Dr. Stacy Sims: Female-Specific Exercise & Nutrition for Health, Performance & Longevity

00:00:00.000 | - Welcome to the Huberman Lab Podcast,

00:00:02.280 | where we discuss science

00:00:03.760 | and science-based tools for everyday life.

00:00:05.920 | I'm Andrew Huberman,

00:00:10.160 | and I'm a professor of neurobiology and ophthalmology

00:00:13.300 | at Stanford School of Medicine.

00:00:15.280 | My guest today is Dr. Stacey Sims.

00:00:17.920 | Dr. Stacey Sims is an exercise physiologist

00:00:20.600 | and a nutrition scientist,

00:00:22.040 | and a world expert in all things training and nutrition,

00:00:25.220 | specifically for women.

00:00:27.000 | In addition to working at Stanford

00:00:28.480 | and with numerous professional athletic teams,

00:00:30.920 | Dr. Sims has authored more than 100 peer-reviewed studies

00:00:34.800 | on exercise physiology.

00:00:36.560 | She has not only evaluated existing protocols

00:00:39.240 | for nutrition and fitness

00:00:40.600 | that are specific to women versus men,

00:00:42.860 | but she has also developed many new protocols

00:00:45.360 | that are now in practice with professional sports teams,

00:00:48.140 | but that can also serve people

00:00:50.040 | who are generally interested in fitness and longevity,

00:00:53.040 | and in doing so, the general public.

00:00:55.400 | The tools that Dr. Sims shares with us today

00:00:58.160 | are applicable to fitness,

00:00:59.940 | to changing your body composition, and to overall health.

00:01:03.480 | Today, we discuss how hormones and hormone cycles

00:01:06.640 | impact nutrition and fitness needs,

00:01:08.640 | specifically in women of different ages.

00:01:11.080 | We, of course, discuss the menstrual cycle,

00:01:13.120 | perimenopause, and menopause,

00:01:14.960 | but also female-specific nutrition and training

00:01:17.800 | as it relates to things independent of hormones.

00:01:20.880 | For instance, we evaluate the evidence

00:01:23.140 | that women may not want to train fasted,

00:01:25.760 | and the reasons for that.

00:01:27.240 | We talk about how training might vary

00:01:29.240 | according to different phases of the menstrual cycle,

00:01:31.920 | and we discuss how women can design

00:01:33.680 | nutrition and training programs

00:01:35.040 | that are optimized for their specific needs,

00:01:37.400 | not just because they are women,

00:01:38.920 | but because they are women of a particular stage of life

00:01:41.760 | and women with particular goals.

00:01:44.000 | As you'll soon see, Dr. Sims is exquisitely skilled

00:01:47.540 | at explaining the human universals

00:01:49.400 | of nutrition and training,

00:01:50.320 | that is, the things that do not differ

00:01:52.200 | between men and women and their needs

00:01:54.500 | in terms of nutrition and training,

00:01:56.280 | but she is also exquisitely skilled

00:01:57.820 | at highlighting the data showing

00:01:59.400 | that there are specific areas of nutrition and fitness

00:02:02.680 | for which women and men differ,

00:02:04.840 | and women have specific needs.

00:02:06.360 | So today you will learn what those are,

00:02:08.360 | and you will learn how to apply those specific protocols,

00:02:11.040 | such that by the end of today's episode,

00:02:13.240 | you will be armed with a tremendous amount of new knowledge

00:02:15.960 | about the biological mechanisms

00:02:17.800 | and the specific do's and do not's

00:02:20.320 | that can guide you towards

00:02:21.520 | your female-specific health and fitness goals.

00:02:24.640 | Before we begin, I'd like to emphasize

00:02:26.440 | that this podcast is separate

00:02:27.880 | from my teaching and research roles at Stanford.

00:02:30.120 | It is, however, part of my desire and effort

00:02:32.040 | to bring zero cost to consumer information

00:02:34.120 | about science and science-related tools

00:02:36.320 | to the general public.

00:02:37.600 | In keeping with that theme,

00:02:38.680 | I'd like to thank the sponsors of today's podcast.

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00:07:00.040 | And now for my discussion with Dr. Stacey Sims.

00:07:03.640 | Dr. Stacey Sims, welcome.

00:07:05.780 | - Thanks.

00:07:07.260 | - Our podcast and I put out a lot of content

00:07:09.900 | about nutrition, fitness, cold exposure,

00:07:14.900 | heat exposure, hydration,

00:07:18.380 | topics that are very near and dear to your heart

00:07:20.580 | and for which you have a ton of expertise,

00:07:22.620 | but for which you have an extra degree of expertise

00:07:26.880 | as it relates to females specifically.

00:07:30.220 | - Yeah.

00:07:31.040 | - So I'm excited to talk to you today

00:07:32.540 | because very often I will get questions

00:07:34.860 | in the comment section on social media or on YouTube.

00:07:38.660 | Was this study done in both men and women?

00:07:40.760 | How does it differ for men versus women?

00:07:43.700 | And on and on.

00:07:44.540 | And I rarely, if ever have answers, but you have answers.

00:07:48.420 | - I have answers for you.

00:07:49.740 | - Great.

00:07:50.740 | So just to kick things off,

00:07:52.740 | because this is a question I get really often.

00:07:55.760 | Fasting.

00:07:58.460 | - Oh yeah.

00:07:59.300 | - Intermittent fasting.

00:08:00.620 | - Yep.

00:08:01.460 | - We need to distinguish between the two, of course.

00:08:04.460 | Perhaps the most common question I get

00:08:06.420 | as it relates to males versus females

00:08:09.660 | is intermittent fasting or time-restricted feeding

00:08:14.140 | as it's sometimes called.

00:08:15.500 | An eight hour feeding window, a six hour feeding window,

00:08:17.820 | a 10 hour feeding window.

00:08:19.820 | Is that something that perhaps differs

00:08:23.700 | in terms of its impact

00:08:25.020 | and how well it works for men versus women?

00:08:30.020 | - Yeah.

00:08:32.220 | That's a short answer.

00:08:33.660 | - Great.

00:08:34.500 | - Yeah, yeah.

00:08:35.500 | So I'll put some parameters around it, right?

00:08:37.500 | So if we talk about intermittent fasting,

00:08:39.700 | that's where you have like the 20 hour non-feeding window

00:08:43.540 | or you're holding a fast until noon or after.

00:08:46.320 | And then we have time-restricted eating

00:08:49.340 | and that's the fancy way of saying normal eating

00:08:51.760 | where you're having breakfast

00:08:52.940 | and then you stop eating after,

00:08:54.540 | or you don't have anything after dinner, right?

00:08:56.100 | So you're eating with your circadian rhythm during the day.

00:08:59.780 | If we look at intermittent fasting

00:09:01.220 | where you're holding the fast up till noon

00:09:03.740 | or you're having days of really low calorie restriction,

00:09:07.300 | we see in active women, it's very detrimental

00:09:11.180 | unless you have PCOS

00:09:12.820 | or you have some other subclinical issue.

00:09:16.980 | And the reason for that is we, as women,

00:09:21.420 | have more oxidative fibers.

00:09:23.260 | So we hear about all the things about fasting

00:09:26.140 | to improve our metabolic flexibility,

00:09:28.600 | to improve telomere length,

00:09:29.940 | to improve parasympathetic activation.

00:09:32.540 | But by the nature of women having more oxidative fibers,

00:09:36.660 | we are already metabolically more flexible than men.

00:09:40.600 | - Interesting.

00:09:41.440 | - Yeah. - I didn't know that.

00:09:42.780 | Could you elaborate on more oxidative fibers,

00:09:45.260 | what that is and how it relates to metabolic flexibility?

00:09:48.180 | - Sure, sure.

00:09:49.020 | So oxidative fibers are muscle fibers

00:09:51.180 | that are more aerobic capacity.

00:09:52.940 | So those are the ones that you can go long and slow

00:09:55.780 | for a very long period of time

00:09:57.880 | because it uses a lot of free fatty acids.

00:10:00.340 | You need a little bit of glucose

00:10:01.980 | in order to activate those free fatty acids.

00:10:04.380 | So when we look, when a woman starts to exercise,

00:10:06.300 | she goes through blood glucose first

00:10:08.080 | and then gets into free fatty acid use.

00:10:10.460 | She doesn't tap so much into liver and muscle glycogen,

00:10:12.820 | which is, I think, another misconception that happens.

00:10:15.860 | So when we're talking about fasting or fasted workouts,

00:10:18.860 | trying to improve that metabolic flexibility,

00:10:21.020 | it increases stress on the woman.

00:10:23.300 | And so when we're talking about overall stress,

00:10:25.500 | we're talking about cortisol increase

00:10:27.700 | and they can't hit intensities high enough

00:10:30.300 | with no fuel to be able to invoke

00:10:33.940 | the post-exercise responses of growth hormone

00:10:36.300 | and testosterone, which then drop cortisol.

00:10:39.300 | So from an overall stress perspective,

00:10:41.760 | that fasted workout and holding that fast

00:10:44.780 | for a long period of time increases cortisol.

00:10:48.260 | But then when we look from like a hypothalamic point of view

00:10:51.500 | and we're looking at how the brain reads it,

00:10:53.300 | so we know that there's one area of cispeptin neurons

00:10:56.300 | in the brain for men, but there are two for women.

00:10:58.820 | So the two areas are distinct where one controls appetite

00:11:02.820 | and luteinizing hormone, and the other one

00:11:05.580 | is looking at estrogen and thyroid.

00:11:07.820 | So if you start having an exercise stress

00:11:10.940 | or a daily stress of getting up and going on with your day

00:11:14.380 | without fuel, you perturb those cispeptin neurons

00:11:17.480 | and downregulate them.

00:11:18.700 | And so when you start downregulating them,

00:11:20.860 | we see that after four days,

00:11:22.340 | you have a dysregulation of thyroid.

00:11:24.940 | We have a change in our luteinizing hormone pulse,

00:11:27.700 | which is really important to maintain endocrine function.

00:11:31.300 | And we'll hear this, oh, I've been fasting for so many years

00:11:34.460 | and it does great for me.

00:11:36.080 | But the other side of the question is, well,

00:11:38.620 | how much better would you be if you were to actually

00:11:41.380 | pay attention to your circadian rhythm

00:11:43.340 | and fuel according to the stress at hand

00:11:46.580 | and knowing that you're gonna garner less stress that way.

00:11:50.420 | And if we're really tying in nutrition

00:11:53.020 | according to that profile, instead of following a fast,

00:11:57.260 | we see better brain improvements as well.

00:11:59.980 | We see more cognitive function.

00:12:01.660 | We see less thyroid dysfunction.

00:12:04.220 | And overall, a woman does much better

00:12:07.260 | when we're not in that fasted state.

00:12:09.660 | Then when you look at population research

00:12:11.660 | that's coming out now, they're showing in both men and women

00:12:15.240 | who hold their fast till noon and then have an eating window

00:12:18.260 | from noon to maybe 6 p.m. have more obesogenic outcomes

00:12:22.860 | than people who break their fast at eight

00:12:25.100 | and finished their eating window by four or 5 p.m.

00:12:28.900 | So it's coming back to the chronobiology

00:12:30.960 | of we need to eat when our body is under stress and needs it

00:12:34.500 | unless we have a specific issue like obesity,

00:12:39.500 | inactivity, PCOS, or other metabolic conditions,

00:12:43.820 | then we can look at using fasting

00:12:46.300 | as a strategic intervention to help with those modalities.

00:12:50.300 | - Super interesting, two questions.

00:12:53.340 | Is there a protective effect of starting the eating window,

00:12:57.620 | and here I'm asking for both men and women,

00:12:59.500 | starting the eating window at say 11 a.m. or noon

00:13:03.540 | and ending it a little bit later,

00:13:05.380 | so not a six-hour eating window or seven-hour eating window,

00:13:08.340 | but extending that to eight or 9 p.m.?

00:13:11.520 | Under those conditions,

00:13:12.580 | do you still see the obesogenic effect?

00:13:15.340 | - Yes, because we're looking at the way cortisol responds.

00:13:18.420 | We know cortisol has lots of fluctuations

00:13:20.880 | throughout the day, and it peaks

00:13:23.220 | about half an hour after you wake up, right?

00:13:25.140 | So if you're having that cortisol peak

00:13:27.460 | half an hour after you wake up but you're not eating,

00:13:29.940 | then that is that higher baseline

00:13:32.380 | sympathetic drive for women.

00:13:33.900 | For men, it's not the same.

00:13:36.100 | So when we're looking at that obesogenic outcome,

00:13:38.980 | the actual timing hasn't been tested yet

00:13:42.300 | to see how can we expand or contract

00:13:45.340 | that eating window for men.

00:13:47.180 | But for women, because of that cortisol peak,

00:13:50.580 | that right after waking up,

00:13:53.120 | women tend to be already sympathetically driven.

00:13:55.680 | So then they walk around more tired but wired

00:13:59.080 | and have a really, really difficult time

00:14:01.680 | accessing any kind of parasympathetic responses down the way.

00:14:05.140 | Where if you have something really small

00:14:06.720 | where you're bringing blood sugar up,

00:14:08.180 | then it's signaling to the hypothalamus,

00:14:09.760 | "Hey, yeah, there's some nutrition on board."

00:14:11.880 | Then we can start our day.

00:14:13.460 | So again, it has to look at that circadian rhythm

00:14:16.100 | and those hormone fluxes,

00:14:17.680 | which people don't really either understand or talk about

00:14:21.080 | 'cause all of our hormones flux through the day.

00:14:22.940 | And so you have to look at where's the peak of cortisol?

00:14:24.960 | How does estrogen flux?

00:14:26.220 | How does luteinizing hormone flux?

00:14:28.460 | Progesterone, all of these things

00:14:30.100 | that have this tight interplay.

00:14:31.940 | And the more we're doing the hormone research

00:14:34.240 | and the more we're understanding these perturbations

00:14:36.380 | and how important it is to fuel for it,

00:14:39.100 | to stay out of any kind of low energy availability stance.

00:14:43.180 | - Regular listeners of this podcast will know this,

00:14:45.500 | but just to remind everybody,

00:14:46.880 | a sympathetic state has nothing to do

00:14:48.760 | with emotional sympathy.

00:14:49.840 | It's the sympathetic arm of the autonomic nervous system,

00:14:53.180 | which drives more arousal and alertness

00:14:56.320 | and at higher levels stress,

00:14:59.360 | sometimes called the fight or flight response.

00:15:01.000 | Parasympathetic being the other arm

00:15:03.080 | of the autonomic nervous system,

00:15:04.240 | sometimes called the rest and digest arm

00:15:06.840 | of the autonomic nervous system.

00:15:08.260 | They work sort of like a seesaw or a push-pull,

00:15:10.480 | pick your analogy.

00:15:11.380 | In any case, it sounds like intermittent fasting

00:15:16.380 | or time-restricted feeding,

00:15:18.000 | unless it's very well aligned to the circadian rhythm,

00:15:21.620 | is not going to be advantageous for women.

00:15:23.920 | That's what I'm hearing.

00:15:25.080 | I'm also hearing that if a woman trains while fasted,

00:15:27.840 | so in the non-feeding window,

00:15:30.720 | so wakes up, maybe has some hydration and trains,

00:15:34.720 | that's going to further exacerbate the stress response

00:15:37.520 | in a way that's not going to be good.

00:15:39.440 | - Exactly.

00:15:40.280 | - And I have to imagine that if she also is drinking caffeine

00:15:45.280 | in order to do that training,

00:15:48.620 | because caffeine is a stimulant of the sympathetic arm

00:15:51.380 | of the autonomic nervous system,

00:15:52.900 | that it will further exacerbate all these issues.

00:15:57.060 | So this is a eye-opener for me

00:15:59.860 | because I've had female training partners for years.

00:16:03.300 | I don't eat until 11 a.m.

00:16:05.300 | I like to hydrate and caffeinate

00:16:07.420 | before I train in the morning.

00:16:08.660 | And then I like to eat starting around noon.

00:16:10.860 | Several of them have hopped on that schedule with me.

00:16:14.800 | Some of them eat breakfast first, some of them don't.

00:16:17.120 | They do as they choose, of course.

00:16:19.080 | But now I'm thinking that's probably the worst way to go.

00:16:24.080 | - And it gets worse as you get older.

00:16:26.380 | Because if we're seeing,

00:16:27.360 | as women are getting into perimenopause,

00:16:29.520 | which is in their forties,

00:16:30.760 | and we have more fluctuation of those hormones

00:16:34.080 | and an increase in baseline cortisol anyway,

00:16:37.600 | then when you look at fasted training,

00:16:40.300 | it increases that cortisol drive and that sympathetic drive.

00:16:44.580 | And because it's at a point

00:16:46.860 | where you really need to polarize your training

00:16:49.260 | to get any kind of body composition change,

00:16:52.100 | not having any fuel before a high-intensity workout

00:16:55.180 | puts them in moderate intensity.

00:16:56.660 | They just can't hit the intensities they need to.

00:16:59.260 | Same with resistance training.

00:17:00.860 | Like you go in, and a lot of women are now working

00:17:03.460 | on sessional RPE, or rating perceived exertion,

00:17:06.580 | where you go in and say,

00:17:07.720 | "Okay, we need you to hit an eight on the squat."

00:17:10.560 | So you have two reps in reserve

00:17:12.060 | and a sessional RPE of an eight.

00:17:14.560 | Well, if they're not fueled,

00:17:16.360 | then we are seeing trends that they're missing

00:17:18.680 | around two to 5% of that top load.

00:17:21.860 | So they're not really lifting in that zone

00:17:23.840 | that they need to be in.

00:17:25.000 | - Let's get people, sorry to interrupt.

00:17:26.600 | Let's get people up to speed on RPE.

00:17:28.280 | 'Cause this is a term that's starting to circulate more

00:17:31.360 | outside the physical training community

00:17:34.880 | and to the broader recreational exerciser community,

00:17:38.460 | which I consider myself part of.

00:17:40.300 | - Me too now.

00:17:41.140 | - I mean, I train regularly and have for years,

00:17:42.540 | but I'm not an athlete.

00:17:44.100 | I don't get paid to train and so forth.

00:17:46.900 | So reps in reserve, perceived effort.

00:17:50.580 | Maybe just explain this.

00:17:52.060 | I think probably 95% of our listenership

00:17:55.460 | has never heard these terms.

00:17:57.680 | - Okay, so if we're talking about reps in reserve,

00:18:00.140 | this is when you go in and if you say eight,

00:18:03.780 | it means you have two reps in reserve.

00:18:05.880 | So you finish your eight and you should be able

00:18:07.900 | to complete two more with a really good form

00:18:11.160 | and then you hit failure.

00:18:12.500 | - So eight repetitions in good form

00:18:17.220 | and the person doing the exercise could in theory,

00:18:22.220 | if they really dug in there, grit their teeth,

00:18:25.180 | could complete two more repetitions in good form

00:18:27.260 | before hitting failure.

00:18:28.440 | The inability to move the weight anymore in good form.

00:18:31.260 | - Exactly.

00:18:32.100 | - Okay, but they're stopping at eight.

00:18:33.160 | So they have two reps in reserve.

00:18:34.620 | - Exactly and so we can correspond that

00:18:37.260 | with your rating perceived exertion.

00:18:39.660 | So if we're saying we need you to hit an eight

00:18:42.280 | on our scale of one to 10 of rating perceived exertion,

00:18:45.100 | we see correlates with that eight with two reps in reserve.

00:18:49.340 | So it's a way of quantifying what you're doing

00:18:51.760 | in the moment for a squat or a deadlift

00:18:54.140 | or some other really heavy lift

00:18:55.660 | that you're trying to accomplish.

00:18:57.460 | - As opposed to looking at say percentage

00:19:00.580 | of one repetition maximum.

00:19:02.380 | - Yeah.

00:19:03.220 | - Saying you're gonna move 70% of your one repetition

00:19:05.080 | maximum for six repetitions.

00:19:07.460 | Seems like that's a great thing as well,

00:19:10.220 | but it's a little bit more complicated

00:19:11.780 | because you need to know your one repetition maximum.

00:19:13.900 | Doing one repetition maximums can be dangerous

00:19:16.040 | if you're not skilled in that,

00:19:16.980 | especially with compound movements

00:19:18.220 | like squats and deadlifts.

00:19:19.980 | Okay, so is there an across the board recommendation

00:19:23.620 | for most people that they should generally train their sets

00:19:28.720 | in good form to failure, to leave a couple reps in reserve?

00:19:33.720 | What do you suggest for, let's say women,

00:19:35.520 | but this could also pertain to men.

00:19:38.200 | - And then that also depends on the age of the woman.

00:19:41.880 | So if we're looking at the reproductive years,

00:19:43.800 | so 20 to 40, then it doesn't matter so much.

00:19:48.800 | You can periodize pretty much how normal periodization works

00:19:52.920 | with your mesocycles and your microcycles.

00:19:54.960 | So you're looking at what you're doing

00:19:56.440 | across a few months, what are you doing in the week?

00:19:58.480 | Are you lifting heavy, power-based training?

00:20:01.040 | But when we start to get to perimenopause

00:20:02.960 | and we're losing all the flux of estrogen,

00:20:05.400 | and estrogen is the woman's testosterone,

00:20:07.560 | the key driver for strength and power,

00:20:09.880 | we have to look at lifting heavy.

00:20:11.960 | So this is where we really turn women on to,

00:20:15.120 | we want you to do something that is two reps in reserve,

00:20:18.700 | three reps in reserve,

00:20:20.200 | because your one rep max also changes

00:20:22.320 | depending on what kind of training block you're doing.

00:20:24.800 | So we're finding that when you're talking

00:20:26.480 | about reps in reserve, then it allows people

00:20:29.600 | to lift more on the day.

00:20:32.320 | So we can get women to get into that strength

00:20:34.960 | and power-based type training,

00:20:37.000 | rather than going, let's lift to fatigue,

00:20:39.040 | 'cause then it might be 20 reps.

00:20:40.960 | And that 20 reps doesn't invoke

00:20:42.880 | a big central nervous system response,

00:20:44.940 | which is what we want.

00:20:45.840 | It's more of that hypertrophy and muscle tearing.

00:20:48.720 | You will gain some lean mass,

00:20:50.600 | but not as much strength as if you were to invoke

00:20:52.980 | that central nervous system response.

00:20:54.880 | And that becomes really critical as women get older,

00:20:58.120 | because we need to find that external response

00:21:00.600 | that's gonna cause the same kind of strength

00:21:02.920 | and power adaptation that estrogen used to support.

00:21:05.880 | - Interesting.

00:21:06.720 | Lots to talk about in terms of exercise,

00:21:09.580 | but before we move on,

00:21:12.060 | if the bad situation is a woman fasting,

00:21:17.060 | drinking caffeine, and training intensely,

00:21:20.640 | but as you told us, not as intensely

00:21:22.500 | as she would be able to otherwise,

00:21:24.540 | what's the solution?

00:21:25.380 | I imagine that solution involves ingesting some fuel.

00:21:28.480 | What is a good example of a pre-training meal, if you will?

00:21:33.480 | And we could put some variation on that

00:21:39.040 | for people with different tendencies

00:21:41.520 | towards omnivore or vegan or whatever.

00:21:43.840 | But what is the timing of that meal relative to training

00:21:48.140 | that works best?

00:21:49.720 | And I'm assuming there's some flexibility there.

00:21:52.840 | - Yeah, I mean, like I'm the kind of person

00:21:54.520 | gets up and is out the door within a half an hour

00:21:57.200 | to go do whatever I'm gonna do.

00:21:58.480 | So it's not like I'm gonna have a full meal.

00:21:59.920 | - I've heard of people like you, yeah.

00:22:02.440 | Meaning I tend to move slowly in the morning.

00:22:04.320 | - I wish I could, but the way my life is,

00:22:06.080 | it doesn't work that way.

00:22:07.320 | But I'm also one of the people

00:22:09.720 | that never really has an appetite till 11 o'clock.

00:22:11.880 | - Okay, so we're similar in that way.

00:22:13.520 | So how do you square that?

