150 g of protein. And then as you get older, you become more anabolically resistant, meaning that you can't build tissue and use it very well to protein and resistance training. So, if we are going to try to build strength and lean mass, we have to be on the upper end of protein, and the timing of that is very important.

Yeah. So, when I just listened to this fantastic lecture about about about you stop because if people just heard anabolic resistance, they probably don't know what that means. Basically, when you're young, you have what we call trophic hormones. You have a lot of hormones that are helping you keep and build muscle. build muscle. build muscle. When you get older, they change, and your muscles change, and you need more protein and more strength training just to tread water. Right. I often say I'm a living example cuz every time I travel out of the country and I'm gone for a month or so, I lose about 3 kilos of muscle.

I know. It's a pain in the ass. And it's really hard to get back. And I get I went to the gym this morning. I try to get to the gym every day when I'm traveling, but sometimes I can't and I can't get my blender and I can't do my whey protein smoothies and I can't like I'm like, okay, I have two eggs, but I need like six eggs. I'm like I know. I know. I know. it's like it's like it's like You get down to the breakfast bar, and you're like all the eggs in your bag, you're like, I didn't eat them all.

Yeah, it's really hard. And so, when people push back on the protein and the strength training, I'm like, it is really, really difficult when you get into your 40s and beyond as a woman and in your 50s and beyond as a man to build and maintain your lean mass. And lean mass isn't just muscle, it's also bone. We know protein's really important for bone as well. And when we look at the stimulus for it, not a lot of the education out there is for the right stimulus to build bone and maintain muscle.

So, if we're looking at strength training, we know the rep ranges and everything for strength training, and for bone, it's not walking. Yes, strength training can help, but we need to do hard landing jump training. So, we need that multi-directional ground reactive force to go up through the whole skeleton to actually stimulate bone um growth and density. So, when we're looking at protein is necessary to help with that, too. So, as we get older, we need to err on the upper side. And like I saying, I listened to this fantastic lecture by Keith Barr, who is tendon and protein guy, molecular researcher out of um California.

And he was saying, yeah, this whole conversation about post-exercise eating is really interesting because most of it's been done on young men and some young women. And so, there really isn't a window. I was like, yeah, of course. But as you get older, your is more important. And Half an hour, one or two hours after you work out. work out. work out. He says even less. Because if you were thinking about what you're trying to drive when you're exercising, you're driving signals to break tissue down.

And the post-exercise response is to help repair that. To repair, you need nutrition. So, if you're delaying that, then you're kind of muting those signals for reparation. So, he really suggests that as you get older, in your mid-40s for women and mid-50s for men, that you really try to get that nutrition as close to the end of exercise as possible. possible. possible. Interesting. Interesting. Interesting. Let me ask you this cuz there's something I just don't know. I mean, I talked to Don Lehman, who's a protein expert.

expert. expert. Yeah. And my understanding was if you are well-trained, like if you're starting out, for sure that's true. But if you're well-trained and you do resistance training regularly, and you have muscle, have muscle, have muscle, then it doesn't matter so much as to the timing. But what you're saying is is different. different. different. It is different, yeah. And so, when we're looking at all the studies that are promoting there's no real difference, and we're looking at resistance training in resistance-trained individuals, and you could have 100 g of protein, and that doesn't matter when you have it as long as you have it throughout the day cuz uh Luke van Loon put out one where it was the barbecue diet where he loaded people up with 100 g of protein post exercise and you were still having protein uptake for 24 hours after.

Again, all done on men, younger men. So when we're really looking at the aging factor of muscle and tendon, we want to use exercise as a signal and we need nutrition to help with that signaling. So that's the angle that a lot of us in this field are like, we're not looking at younger people who have at the ability to repair without necessarily having a big wallop of food afterwards. We're looking at how do we optimize women and men who are aging and still putting in the effort in the work that if you're not fueling to help with those exercise signals, then you're reducing the response.

bottom line is that if you're older and getting older, 40s, 50s, 60s, whatever, when you strength train, make sure you have something within half an hour to an hour at the most. Yeah. Right. Like a whey protein shake or a piece of chicken or six eggs or some some amount that's going to be a an amount Does the amount matter that time? Is it 30, 40, 50 g? Like you can't eat a a pound a gram per eat you can't eat a a pound a gram per pound of protein in one meal, right?

No, no. I wouldn't recommend that. We see that for older women it's 35 to 40 g and for older men it's 25 to 30 g. Mhm. Okay. And Okay. And Okay. And More for women? Yeah. Because we have more of a anabolic resistance to the protein. protein. protein. Abby Smith-Ryan did some really interesting work at pre and post exercise and she found that for women who had 10 to 15 g of protein before exercise, you still had the capability of achieving or of accelerating the the post exercise signals because you had more amino acids circulating.

So if you know that you can't eat after exercise, if you have it beforehand, it still helps. helps. helps. Mhm. And so so let's talk about the beforehand cuz should you exercise fasted or fed? And if you you fed, how much? Cuz much? Cuz much? Cuz I know I can't really eat too much before exercising. I get like just sluggish and nauseous and I can't do it. So So So tell me about that. It's okay for you, but not so great for women. Women should have something before.

And when we look at the reason we look at like energy availability, so we know that men can pretty much get as as low as 15 calories per kilogram of body weight without having dysfunction. For women, it is 35. So there's a big discrepancy right there. So we look at every eating opportunity. We know that if women have something before exercise that they improve the signaling of the post-exercise responses because they aren't producing as much of the breakdown hormones, your catecholamines that help with muscle contraction and fueling and stuff.

So your body, I wouldn't say is more relaxed, but it's not as highly stressed during exercise. So it can hit intensities it needs to. It can do what it needs to do. It can increase the signaling for post-exercise responses, especially if it's cardiovascular. If it's strength training, there's a little bit more of a leeway cuz it's not as metabolically heavy as cardiovascular training. But if you're going to do a weight training circuit, then you do need to eat. Yeah, I mean if I do a circuit, I'm like going my my my heart rate's up about 140 bpm.

bpm. bpm. Yeah. Wow. And I tell people it's not a lot. You don't have to think about having a full meal. I mean, there's a lot of us that are part of the 5:00 a.m. club, and the last thing in the world you want to do is get up at 3:30 to have a full meal before training at 5:30. Like no. It's like I am infamous, you know, on the internet about protein coffee, right? So I love coffee, and I'm not going to not have What's a protein coffee?

I know. So I People always ask me what I had. I'm like, I do a double espresso at night and I put it in the fridge. But I put it in the fridge with almond milk and a scoop of protein, and I stir it up, and then that's my latte in the morning, and I'm drinking it as I'm going out the door to the gym or to the pool. put like whey protein in your almond milk. milk. milk. almond milk. almond milk. almond milk. And then I pour this espresso in.

So, it's like a cold protein latte first thing in the morning. Oh. And Don't ever try to do it hot because the protein gets all gluggy. Oh, so it's like a it's like a ice coffee. Yeah. Wow. Okay, that's a that's a new secret use. secret use. secret use. And then when you're when you're traveling, it's easy, right? Cuz you might have a coffee maker in your room or maybe you can get a coffee and put your protein powder in and then you're like, "Okay, good to go." And then you have your real breakfast when you get home.

Or home. Or home. Or travel with protein powder? I do. I knew it. I travel with protein powder and creatine and then I order groceries to get sent to the hotel or wherever I'm staying. I got meat sticks. I got the Mountain Man meat sticks in my bag. Oh, yeah. creatine. And I'm like, it's tough though, man. though, man. though, man. very tough. very tough. very tough. to like and then I my suitcase is heavy cuz I got this little portable blender. Sometimes I go it's like I choose blender or French press and I always bring the French press.

So, what are the nutrition mistakes that women are making mostly now? And they're listening to all the fad diets and they're listening to the rhetoric that's on social media and they're not really paying attention to, "Okay, who am I? How do I respond? When am I hungry?" I've retrained women so many so many women to listen to hunger cues cuz we've been conditioned not to. We're like, "Oh, well, I've been told that if I delay food it's good for me. I should have lemon water hot lemon water when I first wake up.