00:22:14.920 | - So I make a double espresso at night

00:22:17.720 | and I put some almond milk

00:22:19.120 | and a scoop of protein powder in there.

00:22:20.800 | So the almond milk is sweetened

00:22:23.480 | and usually it's unsweetened, but sweetened for the carb.

00:22:26.420 | And then the protein powder for the protein,

00:22:28.400 | because if I'm gonna go do an ocean swim,

00:22:31.260 | then I need some carbohydrate and protein on board.

00:22:33.760 | If I'm gonna just go to the gym,

00:22:35.360 | then I'll probably just have the protein powder

00:22:37.320 | in the coffee.

00:22:38.560 | Yes, I'm caffeinating, but I'm also getting the calories

00:22:41.320 | for the hypothalamus

00:22:42.240 | and getting some more circulating amino acids.

00:22:44.820 | Abby Smith-Ryan out of UNC did some specific work

00:22:47.720 | looking at carbohydrate, protein, strength, or cardio

00:22:52.720 | and found that if you're gonna do

00:22:54.480 | a true strength training session,

00:22:56.200 | you only need around 15 grams of protein before you go

00:22:59.560 | to really help you get into the idea

00:23:03.520 | that yes, you have some fuel on board

00:23:05.280 | and also increases your post-exercise oxygen consumption

00:23:09.200 | or your EPOC, so your resting metabolism stays elevated,

00:23:13.920 | giving you a better chance for recovery

00:23:16.040 | post-exercise as well.

00:23:17.600 | If you're going to do any kind of cardiovascular type work

00:23:20.380 | up to an hour, then you're adding 30 grams of carb to that.

00:23:23.400 | So it's not a lot of food and it's not a full meal.

00:23:27.600 | Other people are like, I'm starving right before I go

00:23:31.240 | training, then yes, you can have your meal,

00:23:33.200 | giving yourself about half an hour before,

00:23:35.960 | but it doesn't have to be major food

00:23:38.580 | that we're talking about.

00:23:40.640 | But that's just enough to bring blood sugar up

00:23:43.480 | and stimulate the hypothalamus to say,

00:23:45.880 | yeah, there's some nutrition coming in.

00:23:47.740 | And then you have your real food afterwards.

00:23:49.240 | You have your breakfast afterwards within 45 minutes.

00:23:52.480 | - As a neuroscientist, I find it so interesting

00:23:54.480 | that at least some of what you're talking about

00:23:57.400 | with this pre-workout meal, and perhaps most of it

00:24:00.800 | relates to how ingesting those calories impacts the brain,

00:24:05.720 | protects those cispeptin neurons.

00:24:08.760 | We'll talk more about cispeptin, very interesting peptide.

00:24:12.400 | As opposed to saying, okay, you need X number of calories,

00:24:15.860 | because you're going to burn X number of calories.

00:24:18.000 | - I hate that conversation.

00:24:18.840 | - Right, which is a very different conversation.

00:24:22.200 | Here, what we're talking about is the neural aspects

00:24:24.600 | of being able to generate intensity, also blunt cortisol,

00:24:28.640 | and get the most out of training without putting the body

00:24:31.440 | into kind of an emergency state.

00:24:34.280 | - Yeah.

00:24:35.120 | And the longer someone withholds food after exercise,

00:24:38.040 | and the greater they stay in that catabolic

00:24:39.920 | or breakdown state, the more the brain perceives it

00:24:42.880 | as being in a low energy state.

00:24:44.480 | So the first thing to go is lean mass.

00:24:46.940 | When you start telling a woman that, you know,

00:24:48.700 | if you're going to do fasted training,

00:24:50.280 | and/or you're going to delay food intake afterwards,

00:24:52.740 | why are you training?

00:24:53.900 | Because the first thing that goes is lean mass,

00:24:56.100 | and it's really, really hard for women to put on lean mass.

00:24:59.260 | So once you start really nailing that, and then saying,

00:25:01.660 | look, you just need 15 grams of protein to really help

00:25:05.680 | and be able to conserve that lean mass,

00:25:07.940 | it's a small, simple fix.

00:25:09.900 | People try it, and they're like, oh my gosh,

00:25:11.300 | I feel amazing.

00:25:12.400 | So it's small little things when you're working

00:25:14.480 | with the whole system.

00:25:15.800 | 'Cause I get tired, especially around Christmas time

00:25:17.980 | when you're reading all the magazines, it's like,

00:25:20.340 | two cookies means you have to walk for 30 minutes

00:25:22.800 | on the treadmill.

00:25:23.640 | It's like, it doesn't correlate like that at all.

00:25:26.820 | So that's why I was like, I hate the calorie conversation,

00:25:30.100 | because it's just not applicable.

00:25:33.200 | - Right, and it has its own kind of elements

00:25:36.620 | of being laced with neuroticism about calorie counting,

00:25:39.500 | and then that can drift easily into the realm

00:25:42.420 | of eating disorders.

00:25:43.380 | I did an episode about eating disorders some years ago,

00:25:46.260 | and as I was researching that episode,

00:25:49.080 | I learned that people with eating disorders,

00:25:51.340 | women and men, especially anorexia,

00:25:54.200 | become like calorie calculators.

00:25:57.840 | Their eyes and their brain just are constantly evaluating

00:26:01.180 | the caloric load of food,

00:26:02.540 | and it can be obviously very intrusive.

00:26:04.540 | It's also the most deadly of all the psychiatric conditions.

00:26:07.020 | So that's a long way from hopefully

00:26:09.940 | what we're talking about here,

00:26:11.380 | but there's the opportunity for drift

00:26:13.900 | whenever we're talking about calorie counting in and out.

00:26:16.100 | We, of course, believe in the laws of thermodynamics

00:26:19.260 | and calories in, calories out,

00:26:20.980 | but I love what you're describing here

00:26:22.780 | as getting the brain in a mode

00:26:25.260 | that the brain and body are protected

00:26:27.180 | so that one can invest in that high-intensity exercise

00:26:30.380 | and get the adaptations that one wants,

00:26:32.580 | but not send everything down this pathway

00:26:35.000 | of just becoming a computer of how much am I exercising?

00:26:40.000 | What did I burn?

00:26:41.100 | What did I earn?

00:26:41.940 | It's- - Yeah, it's crazy.

00:26:43.460 | - It's crazy. - Yeah.

00:26:45.020 | - As long as we're talking about food

00:26:46.720 | and food intake relative to training,

00:26:49.400 | what is the suggested post-training window

00:26:54.400 | in which one should either avoid

00:26:57.760 | or make sure they get nutrition,

00:26:59.980 | meaning how long does one have after,

00:27:03.080 | let's say, a resistance training session of about an hour?

00:27:07.100 | Seems to me that's what most people are doing

00:27:08.740 | if they're investing in resistance training,

00:27:10.300 | maybe plus or minus, what, 20 minutes?

00:27:14.140 | - Yeah.

00:27:15.300 | - And they're hitting those high-intensity sets

00:27:18.500 | where they have maybe just one or two repetitions in reserve,

00:27:21.560 | maybe going to failure on a few of those sets.

00:27:23.340 | What do you recommend women eat after they train?

00:27:26.260 | - So we know that women who are in their reproductive years

00:27:29.740 | need around 35 grams of good protein,

00:27:32.260 | high-quality leucine-oriented protein within 45 minutes.

00:27:36.820 | And we see that women who are perimenopausal onwards

00:27:40.240 | are 40 to 60 grams

00:27:42.180 | because we become more anabolically resistant

00:27:44.580 | to food and exercise as we get older.

00:27:46.800 | When we look at the recovery window for food,

00:27:50.760 | there are definitely sex differences

00:27:52.380 | 'cause we hear all the conversation of,

00:27:53.820 | there's no recovery window, it's old science.

00:27:58.680 | But we look at the research of when women's metabolisms

00:28:01.720 | come back down to baseline,

00:28:02.840 | meaning that they have constant,

00:28:04.500 | straight blood sugar levels versus men.

00:28:07.440 | Women, it's within 60 minutes.

00:28:10.520 | And for men, it's up to three hours.

00:28:12.500 | So when we're looking at the data that says

00:28:14.220 | there's no window, per se, for getting food in,

00:28:19.060 | it's based on male data.

00:28:20.460 | So when we're looking at women,

00:28:22.300 | we have this tighter window to stop that breakdown effect

00:28:25.780 | and start the reparation.

00:28:27.280 | So yeah, it's like,

00:28:29.820 | when we're talking about the protein intake,

00:28:31.940 | it's really important,

00:28:33.380 | not only to get that leucine content up in the muscle,

00:28:36.540 | to start the reparation or repair,

00:28:38.900 | but also again, to signal that, yeah,

00:28:41.860 | we're in a building state.

00:28:43.500 | We're not holding that catabolic state

00:28:46.440 | and increasing all the repercussions that come with it.

00:28:49.300 | - So women should try and get 30

00:28:51.920 | or as much as 40, maybe 50 grams of protein,

00:28:56.220 | depending on their age,

00:28:58.460 | post-training, within an hour of training.

00:29:01.060 | Men seem to have a longer window.

00:29:04.900 | They could wait an hour, two hours,

00:29:06.740 | maybe even three hours before ingesting protein.

00:29:09.340 | What about carbohydrate?

00:29:10.820 | - We look at mixed, but for men it's more important

00:29:14.060 | because they go through their liver and muscle glycogen

00:29:16.280 | so much faster than women.

00:29:18.420 | So when we look at women,

00:29:19.620 | we want to get around 0.3 grams per kilo of carbohydrate

00:29:24.620 | within two hours of finishing.

00:29:26.780 | So we look at protein and people are like,

00:29:28.740 | well, that's a big dose of protein.

00:29:30.860 | How do I get it all in?

00:29:31.900 | It's like, yeah, well,

00:29:33.020 | you can look at how we mix all of these things.

00:29:35.020 | You're also getting carbohydrate in with that.

00:29:37.360 | So that's why I say you could have your next meal

00:29:39.640 | after your training session.

00:29:41.300 | Yeah, there's a time and a place

00:29:43.620 | for protein supplementation,

00:29:45.200 | but if you're getting that real food

00:29:46.980 | and then you're also getting your magnesium

00:29:50.700 | and your potassium and your sodium

00:29:52.580 | and all the things that people supposedly lose,

00:29:55.180 | and you're able to also repair a lot better.

00:29:59.220 | - As many of you know,

00:30:00.060 | I've been taking AG1 for more than 10 years now.

00:30:02.980 | So I'm delighted that they're sponsoring this podcast.

00:30:05.440 | To be clear, I don't take AG1 because they're a sponsor.

00:30:08.180 | Rather, they are a sponsor because I take AG1.

00:30:11.300 | In fact, I take AG1 once and often twice every single day.

00:30:14.700 | And I've done that since starting way back in 2012.

00:30:18.420 | There is so much conflicting information out there nowadays

00:30:21.020 | about what proper nutrition is.

00:30:23.180 | But here's what there seems to be a general consensus on.

00:30:26.160 | Whether you're an omnivore, a carnivore,

00:30:28.500 | a vegetarian or a vegan,

00:30:30.220 | I think it's generally agreed

00:30:31.380 | that you should get most of your food

00:30:32.920 | from unprocessed or minimally processed sources,

00:30:35.940 | which allows you to eat enough, but not overeat,

00:30:38.440 | get plenty of vitamins and minerals,

00:30:40.020 | probiotics and micronutrients

00:30:42.020 | that we all need for physical and mental health.

00:30:44.460 | Now, I personally am an omnivore

00:30:46.260 | and I strive to get most of my food

00:30:47.800 | from unprocessed or minimally processed sources.

00:30:50.580 | But the reason I still take AG1 once

00:30:52.580 | and often twice every day is that it ensures

00:30:55.180 | I get all of those vitamins, minerals, probiotics, et cetera,

00:30:58.920 | but it also has adaptogens to help me cope with stress.

00:31:01.740 | It's basically a nutritional insurance policy

00:31:04.020 | meant to augment, not replace quality food.

00:31:06.720 | So by drinking a serving of AG1 in the morning

00:31:08.940 | and again in the afternoon or evening,

00:31:10.980 | I cover all of my foundational nutritional needs.

00:31:13.620 | And I, like so many other people that take AG1,

00:31:16.320 | report feeling much better in a number of important ways,

00:31:19.340 | such as energy levels, digestion, sleep, and more.

00:31:22.500 | So while many supplements out there are really directed

00:31:24.700 | towards obtaining one specific outcome,

00:31:27.060 | AG1 is foundational nutrition

00:31:28.820 | designed to support all aspects of wellbeing

00:31:31.020 | related to mental health and physical health.

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00:31:34.940 | you can go to drinkag1.com/huberman

00:31:38.380 | to claim a special offer.

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00:31:44.540 | Again, that's drinkag1.com/huberman.

00:31:48.900 | - At some point, there was a lot of discussion

00:31:51.340 | about training fasted burns more body fat.

00:31:55.820 | I think now most people accept that that's not the case,

00:31:59.820 | that perhaps the percentage of fat as fuel

00:32:04.020 | is increased when one trains fasted,

00:32:06.660 | but that overall in terms of loss of body fat,

00:32:10.980 | it doesn't matter if you train fasted or you train fed.

00:32:14.560 | - Correct.

00:32:15.400 | - Okay, I think that can't be stated enough.

00:32:18.260 | By experts like you,

00:32:19.540 | that doesn't mean that if one prefers to train fasted

00:32:23.420 | or with a minimum of food in their gut

00:32:26.020 | that they can't do that.

00:32:28.100 | Like I like to train fasted,

00:32:29.140 | but what I'm hearing is that women should probably ingest

00:32:32.660 | at least some protein, high quality protein,

00:32:35.180 | and maybe drink the protein in a protein shake form

00:32:38.860 | if they don't want to ingest solid food.

00:32:40.900 | - Yeah, I think the easiest way for people to understand

00:32:43.940 | the basic idea of what low energy is

00:32:46.900 | and how this affects men and women

00:32:49.060 | is when we are looking at a tipping point

00:32:52.340 | for endocrine dysfunction.

00:32:54.300 | For men, we're seeing that tipping point

00:32:57.260 | at 15 calories per kilogram of fat free mass.

00:33:01.180 | For women, it's 30.

00:33:03.020 | So when we're looking at baseline calorie needs

00:33:05.360 | before you really get into that endocrine dysfunction,

00:33:08.360 | when you're looking at those parameters,

00:33:10.460 | you can see why men do better in a fasted state

00:33:13.340 | or a low calorie state.

00:33:15.140 | But for women, our intake

00:33:17.580 | and especially our carbohydrate needs are so much higher

00:33:21.140 | because we have so many other functions

00:33:25.100 | that are reliant on that cispeptin upregulation

00:33:28.700 | or downregulation, preferably upregulation.

00:33:31.400 | So when we're just talking the basic calorie needs

00:33:35.500 | and what we're seeing,

00:33:37.340 | it's that dichotomy right there of 15 to 30.

00:33:40.260 | And when you start telling people that,

00:33:41.580 | they're like, oh, okay, I get it.

00:33:44.020 | Is that a biological aspect?

00:33:46.020 | It's like, well, you could trace it all the way back

00:33:48.220 | where men went out to get the calories

00:33:50.820 | and most tribes and the women were home

00:33:52.660 | and it wasn't advantageous to be pregnant

00:33:54.580 | under low calorie intake.

00:33:56.420 | That's why you have dysfunction

00:33:57.680 | when the calories are too low.

00:33:59.700 | But you can also feed forward to modern day now

00:34:02.900 | and you're seeing that all this perturbance of hormone

00:34:05.860 | and the way we regulate hormone across the circadian rhythm

00:34:09.580 | requires more calories for women than it does for men.

00:34:13.540 | - I know some men that basically don't eat all day

00:34:16.180 | and then eat one meal in the evening

00:34:17.700 | and they'll train in the morning.

00:34:18.740 | That's inconceivable to me

00:34:20.140 | because within an hour or so of training, I'm hungry.

00:34:23.580 | Which brings to mind what we mean when we say training.

00:34:27.820 | I'm a big believer in people,

00:34:29.540 | everybody getting ideally two

00:34:32.340 | or three resistance training sessions in per week

00:34:35.900 | and two, maybe three cardiovascular training sessions

00:34:39.940 | per week.

00:34:40.760 | That would be ideal.

00:34:42.220 | One could potentially do more,

00:34:44.380 | probably not a whole lot less

00:34:45.860 | before you run into long-term health issues

00:34:48.060 | that you could offset.

00:34:49.260 | But I think most people can fit those in

00:34:52.700 | and I'm very frankly delighted that nowadays

00:34:56.760 | there's such a push for women and men to resistance train.

00:34:59.260 | That wasn't the case when I was growing up.

00:35:01.580 | You know, I recall taking my sister to the gym

00:35:03.920 | for the first time and it's like,

00:35:05.460 | I think she was the only woman in the gym

00:35:07.580 | when we were in high school.

00:35:08.780 | Except for a few female bodybuilders

00:35:10.540 | and she said, "Well, I don't wanna look like that."

00:35:12.020 | And I said, "Well, don't worry,

00:35:12.860 | "you're not gonna look like that."

00:35:14.820 | But now you go to a gym and women are lifting weights,

00:35:18.740 | men are lifting weights.

00:35:19.580 | - It's great. - It's terrific.

00:35:20.780 | - I've seen the evolution, right?

00:35:22.580 | When I was 16, one of my friend's brothers

00:35:25.420 | was a bodybuilder and he took us to the gym,

00:35:27.600 | kind of like what you did with your sister.

00:35:30.180 | And so both of us were like,

00:35:31.740 | "Oh, we wanna beat those guys."

00:35:33.260 | So we got into weight training with him,

00:35:35.420 | not to be a bodybuilder,

00:35:36.340 | but it's been like the paramount

00:35:38.540 | throughout all of my athletic career.

00:35:40.540 | Used to be I'd be the only woman on the lifting platform.

00:35:42.900 | And now it's like, you have to wait

00:35:44.860 | because there's so many women on the lifting platforms.

00:35:47.100 | I love it, it's great.

00:35:48.260 | - Yeah, it's awesome.

00:35:49.100 | As I mentioned before, I've had female training partners

00:35:50.940 | and they kill it.

00:35:51.900 | It's a lot of fun to have a female training partner

00:35:56.820 | also because not only is it cool

00:36:01.020 | to see the progress they can make really quickly,

00:36:03.940 | which surprises them often.

00:36:06.620 | I think a lot of women think that,

00:36:08.220 | okay, it's going to require external androgens

00:36:11.300 | or it's going, you know,

00:36:12.460 | and what you pointed out that there are some barriers

00:36:15.280 | to women putting on mass quickly.

00:36:17.420 | I think I've noticed that strength increases

00:36:19.500 | can come really quickly.

00:36:21.300 | Why is that?

00:36:22.140 | - It's a central nervous system aspect.

00:36:24.540 | There's a lot of, like, if we look at the culture

00:36:26.620 | of how a lot of us grew up,

00:36:29.060 | I'm saying us like 45 plus, right?

00:36:32.360 | The women were all the 90s supermodels

00:36:35.360 | don't show muscle, that kind of stuff.

00:36:36.940 | So always been gravitated to cardio.

00:36:40.220 | Even now, if you go to a gym and you're a new member,

00:36:43.340 | you're signing up for a new member and you're a woman,

00:36:45.540 | they'll say, hey, great, here's all of our spin classes

00:36:48.300 | and our box fit classes.

00:36:49.580 | - You're still doing that?

00:36:50.420 | - Yeah, and there's the cardiovascular machines.

00:36:53.260 | A guy comes in like, all right,

00:36:55.220 | how much do you want to put on?

00:36:56.700 | Here are the lifting platforms,

00:36:58.340 | all the weight trainings at the back.

00:37:01.140 | Starting to see a shift with boutique type gyms,

00:37:03.700 | but that's still the commonality there.

00:37:06.720 | So it's still that little bit of taboo.

00:37:09.200 | So when women start strength training,

00:37:11.920 | they haven't been exposed to that kind of

00:37:14.340 | central nervous system stress before.

00:37:16.700 | And the whole aspect of getting the nerve

00:37:20.540 | and the acetylcholine, which are little vesicles

00:37:23.260 | that hold the ability for the nerve

00:37:26.380 | to actually stimulate the muscle fiber,

00:37:29.260 | all that gets trained really quickly.

00:37:31.340 | So the more that you train it

00:37:32.900 | and the more muscle fibers that are recruited

00:37:34.920 | for contraction, you see an increase

00:37:36.780 | in strength really rapidly.

00:37:38.380 | And slowly building on that for increased muscle bulk,

00:37:43.380 | because it takes a long time for women to put bulk on.

00:37:48.720 | Because the driver for strength training

00:37:51.300 | is that central nervous system.

00:37:52.960 | So it's great when we see higher doses, more volume,

00:37:57.580 | we aren't seeing huge hypertrophy,

00:38:00.860 | we're just seeing really good increases in strength.

00:38:04.120 | - Whenever somebody, male or female,

00:38:06.260 | is concerned about growing too big too fast,

00:38:10.060 | I always remind them that resistance training

00:38:13.780 | is unique among different types of exercise

00:38:16.500 | in that because of the blood flow to the muscle

00:38:18.580 | during the exercise session, the so-called pump,

00:38:21.940 | you get a window, a transient window,

00:38:24.340 | but a window nonetheless of what the hypertrophy

00:38:27.860 | could look like if you do everything else correctly

00:38:29.860 | in terms of recovery.

00:38:31.180 | So provided that the size of the muscle

00:38:34.380 | during the training session is not aversive to you,

00:38:37.600 | you're okay.

00:38:38.440 | - You're good, yeah.

00:38:39.800 | - Which is unique among training.

00:38:42.280 | It's not like when you go running,

00:38:43.360 | you get a sense of being much faster.

00:38:45.120 | You actually get the opposite effect.

00:38:46.560 | You feel the burn in your lungs

00:38:48.860 | and the pain of hitting the wall of your limits.

00:38:51.840 | And then hopefully if the adaptation takes place,

00:38:54.160 | then you can push past that next time.

00:38:55.720 | But with resistance training,

00:38:56.600 | you get literally a physical picture

00:38:58.520 | and a somatic feeling for what that hypertrophy

00:39:02.200 | could look like.

00:39:03.040 | - Yeah, that's why on your physique competitions

00:39:05.880 | and bodybuilding competitions,

00:39:07.080 | they're out the back pumping before they go on stage.

00:39:10.080 | - So we've been talking about training,

00:39:11.320 | but we haven't really spelled out

00:39:12.680 | what you would suggest a novice,

00:39:17.080 | perhaps an intermediate resistance training,

00:39:20.580 | cardiovascular training program would look like

00:39:23.880 | in broad terms.

00:39:24.980 | I realize we don't have time here

00:39:26.400 | to get into all the nitty gritty details.

00:39:28.200 | You've written about this elsewhere

00:39:29.360 | and we'll refer people to those terrific resources

00:39:32.320 | in the show note captions.

00:39:33.340 | But what would you like to see women doing?

00:39:37.920 | And maybe we can break up the age brackets

00:39:40.300 | because it sounds like this is something

00:39:41.960 | that is resurfacing again and again here.

00:39:44.760 | Women, let's say 30 and younger,

00:39:47.800 | women 31 to let's say 40,

00:39:51.520 | and then let's say 41 to 60,

00:39:54.540 | and then maybe 61 and on.

00:39:56.560 | In terms of how many sessions

00:39:58.460 | of resistance training per week?

00:40:00.020 | Is it whole body training?

00:40:01.240 | How many sessions of cardiovascular training?

00:40:03.840 | And what sorts of examples could you give?

00:40:06.640 | - Yeah, so if we're looking at that 20 to 30 year old,

00:40:10.740 | a lot of times I really try to get them

00:40:12.560 | to focus on the whole movement aspect first.

00:40:15.840 | So we phase them in, same with older women.

00:40:18.320 | Phase them in, learn how to move, learn complex movements

00:40:21.600 | so that when you are going in to do resistance training,

00:40:25.040 | preferably three to four times a week,

00:40:27.600 | you can look at moving well.