I shouldn't have coffee. I shouldn't delay my breakfast." And then they get into the whole circadian disruption and they're not sleeping. It's like, "Okay, well Oh, really? Yeah. Cuz if you aren't eating, we know that um you know, your body really responds to food and day and and night to look at controlling your circadian rhythm. circadian rhythm. circadian rhythm. So, if you're waking up and one, you're not looking at light, two, you're not eating, then your body's like, "Am I supposed to be up?" And we see that it effectively phase shifts.

So, then your melatonin that starts to rise at 9:00 for women and 10:00 for men, you missed the boat. You don't get that. You get a blunting of that. So, women should eat in the morning and not do this lemon water thing and then delay their breakfast. Correct. And try to look at the light. And by the way, you're you mentioned people listening to nutritionists on the internet or on social media, 40% of them are paid by big food companies I know. to provide misinformation and to confuse people on purpose.

Correct. And sell something. sell something. sell something. It's actually criminal. And sell something. Yeah. To fix it. That's why I'm like I don't partner with anybody. So, what do you think about the protein Cheerios and the Dunkin' Donuts protein shakes and the Starbucks protein coffees and the I know. I laugh. Because being an expat living overseas, we don't have that. Yeah. Like we're really You go to the grocery store and it's not apple season, you can't buy an apple, right? It's very seasonal. Kind of how it usually is in in the San Francisco Bay Area.

Area. Area. But I come to the States, I go to Safeway, I'm like, "What is this? This is a store full of stuff that is a This is a store full of stuff that isn't food." And you have protein Pop-Tarts. You have protein popcorn. You have all these ultra-processed things that have protein protein, high fiber, and it's all additive. And I always remind people that we are not as smart as Mother Nature. So, when you are engineering food, that's not the same as if you're eating the whole food.

Right. Cuz there are cofactors in the whole food that actually work in your body to make it work. And this is this is a tactic And this is this is a tactic of the food industry called nutritionism, which is a term coined by Michael Pollan, Mhm. about about about manipulating processed food to meet the latest food trend or fad, right? Whether it's low fat, low carb, high fiber, high protein. So, I I I I got my go to the high protein Cheerios. I'm like, "Give me a break." I know.

I know. I know. You're like, "How much sugar's in there, too?" too?" too?" it very fast. It's amazing how fast they reformulate. You know, like, "Wow." You know, and so so I think I think people have to really careful and stick to the whole foods and not do all these weird protein kind of fad foods that are out there. Some things are okay. There are some things out there, but just be very discerning and read the ingredient list to make sure they're not full of weird things you can't recognize or pronounce or don't have in your kitchen.

Yeah. So, in New Zealand, one protein bar is anywhere from $5 to $10. So, it's not really that affordable. Oh. And people are like, "Well, what should I have instead?" I was like, "Why don't you just look at a Snicker bar? Because a Snicker bar actually has more protein than these protein bars and it's a dollar." So, it's not like I'm promoting candy bars, but when the comparison when you're looking it's like, "What are you actually getting when it says a protein on or like protein bar on the label?" Yeah.

Like, you can't really identify everything in there. It doesn't taste that great. Whereas if you know that you're hungry, you get a Payday or a Snicker bar that has some fat and protein in it. That's candy bar, you're not going to have it all the time, but it's going to probably fill you up better and it gives you protein and it's cheaper. A Snickers bar? I know. People have pushed back. I'm like, "I know. Desperate times call for desperate measures." measures." measures." I'd rather you have almonds and a cheese stick, but if you're really in a gas station and you have the option of a $10 Musashi bar or a $2 Snicker bar.

If if if you were sort of advising women in the real estate now, which they are mostly a lot of my listeners women and they just need to start one thing today, what would what would it be? I think the very first thing I tell every woman to do is to put some hard meetings in their calendar. That's a wellness meeting with themselves. Because we don't know where they are in their journey. But if we have 10 minutes three times a week dedicated to us, we start to find what we really need.

So, women who've never started a fitness journey, I tell them your 10 minutes on your first day is just to turn off no noise, go outside, look at the light, have your coffee in front of the window. Just really try to like decompress and tune in. And then as you get used to those 10 minutes and you find out, yeah, I really like to or I like to move, or I want to be outside. Then we can tap into that and say, you want to be outside?

Okay, well, let's go outside for 10 minutes. Maybe you meet a friend, and you do stairs for 10 minutes, or maybe you're doing a bodyweight circuit. Is it cold and rainy, and you don't want to go outside? You want to stay in front of the cozy fire? Great. Well, let's do a bodyweight circuit in front of that. Because it's your time, it is for you, and what do we need to do for you to keep that wellness meeting and know that you can't break it, because it's the start of these habits that are going to optimize.

Wellness meetings, wow, what a concept. Wellness meetings. I tell I tell my team like if you in my schedule, there I I I don't care if they're playing United States, call me. I you got to make sure I have blocks of time where I can do my thing in the morning. Me too. Me too. Me too. You know. You know. You know. Uh all right, so let's do some quick fire questions to wrap it up. Uh what's the number one thing women should focus on for longevity?

For longevity, so this is really interesting cuz it's a very big space and lots of like information out there. For longevity, I tell them to look at what are your risk factors, because there's so many different risks. You can look at family risk factors, and know that you have your genetic code, but it doesn't have to dictate what's happening. Yeah. So, if you have a family history of dementia, then we want to focus on strength training. You want to do everything possible so that you don't turn those genes on.

If you have a family history of osteoporosis, then we focus on that. So, that's the first thing. How are we going to optimize? Look at family history. Let's work to optimize that. Your genes are predisposing you, but they're not predestined. Exactly. And that's the thing, oh, my father died of a heart attack, so am I. No. No. You know that you're a predisposed, so let's do all the things cuz we have all these tools. All right. And so, that starts you on your longevity. Okay, so what's the biggest mistake women are making in the gym?

They're following programs that aren't built for them. One size fits all. Yeah. Or they're not following programs, they're just going in and doing a class. What's more important, weight loss or muscle gain? I'm always about what are you gaining, not what you're losing. I'm with you, girl. I mean, I I've been a doctor who's helped people lose hundreds of thousands of pounds, if not millions. I never tell people to lose weight. Yeah. Yeah. Yeah. I never focus on weight loss. I say, "Let's get healthy, and here's how." And the weight loss is a side effect.

Now, how many days a week should women be training in the gym? We see, to maintain, it's one to two if you're strength training. To kind of get gains and keep moving forward, it's three. Is it bad to do four, five, or six? The worry is overtraining or under recovery if you are doing that, cuz if we don't have a right plan, you can do four, or five, or six if you it's planned out and you recover well. But they muscle groups, so you're not doing the same thing every day.

And eat. Please eat. You need abundance. Yeah. You need abundance to build muscle. Like, you need to eat a lot in order to lose weight. I know. But I love it, cuz people are like, "What? What about this calorie deficit? And calories in, calories out?" I'm like, no. like, no. like, no. idea. And still it everybody believes it. it. it. I know. It's like the earth is flat, and it looks flat, and it's going to be flat. flat. flat. Yeah. Yeah. Yeah. It's just, no. What's the top tip to lose Sorry, to prevent muscle loss as we age?

Um protein and fiber at every meal, and a focus on strength training. Uh how about bone density? What's the most effective way to protect your bones? Jump training. Jump training. Jump training. Jump training, which is what? Jumping jacks, burpees? jacks, burpees? jacks, burpees? No, so there's been some really cool research studies that have come out. One is the Lift More study out of Australia. The other is the Osteo Gains stuff out of New Zealand, and it is looking at low landing, but land landing hard. Uh So, it's not landing how we've all learned to absorb it in our joints.