00:40:29.520 | And it doesn't have to be a long period of time.

00:40:31.640 | If you're doing to failure,

00:40:34.200 | which works really well when you're younger

00:40:36.200 | to increase strength and a little bit of hypertrophy,

00:40:39.100 | you're gonna have to spend a little bit more time

00:40:40.760 | in the gym.

00:40:41.600 | So it might be 45 to 60 minutes.

00:40:43.780 | When we're looking at doing that four times a week,

00:40:46.960 | you can add in a sprint interval training

00:40:49.380 | at the end of one of those

00:40:50.280 | to get that super high intensity,

00:40:52.520 | or you can look at putting in, at the most,

00:40:55.120 | two HIIT sessions on separate days.

00:40:58.880 | If you're training specifically for something,

00:41:01.060 | so if I work with a lot of endurance athletes still,

00:41:04.240 | and they're like, "Well, how do I fit it in?"

00:41:05.640 | It's like, okay, well, we look at the quality

00:41:08.180 | and how that fits into your training.

00:41:10.240 | So if you're training for a marathon,

00:41:12.320 | you're training for a triathlon or other endurance stuff,

00:41:15.680 | you can take that high intensity work

00:41:17.280 | and put it into your training program.

00:41:19.960 | So ideally, we look at three to four resistance training

00:41:23.820 | with really good movement when we're in the younger set

00:41:27.440 | with two high intensities.

00:41:29.840 | When we start getting into our 30s,

00:41:32.920 | we start having an eye to how are we actually doing

00:41:35.960 | that resistance training.

00:41:37.120 | Instead of just going and doing a circuit,

00:41:39.160 | we're really focusing on let's do some compound movements,

00:41:42.320 | let's look at doing some heavier work,

00:41:45.400 | let's look at how we are periodizing.

00:41:47.640 | So we're having six week blocks

00:41:49.880 | and we're building on those blocks

00:41:51.960 | because we want that base foundation.

00:41:54.120 | So when we get to be 40 plus,

00:41:56.280 | we can actually go and do our power base training.

00:41:59.480 | If you're in your 40s,

00:42:00.960 | you've never done resistance training at all,

00:42:03.600 | then we take between two weeks to four months

00:42:08.600 | to really learn how to move well

00:42:10.760 | because there's a higher incidence of soft tissue injury

00:42:13.880 | and overall injury as we get into our 40s

00:42:17.400 | because of perturbations of estrogen.

00:42:19.680 | And ideally, when we get there,

00:42:21.240 | we're looking at that around three minimum,

00:42:24.360 | three resistance training with compound movements

00:42:28.080 | and either one sprint interval

00:42:31.000 | or two sprint intervals and one hit in a week.

00:42:34.200 | - And just to remind people, compound movements,

00:42:35.800 | multi-joint movements, squats, deadlifts, chin-ups, rows,

00:42:40.080 | overhead presses, bench presses, et cetera,

00:42:42.440 | as opposed to isolation movements

00:42:43.940 | where only one joint is moving.

00:42:45.960 | - Yeah.

00:42:46.800 | - And for everybody in all those age ranges

00:42:50.760 | that you describe,

00:42:51.800 | are you suggesting they train the same muscle groups

00:42:55.560 | three or four times per week,

00:42:56.880 | or they do some sort of split where it's upper body,

00:42:59.200 | lower body, take a day off,

00:43:00.720 | or upper body, take a day off,

00:43:02.040 | lower body, take a day off,

00:43:03.040 | whatever might work for them.

00:43:04.800 | - Yeah, what works for them.

00:43:06.120 | If you're looking for short amount of time in the gym

00:43:09.660 | because of busy lives and you can split it,

00:43:12.380 | if you're looking at, okay,

00:43:13.560 | well, I can allocate an hour to an hour and a half

00:43:16.480 | in the gym, then you can do total body with adequate rest.

00:43:19.520 | The key when you're younger is working to failure.

00:43:23.840 | The key when you're older is working heavy.

00:43:27.200 | - Interesting. - Yeah.

00:43:28.320 | So when we're looking at working to failure,

00:43:31.040 | we're trying to get more of that lean mass growth

00:43:33.100 | with strength.

00:43:34.400 | When we get older,

00:43:35.280 | because it's so difficult to put on lean mass,

00:43:38.320 | we really want to focus on the strength component

00:43:41.920 | because that becomes more important

00:43:44.400 | when we're talking about longevity.

00:43:46.480 | 'Cause if you're looking at the strength component

00:43:48.360 | from a central nervous system standpoint,

00:43:50.460 | we see it feeds forward into better proprioception,

00:43:54.720 | attenuation of cognitive decline.

00:43:56.720 | And this is the other thing that you in neuroscience

00:44:00.320 | would understand the sex differences

00:44:02.240 | in things like dementia and Alzheimer's.

00:44:04.600 | There's some really interesting research

00:44:06.240 | looking at strength training and that power-based stuff.

00:44:09.800 | When we're getting into our older ages,

00:44:12.100 | because we get more neural growth patterns

00:44:14.520 | and more neural pathways.

00:44:16.200 | - Even some interesting literature

00:44:17.660 | about emphasizing some unilateral movements

00:44:20.440 | as people get older, not just dual limb movements

00:44:23.520 | or dual limb simultaneous movements.

00:44:25.120 | You always want to train both sides of your body, folks.

00:44:27.160 | But so if I understand correctly,

00:44:30.800 | younger women should train to failure,

00:44:34.160 | try and generate strength and hypertrophy.

00:44:36.840 | As women get older,

00:44:37.760 | they should emphasize more strength training,

00:44:39.840 | leave some repetitions in reserve, but train heavier.

00:44:43.420 | It makes so much sense what you're saying.

00:44:45.620 | Because what we know about the nervous system as we age

00:44:50.040 | is that there's some atrophy

00:44:52.320 | or at least some weakening of neuromuscular connections

00:44:55.240 | and the upper motor neurons in the brain

00:44:56.800 | that control the neuromuscular connections

00:44:59.160 | in the spinal cord out to the muscle.

00:45:01.000 | There's something really sticky about this idea

00:45:04.520 | in terms of longevity

00:45:05.480 | that I don't think anyone else has ever said.

00:45:08.520 | - No, the thing about it is men age more in a linear fashion,

00:45:11.940 | whereas women, we have a definitive point

00:45:16.080 | in our late 40s, early 50s,

00:45:17.640 | where all of a sudden things go to shit,

00:45:20.520 | where it's that perimenopausal state.

00:45:22.800 | And I can't tell you how many emails and DMs I get in a day

00:45:26.600 | from women who are like, "I'm 46," or, "I'm 47.

00:45:29.760 | "I'm putting on body fat.

00:45:30.960 | "I don't know what's going on.

00:45:32.000 | "I can't sleep."

00:45:33.040 | And then we say, "It's perimenopause."

00:45:34.800 | Like, what is that?

00:45:36.040 | And so when we're looking at perimenopause,

00:45:38.440 | it is a huge change in the body

00:45:42.680 | because you're having less and less

00:45:45.080 | of your sex hormones circulating.

00:45:47.000 | More and more anovulatory cycles

00:45:48.880 | means no progesterone or very low progesterone.

00:45:51.940 | You're having a difference in the pulse of your estradiol

00:45:55.240 | to those flatline aspects.

00:45:58.200 | And because every system in the body is affected by it,

00:46:00.400 | this is why you see more soft tissue injuries.

00:46:02.420 | Like, two of the biggest things that women

00:46:04.880 | who are in their 40s are going to PTs about

00:46:06.920 | are frozen shoulder and plantar fascia.

00:46:09.080 | These are two really indicative issues

00:46:11.720 | that are happening in perimenopause.

00:46:13.920 | So that whole section of mid-40s to early 50s

00:46:18.920 | is a definitive aging point

00:46:21.600 | where I really tried to get women

00:46:23.560 | to get into the heavy lifting

00:46:24.920 | and get into the patterns of polarizing their training,

00:46:28.240 | not putting an emphasis on zone two,

00:46:30.680 | just really looking at how am I polarizing,

00:46:33.040 | how am I affecting my central nervous system,

00:46:35.880 | so that when they get into that one point in time

00:46:38.960 | of that perimenopause,

00:46:40.640 | their body is already conditioned

00:46:42.440 | for the stress that's coming.

00:46:44.680 | Whereas men, we see that kind of stuff

00:46:46.920 | happens in their late 50s, early 60s.

00:46:49.760 | So the soft tissue injuries,

00:46:52.000 | the change in body comp comes at a later time.

00:46:54.520 | So yes, looking at how we're scoping our strength training,

00:46:59.320 | definitely something to think about in a longevity factor.

00:47:02.800 | But for women, there's a better indication

00:47:05.840 | of the timing across the ages

00:47:07.440 | of when you should start implementing.

00:47:09.360 | For men, I think you have a better bandwidth

00:47:11.840 | of when you should start implementing.

00:47:13.740 | - For women who are not on hormone replacement therapy,

00:47:19.600 | and we did a previous episode about perimenopause, menopause

00:47:22.760 | and hormone replacement therapy,

00:47:23.960 | but if it comes up again and again today,

00:47:25.400 | that would be wonderful

00:47:26.240 | because these are important under-discussed topics.

00:47:29.240 | - Absolutely.

00:47:30.080 | - For women that are not on hormone replacement therapy,

00:47:34.340 | who decide to train heavier,

00:47:36.960 | maybe do a bit more training volume, not train to failure,

00:47:40.600 | they're making sure to not let their cortisol

00:47:42.320 | spike too much by making sure

00:47:43.560 | they have some pre-workout nutrition,

00:47:45.240 | some post-workout nutrition.

00:47:46.860 | Would they be wise to be very careful

00:47:52.400 | in how much cardiovascular exercise they add to that?

00:47:56.600 | Meaning there seems to always be this risk of overtraining.

00:48:01.520 | And as you pointed out, for various reasons,

00:48:04.480 | cultural reasons, historical reasons around exercise,

00:48:08.460 | my observation is that most women sort of,

00:48:12.560 | unless they know better,

00:48:13.680 | default to cardiovascular exercise

00:48:15.720 | as opposed to resistance training.

00:48:18.060 | So if a woman in her 40s, late 30s to,

00:48:21.720 | let's say 50, is doing two to four sessions

00:48:25.680 | of resistance training workouts per week,

00:48:29.000 | and they also really like cardio

00:48:30.520 | or they feel they want to or should do cardio,

00:48:33.920 | should they be careful about how much cardio they're doing?

00:48:37.000 | And is there a best form of cardio?

00:48:38.800 | Should they really emphasize

00:48:40.240 | the high-intensity interval training?

00:48:41.640 | Should they avoid zone two?

00:48:43.760 | We should probably also divine for people what zone two is

00:48:46.280 | if they don't already know.

00:48:49.040 | - So I am notorious for slamming things

00:48:51.920 | like Orange Theory and F45

00:48:54.160 | because they market specifically to that age group of women,

00:48:57.560 | and it's not appropriate

00:48:58.920 | because it's not true high-intensity work.

00:49:02.200 | When we're looking at women who are really trying

00:49:04.680 | to maximize body composition change and longevity,

00:49:08.480 | and unfortunately default to cardio 'cause they think,

00:49:11.400 | oh, that's gonna help change my body composition,

00:49:13.520 | it's gonna help me lose body fat, it doesn't.

00:49:16.240 | - Is this things like soul cycle as well?

00:49:18.320 | Okay, I've never done any of these,

00:49:20.480 | but I imagine there's a lot of spinning,

00:49:22.360 | a lot of moving, a lot of sweating,

00:49:23.640 | and a lot of "calories burned" emphasis.

00:49:27.560 | - Yes, there is.

00:49:28.960 | But it puts women squarely in moderate intensity

00:49:32.020 | where they're so used to leaving one of those classes

00:49:34.600 | feeling absolutely smashed that when you tell them,

00:49:38.080 | actually that training doesn't work for you

00:49:39.760 | because it's putting you in a state of intensity

00:49:42.800 | that drives cortisol up,

00:49:44.200 | but it's not a strong enough stress

00:49:46.440 | to invoke the post-exercise growth hormone

00:49:49.200 | and testosterone responses that we want

00:49:52.000 | to dampen that cortisol.

00:49:53.360 | So this is why we have that hyperbole

00:49:55.360 | of women who are in their 40s plus

00:49:58.400 | shouldn't do high-intensity work.

00:50:00.320 | It's like, well, actually,

00:50:01.800 | they shouldn't do moderate intensity.

00:50:03.440 | They need to avoid that.

00:50:04.440 | Polarizing, absolutely.

00:50:06.280 | That's what we want.

00:50:07.120 | We want true high-intensity work,

00:50:09.040 | which is one to four minutes of 80% or more,

00:50:13.380 | or if you're doing sprint interval,

00:50:15.120 | it's full gas for 30 seconds or less.

00:50:18.040 | And you're doing that a couple of times a week.

00:50:20.320 | You're not doing it every day

00:50:21.880 | because you need to have enough recovery

00:50:24.440 | to hit those intensities truly

00:50:27.520 | because those are the intensities

00:50:29.000 | that are gonna give you those post-exercise

00:50:31.600 | hormonal responses to drop cortisol.

00:50:34.740 | When we're looking at women who are like,

00:50:37.000 | oh, well, I love going out for hours and hours on my bike

00:50:40.680 | and I love doing my spin classes.

00:50:43.320 | It's like, okay, but we need to look at the big rock here.

00:50:46.920 | If you are looking for longevity and body composition change

00:50:50.240 | and cognition and all those things,

00:50:52.400 | you have to polarize your training

00:50:53.920 | and that has to be the focus.

00:50:55.900 | But soul food, I come from a long background of endurance.

00:51:00.120 | I now love riding my gravel bike on the weekends

00:51:03.080 | for long periods of time, which is not optimal for me,

00:51:06.720 | my age, that kind of stuff for all the things

00:51:09.560 | that I want to see improvements in.

00:51:11.820 | But mentally, it's great.

00:51:13.640 | So when we talk about going out for that long stuff,

00:51:16.440 | zone two is at low conversation

00:51:19.040 | and that's fine for mental health and being out in nature.

00:51:23.680 | But for optimal health and wellbeing,

00:51:26.440 | we don't wanna do that.

00:51:27.900 | We want to look at resistance training as a bedrock

00:51:31.500 | and true high intensity work

00:51:33.780 | to help with body composition change, metabolic control,

00:51:37.960 | insulin sensitivity, brain health

00:51:40.720 | and dropping that cortisol.

00:51:42.120 | - I have family members who are women who are thin

00:51:47.980 | because they love to walk and they just walk a ton

00:51:51.540 | and they eat well and enough,

00:51:56.600 | but they are resistant to resistance training.

00:51:59.260 | And if they do pick up a weight,

00:52:01.880 | it's usually some very light dumbbells, do a few curls,

00:52:04.200 | a couple of tricep extensions

00:52:05.800 | and aren't really leaning into the higher intensity work.

00:52:10.800 | I think this is pretty common.

00:52:14.920 | And my observation is that it's common,

00:52:18.400 | not because they couldn't be incentivized

00:52:21.720 | to do the higher intensity work,

00:52:23.180 | but that learning the complex compound movements,

00:52:27.160 | like how to squat properly or even leg press properly,

00:52:32.000 | deadlift properly can be a bit overwhelming,

00:52:34.800 | especially when one walks into a gym.

00:52:36.400 | This is true for men too.

00:52:37.400 | Like all this stuff, all this equipment,

00:52:39.000 | all these bodies and these people look like

00:52:40.680 | they know what they're doing.

00:52:41.520 | It's like if I were to go into an advanced

00:52:43.480 | like kitchen or symphony and all these instruments,

00:52:48.000 | I don't know how to play.

00:52:49.560 | So what's the best line of attack for somebody

00:52:53.080 | who really wants to overcome this longevity barrier?

00:52:56.840 | Because clearly resistance training,

00:52:58.320 | proper nutrition work.

00:53:00.880 | And the cardiovascular exercise piece

00:53:02.760 | is a little bit more intuitive.

00:53:03.960 | Walking, you do it faster.

00:53:05.320 | You're jogging, you do it faster.

00:53:06.480 | You're running.

00:53:07.880 | The bike, the soul cycle class, et cetera.

00:53:10.440 | It's just, it's easier in terms of the mechanics.

00:53:13.600 | One can still get hurt, but it's just more straightforward.

00:53:16.760 | Is there a way that in the absence of a budget

00:53:19.160 | for a personal trainer that somebody can learn

00:53:22.300 | how to do these movements and as you said,

00:53:24.720 | ease into them over the course of even up to four months

00:53:27.540 | in a way that they can be confident

00:53:28.840 | that they're unlikely to get hurt

00:53:31.320 | and really build up their capacity to do real work

00:53:34.640 | that can benefit them?

00:53:35.960 | - Yeah, this is where I love technology for one thing.

00:53:39.120 | But if we're staying really basic,

00:53:41.240 | I look at some of my family members

00:53:42.920 | and I've gotten them started with just body weight stuff

00:53:46.440 | or loading a backpack with cans

00:53:48.200 | to add a little bit of resistance.

00:53:49.960 | So they feel comfortable in their own house

00:53:51.860 | and they might be doing lunges or squats,

00:53:54.800 | just keying them up of like where foot placement

00:53:57.240 | and knee and that kind of stuff.

00:53:58.440 | So they're getting used to that kind of movement.

00:54:00.840 | I love Kelly Starrett's stuff with mobility.

00:54:05.240 | So show them like, here's how we do some of the mobility

00:54:07.880 | to find where the sticking points are.

00:54:10.040 | And then you can either direct them to some of the programs

00:54:14.000 | that are out there that like Haley Happens

00:54:17.900 | has some really good ones for women who are 40 plus.

00:54:20.160 | So does Brie and then Sunny Webster down in Australia.

00:54:27.080 | You can send in a video of what you're doing

00:54:29.900 | and he can critique you and tell you things to do.

00:54:33.720 | There are other programs like that too.

00:54:36.640 | So there's lots of ways of getting help if you seek it.

00:54:40.800 | The personal trainer is very much a stumbling block

00:54:44.880 | for a lot of people.

00:54:46.100 | And as much as I am not a fan of Planet Fitness,

00:54:49.880 | I am a fan of the fact that they've made it really easy

00:54:53.180 | for someone to walk in

00:54:54.480 | who's interested in resistance training.

00:54:56.600 | And they can go to a circuit,

00:54:58.320 | one of the circuit things that they have at the back,

00:55:00.720 | and they can start resistance training on machines,

00:55:03.440 | which is another level up to learning compound movements.

00:55:06.660 | So there's lots of ways of breaking that barrier to entry.

00:55:09.680 | You just have to find the motivation factor

00:55:11.680 | of what's gonna incentivize the person

00:55:13.680 | to give up their time walking every day

00:55:17.560 | and taking time to go to the gym

00:55:19.840 | or taking time to do garage-based stuff

00:55:22.520 | that's going to improve their lean mass.

00:55:25.640 | - I'm a big fan of machines,

00:55:27.840 | especially plate-loaded machines,

00:55:29.200 | but machines just create the close to correct

00:55:34.200 | or correct arc of movement.

00:55:36.360 | - Yeah, for your size.

00:55:39.400 | - Yeah, yeah, exactly.

00:55:41.400 | And to really spend the time adjusting the seat height,

00:55:44.640 | adjusting the various pins on the machine,

00:55:47.800 | not just the weight,

00:55:48.800 | in order to make sure that one gets the best range of motion.

00:55:51.880 | I think this is something small,

00:55:53.760 | but that is significant in terms of its impact.

00:55:55.800 | People just plop down in a machine,

00:55:57.200 | especially if you're working in with somebody,

00:55:59.200 | and feel, especially beginners,

00:56:01.680 | will feel pressure to move quickly,

00:56:03.920 | and they won't adjust the seat height.

00:56:05.360 | And so it's just all wrong for them.

00:56:07.080 | And all it takes is a little bit of time to,

00:56:08.920 | you know, and ask people how to adjust the machines.

00:56:11.880 | - I'm also a fan of kettlebells in the garage

00:56:15.480 | or lighter dumbbells that you can do,

00:56:18.400 | like thrusters or hang cleans or something like that

00:56:21.480 | to get the momentum and movement feeling,

00:56:24.680 | 'cause that's another good learning curve for people.

00:56:28.280 | So like I said, there's lots of ways

00:56:30.120 | that you can implement things

00:56:32.000 | based on someone's intuitive like

00:56:34.960 | or dislike of resistance training.

00:56:37.080 | - So you've mentioned polarized training.

00:56:39.040 | If I understand correctly,

00:56:40.080 | this would be a woman doing three or four days

00:56:43.280 | of high intensity resistance training

00:56:45.520 | for 45 to 60 or 45 to 75 minutes per session.

00:56:51.040 | And then at the opposite extreme,

00:56:53.360 | maybe just walking a lot or jogging a lot.

00:56:57.440 | So is that what you're talking about,

00:56:58.400 | polarized training as opposed to

00:57:00.760 | these other forms of training

00:57:02.080 | where it's designed to get people sweating like crazy,

00:57:05.800 | breathing hard for long periods of time,

00:57:07.600 | but neither putting them in the landscape

00:57:10.600 | of inducing muscle strength adaptations

00:57:12.840 | and hypertrophy adaptations,

00:57:14.120 | nor really taxing the cardiovascular system enough

00:57:17.760 | to create an increase in longevity, for instance?

00:57:21.200 | - When I talk about polarizing,

00:57:22.440 | I look at the high intensity strength,

00:57:24.560 | like that's really hard on the central nervous system.

00:57:27.440 | And then we look from a cardiovascular standpoint

00:57:30.040 | of doing true high intensity work.

00:57:32.320 | So the walking is more of the recovery.

00:57:35.600 | So if you're going to go out and do something long,

00:57:38.160 | it has to be very, very easy.

00:57:41.280 | If you are looking at cardiovascular

00:57:43.480 | and you want that big sweat,

00:57:45.120 | then we are talking true sprint interval training.

00:57:48.440 | So what I have a lot of women do

00:57:50.320 | is a 20 minute lower body heavy set.

00:57:54.760 | And then they'll go on the assault bike

00:57:56.480 | and do as hard as they can for 30 seconds,

00:58:00.120 | and then recover as much as they need to,

00:58:02.280 | to go then do another 30 seconds as hard as they can.

00:58:06.000 | Most people go, "Oh, I can do four or five of those."

00:58:08.360 | After two, they're completely gassed

00:58:10.320 | because it's that hard of work.

00:58:11.920 | And that's what I mean by polarizing.

00:58:13.960 | You have very, very low intensity for recovery

00:58:16.640 | and super, super high intensity for metabolic

00:58:19.880 | and cardiovascular changes is what we're after.

00:58:23.160 | - I'd like to take a quick break to let you know

00:58:24.880 | that the Huberman Lab team has launched a new podcast

00:58:27.880 | with host Dr. Andy Galpin.

00:58:30.120 | Andy is an expert in exercise science and human performance

00:58:33.400 | and has long been a fan favorite

00:58:35.000 | on the Huberman Lab podcast.

00:58:36.880 | This new podcast is called Perform with Dr. Andy Galpin.

00:58:40.600 | And it dives into topics

00:58:42.000 | such as how to build muscle and strength,

00:58:44.200 | how to improve your cardiovascular health

00:58:46.400 | and how to optimize recovery and sleep

00:58:48.440 | for performance and much more.

00:58:50.560 | Andy is an absolutely fantastic educator

00:58:53.120 | and true expert on all things human performance.

00:58:56.040 | I know you'll thoroughly enjoy his new podcast

00:58:58.200 | and learn a ton of useful knowledge from it.

00:59:00.840 | So please check it out and give it a subscribe

00:59:03.400 | wherever you're watching or listening to podcasts now.

00:59:06.160 | Again, the podcast is called Perform with Dr. Andy Galpin.

00:59:10.560 | Let's talk about the menstrual cycle

00:59:12.520 | and how that impacts training

00:59:14.400 | at the level of psychology and physiology.

00:59:17.600 | Meaning, and of course the two are linked.

00:59:19.720 | They're inextricably linked.

00:59:21.120 | For instance, is there a particular phase

00:59:25.840 | of the menstrual cycle where a woman should expect

00:59:29.560 | that motivation and or recovery would be more challenging?

00:59:33.960 | - So this is the sticky point of recent science

00:59:37.240 | because we see all of these research studies

00:59:39.480 | and meta-analyses that are coming out

00:59:40.960 | of the sports science literature saying

00:59:42.640 | that there is no effect of the menstrual cycle on anything.

00:59:46.160 | When you look at that population,

00:59:47.680 | it is specifically eumenorrheic women

00:59:50.880 | might have a subject pool of 10, if you're lucky, 12.

00:59:55.440 | - So this is women who have quote unquote

00:59:57.320 | normal menstrual cycles, eumenorrheic.

00:59:59.400 | - Supposedly ovulating.

01:00:01.280 | So they have a definitive low hormone and high hormone phase.

01:00:05.800 | - And this is probably because these studies

01:00:07.320 | are being done on university campuses

01:00:09.520 | with college undergraduate women.

01:00:11.200 | - Yes, exactly.

01:00:12.240 | - Which typically is in a given age range.

01:00:14.880 | - Right. - Okay.

01:00:16.160 | - And they look at performance,

01:00:17.680 | meaning that one point in time.

01:00:19.440 | And we know that psychologically you can perform

01:00:22.000 | at any point in the menstrual cycle

01:00:24.200 | unless you have something like heavy menstrual bleeding.

01:00:27.760 | When we're looking at a higher touch

01:00:29.880 | and looking not only from a molecular aspect,

01:00:32.920 | but also pulling in mixed methods

01:00:35.040 | and looking at the qualitative,

01:00:36.960 | we need women to track their own cycle

01:00:39.320 | and find their own patterns.

01:00:41.040 | Because we know that there are times

01:00:43.400 | where you feel like crap and you can't push intensity.

01:00:48.120 | But that might be on day eight for one woman,

01:00:50.440 | it might be day 18 for another.

01:00:53.120 | From a molecular standpoint,

01:00:54.920 | we know that the low hormone phase being day one

01:00:57.880 | is the first day of bleeding up through ovulation,

01:01:00.440 | which is midway through your cycle.

01:01:03.280 | You have a greater capacity for pulling in

01:01:07.160 | and accommodating stress, physical and mental stress.

01:01:11.480 | So if we're looking at doing heavier loads,

01:01:13.520 | we're looking at doing high intensity work,

01:01:15.880 | we're looking at motivation,

01:01:17.680 | then that low hormone phase is really optimal

01:01:20.840 | for trying to hit a PR or trying to hit a new speed

01:01:23.880 | 'cause you can take on that stress

01:01:25.720 | and your immune system handles it,

01:01:27.200 | your muscles handle it, your core temperature,

01:01:29.160 | everything handles it.

01:01:30.760 | - So for most women in the weeks before their period,

01:01:35.760 | they're going to feel more robust

01:01:38.800 | except right up until the point of menstruation

01:01:43.520 | or the inverse.

01:01:45.200 | - It is day one of bleeding up through mid cycle

01:01:48.640 | that could feel great.

01:01:50.480 | The sticky point comes, not every woman ovulates.

01:01:54.280 | And this is a thing when we're looking at general pop,

01:01:56.840 | we have lifestyle stress, we have nutrition stress,

01:02:00.600 | we know that women, for the most part,

01:02:02.880 | have four to five anovulatory cycles a year.

01:02:07.200 | So this is where,

01:02:08.480 | when you're looking at that high hormone phase,

01:02:11.480 | we can't say you're definitively in the high hormone phase.

01:02:15.200 | So this is where we need women to track their own cycles

01:02:18.960 | and understand their own patterns.

01:02:20.880 | Because in an ideal world,

01:02:22.480 | we know that in the luteal phase,

01:02:24.320 | this is where we have the most change,

01:02:26.840 | where we have a pro-inflammatory response

01:02:29.200 | from the immune system.

01:02:30.920 | We have inability to access carbohydrate as well.

01:02:35.600 | We have a higher sympathetic drive.

01:02:37.640 | So there's lots of things in there

01:02:39.200 | that aren't so fantastic for accommodating stress.

01:02:42.760 | - So broadly speaking,

01:02:43.720 | the luteal phase is associated with more cortisol,

01:02:47.320 | more kind of baseline levels of stress.

01:02:49.760 | Would it make sense for a woman

01:02:51.080 | to try and offset some of that

01:02:52.480 | with a bit more nutrition during that phase,

01:02:54.840 | a bit more perhaps complex carbohydrate?

01:02:56.960 | We know that some complex carbohydrate

01:02:58.760 | can blunt some of the cortisol response,

01:03:00.720 | maybe just even a little bit more attention to eating.

01:03:04.400 | - Yeah, absolutely.

01:03:05.920 | I mean, core temperature goes up,

01:03:07.120 | but the whole goal of the luteal phase is to build tissue.

01:03:10.400 | So this is where we're seeing a lot of shuttling

01:03:13.120 | of carbohydrate and amino acids

01:03:15.000 | to go to build that endometrial lining.

01:03:16.960 | And that's the whole goal.

01:03:18.120 | So yes, you need to eat more protein.

01:03:20.000 | You need to eat more carbohydrate.

01:03:21.680 | But again, the sticking point is, did you ovulate or not?

01:03:24.440 | So if you aren't aware of if you ovulated or not,

01:03:27.440 | you're tracking your own patterns,

01:03:29.360 | then just be acutely aware

01:03:31.480 | that in about the week before your next period comes,

01:03:34.360 | you really need to be amping up carbohydrate and protein.

01:03:37.440 | 'Cause that's gonna help you hit intensities.

01:03:40.240 | It's gonna kind of level that playing field,

01:03:42.280 | especially on days where you feel

01:03:43.840 | like you can really hit those intensities, you feel great,

01:03:46.560 | but then you go to do something

01:03:47.880 | and your heart rate's higher than it should be.

01:03:49.800 | You don't feel that you can hit those.

01:03:52.440 | If you're offsetting it with some increased carbohydrate

01:03:55.280 | beforehand, you're gonna hit it.

01:03:57.480 | So it's, again, it's really dialing it back down

01:04:00.200 | to the individual now

01:04:01.480 | because we don't have enough robust research

01:04:03.920 | to make generalized ideas

01:04:05.920 | because of the nuance of, have you ovulated or not?

01:04:10.800 | What are your ratios of estrogen and progesterone

01:04:13.320 | in that luteal phase?

01:04:15.360 | So when we bring it back down to the general pop,

01:04:18.720 | it's like the best thing to do

01:04:20.320 | is to track your menstrual cycle over sleep,

01:04:23.640 | over how you're feeling, find your own patterns

01:04:26.080 | and dial in your training in your days

01:04:28.440 | according to what your pattern is.

01:04:30.200 | - How hard should a woman push through the mental

01:04:35.440 | and maybe even physical resistance to train less

01:04:38.600 | or not train during a given phase of the cycle?

01:04:41.760 | - It depends on how she feels.

01:04:43.160 | What we can't rely on are things like heart rate variability

01:04:46.000 | 'cause we know that changes

01:04:47.120 | with the autonomic nervous system change of progesterone.

01:04:49.880 | It's a good indication that you've ovulated

01:04:51.440 | 'cause your heart rate variability tanks,

01:04:53.240 | but it's not a good indication of what your body can do.

01:04:56.120 | If you wake up, I always say it's a 10 minute rule.

01:04:58.640 | You wake up and you feel awful.

01:05:00.560 | And you're like, I really wanna do this workout,

01:05:02.560 | but I don't know how it's gonna go.

01:05:03.960 | Give yourself 10 minutes.

01:05:05.320 | If after 10 minutes, you can't hit those intensities

01:05:08.640 | or you just feel horrible, change it, drop it down,

01:05:12.720 | do something that's more recovery,

01:05:14.680 | do something that's not gonna be so taxing

01:05:16.760 | because we do have a limited amount of that stress acumen

01:05:20.640 | of how much stress we can handle.

01:05:22.880 | So if you're gonna try to exert it all

01:05:24.680 | in a high intensity workout,

01:05:26.200 | what do you have left over for the rest of the day?

01:05:28.520 | And then that compounds

01:05:29.920 | because if you're always fighting it,

01:05:32.160 | then you're going to increase this baseline sympathetic drive

01:05:36.360 | because you're fighting the training, you're fighting life.

01:05:39.240 | So give yourself that 10 minute rule.

01:05:41.440 | If it happens three days in a row, that's okay

01:05:43.600 | 'cause it's a very short period of time.

01:05:46.140 | It's not gonna last forever.

01:05:47.820 | So a lot of women have this internal conversation

01:05:51.780 | of I have to do this.

01:05:53.840 | And it's really based on some kind of external,

01:05:57.540 | they think everyone's watching them.

01:05:59.360 | But internally, you don't have to.

01:06:01.400 | If you give yourself permission, you end up training better,

01:06:04.400 | recovering better and getting better gains.

01:06:07.280 | - On the flip side,

01:06:08.340 | if a woman is feeling spectacularly good,

01:06:11.600 | should she just really push it as hard as she can

01:06:15.560 | or is there anything about the relationship

01:06:18.180 | between the hormone fluctuations of the menstrual cycle

01:06:21.860 | and feeling really, really great

01:06:23.860 | that training hard can somehow disrupt the cycle?

01:06:26.620 | And this is actually kind of the old lore,

01:06:30.220 | probably myth, I would imagine,

01:06:32.300 | that high intensity resistance training

01:06:34.840 | is somehow detrimental to female hormone cycles.

01:06:38.280 | I don't think there's any evidence for that,

01:06:39.820 | but I hear that from time to time.

01:06:43.460 | Why do you think that myth came to be?

01:06:45.620 | Why do you think it propagates

01:06:46.880 | and what can we do to extinguish it

01:06:48.520 | if in fact it's not true?

01:06:49.720 | - It's not true.

01:06:50.780 | We see it comes from a misstep in food intake.

01:06:54.520 | And we also see that it's a cultural influence.

01:06:57.400 | Because if we think about how sports started,

01:06:59.480 | it started as a way for men to demonstrate

01:07:03.400 | how powerful and aggressive they are.

01:07:05.440 | And this is the original Olympics, right?

01:07:07.120 | There were no women allowed.

01:07:08.320 | And as we feed forward into sport

01:07:10.800 | and how it became okay for women to be involved,

01:07:13.540 | at the high performance level,

01:07:15.640 | if a woman walks in and shows any fallibility,

01:07:17.900 | then she's immediately put on a lower stool, right?

01:07:20.940 | You know, you can't play with the boys

01:07:23.020 | because you have a menstrual cycle.

01:07:24.940 | You're bleeding.

01:07:25.780 | You're a woman.

01:07:26.600 | You're a delicate flower.

01:07:28.000 | So women would walk into that professional sports space

01:07:30.580 | and be excited if they were amenorrheic

01:07:32.420 | or didn't have periods.

01:07:33.860 | Or they trained hard enough and their period went away

01:07:36.260 | because then they were more like men

01:07:37.860 | and they could play with the boys.

01:07:40.060 | If you start bringing up menstrual cycle

01:07:41.740 | in professional sport,

01:07:43.060 | now as of the past about four or five years,

01:07:45.520 | it's okay to talk about it,

01:07:46.760 | which is, you know what, 2020.

01:07:49.620 | So that myth of high intensity resistance training

01:07:54.060 | causing issues with the menstrual cycle,

01:07:57.460 | one, it's a cultural nuance for pushback

01:08:00.880 | against women being in that space.

01:08:03.100 | But then the reality is women weren't eating enough

01:08:05.860 | to accommodate for that stress,

01:08:07.680 | which then feeds forward to low energy availability,

01:08:10.320 | maybe relative energy deficiency in sport,

01:08:13.520 | perturbations in all of our menstrual cycle hormones.

01:08:16.840 | So it's not the act

01:08:18.000 | of the high intensity resistance training.

01:08:20.560 | It's the act of not fueling appropriately for it

01:08:24.400 | and then getting the okay to not have your period

01:08:27.400 | because yeah, now you're in with,

01:08:30.080 | you're training hard enough.

01:08:31.140 | You've lost it.

01:08:31.980 | You're more like a man.

01:08:33.880 | - Wow, very interesting history there.

01:08:38.320 | Is it true then that if a woman maintains

01:08:41.360 | either caloric balance with her basically eating enough

01:08:45.640 | to support her energy output

01:08:47.760 | or even a slight caloric surplus,

01:08:50.780 | that it's unlikely that her periods will cease

01:08:54.080 | even if she's training very hard and very often?

01:08:57.000 | - Correct.

01:08:58.380 | - So it basically boils down to calories in, calories out.

01:09:02.040 | Fuel for the task at hand

01:09:04.080 | because some people want to have a slight calorie deficit

01:09:07.520 | even in high training.

01:09:09.200 | And if that deficit is at night away from training,

01:09:12.920 | maybe 150 to 200 calories,

01:09:15.400 | then it's gonna help perpetuate body fat loss,

01:09:18.420 | not lean mass loss,

01:09:19.720 | and it's not gonna interfere with recovery.

01:09:22.480 | It's the fueling in and around the stress,

01:09:26.720 | meaning the exercise stress, it's really important,

01:09:29.120 | but women have been so conditioned to not eat

01:09:32.560 | and not take up space, to be small.

01:09:35.360 | All of these sociocultural things

01:09:37.940 | that women are afraid to admit the fact

01:09:39.680 | that they want to eat and they should be eating.

01:09:42.120 | So this is a nuance within the fitness community

01:09:46.340 | that we're really trying to change

01:09:48.440 | and get the mindset around you train hard, you eat well,

01:09:52.640 | and your body responds in kind.

01:09:55.160 | - Appetite, body temperature,

01:09:57.880 | and hormones are very tightly linked.

01:10:00.120 | - Yes, they are.

01:10:01.040 | - Far too tightly for us to disentangle all of those

01:10:03.840 | in a single conversation here.

01:10:05.560 | But as you're describing the urgent need

01:10:07.400 | for women to fuel enough with the proper fuels,

01:10:10.360 | to train hard enough,

01:10:11.720 | to stimulate the correct adaptations that they need,

01:10:14.320 | I imagine that the shift in appetite and body temperature

01:10:20.280 | that occurs across the menstrual cycle

01:10:21.840 | is also gonna play into this,

01:10:23.240 | meaning there will be phases of the menstrual cycle

01:10:25.400 | where women will be just naturally less motivated

01:10:28.240 | to eat enough carbohydrate, enough protein,

01:10:32.000 | in order to get the most out of their training.

01:10:34.200 | What phases of the menstrual cycle are those

01:10:36.960 | so that women can pay particular attention

01:10:38.720 | to make sure that they're fueling enough?

01:10:40.800 | - Yeah, as estrogen starts to come up

01:10:43.760 | right before ovulation,

01:10:45.280 | that estrogen surge really dampens appetite.

01:10:47.560 | It also has an interplay with our appetite hormones,

01:10:52.480 | which is part of the reason

01:10:53.680 | why we don't have that great of an appetite.

01:10:56.160 | It holds after ovulation.

01:10:58.080 | Estrogen dips, you get hungry, it comes up,

01:11:01.080 | and people are like, I have some cravings

01:11:03.320 | which are driven by progesterone

01:11:04.960 | 'cause your body needs more calories.

01:11:06.720 | But at the same time, with the elevation of estrogen,

01:11:09.600 | you're not hungry.

01:11:11.320 | You have cravings, but you're not hungry.

01:11:13.360 | - Interesting. - Yeah.

01:11:14.640 | So it's trying to disconnect those.

01:11:16.880 | It's like your appetite is something that will come back,

01:11:20.440 | of course, once you eat.

01:11:21.920 | But cravings are more of that psychological capacity

01:11:26.640 | of, yeah, my body needs more, but I'm not quite sure what.

01:11:31.200 | So to get women to understand

01:11:33.240 | what's happening across the board,

01:11:34.920 | it's always coming back to,

01:11:36.800 | let's fuel appropriately for the exercise.

01:11:40.240 | And even if you're not hungry,

01:11:41.640 | if you are fueling appropriately at that point in time,

01:11:46.000 | if you end up with less,

01:11:47.440 | at least you've stopped that breakdown state,

01:11:49.400 | that catabolic state.

01:11:50.440 | So we don't get those perturbations in the hypothalamus.

01:11:53.480 | That's my biggest concern for women,

01:11:55.720 | is really taking care of that signaling from the brain

01:11:59.920 | to the rest of the body.

01:12:01.480 | And if we have fuel on board,

01:12:03.400 | even though we have appetite perturbations,

01:12:05.400 | and if you go do a really hard workout in the heat,

01:12:08.800 | you're not gonna be hungry either.

01:12:10.400 | But if you're having a cold protein drink

01:12:12.720 | after that hot workout,

01:12:14.600 | you're taking care of that immediate need

01:12:17.480 | to shut down the signals that we need to break down things.

01:12:21.680 | - Let's talk about one of the many third rails

01:12:24.480 | of discussions online, which is birth control.

01:12:29.400 | - Yeah.

01:12:30.680 | - And we need to define exactly

01:12:32.400 | what type of birth control we're talking about,

01:12:33.840 | because there are so many different forms.

01:12:35.440 | - Yes.

01:12:36.360 | - There are IUDs, there are the copper IUDs,

01:12:38.320 | there's the ring, there's the, you know.

01:12:40.880 | Let's talk about oral contraceptives

01:12:43.240 | that are designed to prevent ovulation.

01:12:48.240 | So this is, quote unquote, the pill.

01:12:50.160 | So we're being, let's for now limit the conversation to that

01:12:52.840 | so that there isn't confusion.

01:12:55.240 | Share with us, if you will, your thoughts on these,

01:12:58.160 | how they impact any of the things that we're talking about,

01:13:00.640 | or anything else from that, for that matter.

01:13:02.760 | - Can we have another history lesson?

01:13:04.080 | - Please.

01:13:04.920 | - All right.

01:13:05.760 | I just gave a talk at home

01:13:07.440 | to some young athletes on contraception,

01:13:10.600 | because someone might be on the depot,

01:13:13.800 | and if they're on it for more than two years,

01:13:15.600 | they get bone mineral density loss.

01:13:17.800 | So then the question of, okay,

01:13:19.200 | well, how does the oral contraceptive pill come up?

01:13:21.560 | How does that affect things?

01:13:23.280 | It's like, well, let's look at the history of it.

01:13:25.640 | Initially came from Stanford,

01:13:27.880 | was funded by Catherine McCormick from McCormick family,

01:13:32.440 | and a feminist activist, Margaret Singer.

01:13:35.720 | But because they are women, they couldn't get in the lab,

01:13:37.800 | so they got a guy from Stanford to develop the pill.

01:13:40.880 | And he's like, you know what?

01:13:42.160 | We need to put in a placebo week

01:13:44.120 | so that women feel like they're having a bleed.

01:13:46.480 | So if we're looking at the three active pills,

01:13:49.000 | and then the one sugar pill week,

01:13:51.600 | it was by design to make women feel

01:13:54.440 | like they are having control over their menstrual cycle,

01:13:57.640 | and they would still have a bleed.

01:13:59.400 | But it's not a true bleed, it's a withdrawal bleed.

01:14:01.720 | So this becomes the confusing point

01:14:03.760 | for people who are on an oral contraceptive pill.

01:14:05.920 | They're like, I get my period.

01:14:07.360 | It's like, no, you don't.

01:14:08.880 | 'Cause the idea of the hormones

01:14:11.520 | that are in an oral contraceptive pill

01:14:13.200 | is to down-regulate your ovarian function

01:14:16.080 | so that you don't ovulate.

01:14:18.000 | So you have a whole different hormone profile

01:14:21.680 | from someone who naturally cycles.

01:14:23.880 | So this depends on the type

01:14:26.520 | of oral contraceptive pill you're using.

01:14:29.560 | For the most part, monophasic

01:14:31.960 | is the one that's most prescribed.

01:14:33.280 | So that means the three weeks of the active pill

01:14:35.520 | is the same dose of estrogen and progesterone,

01:14:38.080 | and then you have your sugar pill week

01:14:39.720 | or your withdrawal week, and then you start again.

01:14:42.800 | When we look at the repercussions

01:14:44.960 | of using oral contraceptive pill in active women,

01:14:47.960 | there's a higher amount of inflammatory responses

01:14:51.400 | and oxidative responses.

01:14:53.520 | So from a training standpoint, no one's done the study yet,

01:14:56.520 | but I would be interested in doing this,

01:14:59.120 | of looking at how that impacts adaptation.

01:15:02.680 | You do end up with a new baseline of this

01:15:04.840 | when you start taking the pill,

01:15:06.000 | but we're not really sure how that impacts adaptation.

01:15:10.200 | We also look at the progestin component

01:15:12.560 | of the oral contraceptive pill,

01:15:14.120 | 'cause we have four generations of progesterone.

01:15:17.240 | First generation was really high dose

01:15:19.120 | and has a lot of risk factors,

01:15:20.480 | not really prescribed that much.

01:15:22.320 | Second generation is the most prescribed,

01:15:25.360 | and this is the one that people just take,

01:15:28.880 | it's in your IUD, it's in your OC,

01:15:31.920 | has the least amount of side effects.

01:15:33.400 | And then we have a third and a fourth generation.

01:15:36.120 | The fourth generation is primarily used

01:15:38.080 | for women who have really bad PMS or PMDD,

01:15:40.840 | which is your premenstrual dysphoria disorder.

01:15:45.440 | So significant mood issues,

01:15:47.640 | because that progestin has a direct effect

01:15:50.560 | on a lot of the dopamine receptors in the brain as well.

01:15:55.560 | The third generation is very androgenic.

01:15:58.960 | So we see that in some preliminary research,

01:16:02.920 | that improves speed and power

01:16:06.160 | by the second week of intake because it's accumulated.

01:16:09.600 | So when we're looking directly

01:16:10.880 | at an oral contraceptive pill,

01:16:12.960 | we can't make generalizations

01:16:14.640 | because you have low dose, high dose estrogen.

01:16:17.520 | We see that a 30 microgram dose increases hypertrophy,

01:16:20.880 | but not strength,

01:16:22.240 | 'cause estrogen increases the satellite cell aspect.

01:16:25.480 | So for my power and Olympic athletes,

01:16:28.560 | Olympic lifting athletes, that's a detriment

01:16:30.880 | because they'll put on muscle mass, but no strength.

01:16:33.480 | So we've had to look at changing their OC

01:16:35.320 | or getting them off.

01:16:36.920 | For women who have breakthrough bleeding,

01:16:39.040 | that higher incidence of,

01:16:40.400 | or that higher intake of estrogen is really beneficial.

01:16:43.680 | So when we look overall at how it impacts women

01:16:46.920 | from an athletic standpoint,

01:16:48.920 | it's so variable in the hormone profile

01:16:52.320 | that we can't make generalizations.

01:16:53.880 | We only look at the very high performance athletes

01:16:56.920 | and what's happening up there

01:16:58.320 | because that can make or break an athlete.

01:17:00.880 | So from the general touch point, we don't know enough.

01:17:04.480 | Like the beginning of this year, 2024,

01:17:07.080 | there was a study that came out looking at changes

01:17:09.360 | in the amygdala that happens with oral contraceptive use.

01:17:13.960 | It's reversible in adults,

01:17:15.640 | but for young girls, we don't know

01:17:17.600 | because their brain is developing.

01:17:19.360 | And unfortunately physicians will pass out OCs

01:17:22.200 | as if it's candy.

01:17:23.160 | - OCs.

01:17:24.000 | - Oral contraceptive. - Oral contraceptives.

01:17:25.440 | And do you recall what the direction

01:17:26.920 | of the effect was on the amygdala?

01:17:28.760 | For those that don't recall

01:17:30.560 | the amygdala bilateral brain structure,

01:17:32.800 | meaning one on each side of your brain,

01:17:35.560 | literally means almond in Latin, it's almond shaped.