It's not plyometrics. plyometrics. plyometrics. do that. I'd back surgery. Yeah. Well, you could do a lift and slam your heels down. So, it's not actually jumping. jumping. jumping. Yeah, yeah. So, there's ways of doing or like you You look at med ball slams, right? Cuz then you're absorbing and you slam it slam it slam it or you slam it down, and so you're like really getting that isometric Interesting. Amazing. Okay, what about creatine for women? Yes or Absolutely. Absolutely. Absolutely. And how much? Oh, so I love this question because a systematic review came out 3 days ago, and I was reading it I'm like, "Kinky bubble you girl." Like 3 days ago, a month ago.

I'm like, "All right." That's because I'm always reading, right? It went through all the creatine studies that were not like bodybuilding type, and it said the people that benefit the most from creatine supplementation are women aged 18 to 65. And the lowest dose of 3 to 5 g is optimal. optimal. optimal. And then there are variations with that, of course. So, if you're looking for a cognitive benefits, it can go up a little bit higher. And Yeah. And then if you're looking at like fatigue and shift work, it's that point 38 g per kilogram, which ends up about 20.

So, there's different variations within the dosage depending on what you need. But the baseline is that 3 to 5 g, and takes about 3 weeks to fully saturate, and then you start getting all of the benefit. What's the biggest myth in women's health or fitness? That we age the same as men. And that we should be doing the same. Yeah. And we unpacked that pretty well. Yeah. And what's one nutrition rule that most women get wrong? Oh, there are too many. many. many. Too many rules.

Calories in, calories out. Let let's go with that one, yeah. Calories in, calories out, yeah. Okay, what's your favorite pre-workout snack? Um Your your coffee coffee. Yeah. Yeah. Yeah. And how about post-workout meal? Uh I always crave my bowl of Greek yogurt, nuts, protein powder, berries, chia seeds, and a double espresso. espresso. espresso. Damn. So so you do the double espresso before and after? Oh yeah, and then I stop. Okay. All right. And we didn't talk about this, but better workout in the morning or evening?

For consistency sake, we see that habits in the morning last longer. Mhm. [clears throat] [clears throat] [clears throat] Uh when you're looking at time pressed and you can do it at the end of the day, that's great cuz it's still getting it in, but we also then have to look at how close to bed it is because if you're driving your core temperature up, then that can lead to a couple of sleep issues unless you know how to drive it down. down. down. Mhm. Mhm. Mhm.

And knowing what you know now, what would you tell your 20-year-old self? Oh my gosh, there's so many things. things. things. Cuz when I was 20, I was like fully endurance athlete, like little bit of strength training, but just running and cycling and swimming and all those things and not eating enough. Full low energy availability. All All All Probably not having your period. Yeah, all this got it, lost it, got it, lost it. Um stress fractures, all those things. So I would go back and say, "Look, you don't need to do all this.

Let's look at how you're going to train for Ironman and Xterra doing it properly." Amazing. Okay. And your website is drstacysims.com. Yes. With a Y, Stacy with a Y? Yeah, no E. And E. And E. And where else can people learn about you and your work? So socials of course the same, drstacysims.com, same, drstacysims.com, same, drstacysims.com, and then our new company is Collective X, Collective X Health. Okay, give us a one or two cents on that. So we are going at it's a women's intelligence platform.

So we're going after the problem with AI and the rhetoric of regurgitating poor information that's been based on male data. So we have a research arm with with with have a patriarchal AI system and you're trying to fix that. Exactly. We're going after the sports Got it. to correct the sports outcome. We're looking at um the wearables, we're looking at the medical. So we're really going after it and it's a collective because we're partnering with all the other people who want to do the same thing.

Well, Stacy, you're just a wealth of information. I learned so much and I I'm in this field, so I you're you're I'm like just kind of leaving with all kinds of news to use and nuggets and wisdom. So thank you so much. Yeah. I'm going to try your uh protein coffee. coffee. coffee. Awesome. Awesome. Awesome. I love it. Thanks. And uh and good luck with everything you're doing. Thank you so much. It's been great. If you loved that last video, you're going to love the next one.

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