01:17:38.040 | And it's part of a larger network

01:17:39.680 | associated with threat detection.

01:17:42.440 | Sometimes it's described the locus of fear in the brain,

01:17:45.760 | but it's involved in a lot of other things too,

01:17:47.840 | both positive valence and negative valence,

01:17:49.560 | but nonetheless is part of the threat detection system,

01:17:55.000 | elevated levels of arousal,

01:17:57.360 | which is why it's often discussed

01:17:59.400 | in the context of fear, anxiety, et cetera.

01:18:02.400 | - It increased fear in women who are on the OC,

01:18:06.600 | oral contraceptive pill,

01:18:07.880 | made them less willing to take chances.

01:18:12.880 | And when they went off it,

01:18:15.000 | they're like, well, why couldn't I do that before?

01:18:18.040 | So that's why they started looking at the amygdala.

01:18:20.800 | And when I say we're looking at young girls,

01:18:22.960 | and again, we don't know what's happening.

01:18:24.640 | Is it reversible in young girls that are put on it or not

01:18:27.600 | because of the brain structure changes that are happening?

01:18:30.560 | So when we talk about an oral contraceptive pill,

01:18:35.600 | I want people to understand

01:18:36.960 | that it has a significant effect on the body,

01:18:40.000 | not just reproductive.

01:18:41.400 | We don't know enough about all the other effects.

01:18:44.040 | So I have parents who say,

01:18:45.760 | my daughter wants to go on the oral contraceptive pill.

01:18:48.440 | She's having irregular periods.

01:18:50.000 | She's an athlete.

01:18:51.320 | We wouldn't be able to control it.

01:18:53.280 | And it's like, if there's a issue

01:18:55.840 | with your menstrual cycle now,

01:18:57.240 | it's still gonna be there when you get off it.

01:18:58.800 | So we have to look and see what's going on here.

01:19:02.480 | If you're looking to get on it

01:19:03.600 | to control your menstrual cycle, why?

01:19:06.240 | Because we know that you can have an increase

01:19:08.480 | in your VO2 max and other anaerobic capacity

01:19:13.160 | when you're not on it.

01:19:14.720 | So you have a better top end capacity

01:19:17.080 | when you're not being blunted by these hormones.

01:19:20.360 | And then the other conversation is,

01:19:22.200 | oh, my skin.

01:19:23.160 | It's like, well, they have really good dermatologists

01:19:25.040 | that can help you with that.

01:19:26.080 | You don't have to go on an oral contraceptive pill.

01:19:28.920 | But unfortunately, GPs don't understand all of that.

01:19:31.920 | And if a girl comes in and says,

01:19:33.360 | I'm having irregular cycles, heavy menstrual bleeding,

01:19:36.040 | I wanna go on the OC, here you go.

01:19:38.680 | So it is a huge conversation still we had.

01:19:42.240 | I put it in the same category as menopause hormone therapy

01:19:45.240 | 'cause there isn't enough research

01:19:46.560 | to address all the population needs.

01:19:48.640 | And we see these big pendulum switches.

01:19:51.520 | So before it was like, everyone be on the OC.

01:19:53.440 | And now it's like, maybe not.

01:19:54.880 | And then it was no one be on menopause hormone therapy.

01:19:57.640 | Everyone should be on it.

01:19:59.080 | But we need to land in the middle

01:20:00.480 | and understand more of what's happening

01:20:02.760 | with these exogenous hormones.

01:20:04.520 | - Is there any evidence that other forms

01:20:06.000 | of female contraception can be, let's just say problematic

01:20:10.200 | for the types of things we're discussing today?

01:20:12.520 | - Like the implant in the depot?

01:20:14.120 | - Or IUD, copper IUD?

01:20:16.600 | - Copper IUD and the Mirena

01:20:18.720 | or your progestin-laced IUD,

01:20:21.160 | those are what a lot of my tactical athletes will use

01:20:25.240 | 'cause it doesn't have a systemic effect

01:20:27.240 | on adaptation or inflammation, mood, any of those things.

01:20:32.240 | And it's a fit and forget.

01:20:34.640 | So you can put it in for up to three to five years.

01:20:37.320 | If you have a really heavy bleeding, it really dissipates

01:20:40.040 | because the whole idea of an IUD

01:20:42.240 | is that then the endometrial lining.

01:20:44.120 | And so then you have autophagy

01:20:45.520 | that takes care of the endometrial lining.

01:20:47.880 | So you don't necessarily have a bleed.

01:20:50.400 | The copper IUD is different

01:20:51.760 | because you do have really heavy bleeding

01:20:53.600 | for the first three cycles, and then it attenuates.

01:20:57.160 | - Before we got started today,

01:20:58.240 | you mentioned some very interesting pioneering studies

01:21:03.000 | on evaluating menstrual blood itself as a window

01:21:08.000 | into some larger themes about what's going on

01:21:12.880 | physiologically, maybe even psychologically.

01:21:16.000 | Now might be a good time to just touch into that.

01:21:19.760 | We can always return to it again later,

01:21:21.120 | but let me just ask it more directly.

01:21:23.760 | What are some things that can be measured directly

01:21:26.400 | from menstrual blood that are informative for women?

01:21:31.400 | And it sounds like there's a new generation

01:21:33.760 | of at-home tests that might be interesting

01:21:36.560 | and informative for them to think about.

01:21:38.720 | - Yeah, well, if you think about menstrual fluid,

01:21:41.520 | everyone thinks about it as a discard product,

01:21:43.520 | but it's a very good indicator of what's happening

01:21:46.720 | from an endocrine standpoint,

01:21:49.080 | gives a really good indication of what's happening

01:21:51.000 | from an endometrial standpoint.

01:21:53.280 | So if you're looking at all the cytokines and the proteins

01:21:56.640 | and the tissue that comes from it,

01:21:58.040 | it's a huge indicator that's naturally discharged

01:22:03.040 | that we're now looking at for determining HPV,

01:22:08.040 | do you have it or not?

01:22:09.680 | What about proteins for PCOS?

01:22:11.440 | Can we really identify PCOS or endometriosis?

01:22:15.560 | - We talk about PCOS for a moment.

01:22:16.960 | Most people have heard of it by now,

01:22:18.240 | but polycystic ovarian syndrome,

01:22:20.440 | it's associated with typically elevated androgens.

01:22:23.880 | It's becoming more and more common

01:22:26.240 | or perhaps detected more based on better detection methods.

01:22:30.680 | I don't know which.

01:22:31.680 | The prevalence of PCOS seems to be very, very high.

01:22:36.800 | - It does, and I think it's a combination of both.

01:22:40.920 | We also see some rebound PCOS that happens

01:22:43.600 | when someone gets off an oral contraceptive pill.

01:22:46.560 | It's not necessarily true PCOS 'cause what's happening now,

01:22:50.960 | your ovaries are producing eggs

01:22:54.520 | that have been downregulated for so long.

01:22:56.680 | So under ultrasound, it might look like PCOS,

01:22:59.760 | but it's not necessarily true indication.

01:23:02.720 | The other is more and more women are starting to eat more,

01:23:05.800 | and so they're coming out of low energy availability.

01:23:07.800 | If you have more carbohydrate,

01:23:09.040 | you end up with greater follicular stimulation,

01:23:11.680 | which also shows up as PCOS.

01:23:13.920 | So the true PCOS, yes, there is a high incidence

01:23:18.280 | from a reporting standpoint,

01:23:19.800 | but is it that rebound

01:23:21.280 | where it's not having all the androgenetic changes?

01:23:24.600 | That's still kind of up in the air at the moment,

01:23:27.160 | but it is a big concern for women

01:23:30.160 | because it is an indication that something's going on

01:23:32.600 | and they might have some fertility issues.

01:23:35.560 | We see a really high incidence of PCOS

01:23:38.360 | in Olympic-level athletes

01:23:40.160 | because of the higher androgenetic aspect of PCOS,

01:23:42.960 | so better recovery time,

01:23:45.040 | a little bit higher baseline testosterone.

01:23:47.280 | So yeah, it's a population specificity as well.

01:23:51.720 | - In the '80s and '90s, there was a lot of excitement

01:23:55.480 | in the kind of neurobehavioral endocrinology fields,

01:23:59.360 | largely based on animal literature,

01:24:01.560 | but then expanding into human literature

01:24:03.840 | that certain forms of activities

01:24:06.240 | could change hormone patterns and maybe even psychology.

01:24:09.640 | And that makes sense on the surface of it,

01:24:12.400 | but is there evidence that if somebody engages

01:24:15.640 | in say high-intensity training or competitive scenarios,

01:24:19.960 | this has been explored a lot in men,

01:24:21.440 | but I'm wondering if it's also been explored now in women,

01:24:24.640 | that androgens go up?

01:24:27.240 | I mean, there's been these studies,

01:24:29.440 | I don't know how good they are,

01:24:30.800 | of people on the stock exchange

01:24:34.200 | watching their stress fluctuations, measuring testosterone.

01:24:37.040 | I think most of those studies were done in men,

01:24:39.600 | but other competitive scenarios,

01:24:41.640 | even showing, for instance, that exogenous testosterone

01:24:45.160 | can increase altruism in men if men are competing

01:24:49.140 | for who's donating the most money at a philanthropic event.

01:24:53.520 | But you put them in a different scenario

01:24:55.120 | where it's far less benevolent in goal,

01:24:57.600 | and then exogenous testosterone drives competitiveness

01:25:00.960 | towards things that are more traditionally thought of

01:25:03.440 | as male-male competition.

01:25:05.640 | In other words, it's all context dependent.

01:25:07.840 | Is there anything that kind of springs to mind

01:25:09.800 | of interesting studies as it relates to androgens

01:25:12.120 | or estrogens in women athletes,

01:25:15.480 | and as it relates to exercise?

01:25:17.200 | - They haven't done any specific studies like that in women.

01:25:20.880 | We do see that under stress, the cortisol increases,

01:25:24.000 | and if you have an adequate response to it

01:25:27.400 | and your body can overcome it,

01:25:28.640 | then yes, you get a boost in testosterone for women.

01:25:31.880 | We see this in a lot of the night mission shift changes

01:25:35.700 | in tactical athletes.

01:25:37.460 | There is also, I guess, a lessening of circulating estrogen

01:25:42.460 | so the pulse changes when we start getting to the end

01:25:47.880 | of a really strong training block,

01:25:50.500 | because we're starting to have a little bit

01:25:52.360 | of a down regulation of our luteinizing hormone,

01:25:55.360 | pulse, and estrogen.

01:25:56.580 | But it shouldn't be severe enough

01:25:59.360 | to cause menstrual cycle dysfunction.

01:26:01.760 | What we want people to do is look at the ratio

01:26:04.300 | of their estrogen, progesterone,

01:26:06.200 | and keeping track of luteinizing hormone

01:26:08.120 | if they're at that point where they are going

01:26:10.700 | to have a really big training block.

01:26:13.080 | So we look at pre-season, during season, end of season,

01:26:16.480 | and people who might be at a higher risk factor

01:26:19.960 | for becoming amenorrheic, then we keep track that way.

01:26:23.400 | Because it is the stress component that can down regulate,

01:26:26.720 | not actually causing a permanent change.

01:26:31.080 | - As we talk about menstruation,

01:26:32.320 | we should probably talk about iron stores and iron.

01:26:35.800 | - Yeah.

01:26:37.280 | - Do women need to supplement iron,

01:26:39.240 | given that they lose iron during menstruation?

01:26:42.200 | - It's interesting because we have a change in hepcidin,

01:26:45.160 | or hepcidin, depending on which part

01:26:46.960 | of the world you come from.

01:26:48.320 | Because it is increased under times of inflammation

01:26:52.640 | and decreased under times of iron loss.

01:26:55.800 | So we see a significant change across the menstrual cycle.

01:26:59.720 | So I tell women, if you are concerned with low ferritin,

01:27:04.720 | then we want you to take an iron supplement

01:27:07.400 | every other day, starting with the first day

01:27:10.000 | of your bleed for 10 days.

01:27:12.120 | Because that's going to really allow your body

01:27:14.280 | to absorb it and stay on top of it.

01:27:17.480 | After that, every other day, yeah,

01:27:19.960 | but you're not gonna be absorbing as much of it

01:27:22.920 | because hepcidin starts to come up after ovulation.

01:27:26.120 | Again, you have a pro-inflammatory response,

01:27:28.240 | you have greater inflammation.

01:27:30.400 | Do women blanket need to supplement?

01:27:32.960 | No, because we see fatigue isn't necessarily

01:27:37.360 | just iron related.

01:27:38.960 | There's so many other reasons why women are fatigued.

01:27:43.680 | The one problem is the baseline levels for like ferritin.

01:27:48.320 | For active women, if you go in and you have a ferritin level

01:27:52.040 | of 20 to 25, they're gonna say it's normal.

01:27:54.720 | But we'd rather see you up around 50.

01:27:57.440 | So if you are in that low end of normal,

01:28:00.280 | then supplementing will help you get up into that 50

01:28:03.080 | and see if it makes a difference.

01:28:05.280 | If a woman is going to get a blood test

01:28:07.920 | to evaluate testosterone, estrogen, lipids,

01:28:11.120 | metabolic factors, et cetera,

01:28:13.160 | and she can only afford to do that at one point

01:28:16.920 | during her cycle and compare at various times,

01:28:20.360 | maybe every six months, or once a year even,

01:28:23.600 | at that specific time of her cycle,

01:28:25.160 | is there a best time and cycle to do that blood test?

01:28:30.000 | If I'm limited to say that,

01:28:31.640 | then I would say five to seven days

01:28:33.320 | before her next period starts, so mid luteal,

01:28:36.840 | because then you can get a good indication

01:28:38.800 | of estrogen progesterone peak.

01:28:41.120 | Testosterone doesn't fluctuate as much as those two,

01:28:43.960 | so you're gonna get a good idea

01:28:45.240 | what baseline testosterone is.

01:28:47.440 | And we know that there's a greater inflammatory response,

01:28:49.960 | so anything that's outside of the norm

01:28:52.080 | of that upper elevation of inflammation,

01:28:54.120 | you're going to be able to pick out.

01:28:57.920 | So yeah, I would say if you could only do it

01:29:00.880 | at one point in time, that would be the time to do it.

01:29:03.840 | - And if she can add a second blood test

01:29:06.040 | at a different phase of the menstrual cycle,

01:29:08.120 | where would you place that second test?

01:29:10.640 | - Day two of the menstrual cycle, second day of bleeding,

01:29:14.640 | to get a really good indication

01:29:16.400 | of what your true estrogen level is at baseline.

01:29:19.320 | - And if she measures her hormones

01:29:21.440 | at those two times within the cycle,

01:29:23.240 | do you think that's sufficient to get 75% plus

01:29:27.880 | of the relevant data?

01:29:29.880 | - Yeah, definitely.

01:29:31.360 | - Terrific.

01:29:32.200 | Caffeine. - Yes.

01:29:35.240 | - In the old days, meaning when I was a kid,

01:29:38.360 | and not long ago, three weeks ago,

01:29:41.480 | we would hear these crazy statements about caffeine.

01:29:46.200 | It pulls calcium out of the bones.

01:29:48.880 | It's, you know, you'd hear this stuff.

01:29:50.240 | I did a whole episode on caffeine.

01:29:51.640 | I'm a big fan of caffeine,

01:29:52.760 | but I do warn people that if they suffer from anxiety

01:29:56.440 | or they're going through a particularly stressful life event,

01:30:00.000 | it can raise the activity of the sympathetic arm

01:30:03.120 | or the autonomic nervous system.

01:30:04.280 | You'll feel more nervous.

01:30:05.200 | You're more prone to panic when you're drinking caffeine,

01:30:07.560 | but many people love caffeine.

01:30:10.760 | I think 90% of the adult population of the world

01:30:13.240 | ingests some form of caffeine every single day.

01:30:15.880 | - I'm in that 90%.

01:30:17.080 | - Likewise, making it the most consumed drug worldwide.

01:30:22.440 | - Is caffeine safe for women?

01:30:25.040 | I suspect, based on what you just said,

01:30:27.000 | that the answer will be yes,

01:30:28.000 | but are there case conditions

01:30:30.720 | where women should be cautious about their intake of caffeine

01:30:33.920 | independent of this anxiety thing?

01:30:36.160 | I mean, people probably shouldn't drink more caffeine

01:30:40.000 | than they can tolerate psychologically.

01:30:42.760 | No one, male, female, young or old.

01:30:44.640 | - Yeah, it's more of a genetic factor

01:30:46.840 | than it is a sex factor.

01:30:49.200 | So, I mean, both men and women will be fast metabolizers,

01:30:52.960 | slow metabolizers or not have an effect.

01:30:55.600 | That becomes the bigger rock of them.

01:30:58.040 | What we do find is in that perimenopausal state,

01:31:02.520 | women will become more sensitive

01:31:04.200 | to the blood sugar fluctuations that happen with caffeine.

01:31:07.960 | So they're used to having coffee in the morning

01:31:10.480 | with something, then halfway through their workout,

01:31:12.600 | they become a little bit hypoglycemic

01:31:15.200 | because there's changes in insulin sensitivity,

01:31:20.200 | insulin responses.

01:31:21.680 | So there's changes also in blood sugar control

01:31:24.440 | and caffeine can exacerbate that.

01:31:26.720 | So if you are someone who's like,

01:31:28.560 | oh, I always have a double espresso before I go workout

01:31:31.720 | and then halfway through, I'm really hypoglycemic.

01:31:33.760 | I'm really dizzy and lightheaded.

01:31:35.240 | I don't know what to do.

01:31:36.280 | - Feel sick or nauseous.

01:31:37.360 | - Yeah. - Yeah.

01:31:38.240 | - Eat some food.

01:31:39.760 | Eat some food with it.

01:31:41.080 | - What about sipping caffeine through the workout?

01:31:43.680 | You know, taking that coffee in

01:31:45.400 | and just having a sip between sets.

01:31:46.760 | Can that offset some of that?

01:31:48.520 | - I don't think so.

01:31:49.360 | - Okay.

01:31:50.400 | I hear a lot that people who drink caffeine

01:31:52.640 | before a workout, you know, midway through,

01:31:54.600 | they're like, I don't feel good.

01:31:55.760 | - Yeah. - Yeah.

01:31:56.600 | - 'Cause they don't eat.

01:31:58.520 | - For me, that just stimulates the desire for more caffeine,

01:32:00.880 | but, or even, dare I say, a half piece of nicotine gum,

01:32:05.880 | which I experimented with, but I was told,

01:32:08.960 | and this is why I'm not going to continue to do it.

01:32:10.880 | Not only is it very habit forming,

01:32:13.480 | it actually is such a vasoconstrictor

01:32:16.640 | that I was told by a dermatologist

01:32:19.120 | that it's terrible for skin,

01:32:20.240 | even if you're not getting your nicotine by smoking,

01:32:22.920 | vaping, dipping, or snuffing.

01:32:25.040 | So this big trend now toward ingesting nicotine

01:32:29.400 | as a stimulant and cognitive enhancer

01:32:31.480 | and performance enhancer, I think people should

01:32:33.320 | at least be aware of the negative effects on skin.

01:32:36.020 | - Never would have known 'cause I'm not a nicotine person.

01:32:40.200 | - I'll tell you that half piece of nicotine gum

01:32:42.440 | is the first time you do it,

01:32:44.960 | it's an unbelievable experience.

01:32:48.960 | It's like your first real cup of coffee.

01:32:52.640 | - Oh, really wakes you up?

01:32:53.840 | - Yeah, and dials you in.

01:32:55.280 | I recommend nobody do it because it feels that pleasant

01:32:59.220 | if you like caffeine.

01:33:00.400 | - I like Shashandra for that reason.

01:33:02.060 | - Shashandra?

01:33:02.900 | - Yeah.

01:33:03.720 | - What's Shashandra?

01:33:04.560 | - It's an adaptogen.

01:33:05.400 | - Oh, I should know what this is.

01:33:06.220 | - You should know what this is.

01:33:07.060 | - I should know.

01:33:07.900 | Well, I'm here to learn.

01:33:08.720 | - Okay.

01:33:10.120 | - Shashandra.

01:33:10.960 | - Shashandra, yeah, so it is an adaptogenic plant.

01:33:15.960 | So, you know, like ginseng, Siberian ginseng,

01:33:19.160 | maca, ashiganda, all those buzzwords out there.

01:33:23.720 | Shashandra is another really well-studied adaptogen

01:33:26.480 | and I have friends who say it's like Adderall

01:33:28.640 | where you take it and it's immediate focus and function

01:33:32.720 | because its main goal is to regulate dopamine,

01:33:36.120 | serotonin and cortisol.

01:33:38.380 | So it gives you, gets women and men out of that brain fog,

01:33:41.940 | gives them incredible focus.

01:33:43.500 | - Do you use it?

01:33:44.340 | - Yep.

01:33:45.160 | - Are you on it now?

01:33:46.140 | - I put it in my morning coffee.

01:33:47.500 | - Okay.

01:33:48.340 | You just sent people down the rabbit hole of the internet.

01:33:52.300 | - The rabbit hole of Shashandra.

01:33:53.140 | - Of the internet, all right.

01:33:53.960 | - Yeah, yeah.

01:33:54.800 | - You heard it here first, Dr. Stacey Sims.

01:33:57.180 | I'm gonna give it a try.

01:33:58.360 | Because the nicotine thing is an interesting one

01:34:00.300 | and there are some cognitive enhancing effects of nicotine

01:34:02.760 | that perhaps in people 65 and older

01:34:06.580 | might actually be beneficial for offsetting

01:34:08.380 | some forms of neurodegeneration,

01:34:10.180 | but that needs to still be explored and researched.

01:34:12.820 | Don't cut that and clip it and put it out there like so,

01:34:15.180 | that's happened already.

01:34:16.780 | Very interesting.

01:34:17.620 | All right, caffeine we both agree is great.

01:34:19.300 | Shashandra.

01:34:20.540 | - You gotta try it.

01:34:21.380 | - Check it out.

01:34:22.220 | - Let me know.

01:34:23.040 | - All right, will do.

01:34:23.880 | Cold.

01:34:25.580 | - Yeah.

01:34:26.400 | - For reasons I still don't understand,

01:34:28.740 | people have associated me or this podcast

01:34:30.940 | with deliberate cold exposure.

01:34:32.100 | I like deliberate cold exposure in the form of a cold shower

01:34:34.980 | or a cold plunge or an ice bath,

01:34:37.000 | mostly for the effects that occur afterward,

01:34:40.900 | meaning more alertness, a kind of semi-euphoric buzz

01:34:44.780 | that goes on a long, long time.

01:34:47.100 | No, I don't think it increases metabolism

01:34:49.420 | significantly enough to have a meaningful difference,

01:34:51.740 | but the long lasting increases in the so-called catecholamines

01:34:56.740 | dopamine, norepinephrine and epinephrine

01:34:59.100 | to me are pretty impressive.

01:35:00.420 | And I just like the way it makes me feel.

01:35:02.280 | So that's the main reason I believe

01:35:05.200 | why people do deliberate cold exposure.

01:35:08.040 | And every time I do a post about deliberate cold exposure,

01:35:11.340 | I get asked, understandably so,

01:35:14.160 | how does it affect women differently than men?

01:35:16.880 | And then I usually get questions about Raynaud's syndrome.

01:35:19.080 | - Oh yeah.

01:35:19.920 | - Yeah, so is there a difference

01:35:22.640 | in terms of how deliberate cold exposure impacts women?

01:35:25.200 | I have to imagine the answer is yes,

01:35:26.560 | given what you said earlier about vasoconstriction

01:35:28.480 | versus vasodilation, but deliberate cold exposure,

01:35:31.800 | like it, hate it.

01:35:33.080 | What do you think?

01:35:33.920 | Do you recommend it for women?

01:35:35.600 | - I recommend it for open water swimmers

01:35:37.920 | who might experience that vagal response

01:35:40.360 | when they first dive into the cold.

01:35:42.520 | I prefer heat for women.

01:35:44.280 | Everyone's a responder to the heat.

01:35:45.800 | You get better adaptations.

01:35:48.000 | - So sauna?

01:35:48.960 | - Yep, sauna.

01:35:49.800 | - Hot tub?

01:35:50.880 | - Yep, preferably a true finish sauna.

01:35:52.920 | Infrared doesn't, it warms the skin, but not the core.

01:35:56.200 | - Thank you for saying that.

01:35:57.120 | I'm not a big fan of infrared sauna

01:35:58.840 | because it doesn't get hot enough.

01:36:00.000 | - No.

01:36:00.840 | You can bring an infrared light into a traditional sauna

01:36:03.320 | if it can tolerate the heat.

01:36:04.680 | But finish sauna would be what?

01:36:06.000 | Something between 185 degrees Fahrenheit

01:36:08.320 | and maybe 210 if you're really heat adapted.

01:36:12.320 | - Yeah, I'm still working on metric.

01:36:13.840 | Let me do the conversion.

01:36:14.960 | - Oh, sorry.

01:36:15.800 | Yeah, you're living down in New Zealand now.

01:36:16.640 | - Yeah, so 60 to 80 degrees C.

01:36:19.080 | - I need to look.

01:36:19.920 | Every time I've tried to do math on the fly

01:36:21.520 | on this podcast in my head.

01:36:22.360 | - I know, it's like, okay,

01:36:23.680 | times nine divided by five, plus 32, yeah.

01:36:27.480 | - People can look it up.

01:36:28.320 | - Yeah, look it up.

01:36:30.920 | So the thing with cold water exposure

01:36:33.280 | is the whole conversation about ice cold, ice baths,

01:36:37.360 | and how cold it is, it's too cold for women.

01:36:41.120 | Because when we're looking at that severe,

01:36:43.880 | immediate jump into that icy cold,

01:36:47.560 | it causes such severe constriction and shutdown.

01:36:51.000 | So women do really well and get that whole dopamine response

01:36:55.360 | and everything if the water is around 16 degrees C,

01:36:59.360 | which is 55 to 56 degrees Fahrenheit.

01:37:03.040 | - Which is chilly.

01:37:04.080 | - It's chilly.

01:37:04.920 | - It's not warm.

01:37:05.760 | - No, it's go dive in San Francisco Bay, right?

01:37:09.160 | And that is enough to offset

01:37:12.320 | that severe constriction survival,

01:37:15.160 | but it is cold enough to invoke all the changes

01:37:19.280 | that we want with cold water exposure.

01:37:22.920 | So it's a temperature nuance that sets sex difference.

01:37:27.240 | And like I said, when I have open water swimmers

01:37:29.960 | who are going to do a long swim

01:37:32.360 | or they're going to do a triathlon and the water is colder,

01:37:36.000 | I have them do cold water exposure,

01:37:37.920 | especially face exposure into the cold water

01:37:41.760 | to get them habituated to that initial severe constriction

01:37:46.760 | and sympathetic activity

01:37:49.160 | that we don't want to happen before a race.

01:37:52.160 | With heat being the truth,

01:37:54.240 | like true heat that we're talking about with sauna,

01:37:56.840 | we see a lot of metabolic changes for women.

01:38:00.840 | So we're having better insulin and glucose control.

01:38:04.800 | We're seeing a better expression of our heat shock proteins

01:38:09.800 | and the uncoupling and the rebuilding of those proteins

01:38:13.880 | that are cardiovascular responses.

01:38:16.480 | And then for women, as we get older

01:38:19.000 | and have the offshoot of hot flashes,

01:38:23.440 | night sweats, that kind of stuff.

01:38:25.480 | If you're doing heat exposure,

01:38:27.840 | you're sending a stronger stimulus to the hypothalamus

01:38:32.000 | and you're also getting a better serotonin production

01:38:35.680 | from the gut because we have 95% of our serotonin

01:38:39.560 | produced from the gut,

01:38:41.040 | which lends to better temperature control

01:38:43.760 | and shuts down hot flashes.

01:38:45.680 | - I think some people might be confused

01:38:48.080 | by the idea of using sauna

01:38:50.480 | in order to reduce the hot flashes.

01:38:54.080 | So I'll just remind people that your brain

01:38:56.400 | has a set of neurons in the medial preoptic area

01:38:59.920 | that's sort of a thermostat, if you will,

01:39:02.480 | controlling core body temperature.

01:39:04.200 | And if you heat the surface of your body,

01:39:07.000 | your medial preoptic neurons say,

01:39:08.440 | "Oh, let's cool down the core of the body."

01:39:10.800 | Now, if you stay in that heat too long,

01:39:12.280 | you'll cook, your core body temperature will go up.

01:39:15.380 | But conversely, if the surface of your body is made cold,

01:39:19.680 | the internal milieu of your body will heat up

01:39:21.640 | 'cause those medial preoptic neurons will say,

01:39:23.220 | "Oh, this is like putting an ice pack on the thermostat,"

01:39:27.920 | which is what graduate students and postdocs

01:39:30.720 | used to do in the lab side working

01:39:32.120 | 'cause it was a battle over the heater, right?

01:39:34.880 | Some people were in hot, some people were in cold.

01:39:36.440 | So it was always this business.

01:39:38.480 | In any event, so it's not that you disapprove

01:39:42.160 | of using deliberate cold exposure.

01:39:44.240 | You just recommend that women do deliberate cold exposure

01:39:47.280 | with temperatures that are maybe

01:39:48.580 | in the low 50 degree Fahrenheit range,

01:39:53.040 | as opposed to the really, frankly,

01:39:56.620 | just painfully cold for anybody,

01:39:59.500 | 38 to 50 degree temperatures, is that right?

01:40:05.200 | - We did a pilot study looking,

01:40:06.860 | 'cause Wim Hof has been down to New Zealand quite a bit.

01:40:09.280 | And so his breathing and ice bath stuff

01:40:13.320 | has been making the rounds.

01:40:14.920 | And working in the high performance,

01:40:17.720 | people wanted to do that.

01:40:18.940 | But we have few athletes

01:40:20.260 | that have really severe endometriosis.

01:40:22.540 | It's like, well, we could look at using cold exposure

01:40:24.700 | to help control that.

01:40:26.180 | And what we found over the course of this study

01:40:28.760 | was that if we were to do deliberate cold exposure

01:40:31.980 | around ovulation and then hold it for 10 days

01:40:37.560 | over the course of three menstrual cycles,

01:40:40.160 | it attenuated the endometriosis.

01:40:43.420 | 'Cause endometriosis is an inflammatory disease, right?

01:40:46.700 | So if we're looking at inflammation process

01:40:48.780 | and growing the tissue,

01:40:50.380 | if we can dampen that inflammation

01:40:51.960 | and create a response that learns that inflammation

01:40:55.700 | and dampens it, then it helps with endometriosis.

01:40:59.220 | - Very interesting.

01:41:00.060 | - So that's another avenue that we really wanna take

01:41:02.980 | when we're looking at deliberate cold exposure.

01:41:06.700 | - Wow, fascinating.

01:41:07.960 | As a cautionary note,

01:41:10.180 | if anyone is going to explore Wim Hof type methods,

01:41:13.940 | please, please, please do not combine

01:41:17.340 | cyclic hyperventilation or hyperventilation of any kind

01:41:21.020 | with breath holds and water exposure,

01:41:22.900 | not even in the depth of a puddle.

01:41:25.460 | There have been drownings associated

01:41:27.340 | with people doing cyclic hyperventilation

01:41:29.380 | in various contexts, not just related to Hof breathing,

01:41:32.900 | but basically people who are not skilled

01:41:35.400 | and even some who are skilled

01:41:37.820 | combining cyclic hyperventilation, breath holds and water

01:41:40.740 | in any form, cold or warm water.

01:41:42.460 | - Bad idea. - Just don't.

01:41:43.380 | If you're going to do any kind

01:41:44.620 | of cyclic hyperventilation breathing,

01:41:46.020 | and my lab's actually published on this in a clinical trial,

01:41:48.860 | do it on dry land or don't do it at all.

01:41:51.420 | And if you're going to do deliberate cold exposure,

01:41:54.040 | limit your breathing to slow, deep breaths,

01:41:57.860 | make sure that you're well-supervised

01:42:00.980 | and just stay alive, please.

01:42:03.300 | - Yeah, we didn't incorporate any of the Wim Hof breathing.

01:42:06.220 | We just incorporated the deliberate water,

01:42:09.020 | cold water exposures.

01:42:10.500 | - Cold and temperature generally

01:42:12.140 | is such a potent stimulus.

01:42:13.660 | And it's exciting that people are starting to explore this,

01:42:16.060 | especially the, in my opinion, the sauna work.

01:42:19.340 | One thing I suppose that we should discuss

01:42:21.780 | very briefly before we move on,

01:42:23.080 | since we've been talking about resistance training,

01:42:25.780 | we've been talking about deliberate cold exposure.

01:42:29.060 | There is evidence that doing deliberate cold exposure,

01:42:32.580 | not so much in the form of a cold shower,

01:42:34.100 | but in the form of a submersion up to the neck,

01:42:37.660 | post-strength or resistance training,

01:42:40.020 | say in the four, but probably the eight hours

01:42:42.180 | after resistance training,

01:42:43.220 | because of the attenuation of the inflammatory response,

01:42:45.960 | which sounds like a great thing,

01:42:47.420 | it actually can inhibit some of the strength

01:42:49.380 | and hypertrophy gains that one would otherwise experience.

01:42:52.420 | So if you're going to do deliberate cold exposure,

01:42:55.340 | best to not do it in the eight hours

01:42:57.620 | or even on the same day after resistance training

01:43:01.980 | geared towards developing strength

01:43:03.500 | and hypertrophy increases.

01:43:05.000 | No problem to do it first.

01:43:06.480 | In fact, maybe even some performance enhancing effects

01:43:08.600 | of doing it first.

01:43:09.440 | There's some athletes at Stanford doing that,

01:43:10.820 | but just want to throw that out there.

01:43:12.220 | Is there anything else you want to add to that?

01:43:14.860 | - Which is different from heat exposure,

01:43:16.500 | because heat exposure you want to do afterwards.

01:43:19.020 | - Get the vasodilation.

01:43:19.860 | - Yeah, because it extends that training stimulus

01:43:23.740 | and also the passive dehydration from training

01:43:28.100 | will stimulate greater blood volume improvements.

01:43:31.500 | - Oh, interesting.

01:43:32.620 | So after a good weight training session,

01:43:34.860 | if one has the luxury of doing it,

01:43:36.340 | get into the sauna for-

01:43:38.060 | - Up to 30 minutes.

01:43:39.340 | - Make sure you're hydrating.

01:43:41.200 | - You want slow rehydration

01:43:42.940 | because part of it is that dehydration

01:43:45.660 | and the decrease of oxygen at the level of the kidney

01:43:49.480 | to stimulate more EPO.

01:43:51.340 | So with more red cell production,

01:43:52.820 | you have natural increase in plasma volume.

01:43:55.060 | So it's a blood volume expander.

01:43:56.700 | - Ooh, so now we're getting

01:43:57.620 | into real performance enhancement.

01:43:59.300 | Is this true for men and for women?

01:44:00.700 | - Yep, yep.

01:44:01.860 | - Let's walk through this protocol.

01:44:03.260 | I like this.

01:44:04.820 | This has not been discussed on this podcast.

01:44:06.460 | So somebody does their resistance training,

01:44:11.300 | finishes up, drinks eight or 16 ounces of water

01:44:15.660 | with a little salt in it maybe,

01:44:17.440 | and then hops in the sauna.

01:44:19.320 | - Yep.

01:44:20.160 | - For how long?

01:44:21.580 | - Up to 30 minutes.

01:44:22.860 | - Okay.

01:44:23.700 | - No longer.

01:44:24.520 | - No longer.

01:44:25.360 | - No longer, yeah.

01:44:26.200 | - They'll probably be a little bit thirsty in there.

01:44:28.140 | You're looking for a little low level dehydration.

01:44:30.060 | Is that right?

01:44:31.020 | - Yep.

01:44:31.860 | - Okay.

01:44:32.960 | The ranges that I've seen published in the finished studies

01:44:36.060 | are, as I recall, and I'll double-check these numbers,

01:44:39.020 | 186 degrees Fahrenheit up to about 210 Fahrenheit.

01:44:44.180 | And the higher end only being for those

01:44:48.560 | that are heat adapted.

01:44:50.140 | - Yeah.

01:44:51.160 | - One can cover their head with a towel

01:44:52.580 | and actually feel more comfortable

01:44:54.020 | because the brain is insulated.

01:44:55.260 | This surprises people.

01:44:56.160 | They think putting something on their head

01:44:58.340 | would make it excessively warm.

01:45:00.520 | - Yeah.

01:45:01.360 | - But you actually are protecting your brain

01:45:02.260 | from some of the heat.

01:45:03.300 | - And people will put a towel over it

01:45:04.900 | so that when they breathe it doesn't burn

01:45:07.380 | the inside of their nose and their mouth either.

01:45:10.620 | I'm always like, if you're gonna be in and it's that hot,

01:45:13.300 | just move down a level.

01:45:14.540 | So then--

01:45:16.220 | - Down on the floor?

01:45:17.040 | - Yep.

01:45:18.220 | - And this stimulates the production

01:45:20.920 | of more red blood cells?

01:45:22.380 | - Mm-hmm.

01:45:23.220 | - Okay.

01:45:24.040 | Which then translates to what

01:45:25.620 | in terms of athletic performance?

01:45:27.900 | - You have an increase in your cardiovascular effort.

01:45:31.500 | And because you have a greater amount of blood volumes,

01:45:34.100 | you have greater amount of pretty much blood circulating.

01:45:37.580 | So you have more available for muscle metabolism, heat loss.

01:45:42.580 | So it's akin to going to altitude.

01:45:46.740 | So people will go to altitude

01:45:48.620 | to get that blood volume boost,

01:45:51.260 | but not everyone responds to altitude

01:45:52.940 | 'cause you have responders,

01:45:54.020 | non-responders over responders.

01:45:55.940 | - Okay.

01:45:56.760 | This is why when I go to Colorado,

01:45:57.940 | I'm gasping for air while I do a walk,

01:45:59.940 | but then I come back to sea level and I feel better.

01:46:03.140 | My endurance is better,

01:46:03.980 | but some people might not experience that effect.

01:46:05.980 | - True.

01:46:06.820 | This is, I was telling the guys before we started

01:46:08.380 | that I've been in our sauna at home

01:46:10.620 | in preparation for going to Park City

01:46:12.900 | because I live at a beach town and going to Park City,

01:46:16.300 | I am a significant responder to altitude

01:46:19.420 | and I won't be able to have coherent meetings at altitude

01:46:22.540 | if I am not adapted, so.

01:46:25.140 | - Okay.

01:46:25.980 | - Yeah.

01:46:26.800 | - So this explains why when I've gone to meetings

01:46:28.300 | in Colorado at altitude,

01:46:29.620 | some people can have a drink that first night

01:46:31.420 | and they're perfectly fine,

01:46:32.440 | even though they normally live at sea level

01:46:34.260 | and I'm trying to see the stairs correctly,

01:46:37.020 | even though I don't drink.

01:46:38.380 | - Yep, that would be it.

01:46:40.180 | - Very interesting.

01:46:41.020 | So you can use post-resistance training sauna exposure

01:46:44.260 | to improve performance.

01:46:47.420 | - Yeah.

01:46:48.260 | And you can use it post-cardio as well.

01:46:51.460 | So anything that is giving you that passive dehydration

01:46:54.860 | from training 'cause you're not,

01:46:56.340 | because you will become passively dehydrated

01:46:58.460 | when you're training, right?

01:46:59.380 | You can't keep in as much fluid.

01:47:02.760 | So I'm saying passive as in,

01:47:04.240 | you're not able to stop that dehydration.

01:47:08.080 | And then you go into the sauna

01:47:10.200 | and you are extending that training stimulus

01:47:12.920 | 'cause your heart rate is elevated.

01:47:14.280 | You're putting your body under stress from dehydration

01:47:18.480 | and the body responds in kind of we need more blood volume.

01:47:22.540 | So let's jumpstart that.

01:47:24.880 | - I love it.

01:47:25.700 | Logically watertight and I'm gonna give it a try.

01:47:29.280 | - Yeah.

01:47:30.240 | - What other training tricks, tips

01:47:32.320 | do you have up your sleeve, Dr. Sims?

01:47:34.600 | - What you wanna talk about?

01:47:36.000 | - Do you have any favorites besides that?

01:47:38.760 | I delight in these and I know other people will as well.

01:47:42.100 | Do any come to mind?

01:47:44.200 | I mean, you've taught us about Shashandra,

01:47:46.300 | about post-training sauna exposure to improve performance

01:47:51.200 | by increasing red blood cell count.

01:47:53.120 | Is there anything else that kind of springs to mind?

01:47:54.760 | No pressure.

01:47:56.920 | - I'm a fan of what I call the track stack

01:48:00.240 | that we used to use for track athletes,

01:48:02.880 | but then for really significant high intensity work.

01:48:07.880 | So track stack is kind of the idea

01:48:10.300 | from the old bodybuilding set

01:48:11.780 | where you're taking 200 milligrams of caffeine,

01:48:15.260 | low dose baby aspirin, but then I add beta alanine.

01:48:20.440 | - Used to be ephedrine.

01:48:21.680 | - I know.

01:48:22.520 | - So I'm old enough to remember when they would sell it

01:48:24.720 | as the triple stack with ephedrine,

01:48:27.240 | but some people dropped dead

01:48:28.760 | and they took it off the market.

01:48:30.280 | - Hey, it came back on the market in New Zealand last week.

01:48:32.840 | - Did it really?

01:48:33.660 | - Yeah.

01:48:34.500 | - It gets you going.

01:48:36.320 | - Yes, it does.

01:48:37.160 | - It's speedy.

01:48:38.800 | It's dangerous.

01:48:41.440 | - But the track stack, which has beta alanine

01:48:43.820 | and not ephedrine is really good

01:48:47.400 | at encouraging an extra top end effect

01:48:52.360 | 'cause you're having the caffeine,

01:48:53.560 | you're having a little bit of the blood thin

01:48:56.280 | from the aspirin and then the vasodilatory properties

01:49:00.320 | and the carnosine aspect for muscle contraction

01:49:03.140 | from the beta alanine.

01:49:04.800 | And so like training for gravel races in the top end sprint,

01:49:09.720 | you do a couple of sprint sessions with that

01:49:11.680 | and it's increasing your training stress

01:49:14.120 | during the training.

01:49:14.960 | So your adaptation is to that higher stress.

01:49:18.000 | - Should anything be done in terms of recovery

01:49:20.080 | to make sure that you offset that additional stress?

01:49:23.280 | That's achieved with this track stack.

01:49:25.040 | - Yeah, just making sure that you're not stacking

01:49:29.920 | two days in a row of high intensity work,

01:49:32.320 | like really making sure that you're recovering well

01:49:34.360 | 'cause it is a significant stress on the body.

01:49:37.360 | - What about sleep?

01:49:38.440 | We hear so much these days about the importance of sleep

01:49:40.440 | for mental health, physical health, performance.

01:49:43.080 | I think this is a great thing, a great trend.

01:49:45.840 | Are there female specific requirements for sleep

01:49:50.040 | that vary across the menstrual cycle and or by age

01:49:53.100 | or just generally, do men and women need to think about

01:49:56.400 | the need for sleep differently?

01:49:58.000 | - Yeah, part of it is the obvious.

01:50:01.500 | Like when you're talking about sleep temperature, right?

01:50:04.340 | Women and men have variations in their sleep temperature

01:50:08.360 | and what's optimal.

01:50:09.200 | So looking at that, like you need to create an environment

01:50:12.480 | for you that is cool, comfortable,

01:50:15.440 | which is probably gonna be different from your partner

01:50:17.600 | who might be sharing your bed.

01:50:19.040 | So that becomes a sticky point.

01:50:20.760 | When we talk about the menstrual cycle,

01:50:22.140 | there are definitive changes in sleep architecture.

01:50:25.760 | We're seeing that in around the mid luteal

01:50:30.280 | to the premenstrual.

01:50:32.540 | So you know that about 10 days before your period starts.

01:50:36.300 | Significant change in your slow wave sleep.

01:50:39.280 | There's less of it.

01:50:40.520 | Latency is increased.

01:50:42.220 | So you have a longer time to get to sleep

01:50:44.160 | and you have more light sleep.

01:50:45.560 | So overall, you know, less of that deep recovery sleep.

01:50:49.300 | And this is where women tend to have more

01:50:52.100 | of their mood issues too,

01:50:54.140 | because of estrogens play with serotonin in the brain.

01:50:57.760 | So we really need to nail down our sleep hygiene

01:51:00.500 | in that time period.

01:51:01.780 | So looking at things like L-theanine and apigenin

01:51:07.380 | and looking at your room temperature and the screens

01:51:11.840 | and all the things that you've talked about

01:51:13.780 | for the most part about sleep and sleep hygiene.

01:51:16.340 | Super important.

01:51:17.580 | And then of course, as you get older,

01:51:19.420 | in both men and women, it becomes more difficult to sleep.

01:51:21.980 | But we see a significant issue with insomnia

01:51:25.380 | in women who have really bad hot flushes

01:51:28.060 | and significant menopausal symptoms.

01:51:31.820 | And again, this has to do with lots of the perturbations

01:51:34.580 | from temperatures, night sweats, increased sympathetic load,

01:51:39.020 | not being able to get into a parasympathetic state.

01:51:41.820 | So this is where working with a specific sleep specialist

01:51:44.920 | might come into play.

01:51:46.180 | We can also look at using some adaptogens,

01:51:48.220 | the rhodiola stacked with theanine,

01:51:50.940 | and looking at the cold temperature,

01:51:55.060 | getting people to use the non-sleep deep rest

01:51:57.980 | or yoga nidra or some other kind of meditative property

01:52:01.360 | that they can then access when they're in bed.

01:52:04.220 | So there's a lot of different things

01:52:05.620 | that we have to be aware of.

01:52:06.980 | And again, in that perimenopausal state,

01:52:10.440 | we see that significant change in sleep

01:52:12.540 | and sleep architecture and quality of the sleep,

01:52:15.500 | but men don't have the same thing.

01:52:17.260 | So women have to be a little bit more aligned

01:52:19.660 | with what's happening from a hormonal profile standpoint,

01:52:22.460 | because it does definitively affect serotonin, melatonin,

01:52:26.860 | and sleep architecture because of the interplay

01:52:29.540 | that estrogen has on the brain and the receptors.

01:52:33.100 | - That makes very good sense.

01:52:34.140 | We'll put a link in the show notes captions

01:52:35.900 | to some zero-cost non-sleep deep rest yoga nidras.

01:52:39.080 | We've put out a couple with my voice,

01:52:41.260 | if you prefer another voice.

01:52:43.040 | I'm a big fan of the ones by Kelly Boyes,

01:52:45.500 | who's contributed to the Waking Up app.

01:52:48.780 | It also has terrific non-sleep deep rest yoga nidras

01:52:51.820 | out there, and there are others as well.

01:52:54.140 | You mentioned a few supplements.

01:52:55.900 | Theanine, epigenin, which is chamomile extract.

01:53:00.700 | Maybe let's just have a general conversation

01:53:02.940 | about supplements.

01:53:03.780 | What's your thought on supplements?

01:53:06.020 | How do you place them into the landscape of nutrition?

01:53:08.780 | They are after all supplements, not replacements.

01:53:10.900 | But the word supplements, I believe,

01:53:13.240 | is a little bit misleading

01:53:14.600 | because there are food-based supplements,

01:53:18.320 | like a protein powder.

01:53:20.380 | There are supplements designed to achieve

01:53:21.760 | a specific outcome, and then there are supplements

01:53:23.820 | that are designed to be a more support

01:53:27.080 | for a bunch of things, kind of insurance policy.

01:53:29.600 | What are some of your favorite supplements

01:53:33.600 | in any of those categories, specifically for women,

01:53:36.600 | and perhaps even specifically during certain phases

01:53:39.340 | of the menstrual cycle and/or perimenopause menopause?

01:53:42.280 | I just threw about nine questions at you.

01:53:44.880 | Okay, the number one is creatine.

01:53:47.340 | Creatine for women, doesn't matter what age.

01:53:50.220 | It's really important, we're seeing a lot,

01:53:52.840 | for brain mood and actually gut health.

01:53:57.240 | So five grams of creatine monohydrate per day,

01:54:00.080 | sort of typical? Three to five.

01:54:01.100 | Three to five? Yep.

01:54:02.800 | Preferably, of course, Creapure

01:54:04.360 | 'cause of the way it's produced.

01:54:05.920 | So if you're looking at Creapure,

01:54:07.400 | it's the German company that produces it,

01:54:09.600 | uses a water-based wash to produce the creatine.

01:54:12.880 | Interesting.

01:54:13.720 | Whereas others use an acid-based wash,

01:54:15.880 | and we see a lot of side effects with the acid-based wash.

01:54:18.340 | Like gastric distress. Yeah.

01:54:19.720 | So people are like, "Oh, I'm really bloated,

01:54:21.120 | "and I have nausea and stuff from taking creatine."

01:54:23.200 | I'm like, "Is it Creapure?"

01:54:24.620 | Actually, no, it's like switch to Creapure.

01:54:26.720 | And so they switch, and they're like,

01:54:27.880 | "Oh my gosh, I feel so much better."

01:54:29.400 | Noted. Yeah.

01:54:30.400 | And then vitamin D3, really important,

01:54:35.440 | especially when we're looking at all the information

01:54:39.520 | that's coming out from cardiovascular, muscle, brain,

01:54:42.880 | everything that goes with vitamin D, also with iron.

01:54:46.080 | So vitamin D is really important

01:54:47.720 | for absorbing and maintaining iron stores.

01:54:50.300 | So those are the two big ones, and then-

01:54:53.480 | Sorry, I just want to stop you for a moment.

01:54:55.840 | As it relates to creatine,

01:54:57.720 | I hear two general lines of concern.

01:55:00.720 | One, I hear more often from women.

01:55:03.920 | My understanding is that because creatine

01:55:05.600 | brings water into the muscle,

01:55:07.080 | as well as supporting the phosphocreatine system

01:55:09.320 | of the brain, the water into the muscle component means,

01:55:13.080 | yes, people who take creatine, three to five grams per day,

01:55:18.080 | will gain a few pounds of body weight.

01:55:21.080 | That's solid body weight in the form of water

01:55:24.040 | within the muscle, so solid in air quotes.

01:55:26.320 | It's water, but it's within the muscle.

01:55:28.260 | So they should know that.

01:55:31.480 | It's not a given, though.

01:55:33.660 | - Interesting.

01:55:34.500 | - It's not a given.

01:55:35.320 | There are some women on the lower dose of three

01:55:37.500 | that don't experience the water gain.

01:55:39.460 | - Okay, and this is not bloat, like water,

01:55:42.640 | subcutaneous water.

01:55:44.280 | This is water within the muscles.

01:55:45.960 | So it will be stored within lean tissue.

01:55:49.040 | And then I do hear concerns

01:55:52.200 | about creatine causing hair loss.

01:55:55.560 | My understanding is there is zero evidence for that.

01:55:58.640 | There is a smidgen of evidence

01:56:00.180 | that it might increase dihydrotestosterone levels,

01:56:02.480 | but it's like one study, marginal increase,

01:56:05.320 | and then people linked dihydrotestosterone to hair loss.

01:56:08.560 | And so then the conclusion people drew

01:56:11.040 | was that somehow creatine increases hair loss.

01:56:13.160 | But you're saying zero evidence.

01:56:15.000 | - No evidence.

01:56:16.000 | We see that women who start taking it midlife

01:56:19.920 | are complaining about it,

01:56:21.160 | but it's actually a progestin-driven thing.

01:56:24.220 | We see progesterone and fluctuation of progesterone

01:56:27.400 | can exacerbate any hair loss.

01:56:30.080 | So if women are experiencing that

01:56:31.840 | and they're saying, "Oh, it's creatine.

01:56:33.600 | "I've read all this stuff on creatine."

01:56:35.160 | No, it's not.

01:56:36.400 | - Okay, so we've got creatine D3,

01:56:38.420 | 1,000 IUs per day, 5,000 IUs.

01:56:42.200 | I guess it depends a little bit.

01:56:43.360 | - Yeah.

01:56:44.760 | Being very close to Antarctica

01:56:46.760 | in the Southern Hemisphere in the winter,

01:56:49.440 | very low sunlight exposure,

01:56:52.600 | looking at around the 5,000.

01:56:55.440 | Same with Upper Northern Hemisphere, UK,

01:56:58.360 | that kind of stuff.

01:56:59.360 | The closer you get to the equator, the less you need.

01:57:01.880 | The one concern is like a day here where it's foggy

01:57:04.440 | and it's supposed to be sunny.

01:57:05.520 | And people are like, "Great, I don't have to worry

01:57:09.040 | "about going out in sun exposure."

01:57:10.560 | But then the next day it's bright and sunny.

01:57:12.320 | And they're like, "Ooh, sunscreen."

01:57:14.120 | So they put sunscreen on

01:57:15.200 | and not getting the right sun exposure.

01:57:16.680 | So then again, it is a lifestyle thing.

01:57:18.960 | So basic is two to 5,000.

01:57:21.280 | - Great.

01:57:22.320 | Okay, so we've got creatine, vitamin D3.

01:57:25.040 | What are some of the other supplements

01:57:26.560 | that you take or that you, I don't know if we say suggest,

01:57:30.640 | but that you perhaps suggest women consider?

01:57:35.000 | - Yeah, so protein powder, really good high quality

01:57:38.440 | because the amount of protein that women should be getting

01:57:41.040 | is often difficult to eat.

01:57:43.640 | So again, supplementing, not using it as the mainstay.

01:57:47.560 | That's one to consider.

01:57:50.160 | And then again, I'm about adaptogens.

01:57:53.040 | So looking at the different adaptogens,

01:57:55.400 | ashwagandha is a good one.

01:57:57.000 | Holy basil or tulsi is another one, shishandra.

01:58:00.160 | And then getting into some of your medicinal mushrooms,

01:58:02.520 | lion's mane, reishi.

01:58:04.840 | Those are the two big ones that I look to

01:58:07.940 | and often have women use.

01:58:09.720 | - If these adaptogens blunt cortisol,

01:58:14.800 | because certain ones do like ashwagandha,

01:58:17.160 | which by the way, I do think people should cycle

01:58:19.080 | if they're gonna take it high doses, right?

01:58:21.240 | 'Cause there are some issues with liver.

01:58:23.480 | - And thyroid.

01:58:24.320 | - And thyroid problems if people take ashwagandha

01:58:26.960 | at high doses for too long.

01:58:28.640 | So that's important to note.

01:58:31.760 | But assuming that the adaptogens

01:58:34.240 | are reducing cortisol levels,

01:58:37.520 | in addition to doing other things,

01:58:38.860 | is there a particular time of day or night

01:58:41.340 | that people should consider taking them?

01:58:43.520 | Should they avoid taking it early in the day?

01:58:45.280 | My understanding was that you want a bit of that cortisol

01:58:49.200 | bump early in the day,

01:58:50.320 | but you certainly want cortisol lower later in the day.

01:58:53.040 | - Yep, and I think the problem is people think

01:58:55.940 | that they don't want any cortisol.

01:58:57.560 | And they think--

01:58:58.400 | - That would be bad.

01:58:59.220 | - That would be bad.

01:59:00.060 | They don't understand that the body has fluctuations

01:59:02.320 | of cortisol throughout the day and that's normal.

01:59:05.180 | If we're looking at having issues with sleeping

01:59:07.600 | and that anxiety provoke from that sympathetic drive

01:59:11.540 | and elevation of cortisol,

01:59:13.240 | let it peak in the morning after you're waking up

01:59:16.440 | and look late afternoon, like four o'clock

01:59:19.480 | when it starts to dip, to take your adaptogens then.

01:59:22.560 | 'Cause then it feeds forward to being able to relax more,

01:59:26.120 | which feeds forward to better sleep.

01:59:28.480 | For something like Shoshandra,

01:59:29.600 | where you're looking for that brain focus,

01:59:32.200 | you can have it in the morning.

01:59:33.240 | It doesn't necessarily have as big an impact on cortisol

01:59:37.560 | that you see with something like Tulsi or Ashwagandha.

01:59:41.560 | 'Cause Shoshandra's more stimulatory.

01:59:44.540 | The other two are more calming.

01:59:46.840 | I put some in my morning coffee and then in the afternoon,

01:59:49.620 | when I need to pick me up instead of more caffeine,

01:59:51.760 | I'll use Shoshandra.

01:59:53.160 | 'Cause it gives you that boost without the effects

01:59:55.520 | of caffeine and it doesn't interfere with sleep.

01:59:57.680 | So there's a time and a place to take them.

01:59:59.400 | And yes, some need to be cycled on,

02:00:01.080 | some need to be cycled off.

02:00:02.640 | But I tell women, what are your main symptoms?

02:00:05.820 | What are the things you're looking to control?

02:00:07.760 | And we can look and see what kind of adaptogens we can use

02:00:10.560 | and how we place them.

02:00:12.280 | - What's the story with pregnancy and training?

02:00:15.840 | - Yeah.

02:00:16.680 | - Is there an official word on this?

02:00:20.640 | Assuming a woman knows that she's pregnant

02:00:22.880 | from the very beginning of missing a period

02:00:26.480 | where she's in a position to make decisions

02:00:28.400 | about training or not training,

02:00:30.040 | training at a given intensity or not.

02:00:32.540 | What are your recommendations?

02:00:35.640 | - The human body is really interesting.

02:00:38.160 | And when you get pregnant,

02:00:39.280 | your body tells you what you can do.

02:00:41.680 | So we see that you have a reduction

02:00:43.760 | in your anaerobic capacity on purpose.

02:00:46.220 | Your body's trying to be protective.

02:00:47.760 | You do have an expansion of your blood volume.

02:00:50.360 | So endurance is really good,

02:00:51.960 | but you can't do high intensity.

02:00:53.900 | When we're looking at the general guidelines

02:00:56.940 | that are out there,

02:00:58.360 | they've gotten rid of the heart rate rule.

02:01:00.520 | They are now telling women to be as active as they can be

02:01:04.040 | without creating injury and without trying to make gains.

02:01:09.040 | So that means if you're in the weight room,

02:01:10.860 | you're not looking to improve, you're looking to maintain.

02:01:14.380 | If you're doing cardiovascular work

02:01:16.800 | and you have a specific class that you'd love to go to,

02:01:19.660 | yeah, but don't beat yourself up

02:01:20.960 | that you can't hit that high intensity.

02:01:22.400 | You're going for the social aspect.

02:01:24.400 | You're not trying to gain fitness.

02:01:26.180 | You're trying to maintain.

02:01:27.720 | I think the very worst possible scenario

02:01:30.080 | is someone is super active and stops doing everything

02:01:33.200 | because they're afraid.

02:01:34.480 | 'Cause then they get deconditioned

02:01:35.900 | and then they end up in a worse state

02:01:38.360 | than someone who was sedentary,

02:01:40.360 | who's now encouraged to walk during exercise.

02:01:42.920 | It hasn't been well-researched

02:01:45.280 | because you can't get ethics

02:01:47.000 | to study pregnant women very well.

02:01:49.160 | So we go on a lot on case studies and case study notes.

02:01:53.220 | And the bottom line of it all is you stay active

02:01:56.620 | and you can do resistance training.

02:01:58.340 | You can do all the cardiovascular work

02:02:00.260 | and your body will tell you what you can and can't do.

02:02:03.820 | - I've been asked whether or not pregnant women

02:02:06.900 | can do deliberate cold exposure

02:02:09.460 | probably no fewer than 2,500 times on social media.

02:02:14.380 | And I never have an answer,

02:02:16.020 | but I always default to the cautious answer,

02:02:19.940 | which is please don't until you talk to somebody

02:02:22.520 | who actually has an answer.

02:02:24.120 | Just because it sounds like a very precarious situation,

02:02:26.380 | but in all honesty, I don't know.

02:02:27.980 | I'm just biding time there and just saying,

02:02:30.020 | please go ask somebody

02:02:30.900 | who can give you a definitive answer.

02:02:32.540 | - Yeah, so we see women who have a high risk for miscarriage

02:02:36.380 | that anything that they do that's incredibly stressful

02:02:39.020 | for the first 12 to 20 weeks,

02:02:41.200 | will put them at a higher risk for it.

02:02:45.240 | So while being very cautious, especially with cold,

02:02:48.760 | because we know that there are so many different nuances,

02:02:52.140 | doing something like hot yoga when you're pregnant

02:02:54.980 | is not, there is research, so it's not detrimental.

02:02:58.500 | - Really? - Yeah.

02:02:59.860 | Because when we're looking at blood flow diversion that way,

02:03:03.500 | when you have slight hypoxia to the placenta and to the baby,

02:03:08.500 | there is a rebound effect that increases the vascularization

02:03:14.540 | so that the baby has better nutrients.

02:03:17.520 | We see this also with exercise and exercise intensities.

02:03:21.120 | This is why people are now saying

02:03:22.500 | you need to have some kind of blood flow change

02:03:25.080 | and increase in core temperature

02:03:26.960 | to create these vascular effects within the placenta

02:03:30.520 | to improve nutrient and nutrient delivery

02:03:33.960 | to the developing fetus.

02:03:36.300 | So heat's good.

02:03:37.440 | Cold, I'm not so sure of.

02:03:39.480 | - But probably not extreme heat.

02:03:41.100 | - Not extreme heat.

02:03:42.320 | So that's why I mean like hot yoga

02:03:43.760 | is not going to the sauna.

02:03:45.580 | Hot yoga sits around 40 degrees Celsius.

02:03:48.680 | So what is that?

02:03:49.520 | Just around 100 degrees Fahrenheit.

02:03:52.200 | And in that situation, if you're feeling too hot,

02:03:55.680 | you leave, you lie down on the floor,

02:03:58.200 | don't try to stay for the whole class,

02:04:00.880 | but it's not going to be detrimental

02:04:03.280 | unless you're pushing yourself too much.

02:04:05.460 | Again, everything in moderation,

02:04:06.800 | especially when you're pregnant.

02:04:08.360 | - It's almost the inverse of what we know for males,

02:04:10.560 | which is if men want to conceive,

02:04:14.000 | they should avoid the sauna

02:04:16.740 | because we know that heat is detrimental

02:04:18.640 | to sperm viability in a real way.

02:04:22.240 | So much so that I tell guys

02:04:25.080 | if they are trying to get their partner pregnant

02:04:27.420 | that they should bring an ice pack into the sauna.

02:04:29.560 | They should insulate that ice pack.

02:04:31.200 | Don't put it directly on the scrotum for other reasons,

02:04:34.000 | but that the effects of heat,

02:04:36.700 | the negative effects of heat on sperm are real.

02:04:39.580 | But there's also an interesting, it's not just a trend.

02:04:41.880 | There's actually some research showing

02:04:43.200 | that cooling the testicles

02:04:47.360 | leads to increases in testosterone,

02:04:50.720 | which is on the face of it kind of counterintuitive

02:04:55.480 | because it turns out that it's about the vasoconstriction

02:04:59.840 | causing the subsequent increase in blood flow,

02:05:04.320 | increased vasodilation.

02:05:05.600 | So the inverse of what you just said,

02:05:07.440 | which is that during the heating process,

02:05:09.620 | the hypoxia induces more vascularization of the placenta.

02:05:13.620 | So when talking about temperature,

02:05:15.740 | one always has to think about the surface of the body

02:05:17.780 | versus the brain response, as we talked about earlier.

02:05:19.940 | And then what's happening during the deliberate heat

02:05:22.100 | or deliberate cold versus what's happening

02:05:23.940 | after the deliberate heat or deliberate cold, right?

02:05:27.100 | Everything in biology is a process, not an event.

02:05:29.580 | - Yeah, and I should make full disclosure.

02:05:31.220 | I started as an environmental exercise physiologist

02:05:34.020 | and my PhD was all in heat and heat research.

02:05:37.180 | So I'm a little bit biased towards heat,

02:05:40.100 | but I've done a significant amount of research

02:05:43.140 | in the hot and cold.

02:05:44.340 | - Thank you for the disclosure.

02:05:45.580 | I see it more as an indication of real knowledge.

02:05:49.800 | So thank you.

02:05:50.640 | This is an aspect of your training I knew a little bit about

02:05:52.740 | based on your publications,

02:05:53.740 | but I didn't realize the depth of knowledge.

02:05:55.200 | So we're all benefiting here,

02:05:56.380 | including this earlier protocol of sauna post-training.

02:05:59.740 | You can bet a lot of people

02:06:00.640 | are gonna start incorporating that.

02:06:02.020 | I think we might need to name that.

02:06:03.660 | I've done this from time to time, named protocols,

02:06:06.300 | because people are reluctant to name them after themselves.

02:06:08.420 | Maybe we call that the SIMS protocol

02:06:11.820 | or something like that.

02:06:13.020 | (laughs)

02:06:14.420 | Anyway, your discomfort will be other people's benefit.

02:06:17.460 | Now seems like a good time

02:06:20.420 | to address some specific questions

02:06:22.860 | related to the age brackets that you mentioned earlier.

02:06:27.860 | In anticipation of sitting down with you today,

02:06:30.180 | I asked some different women that I know,

02:06:32.860 | if you could ask the world expert

02:06:34.780 | in exercise physiology, hormones, and nutrition, et cetera,

02:06:39.780 | as it relates to women, one question, what would it be?

02:06:42.660 | And one of the most common questions I got

02:06:44.660 | in the 50 and up category was,

02:06:48.540 | what is the most efficient way

02:06:50.620 | for a woman older than 50 to train

02:06:53.220 | for the maximum healthspan and lifespan benefits?

02:06:57.140 | - I love this question 'cause I get it all the time.

02:06:59.460 | We have to turn our brains away from everything

02:07:02.420 | that's been predicated before to this point.

02:07:05.380 | So if we're looking for longevity

02:07:07.020 | and we're looking at what we want to do

02:07:08.540 | when we're 80 or 90, we want to be independently living,

02:07:11.380 | we want to have good proprioception balance,

02:07:13.620 | we want to have good bones, and we want to be strong.

02:07:16.840 | So this is where we look at 10 minutes,

02:07:19.500 | three times a week, jump training.

02:07:21.680 | So this isn't your landing softly in our knees.

02:07:24.640 | This is like impact in the skeletal system.

02:07:27.960 | A colleague and friend of mine, Tracy Klissel,

02:07:30.980 | did a PhD and post, not a post-doc,

02:07:35.260 | but post-research on this and is developing an app on it

02:07:39.100 | to show women how to jump to improve bone mineral density.

02:07:42.460 | Over the course of four months of this type of training,

02:07:45.300 | people have gone from being osteopeniac

02:07:49.700 | to normal bone density.

02:07:51.140 | So it's a different type of stress.

02:07:53.200 | So if your concern is that,

02:07:54.460 | which a lot of women do have a concern

02:07:56.700 | 'cause they lose about 1/3 of their bone mass

02:07:59.180 | at the onset of menopause.

02:08:01.420 | - Wow. - Yeah.

02:08:02.380 | Significant amount. - 1/3?

02:08:03.420 | - Yeah.

02:08:04.340 | - Goodness gracious.

02:08:05.180 | - If you don't do something as an intervention.

02:08:06.860 | So we see a lot of women are like,

02:08:08.500 | "Oh, I'm going to go on menopause hormone therapy

02:08:11.260 | "to stop bone loss."

02:08:14.420 | Yeah, it can be a treatment,

02:08:15.580 | but I always look at an external stress

02:08:18.260 | that we can put on the body

02:08:19.380 | that's gonna invoke a change without pharmaceuticals.

02:08:22.880 | So jump training, heavy resistance training,

02:08:26.460 | and sprint interval training.

02:08:27.900 | Those are the three key things.

02:08:30.020 | And from a training standpoint,

02:08:32.140 | and then from a nutrition standpoint, getting protein.

02:08:35.420 | Protein is so important.

02:08:37.100 | When you start telling women they need to look at

02:08:39.300 | around one to 1.1 grams per pound,

02:08:43.420 | which is around that two to 2.3 grams per kilo per day,

02:08:47.380 | they're like, "Whoa, that's a lot of protein."

02:08:49.540 | It is because we haven't been conditioned to eat it,

02:08:52.380 | but reality- - It's a few scrambled eggs.

02:08:53.900 | - Yeah. - It's a chicken breast

02:08:54.900 | at lunch. - Yeah.

02:08:55.740 | - It's a small steak at dinner.

02:08:57.300 | - Yeah. - Plus other things.

02:08:58.460 | - Right, exactly.

02:08:59.300 | And it doesn't all have to be animal products.

02:09:00.980 | I mean, you're looking at all the different beans

02:09:02.500 | and things that you can put together,

02:09:04.100 | and that's the other big thing,

02:09:05.460 | that in order to build the muscle

02:09:07.580 | and to keep the body composition in a state

02:09:10.500 | that we want it to keep going for longevity,

02:09:13.420 | those are the big rocks.

02:09:15.140 | The sprint interval training,

02:09:16.340 | the heavy resistance training,

02:09:17.780 | the jump training, and the protein.

02:09:20.060 | - I'm thinking about this,

02:09:21.020 | and I'm thinking about my mother who's 79 years old.

02:09:24.100 | She'll be 80 at the end of June and is in good health,

02:09:28.300 | walks a lot, gardens, does some yoga,

02:09:30.500 | but does none of the things that you're describing.

02:09:33.060 | So mom, please, I'm gonna send her to listen to this.

02:09:36.060 | - I got my mom to switch.

02:09:37.900 | - In the same vein,

02:09:40.140 | what about the women out there age 20 to,

02:09:45.340 | maybe we make it the 20 to 40 bracket.

02:09:48.340 | And if we need to divide that more finely, we can.

02:09:52.320 | What is the most efficient way for them to train

02:09:54.680 | for health, vigor, and longevity?

02:09:57.520 | - Making things fun for the most part.

02:10:01.200 | I don't want people to think that it's a chore.

02:10:02.920 | So if you're someone who's been told you need to run

02:10:05.280 | and you hate running, then don't run.

02:10:07.520 | That's common sense.

02:10:08.720 | And I say that because I see little kids

02:10:11.440 | in non-US countries that have to run across country.

02:10:15.960 | And you see these kids when they're six years old

02:10:19.320 | and they're all running around the field,

02:10:20.720 | and they're the kids that hate running

02:10:22.320 | that aren't natural runners.

02:10:23.280 | And then they hate physical activity

02:10:24.560 | for the rest of their life.

02:10:26.000 | So I put that in, like when you are exercising,

02:10:28.840 | you wanna find something that you find fun.

02:10:31.200 | When you're in your 20s to 40s,

02:10:32.720 | you have more room to get away with things

02:10:35.320 | that might not be optimal for you

02:10:37.500 | when you start to get older.

02:10:39.580 | Big rock again is resistance training.

02:10:41.640 | It doesn't have to be heavy resistance training.

02:10:43.560 | Like I said earlier, to failure, you're periodizing.

02:10:46.200 | If you wanna do a block of Olympic lifting, go for it.

02:10:49.120 | If you're like, I'm not comfortable

02:10:50.540 | doing that kind of lifting,

02:10:51.720 | I wanna do more machine stuff, great.

02:10:54.360 | But we wanna make sure that you're changing it up

02:10:56.080 | all the time to keep things moving and shaking

02:10:58.980 | with regards to strength and hypertrophy.

02:11:01.600 | And then it becomes more of,

02:11:03.700 | are you training for something that's endurance?

02:11:05.680 | Are you looking for just longevity for brain health?

02:11:09.460 | We need to have some lactate production.

02:11:12.120 | Because women, as I said at the beginning of the podcast,

02:11:14.680 | are more oxidative.

02:11:15.920 | We don't have as many of those glycolytic fibers.

02:11:18.280 | So what we're finding in older research

02:11:20.160 | is that there's a misstep in brain lactate metabolism.

02:11:24.060 | Because the brain hasn't been exposed to it,

02:11:26.120 | especially for looking at women who are being studied now,

02:11:28.560 | it hasn't been in a societal context

02:11:31.160 | to do that kind of work.

02:11:33.100 | The younger we are and the more that we can keep

02:11:35.440 | our glycolytic fibers going by doing high intensity work,

02:11:39.420 | the more we're exposing our brain to lactate,

02:11:42.100 | the better we see fast forward

02:11:43.960 | to attenuating cognitive decline

02:11:46.120 | and reducing the plaque development of Alzheimer's.

02:11:49.560 | This is why women who are in their 40s plus,

02:11:51.740 | I want them to do the sprint and the high intensity work

02:11:54.260 | for that lactate production.

02:11:55.880 | Start early, because then you can take

02:11:58.280 | some of those type two B fibers

02:12:00.020 | that could either go more aerobic or anaerobic

02:12:02.400 | and make them more anaerobic.

02:12:04.120 | So those are the two big things for women who are younger.

02:12:08.080 | And then you can play around with the other things

02:12:10.360 | if you want to be an ultra endurance athlete.

02:12:13.260 | Yeah, not really ideal, but yeah,

02:12:15.840 | you can do that, that's fine, you'll recover well.

02:12:18.840 | - Now, forgive me because you've said it several times

02:12:21.040 | throughout today's discussion,

02:12:22.280 | but I really want to drive home a key point

02:12:24.560 | that I think for most people, men and women,

02:12:28.400 | is not obvious, but is really important.

02:12:31.560 | When you say high intensity,

02:12:33.520 | you don't mean a class or a run

02:12:38.520 | where you're drenched in sweat

02:12:40.680 | and gasping for air at the end, necessarily.

02:12:44.000 | Let's disambiguate high intensity

02:12:46.360 | from what most people think of high intensity,

02:12:48.400 | which is a really hard workout,

02:12:50.120 | a tough class where they had me moving the whole time,

02:12:53.080 | doing a circuit, et cetera.

02:12:54.920 | What is the appropriate high intensity workout look like?

02:12:58.360 | - Okay, so if I talk about

02:13:01.240 | true high intensity interval training,

02:13:03.800 | if you're a runner, it's going to the track

02:13:05.560 | and doing sets of 400 to 800s.

02:13:08.040 | - Okay, so 400, a lap.

02:13:10.560 | - Yep. - 800, two laps.

02:13:12.720 | So you're looking at between a minute and four minutes

02:13:16.920 | of hard work at 80% or more with variable recovery.

02:13:21.680 | So that's why I use a track as an example.

02:13:23.920 | So if you do one lap and you're like,

02:13:26.120 | I'm going to walk half a lap and then do it again,

02:13:28.440 | that's adequate recovery.

02:13:29.680 | - Pretty tough. - Yeah, it's hard.

02:13:31.640 | But it's not like you're going to be there for 90 minutes

02:13:33.640 | doing as many 400s as you can.

02:13:35.720 | Because you have that variable recovery,

02:13:37.440 | it might take a half an hour to 40 minutes max,

02:13:40.360 | and then you're gassed out, you can't do it anymore.

02:13:43.440 | If we're looking at a gym situation,

02:13:45.980 | I like to look at something like every minute on the minute,

02:13:50.200 | where you might be doing 10 deadlifts

02:13:54.160 | at moderate intensity weight.

02:13:56.040 | - 10 repetitions. - Yeah.

02:13:57.960 | So it takes you 50 seconds to complete that.

02:14:00.600 | Then you have 10 seconds to move to the next exercise

02:14:03.120 | that might be thrusters.

02:14:04.640 | So, you know, a squat clean thruster.

02:14:07.160 | So it's a squat, pulling the weight up overhead.

02:14:09.840 | So you're doing maybe eight of those in that minute,

02:14:13.280 | and you might have 10 second recovery.

02:14:15.100 | You go to the next exercise that might be kettlebell swings,

02:14:20.100 | and you're doing explosive kettlebell swings,

02:14:22.760 | and you'll finish, you know, 10 seconds to go.

02:14:26.260 | You go to the fourth exercise, I don't know,

02:14:28.680 | toes to bar or some other kind of V-up,

02:14:30.680 | some other high intensity.

02:14:32.440 | And then you have one minute completely off.

02:14:34.840 | So you've had four minutes of really heavy work

02:14:37.260 | with maybe 10 seconds to move to the next exercise,

02:14:40.240 | one minute completely off,

02:14:41.760 | and then you repeat that three times.

02:14:43.640 | - And this is high intensity interval training.

02:14:45.500 | This is not what you would consider resistance training

02:14:47.760 | for sake of building muscle or strength.

02:14:49.520 | - Correct, this is the cardio. - You're using these loads,

02:14:51.320 | these machines, the pike, you know, hanging from the bar

02:14:54.720 | and bringing your knees up or L-sit or something

02:14:56.520 | as a tool to get the heart rate up continually.

02:14:59.880 | - Yep, yep. - Very different

02:15:01.400 | than resistance training

02:15:02.960 | the way most people think about it.

02:15:04.240 | - Correct, so this is the cardiovascular

02:15:06.360 | high intensity interval training.

02:15:07.980 | And the subset of that is sprint interval training.

02:15:11.320 | And this is something that's really, really hard

02:15:13.580 | and people don't get it.

02:15:14.420 | I don't necessarily mean running.

02:15:16.500 | It can be whatever mode of activity,

02:15:18.880 | but it's 30 seconds or less as hard as you can go.

02:15:22.340 | So this is your nine or 10

02:15:24.140 | on your rating of perceived exertion, 110%, it's max effort.

02:15:28.260 | - On the rower, on the Airdyne bike.

02:15:30.500 | - Yeah. - Running if you like.

02:15:32.020 | - Yeah, any of those things. - The skier, yeah.

02:15:34.460 | - Battle ropes, battle ropes are big.

02:15:36.860 | - So 30 seconds all out, then rest, what?

02:15:39.080 | 10, 15 seconds, repeat? - No, no.

02:15:41.460 | You want to, 'cause now we're looking at that top end

02:15:44.660 | where we want regeneration of your ATP, you know,

02:15:49.160 | all of that system and central nervous system recovery.

02:15:53.060 | So this is 30 seconds all out.

02:15:55.700 | It can be two or three minutes of recovery.

02:15:57.500 | - Oh, nice. - 'Cause I'm not looking

02:15:58.740 | at Tabata where you're 20 seconds on, 20 seconds off

02:16:01.620 | because that's not the intensity we want.

02:16:03.820 | We want you to go all out and recover well enough

02:16:07.400 | to be able to go all out again.

02:16:09.660 | You're not leaving anything in the tank.

02:16:12.020 | So those are what I mean by high intensity interval training

02:16:15.580 | or when you're looking at polarizing

02:16:17.800 | your cardiovascular work, that's the top end.

02:16:20.340 | Those are the two examples of your top end.

02:16:22.540 | And then your recovery is that long, slow walking

02:16:26.060 | on another day where you're not going and doing a tempo run.

02:16:29.060 | You're not doing a 5K easy jog

02:16:31.500 | 'cause that puts you in that moderate intensity.

02:16:33.580 | - And if I heard you correctly earlier,

02:16:35.500 | you are suggesting most women do one or two days

02:16:39.460 | of high intensity interval training

02:16:41.780 | plus three to four days of resistance training

02:16:45.260 | for sake of building strength and muscle,

02:16:47.060 | which looks very different.

02:16:48.180 | It's more warm up, do a couple work sets,

02:16:53.180 | you know, two to four work sets of, you know,

02:16:56.340 | an overhead press, two or four work sets

02:16:58.360 | of maybe a barbell curl, two or four sets of some dips

02:17:01.200 | or whatever one's, you know, personal choices.

02:17:04.920 | - Yeah, yeah, yeah.

02:17:05.760 | - Okay, got it.

02:17:07.260 | Very different, far and away different

02:17:11.400 | than what most people, men or women are doing out there,

02:17:14.700 | which is a lot of Stairmaster treadmill jogging,

02:17:19.640 | maybe some lifting for hypertrophy.

02:17:22.320 | - Because I look at the general consensus

02:17:24.360 | of what's out there in the fitness world

02:17:25.820 | is all based on aesthetics and body composition.

02:17:29.320 | So people have this mentality of,

02:17:31.360 | I need to be hypertrophy to get swole,

02:17:33.820 | and I need to do long, slow stuff on the cardio machine

02:17:36.380 | to lose body fat, but that isn't what we're after.

02:17:40.800 | We're after, let's create really strong external stress

02:17:45.500 | to create adaptations, not only from a neural

02:17:48.240 | and a brain standpoint that's understanding it,

02:17:50.720 | but also feeding down to metabolic change.

02:17:53.960 | Because if you have a really significant high stress,

02:17:57.020 | we see epigenetic changes within the muscle

02:17:59.240 | that increase the amount of what we call

02:18:01.040 | the GLUT4 gates, so the proteins that open up

02:18:04.240 | that allow carbohydrate to come in without insulin.

02:18:07.200 | So we're expanding that acute glucose uptake

02:18:11.440 | through an epigenetic change.

02:18:13.320 | The other thing that it does is it causes

02:18:15.320 | an acute inflammatory response

02:18:17.580 | that your body learns to overcome,

02:18:19.000 | and it's really important for women to do that.

02:18:22.000 | Because as we start to lose estrogen,

02:18:24.240 | we lose a significant anti-inflammatory agent.

02:18:28.000 | So this is why we see that increase in the visceral fat,

02:18:31.080 | especially when we're hitting your mid 40s onwards,

02:18:34.880 | is because now you have this increase in free fatty acids

02:18:38.280 | and the inability for inflammation to come down.

02:18:42.200 | So the muscle cell is going,

02:18:43.880 | "Hmm, I don't know what to do with this."

02:18:45.400 | So it gets circulated to the liver,

02:18:47.480 | and the liver stores it as visceral fat.

02:18:50.040 | Whereas if you do that high intensity work,

02:18:52.060 | it creates that change within the muscle to understand,

02:18:55.000 | pull that in, let's use it,

02:18:57.640 | let's also bring more carbohydrate in and more glucose in,

02:19:00.240 | use that, which helps use free fatty acids.

02:19:03.920 | And it also creates a significant anti-inflammatory response

02:19:08.440 | at the level of the mitochondria and within the cell itself,

02:19:12.320 | which is what estrogen used to do.

02:19:14.400 | So if we look at those external stresses,

02:19:16.640 | it's not about body comp and aesthetics per se,

02:19:20.320 | it's about the molecular changes that we want to invoke

02:19:23.400 | to get that body composition and the brain health

02:19:26.500 | that allow us to be 80 or 90 and independently living.

02:19:30.840 | - And in terms of nutrition,

02:19:32.040 | you mentioned women should shoot for 1.1, 1.2 grams

02:19:37.040 | of quality protein per pound of body weight.

02:19:40.980 | What other types of foods do you like to see women ingesting?

02:19:46.880 | So are you a fan of fruit?

02:19:49.560 | - Yeah.

02:19:50.400 | - Great, well, these days you sort of have to ask

02:19:52.320 | in these circles, vegetables, fiber is important.

02:19:56.480 | - Yeah, absolutely.

02:19:57.920 | - And then in terms of starches to replace glycogen,

02:20:02.240 | especially if people are doing

02:20:03.440 | these high-intensity interval training sessions

02:20:05.320 | and the resistance training, what are your preferred sources?

02:20:10.040 | - Depends on who I'm working with.

02:20:12.120 | I have some people who love Cocoa Pops and kid cereal.

02:20:15.800 | - Ooh, I cringe at that stuff,

02:20:17.960 | but I prefer rice and oatmeal

02:20:20.440 | and I like a really good sourdough bread

02:20:22.840 | with butter or olive oil.

02:20:24.320 | - Yeah.

02:20:25.160 | - I'm guilty of that.

02:20:25.980 | - But there are some people

02:20:26.820 | who like the ultra-processed stuff.

02:20:28.000 | So I'm like, okay, if you really, really need it,

02:20:30.240 | then you can put it on top of your yogurt

02:20:32.560 | after training as part of your carbohydrate uptake.

02:20:34.920 | It's the only time.

02:20:35.760 | - Because GLUT4 levels are so high,

02:20:37.320 | you're basically pulling everything into glycogen

02:20:39.040 | at that point anyway.

02:20:40.080 | - But ideally, carbs are all the different

02:20:45.920 | colorful fruit and veg.

02:20:47.560 | And if we're looking at sweet potatoes

02:20:50.080 | or kumara if you're from other parts of the world,

02:20:53.440 | yams, all those kinds of things,

02:20:56.240 | sprouted bread, fantastic, quinoa, amaranth,

02:20:59.800 | all of those different types of things.

02:21:02.040 | It's just staying away from the ultra-processed.

02:21:04.960 | And when we look at women,

02:21:06.440 | it's really important to have a very significant diversity

02:21:09.760 | in the gut microbiome.

02:21:11.120 | So we see there's a definitive decrease

02:21:13.200 | when we start to have hormonal shifts

02:21:15.320 | because of the way the gut bugs help deconjugate

02:21:18.520 | or unwrap some of our hormones

02:21:20.400 | and shoot them back out in the circulation.

02:21:22.780 | So as much fiber, colorful fruit and veg as you can,

02:21:26.720 | but also it's the 80/20 rule, right?

02:21:28.920 | 80% of the time you're spot on, 20% is life

02:21:32.120 | 'cause otherwise, where do we get our chocolate

02:21:33.720 | and our whiskey?

02:21:35.240 | - And there's some data that chocolate is good for us.

02:21:38.080 | - It is.

02:21:38.920 | - Especially the low sugar, dark chocolates.

02:21:40.720 | - I look at how it makes you feel, it makes you feel good.

02:21:43.920 | - Right.

02:21:44.760 | - Yeah.

02:21:45.600 | - Yeah, one has to live.

02:21:46.800 | - Yeah.

02:21:47.920 | And fats, where do you like to see women

02:21:51.120 | get their fats from?

02:21:53.240 | - Again, I'll do a full disclosure.

02:21:54.640 | I have been vegan since I was in high school

02:21:58.240 | because of an incident of a field trip

02:22:00.520 | to a pig slaughterhouse and driving down the five,

02:22:03.640 | but that's my own preference.

02:22:05.440 | So when we're looking at fats,

02:22:07.840 | it can be from a lot of different sources.

02:22:10.600 | I prefer women to have most their fats

02:22:13.000 | from plant-based stuff, not because I am plant-based,

02:22:15.480 | but because of the effect it has on the body.

02:22:17.600 | But there is a time and a place for animal fats too.

02:22:20.880 | The whole fear mongering of saturated fatty acids

02:22:24.440 | from dairy has been disproven.

02:22:26.600 | So if we're looking at what kinds of fats

02:22:28.800 | you want a conglomerate,

02:22:30.240 | but you want most of them to come from whole food,

02:22:33.040 | plant-based, not from ultra-processed.

02:22:35.960 | And then of course you're reaching for some real butter,

02:22:39.200 | you're reaching for some 4% fat yogurt

02:22:42.640 | or something like that to compliment your avocados,

02:22:45.920 | your nuts, your seeds, and your olive oils.

02:22:48.280 | - That all sounds very rational

02:22:50.800 | and delicious in my opinion.

02:22:52.720 | - Yeah, it's too common sense.

02:22:54.760 | People don't do it.

02:22:55.800 | - I think if people hear it from you, they'll do it.

02:23:00.800 | I think people just need to hear it

02:23:02.240 | in the context of a non-diet context.

02:23:06.040 | And you've done an amazing job today

02:23:07.760 | of explaining how nutrition fuels training,

02:23:10.040 | training fuels changes at the level of the muscle,

02:23:13.040 | the liver, et cetera, that allow one to ingest more fuel.

02:23:16.800 | In fact, a lot of what I'm hearing

02:23:18.400 | is that women should probably ingest more quality fuels

02:23:20.800 | in order to offset these cortisol spikes

02:23:23.160 | and feel better while training and to train more,

02:23:25.920 | which everyone agrees,

02:23:27.560 | provided it's done properly is great for us.

02:23:30.000 | Kind of a fun, hopefully fun question for you.

02:23:33.640 | If you had a magic wand

02:23:35.320 | and you could get all the women on earth now

02:23:39.040 | and going forward to make a change or changes,

02:23:42.920 | you don't have to pick just one,

02:23:44.400 | in terms of nutrition,

02:23:46.520 | how they think about their hormone cycle,

02:23:48.840 | exercise, health span, lifespan, what would it be?

02:23:52.340 | - I think I would have everyone understand

02:23:56.600 | their intrinsic selves

02:23:58.640 | because we have been inundated so much

02:24:01.080 | with sociocultural rhetoric and so much external noise

02:24:05.160 | that women have forgotten what it means

02:24:06.800 | to listen to themselves and their bodies.

02:24:09.360 | I mean, that's the one thing

02:24:10.300 | that I have to reteach women to do so often.

02:24:13.500 | So if I could have a magic wand

02:24:15.640 | and have every woman understand

02:24:17.800 | what their bodies are saying

02:24:19.380 | and what their cycles are saying,

02:24:21.040 | and perimenopause is normal,

02:24:23.760 | everyone's gonna go through it

02:24:24.960 | if you have had a menstrual cycle,

02:24:27.520 | just to intrinsically understand what their body is,

02:24:30.560 | so then they have the tool

02:24:32.400 | to be able to implement external stressors

02:24:34.660 | that's gonna be beneficial for them.

02:24:37.460 | - Well, Dr. Stacy Sims,

02:24:40.360 | this has been tremendously educational for me

02:24:42.520 | and I know for everybody listening and/or watching,

02:24:45.800 | you've taken us on an amazing tour

02:24:47.640 | of the best ways to train with cardiovascular training

02:24:50.960 | and resistance training,

02:24:52.900 | those tailored specifically for women,

02:24:56.200 | as well as touching into some protocols

02:24:57.720 | for both men and women that are immensely powerful.

02:25:00.960 | Talked a lot about the menstrual cycle.

02:25:02.560 | I get asked about the menstrual cycle

02:25:04.760 | and how it relates to training

02:25:05.840 | and vice versa so many times,

02:25:08.160 | and thank you for providing clear, actionable answers.

02:25:12.280 | And you've also educated us on caffeine supplements,

02:25:16.860 | including revealing some supplements

02:25:19.060 | that I didn't know existed,

02:25:20.040 | which is not a common occurrence for me.

02:25:23.400 | - Yay, I win.

02:25:24.240 | - And many wins, many, many wins, thanks to you,

02:25:27.520 | and on and on.

02:25:28.400 | So just such a rich data set here

02:25:31.520 | presented with such clarity and in an actionable way.

02:25:35.740 | So on behalf of myself and everyone listening and watching,

02:25:38.740 | I just wanna say thank you.

02:25:40.480 | I know you've come a very long way

02:25:41.960 | from the other side of the equator, not just to see us,

02:25:44.240 | but given that your time is so precious

02:25:47.080 | that you've come to visit us

02:25:48.200 | and share with us your knowledge,

02:25:49.360 | I just wanna say a really deep, heartfelt thank you.

02:25:53.020 | - Yeah, thanks for having me.

02:25:54.040 | It's been fun.

02:25:54.880 | - Yeah, we'll have to have you back again.

02:25:56.040 | Maybe we'll come to New Zealand.

02:25:57.360 | - You should come down.

02:25:58.200 | - All right. - Yeah, definitely.

02:25:59.520 | - Thank you.

02:26:00.360 | Thank you for joining me for today's discussion

02:26:02.400 | with Dr. Stacey Sims.

02:26:03.920 | To learn more about her work,

02:26:05.120 | please see the links in our show note captions.

02:26:07.660 | If you're learning from and/or enjoying this podcast,

02:26:10.080 | please subscribe to our YouTube channel.

02:26:12.140 | Please also subscribe to the podcast

02:26:13.880 | on both Spotify and Apple.

02:26:15.500 | That's a terrific zero-cost way to support us.

02:26:17.960 | And on both Spotify and Apple,

02:26:19.280 | you can leave us up to a five-star review.

02:26:21.440 | Please also check out the sponsors that I mentioned

02:26:23.420 | at the beginning and throughout today's episode.

02:26:25.720 | That's the best way to support this podcast.

02:26:28.160 | If you have questions for me or comments about the podcast

02:26:31.080 | or topics or guests you'd like me to consider

02:26:32.900 | for the "Huberman Lab" podcast,

02:26:34.440 | please put those in the comments section on YouTube.

02:26:36.960 | I do read all the comments.

02:26:38.800 | For those of you that haven't heard,

02:26:39.940 | I have a new book coming out.

02:26:41.140 | It's my very first book.

02:26:42.760 | It's entitled "Protocols,

02:26:44.160 | an Operating Manual for the Human Body."

02:26:46.320 | This is a book that I've been working on

02:26:47.480 | for more than five years,

02:26:48.640 | and that's based on more than 30 years

02:26:50.960 | of research and experience.

02:26:52.520 | And it covers protocols for everything from sleep,

02:26:55.560 | to exercise, to stress control,

02:26:58.060 | protocols related to focus and motivation.

02:27:00.520 | And of course, I provide the scientific substantiation

02:27:03.880 | for the protocols that are included.

02:27:05.960 | The book is now available by presale at protocolsbook.com.

02:27:09.860 | There you can find links to various vendors.

02:27:12.240 | You can pick the one that you like best.

02:27:14.000 | Again, the book is called "Protocols,

02:27:15.760 | an Operating Manual for the Human Body."

02:27:18.360 | If you're not already following me on social media,

02:27:20.480 | I am Huberman Lab on all social media channels.

02:27:23.360 | So that's Instagram, X, formerly known as Twitter,

02:27:26.360 | Threads, LinkedIn, and Facebook.

02:27:28.600 | And on all those platforms,

02:27:30.080 | I discuss science and science-related tools,

02:27:32.240 | some of which overlap with the contents

02:27:33.740 | of the Huberman Lab podcast,

02:27:35.160 | but much of which is distinct from the contents

02:27:37.320 | of the Huberman Lab podcast.

02:27:38.820 | Again, that's Huberman Lab on all social media channels.

02:27:42.180 | If you haven't already subscribed

02:27:43.420 | to our Neural Network Newsletter,

02:27:45.440 | our Neural Network Newsletter

02:27:46.840 | is a zero-cost monthly newsletter

02:27:48.520 | that includes podcast summaries,

02:27:50.400 | as well as protocols in the form of brief PDFs

02:27:53.040 | of one to three pages,

02:27:54.440 | where I spell out the specific do's,

02:27:56.320 | and in some cases do nots,

02:27:57.560 | but mostly do's related to things like

02:27:59.520 | how to optimize your sleep,

02:28:01.120 | how to regulate your dopamine levels.

02:28:03.160 | There's a protocol for neuroplasticity and learning,

02:28:06.120 | as well as protocols for fitness,

02:28:08.280 | which we call the Foundational Fitness Protocol,

02:28:10.120 | includes everything, sets, reps, cardiovascular training.

02:28:12.620 | Again, all available, completely zero cost.

02:28:14.840 | You simply go to HubermanLab.com,

02:28:17.040 | go to the menu tab,

02:28:18.120 | scroll down to newsletter, and provide us your email.

02:28:20.600 | But I should point out,

02:28:21.680 | we do not share your email with anybody.

02:28:23.900 | Thank you once again for joining me

02:28:25.220 | for today's discussion with Dr. Stacey Sims.

02:28:27.900 | And last, but certainly not least,

02:28:30.160 | thank you for your interest in science.

02:28:32.260 | (upbeat music)

02:28:34.840 | [MUSIC PLAYING]

Dr. Stacy Sims: Female-Specific Exercise & Nutrition for Health, Performance & Longevity

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